Search results for: satisfaction of disbursement

Authors: Mahmoud Hassanin, Roshan Thawale, Kiran Yelamati

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Background: During current practice, intraoperative regular endotracheal cuff pressure monitoring is not routine, despite the significant number of clinicians interested in checking it after intubation to ensure a good seal and adequate ventilation. Aims and objectives: to highlight that the current practice has no guidance related to regular intra-operative monitoring of the endotracheal tube cuff pressure, which can improve patient safety and post-operative experience. Methods: local department survey was done targeting anaesthetists' current practice, measuring their knowledge and problem awareness to improve patient satisfaction and change the current approach. Results: The participants were not using the manometer, despite their interest in ensuring that the cuff pressure was high enough and there was a proper seal. More than 50% of the participant don't know the ideal range of the endotracheal tube cuff pressure range, and 32% don't know whether it is available or not in the theatre. Despite the previous finding, 100% of the participants used different methods to ensure adequate cuff pressure. The collected data revealed that at least 26% of the participant confirmed that they had seen patients having post-intubation complications. Conclusion: There is an increasing importance placed on quality assurance. Clinical practice varies widely among practitioners, with the only consistency being the omission of cuff manometers during routine intra-operative management, despite their proven benefit and efficacy. Encourage the anaesthetists and ODPs to use cuff pressure manometers. The availability of portable pressure manometers can help to maintain safe cuff pressures in patients requiring endotracheal intubation.

Keywords: endotracheal cuff pressure, intra-operative monitoring, current practice, patient satisfaction

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Authors: Jeffrey Ho, Scott Joing, Paul Nystrom, William Heegaard, Danielle Hart, David Plummer, James Miner

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Body-Worn Cameras (BWCs) are used in public safety to record encounters. They are shown to enhance the accuracy of documentation in virtually every situation. They are not widely used in medical encounters in part because of concern for patient acceptance. The goal of this pilot study was to determine if BWC use is acceptable to the patient. This was a prospective, observational study of the AXON Flex BWC (TASER International, Scottsdale, AZ) conducted at an urban, Level 1 Trauma Center Emergency Department (ED). The BWC was worn by Emergency Physicians (EPs) on their shifts during a 30-day period. The BWC was worn at eye-level mounted on a pair of clear safety glasses. Patients seen by the EP were enrolled in the study by a trained research associate. Patients who were <18 years old, who were with other people in the exam room, did not speak English, were critically ill, had chief complaints involving genitalia or sexual assault, were considered to be vulnerable adults, or with an altered mental status were excluded. Consented patients were given a survey after the encounter to determine their perception of the BWC. The questions asked involved the patients’ perceptions of a BWC being present during their interaction with their EP. Data were analyzed with descriptive statistics. There were 417 patients enrolled in the study. 3/417 (0.7%) patients were intimidated by the BWC, 1/417 (0.2%) was nervous because of the BWC, 0/417 (0%) were inhibited from telling the EP certain things because of the BWC, 57/417 (13.7%) patients did not notice the device, and 305/417 (73.1%) patients were had a favorable perception about the BWC being used during their encounter. The use of BWCs appears feasible in the ED, with largely favorable perceptions and acceptance of the device by the patients. Further study is needed to determine the best use and practices of BWCs during ED patient encounters.

Keywords: body-worn camera, documentation, patient satisfaction, video

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Authors: Anna Bjällmark, Victoria Persson, Bodil Karlsson, May Bazzi

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Introduction: Interventional radiology (IR) is a continuously growing discipline that allows minimally invasive treatments of various medical conditions. The IR environment is, in several ways, comparable to the complex and accident-prone operation room (OR) environment. This implies that the IR environment may also be associated with various types of risks related to the work process and communication in the team. Patient safety is a central aspect of healthcare and involves the prevention and reduction of adverse events related to patient care. To maintain patient safety, it is crucial to build a safety culture where the staff are encouraged to report events and incidents that may have affected patient safety. It is also important to continuously evaluate the staff´s attitudes to patient safety. Despite the increasing number of IR procedures, research on the staff´s view regarding patients is lacking. Therefore, the main aim of the study was to describe and compare the IR team members' attitudes to patient safety. The secondary aim was to evaluate whether the WHO safety checklist was routinely used for IR procedures. Methods: An electronic survey was distributed to 25 interventional units in Sweden. The target population was the staff working in the IR team, i.e., physicians, radiographers, nurses, and assistant nurses. A modified version of the Safety Attitudes Questionnaire (SAQ) was used. Responses from 19 of 25 IR units (44 radiographers, 18 physicians, 5 assistant nurses, and 1 nurse) were received. The respondents rated their level of agreement for 27 items related to safety culture on a five-point Likert scale ranging from “Disagree strongly” to “Agree strongly.” Data were analyzed statistically using SPSS. The percentage of positive responses (PPR) was calculated by taking the percentage of respondents who got a scale score of 75 or higher. The respondents rated which corresponded to response options “Agree slightly” or “Agree strongly”. Thus, average scores ≥ 75% were classified as “positive” and average scores < 75% were classified as “non-positive”. Findings: The results indicated that the IR team had the highest factor scores and the highest percentages of positive responses in relation to job satisfaction (90/94%), followed by teamwork climate (85/92%). In contrast, stress recognition received the lowest ratings (54/25%). Attitudes related to these factors were relatively consistent between different professions, with only a few significant differences noted (Factor score: p=0.039 for job satisfaction, p=0.050 for working conditions. Percentage of positive responses: p=0.027 for perception of management). Radiographers tended to report slightly lower values compared to other professions for these factors (p<0.05). The respondents reported that the WHO safety checklist was not routinely used at their IR unit but acknowledged its importance for patient safety. Conclusion: This study reported high scores concerning job satisfaction and teamwork climate but lower scores concerning perception of management and stress recognition indicating that the latter are areas of improvement. Attitudes remained relatively consistent among the professions, but the radiographers reported slightly lower values in terms of job satisfaction and perception of the management. The WHO safety checklist was considered important for patient safety.

Keywords: interventional radiology, patient safety, safety attitudes questionnaire, WHO safety checklist

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Authors: Pui-Lai To, Chechen Liao, Ming-Chi Sung

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Work and family life are the most important areas for men and women today. Every professional is required to meet and fulfill the responsibilities of work and family roles. Although the development and popularity of communication technology bring a lot of benefits, including effective and efficient communication, may also generate conflicts between work and family life. Since mobile devices and the applications of mobile devices, such as instant messages, are ubiquitous, the boundaries of work and family roles are increasingly blurred. Professionals may be in the risk of work over-loading and work-family conflict. This study examines the impact of work stress on professionals’ life and health in the context of instant messaging application of smart phone. This study uses a web-based questionnaire to collect samples. The questionnaires are sent via virtual community sites, instant messaging applications, and e-mail. The study develops and empirically validates a work-family conflict model by integrating the pressure theory and technostress factors. The causal relationship between variables in the research model is tested. In terms of data analysis, Partial Least Square (PLS) in Structural Equation Modeling (SEM) is used for sample analysis and research model testing. The results of this study are as follows. First, both the variables of work-related stress and technological violations positively affect the work-family conflict. Second, both the variables of work-loading and technology-overloading have no effect on work-family conflict. Third, work-family conflict has negative effect on job satisfaction, family satisfaction, physical health, and mental health.

Keywords: mental health, physical health, technostress, work-family conflict, work-related stress

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Authors: Qingqing Feng, S. Thomas Ng, Frank Xu

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Energy consumption in domestic sector has been increasing rapidly in China all along these years. Confronted with environmental challenges, the international society has made a concerted effort by setting the Paris Agreement, the Sustainable Development Goals, and the New Urban Agenda. Thus it’s very important for China to put forward reasonable countermeasures to boost building energy conservation which necessitates looking into the actuality of residential energy end-use profile and its influence factors. In this study, questionnaire surveys have been conducted in Zhuhai city in China, a typical city in hot summer warm winter climate zone. The data solicited mainly include the occupancy schedule, building’s information, residents’ information, household energy uses, the type, quantity and use patterns of appliances and occupants’ satisfaction. Over 200 valid samples have been collected through face-to-face interviews. Descriptive analysis, clustering analysis, correlation analysis and sensitivity analysis were then conducted on the dataset to understand the energy end-use profile. The findings identify: 1) several typical clusters of occupancy patterns and appliances utilization patterns; 2) the top three sensitive factors influencing energy consumption; 3) the correlations between satisfaction and energy consumption. For China with many different climates zones, it’s difficult to find a silver bullet on energy conservation. The aim of this paper is to provide a theoretical basis for multi-stakeholders including policy makers, residents, and academic communities to formulate reasonable energy saving blueprints for hot and humid urban residential buildings in China.

Keywords: residential building, energy end-use profile, questionnaire survey, sustainability

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Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

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Authors: Chiahsu Yang, Peiling Wu, Ted Ho

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From emphasizing economic development to stressing public happiness, the international community mainly hopes to be able to understand whether the quality of life for the public is becoming better. The Better Life Index (BLI) constructed by OECD uses living conditions and quality of life as starting points to cover 11 areas of life and to convey the state of the general public’s well-being. In light of the BLI framework, the Directorate General of Budget, Accounting and Statistics (DGBAS) of the Executive Yuan instituted the Gross National Happiness Index to understand the needs of the general public and to measure the progress of the aforementioned conditions in residents across the island. Whereas living conditions consist of income and wealth, jobs and earnings, and housing conditions, health status, work and life balance, education and skills, social connections, civic engagement and governance, environmental quality, personal security. The ICT area consists of health care, living environment, ICT-enabled communication, transportation, government, education, pleasure, purchasing, job & employment. In the wake of further science and technology development, rapid formation of information societies, and closer integration between lifestyles and information societies, the public’s well-being within information societies has indeed become a noteworthy topic. the Board of Science and Technology of the Executive Yuan use the OECD’s BLI as a reference in the establishment of the Taiwan-specific ICT-Enabled Better Life Index. Using this index, the government plans to examine whether the public’s quality of life is improving as well as measure the public’s satisfaction with current digital quality of life. This understanding will enable the government to gauge the degree of influence and impact that each dimension of digital services has on digital life happiness while also serving as an important reference for promoting digital service development. The content of the ICT Enabled Better Life Index. Information and communications technology (ICT) has been affecting people’s living styles, and further impact people’s quality of life (QoL). Even studies have shown that ICT access and usage have both positive and negative impact on life satisfaction and well-beings, many governments continue to invest in e-government programs to initiate their path to information society. This research is the few attempts to link the e-government benchmark to the subjective well-being perception, and further address the gap between user’s perception and existing hard data assessment, then propose a model to trace measurement results back to the original public policy in order for policy makers to justify their future proposals.

Keywords: information and communications technology, quality of life, satisfaction, well-being

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Authors: F. Iberraken, R. Medjoudj, D. Aissani

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The development of the smart grids concept is built around two separate definitions, namely: The European one oriented towards sustainable development and the American one oriented towards reliability and security of supply. In this paper, we have investigated reliability merits enabling decision-makers to provide a high quality of service. It is based on system behavior using interruptions and failures modeling and forecasting from one hand and on the contribution of information and communication technologies (ICT) to mitigate catastrophic ones such as blackouts from the other hand. It was found that this concept has been adopted by developing and emerging countries in short and medium terms followed by sustainability concept at long term planning. This work has highlighted the reliability merits such as: Benefits, opportunities, costs and risks considered as consistent units of measuring power customer satisfaction. From the decision making point of view, we have used the analytic hierarchy process (AHP) to achieve customer satisfaction, based on the reliability merits and the contribution of such energy resources. Certainly nowadays, fossil and nuclear ones are dominating energy production but great advances are already made to jump into cleaner ones. It was demonstrated that theses resources are not only environmentally but also economically and socially sustainable. The paper is organized as follows: Section one is devoted to the introduction, where an implicit review of smart grids development is given for the two main concepts (for USA and Europeans countries). The AHP method and the BOCR developments of reliability merits against power customer satisfaction are developed in section two. The benefits where expressed by the high level of availability, maintenance actions applicability and power quality. Opportunities were highlighted by the implementation of ICT in data transfer and processing, the mastering of peak demand control, the decentralization of the production and the power system management in default conditions. Costs were evaluated using cost-benefit analysis, including the investment expenditures in network security, becoming a target to hackers and terrorists, and the profits of operating as decentralized systems, with a reduced energy not supplied, thanks to the availability of storage units issued from renewable resources and to the current power lines (CPL) enabling the power dispatcher to manage optimally the load shedding. For risks, we have razed the adhesion of citizens to contribute financially to the system and to the utility restructuring. What is the degree of their agreement compared to the guarantees proposed by the managers about the information integrity? From technical point of view, have they sufficient information and knowledge to meet a smart home and a smart system? In section three, an application of AHP method is made to achieve power customer satisfaction based on the main energy resources as alternatives, using knowledge issued from a country that has a great advance in energy mutation. Results and discussions are given in section four. It was given us to conclude that the option to a given resource depends on the attitude of the decision maker (prudent, optimistic or pessimistic), and that status quo is neither sustainable nor satisfactory.

Keywords: reliability, AHP, renewable energy resources, smart grids

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Authors: Sharifa Alduraibi, Abir El Sadik, Ahmed Elzainy, Alaa Alduraibi, Ahmed Alsolai

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Introduction: Problem-based learning (PBL) is an active student-centered educational modality, influenced by the students' interest that required continuous motivation to improve their engagement. The new era of professional information technology facilitated the utilization of educational multimedia, such as videos, soundtracks, and photographs promoting students' learning. The aim of the present study was to introduce multimedia-enriched PBL scenarios for the first time in college of medicine, Qassim University, as an incentive for better students' engagement. In addition, students' performance and satisfaction were evaluated. Methodology: Two multimedia-enhanced PBL scenarios were implemented to the third years' students in the urinary system block. Radiological images, plain CT scan, and X-ray of the abdomen and renal nuclear scan correlated with their pathological gross photographs were added to the scenarios. One week before the first sessions, pre-recorded orientation videos for PBL tutors were submitted to clarify the multimedia incorporated in the scenarios. Other two traditional PBL scenarios devoid of multimedia demonstrating the pathological and radiological findings were designed. Results and Discussion: Comparison between the formative assessments' results by the end of the two PBL modalities was done. It revealed significant increase in students' engagement, critical thinking and practical reasoning skills during the multimedia-enhanced sessions. Students' perception survey showed great satisfaction with the new strategy. Conclusion: It could be concluded from the current work that multimedia created technology-based teaching strategy inspiring the student for self-directed thinking and promoting students' overall achievement.

Keywords: multimedia, pathology and radiology images, problem-based learning, videos

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Authors: Kim Dongwon, Yu Songjin

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This study identifies the business value of VOC (Voice of Customer) on the business. Precisely, we intend to demonstrate how much negative and positive sentiment of VOC has an influence on car sales market share in the unites states. We extract 7 emotions such as sadness, shame, anger, fear, frustration, delight and satisfaction from the VOC data, 23,204 pieces of opinions, that had been posted on car-related on-line community from 2007 to 2009(a part of data collection from 2007 to 2015), and intend to clarify the correlation between negative and positive sentimental keywords and contribution to market share. In order to develop a lexicon for each category of negative and positive sentiment, we took advantage of Corpus program, Antconc 3.4.1.w and on-line sentimental data, SentiWordNet and identified the part of speech(POS) information of words in the customers' opinion by using a part-of-speech tagging function provided by TextAnalysisOnline. For the purpose of this present study, a total of 45,741 pieces of customers' opinions of 28 car manufacturing companies had been collected including titles and status information. We conducted an experiment to examine whether the inclusion, frequency and intensity of terms with negative and positive emotions in each category affect the adoption of customer opinions for vehicle organizations' market share. In the experiment, we statistically verified that there is correlation between customer ideas containing negative and positive emotions and variation of marker share. Particularly, "Anger," a domain of negative domains, is significantly influential to car sales market share. The domain "Delight" and "Satisfaction" increased in proportion to growth of market share.

Keywords: data mining, opinion mining, sentiment analysis, VOC

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Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

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Authors: Majid Alsubaie, Hamed Sarbazhosseini

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Many working environments have experienced increased uncertainty due to the fast-moving and unpredictable world. IT systems development projects, in particular, face several challenges because of their rapidly changing environments and emerging technologies. Information technology organizations within these contexts adapt systems development methodology and new software approaches to address this issue. One of these methodologies is the Agile method, which has gained huge attention in recent years. However, due to failure rates in IT projects, there is an increasing demand for the use of hybrid Agile methods among organizations. The scarce research in the area means that organizations do not have solid evidence-based knowledge for the use of hybrid Agile. This research was designed to provide further insights into the development of hybrid Agile methods within systems development projects, including how frameworks and processes are used and what benefits and challenges are gained and faced as a result of hybrid Agile methods. This paper presents how three organizations (two government and one private) use hybrid Agile methods in their Agile environments. The data was collected through interviews and a review of relevant documents. The results indicate that these organizations do not predominantly use pure Agile. Instead, they are waterfall organizations by virtue of systems nature and complexity, and Agile is used underneath as the delivery model. Prince2 Agile framework, SAFe, Scrum, and Kanban were the identified models and frameworks followed. This study also found that customer satisfaction and the ability to build quickly are the most frequently perceived benefits of using hybrid Agile methods. In addition, team resistance and scope changes are the common challenges identified by research participants in their working environments. The findings can help to understand Agile environmental conditions and projects that can help get better success rates and customer satisfaction.

Keywords: agile, hybrid, IT systems, management, success rate, technology

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Authors: Huan Zhang, Darius K. S Chan

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Despite a large number of studies linking emotional labor and its detrimental impact for laborer, research on how emotional labor would influence the receiver is still in its infancy. Especially under the call for “people management”, supervisors inside the organization are more inclined to display happy mood to support their employees, thus endorsing emotional labor. The present study focuses on the employees in the service industry as emotional labor recipients and investigates how they respond to their supervisors’ emotional display, given their sensitivity to emotional cues. Targeted at a sample of 250 survey data from a wide range of customer service professions, this ongoing study examines how perceived supervisory emotional labor would moderate the relationship between employees surface acting and their well-being. Our major hypotheses are that employees’ surface acting predicts well-being level, and that perceived supervisory emotional labor to moderate the surface acting—outcome links. Preliminary findings have provided some support to the hypothesized model. Specifically, supervisors who are perceived to be high in surface acting are also regarded as fake and pseudo, hence the enhancing the detrimental effect of employees’ surface acting is attenuated, resulting in lower job satisfaction, higher physical stress and burnout; whereas perceived high supervisor’s deep acting, as associated with genuine and authenticity, buffers the negative impact and leads to higher job satisfaction, lower physical stress and burnout. This study first confirms the negative impacts of the surface acting on well-being for service industry employees as laborer and then extends the emotional labor studies by considering them as recipients of supervisory emotional labor. The findings provide insights for leaders by pointing out the importance of authentic emotional expression in workplace.

Keywords: perceived supervisory emotional labor, surface acting, well-being

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Authors: Shwadhin Sharma

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As there has been increasing focus on the shorter attention span of the millennials students, there is a relative absence of instructional tools on behavioral assessments in learning information technology skills within the information systems field and textbooks. This study uses project-based learning in which students gain knowledge and skills related to information technology by working on an extended project that allows students to find a real business problem design information systems based on information collected from the company and develop an information system that solves the problem of the company. Eighty students from two sections of the same course engage in the project from the first week of the class till the sixteenth week of the class to deliver a small business information system that allows them to employ all the skills and knowledge that they learned in the class into the systems they are creating. Computer Information Systems related courses are often difficult to understand and process especially for the Under Representative Minorities students who have limited computer or information systems related (academic) experiences. Project-based learning demands constant attention of the students and forces them to apply knowledge learned in the class to a project that helps retaining knowledge. To make sure our assumption is correct, we started with a pre-test and post-test to test the students learning (of skills) based on the project. Our test showed that almost 90% of the students from the two sections scored higher in post-test as compared to pre-test. Based on this premise, we conducted a further survey that measured student’s job-search preparation, knowledge of data analysis, involved with the course, satisfaction with the course, student’s overall reaction the course and students' ability to meet the traditional learning goals related to the course.

Keywords: project-based learning, job-search preparation, satisfaction with course, traditional learning goals

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: Idris M. Olatunde, Kareem B.

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In manufacturing systems, especially job shops, service performance is a key factor that determines customer satisfaction. Service performance depends not only on the quality of the output but on the delivery lead times as well. Besides product quality enhancement, delivery lead time must be minimized for optimal patronage. Quoting accurate due dates is sine quo non for job shop operational survival in a global competitive environment. Quoting accurate due dates in job shops has been a herculean task that nearly defiled solutions from many methods employed due to complex jobs routing nature of the system. This class of NP-hard problems possessed no rigid algorithms that can give an optimal solution. Jobshop operational problem is more complex in developing nations due to some peculiar factors. Operational complexity in job shops emanated from political instability, poor economy, technological know-how, and the non-promising socio-political environment. The mentioned exogenous factors were hardly considered in the previous studies on scheduling problem related to due date determination in job shops. This study has filled the gap created in the past studies by developing a dynamic model that incorporated the exogenous factors for accurate determination of due dates for varying jobs complexity. Real data from six job shops selected from the different part of Nigeria, were used to test the efficacy of the model, and the outcomes were analyzed statistically. The results of the analyzes showed that the model is more promising in determining accurate due dates than the traditional models deployed by many job shops in terms of patronage and lead times minimization.

Keywords: due dates prediction, improved performance, customer satisfaction, dynamic model, exogenous factors, job shops

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Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

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Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

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Authors: Artitaya Sabangbal, Darawan Augsornwan, Palakorn Surakunprapha, Lalida Petphai

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Background: Srinagarind Hospital Ward 3C has about 180 cases of patients with head and neck cancer per year. Almost all of these patients suffer with pain, fatigue, low self image, swallowing problem and when the tumor is larger they will have breathing problem. Many of them have complication after operation such as pressure sore, pneumonia, deep vein thrombosis. Nursing activity is very important to prevent the complication especially promoting patients early ambulation. The objective of this study was to develop early ambulation protocol for patients with head and neck cancer undergoing operation. Method: this study is one part of nursing system development in patients undergoing operation in Ward 3C. It is a participation action research divided into 3 phases Phase 1 Situation review: In this phase we review the clinical outcomes, process of care, from document such as nurses note and interview nurses, patients and family about early ambulation. Phase 2 Searching nursing intervention about early ambulation from previous study then establish protocol . This phase we have picture package of early ambulation. Phase 3 implementation and evaluation. Result: Patients with head and neck cancer after operation can follow early ambulation protocol 100%, 85 % of patients can follow protocol within 2 days after operation and 100% can follow protocol within 3 days. No complications occur. Patients satisfaction in very good level is 58% and in good level is 42% Length of hospital stay is 6 days in patients with wide excision and 16 day in patients with flap coverage. Conclusion: The early ambulation protocol is appropriate for patients with head and neck cancer who undergo operation. This can restore physical health, reduce complication and increase patients satisfaction.

Keywords: nursing system, early ambulation, head and neck cancer, operation

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Authors: Nasibeh Mohammadpour, Ali Rajabzadeh, Adel Azar, Hamid Zargham Borujeni,

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Generally, various industries development depends on their stakeholders and beneficiaries supports. One of the most important stakeholders in tourism industry ( which has become one of the most important lucrative and employment-generating activities at the international level these days) are host communities in tourist destination which are affected and effect on this industry development. Recognizing host community and its segmentations can be important to get their support for future decisions and policy making. In order to identify these segments, in this study, clustering of the residents has been done by using some tools that are designed to encounter human complexities and have ability to model and generalize complex systems without any needs for the initial clusters’ seeds like classic methods. Neural networks can help to meet these expectations. The research have been planned to design neural networks-based mathematical model for clustering the host community effectively according to multi criteria, and identifies differences among segments. In order to achieve this goal, the residents’ segmentation has been done by demographic characteristics, their attitude towards the tourism development, the level of satisfaction and the type of their support in this field. The applied method is self-organized neural networks and the results have compared with K-means. As the results show, the use of Self- Organized Map (SOM) method provides much better results by considering the Cophenetic correlation and between clusters variance coefficients. Based on these criteria, the host community is divided into five sections with unique and distinctive features, which are in the best condition (in comparison other modes) according to Cophenetic correlation coefficient of 0.8769 and between clusters variance of 0.1412.

Keywords: Artificial Nural Network, Clustering , Resident, SOM, Tourism

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

Abstract:

Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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Authors: S. Srinivas Rao, Pallavi Chitnis, Himanshu Prajapati

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The green building movement in India commenced in 2003. Since then, more than 4,300 projects have adopted green building concepts. For last 15 years, the green building movement has grown strong across the country and has resulted in immense tangible and intangible benefits to the stakeholders. Several success stories have demonstrated the tangible benefit experienced in green buildings. However, extensive data interpretation and qualitative analysis are required to report the intangible benefits in green buildings. The emphasis is now shifting to the concept of people-centric design and productivity, health and wellbeing of occupants are gaining importance. This research was part of World Green Building Council’s initiative on 'Better Places for People' which aims to create a world where buildings support healthier and happier lives. The overarching objective of this study was to understand the perception of users living and working in green buildings. The study was conducted in twenty-five IGBC certified green buildings across India, and a comprehensive questionnaire was designed to capture occupant’s perception and experience in the built environment. The entire research focussed on the eight attributes of healthy buildings. The factors considered for the study include thermal comfort, visual comfort, acoustic comfort, ergonomics, greenery, fitness, green transit and sanitation and hygiene. The occupant’s perception and experience were analysed to understand their satisfaction level. The macro level findings of the study indicate that green buildings have addressed attributes of healthy buildings to a larger extent. Few important findings of the study focussed on the parameters such as visual comfort, fitness, greenery, etc. The study indicated that occupants give tremendous importance to the attributes such as visual comfort, daylight, fitness, greenery, etc. 89% occupants were comfortable with the visual environment, on account of various lighting element incorporated as part of the design. Tremendous importance to fitness related activities is highlighted by the study. 84% occupants had actively utilised sports and meditation facilities provided in their facility. Further, 88% occupants had access to the ample greenery and felt connected to the natural biodiversity. This study aims to focus on the immense advantages gained by users occupying green buildings. This will empower green building movement to achieve new avenues to design and construct healthy buildings. The study will also support towards implementing human-centric measures and in turn, will go a long way in addressing people welfare and wellbeing in the built environment.

Keywords: health and wellbeing, green buildings, Indian green building council, occupant’s satisfaction

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Authors: Dorcas Matowe

Abstract:

Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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Authors: Chueh Chi-An, Chan Hui-Ya

Abstract:

Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Tomas O. Ortega, Cecilia T. Reyes, Cecile O. Legaspi, Cylde G. Abayon, Anna Mae C. Relingo, Mary Eden M. Teruel

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A study was conducted to evaluate the performance in the delivery of environmental management programs of the local government of Malay, Aklan, Philippines. The samples were determined by adopting the Multi-Stage Random Probability Sampling technique. The 150 respondents were drawn from barangays with larger shares of the population based on the Philippine Statistical Authority’s Data on Census Population and Housing for the year 2015. The qualified sample respondents were selected using the Kish Grid. Female respondents were targeted for even numbered questionnaires while male respondents were targeted for odd numbers. The four major core concepts namely awareness, availment, satisfaction and need for action were used in measuring the rating of the respondents and presented in frequency and percentage distributions. The reasons for their response were likewise gathered. The study inferred that a large portion of the respondents was profoundly aware of the environmental management programs implemented by their local government unit especially the solid waste management and the clean-up programs/projects. Programs to control air pollution and waste water management obtained the least awareness ratings from the respondents. A high percentage of respondents had availed of environmental management programs, particularly solid waste management. Overall, majority of the respondents were satisfied with the environmental management programs rendered by the local government unit and therefore needs less action. It is recommended that the local government unit must strengthen air pollution control program. Appropriate action must be taken to support the people’s interest in this program most particularly to the individuals who burn their garbage. Seminars and training-workshops about appropriate waste disposal will most likely help settle this issue.

Keywords: availment, awareness, environmental management, need for action, satisfaction

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

Abstract:

During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Mahshid Asadollahi, Mohammad Akbari Asl

Abstract:

The restaurant industry is highly competitive, and restaurants are constantly looking for ways to attract new customers and retain their existing ones. Nonverbal communication is an important factor in creating a positive customer experience and can play a significant role in attracting customers to restaurants. Nonverbal communication can include body language, facial expressions, tone of voice, and physical proximity, among other things. The present study aimed to investigate the impact of nonverbal communication between restaurant employees and customers on attracting customers in food courts in Tehran. The research method was descriptive-correlational, and the statistical population of this study included all customers of food court restaurants in Tehran, which was about 30 restaurants. The research sample was selected through probability sampling, and 440 customers completed emotional response, customer satisfaction, and nonverbal communication questionnaires in person. The data obtained were analyzed using multiple regression analysis. The results showed that vocal language, employee proximity, physical appearance, and speech movements, as components of nonverbal communication of restaurant employees, had an impact on attracting customers. Additionally, positive and negative emotions of customers have a significant relationship with customer attraction in Food Court restaurants. The study shows that various nonverbal communication factors can play a significant role in attracting customers, and that positive and negative customer emotions can affect customer satisfaction. Therefore, restaurant owners and managers should pay attention to nonverbal communication and train their employees accordingly to create a positive and welcoming atmosphere for customers.

Keywords: verbal language, proximity of employees, physical appearance, speech gestures, nonverbal communication, customer emotions, customer attraction

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Authors: Seetanah Boopen, Padachi Kesseven, R. Juwaheer , R. V. Sannassee, M. L. Lamport

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This study aims primarily at investigating the importance of soft infrastructure in tourism development for the case of an island economy namely Mauritius. The study in the first place assesses the level of perceived and actual satisfaction of the present state of the different types of soft tourism infrastructure and the allied services provided by tourism stakeholders in Mauritius and address the identified gaps. In order to address the study objectives, a rigorous survey analysis among 1741 international tourists at the departure lounge of the Sir Seewoosagur International Airport of Mauritius was carried out. The respondents placed significant emphasis on the different elements of the soft infrastructure dimension, where many of the elements falling under this dimension were rated with a high mean score. In particular the visitors rated communication, both internet and telephone services, and security to be most important. Significant gap has been found in the categories of ‘Health’ and ‘Security’. This indicates that the tourists ascribe high importance to the soft infrastructure dimension. The link between the respondent profile and the key variables which influence the tourist choice of the island as a destination are found to be equally important for most of the international tourists. However, these were deemed to be more critical for tourists travelling with family members. Although the survey instrument attempted to measure any gap between on the one hand, the importance of the infrastructure dimension and on the other hand, the level of satisfaction with the infrastructure dimension, overall the results do not show any statistically significant gap among the different elements of the infrastructural dimension. The study dwells into further analysis by engaging into an econometric framework related to a Probit Model, using the data collected, to gauge the effect of soft infrastructure on tourist intention to repeat or recommend the destination. The results confirm that soft infrastructure is found to be sensible to tourists, although relatively less sensitive as compared to tourism and transport and hotel infrastructure.

Keywords: tourism development, soft infrastructure, Mauritius, hotel infrastructure

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Authors: Suparpit von Bormann, Winai Sayorwan, Sirichai Channim, Sararat Rungruangkhanarak, Premchai Suksamran, Piyaporn Srisuk, Piyatida Phosri

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The best medicine will not work if the patient does not take them. There are several methods developed to help patients to be adherent to medicine. However, non-adherent rate still high: 24% in physically ill and 42% in mentally ill patients. Moreover, patients might feel less confident when carrying medicine around. Normal medicine box has no alarm; whereas the one with alarm is not handy and might be left at home. Therefore, Medication Reminder (MR) was invented. MR is a medicine pocket that has an alarm clock to remind the patient when it is the time to take medicine. It also has a small light indicating the medicine the patient has to take. This pocket is attached within a purse or wallet because most people forget medicine but do not forget to take their money. This research was conducted to develop innovation assisting patients to take their medicine on time. Samples were 24 volunteers who went out to work every day. Uncoated tablets, coated tablets, and capsules were filled in three types of containers: MR, plastic bag with ziplock, and normal plastic box. Each volunteer carried three types of containers everywhere during day time. After three days, medicines were tested for physical quality (appearance, odor, color, hardness, and weight) in laboratory. Medication adherence and satisfaction questionnaires were completed by participants. The results showed that MR showed significant improvement in participants’ adherence than plastic bag with ziplock, and normal plastic box at p < .001 (x̄(SD) = 11.16(0.75), 7.83(0.98), 8.83(1.32), respectively). Based on the quality test, MR and normal plastic box significantly better protected medicine than plastic bag with zip lock at p < .001 (x̄(SD) = 4(0.00), 4(0.00), 2.5(0.54), respectively). Most participants were satisfied with the innovation in highest level (4.50 out of 5). MR has a potential to improve adherent rates of participants and therefore to be an innovation that helps reducing the cost of treatment due to non-adherence. MR also has a potential in commercial aspect due to its effects in preserving quality of medicine. MR can be integrated with local products such as silk purse that can increase income for local people.

Keywords: medication, reminder, adherence, satisfaction

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Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie

Abstract:

Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.

Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems

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

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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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