Search results for: public hospital unions

Authors: Kholood A. Baron

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While radiologist numbers specialized in spine interventional procedures are limited in Kuwait, the number of patients demanding these procedures is increasing rapidly. Due to this high demand, the workload of radiologists is increasing, which might represent a radiation exposure concern. During these procedures, the doctor’s hands are in very close proximity to the main radiation beam/ if not within it. The aim of this study is to measure the radiation dose for radiologists during several interventional procedures for the spine. Methods: Two doctors carrying different workloads were included. (DR1) was performing procedures in the morning and afternoon shifts, while (DR2) was performing procedures in the morning shift only. Comparing the radiation exposures that the hand of each doctor is receiving will assess radiation safety and help to set up workload regulations for radiologists carrying a heavy schedule of such procedures. Entrance Skin Dose (ESD) was measured via TLD (ThermoLuminescent Dosimetry) placed at the right wrist of the radiologists. DR1 was covering the morning shift in one hospital (Mubarak Al-Kabeer Hospital) and the afternoon shift in another hospital (Dar Alshifa Hospital). The TLD chip was placed in his gloves during the 2 shifts for a whole week. Since DR2 was covering the morning shift only in Al Razi Hospital, he wore the TLD during the morning shift for a week. It is worth mentioning that DR1 was performing 4-5 spine procedures/day in the morning and the same number in the afternoon and DR2 was performing 5-7 procedures/day. This procedure was repeated for 4 consecutive weeks in order to calculate the ESD value that a hand receives in a month. Results: In general, radiation doses that the hand received in a week ranged from 0.12 to 1.12 mSv. The ESD values for DR1 for the four consecutive weeks were 1.12, 0.32, 0.83, 0.22 mSv, thus for a month (4 weeks), this equals 2.49 mSv and calculated to be 27.39 per year (11 months-since each radiologist have 45 days of leave in each year). For DR2, the weekly ESD values are 0.43, 0.74, 0.12, 0.61 mSv, and thus, for a month, this equals 1.9 mSv, and for a year, this equals 20.9 mSv /year. These values are below the standard level and way below the maximum limit of 500 mSv per year (set by ICRP = International Council of Radiation Protection). However, it is worth mentioning that DR1 was a senior consultant and hence needed less fluoro-time during each procedure. This is evident from the low ESD values of the second week (0.32) and the fourth week (0.22), even though he was performing nearly 10-12 procedures in a day /5 days a week. These values were lower or in the same range as those for DR2 (who was a junior consultant). This highlighted the importance of increasing the radiologist's skills and awareness of fluoroscopy time effect. In conclusion, the radiation dose that radiologists received during spine interventional radiology in our setting was below standard dose limits.

Keywords: radiation protection, interventional radiology dosimetry, ESD measurements, radiologist radiation exposure

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Authors: Zarema Urustamova, Chunsheng Shi, Ghulam Mujtaba Kayani 

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This research paper helps to understand the comparative analysis of recruitment problems which majorly faced by HRD of Public/Semi-Govt. and private sectors of Russia. The natures of different recruitment problems faced by HRD are different in both sector of Russia. Recruitment is one of very critical and important decision taken by HR department and some recruitment problems are highly faced by HR department of public/semi Govt. sector but are not major problems for private sector. Moreover, some problems are majorly influence in private sector but are not major problems in public/semi-govt. sector of Russia in recruitment. It is also identified that some recruitment problems are majorly affect in recruitment in both sectors. This paper helps to understand the recruitment problems faced by HR department while recruiting the new employee in both sectors. This paper also identified that “environment” and “prejudice” in public sector have higher affect and considered as a major problems in employee recruitment and “reference”, “selection standards” are considered as a least affecting problems of recruitment in public sector. Further, in private sector, “prejudice” and “culture” are major issues and “selection standards” and “reference” is considered as least affecting recruitment problems in private sector of Russia. So, HR department will be able to hire right person on right time, and it is possible when different HR departments focus to overcome these recruitment problems more efficiently and effectively.

Keywords: Govt. /Semi-Govt. vs. private sector, HR department, recruitment problems, Russia

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Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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Authors: William Xiu Shun Wong, Myungsu Lim, Yoonjin Hyun, Chen Liu, Seongi Choi, Dasom Kim, Kee-Young Kwahk, Namgyu Kim

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Recently, many users have begun to frequently share their opinions on diverse issues using various social media. Therefore, numerous governments have attempted to establish or improve national policies according to the public opinions captured from various social media. In this paper, we indicate several limitations of the traditional approaches to analyze public opinion on science and technology and provide an alternative methodology to overcome these limitations. First, we distinguish between the science and technology analysis phase and the social issue analysis phase to reflect the fact that public opinion can be formed only when a certain science and technology is applied to a specific social issue. Next, we successively apply a start list and a stop list to acquire clarified and interesting results. Finally, to identify the most appropriate documents that fit with a given subject, we develop a new logical filter concept that consists of not only mere keywords but also a logical relationship among the keywords. This study then analyzes the possibilities for the practical use of the proposed methodology thorough its application to discover core issues and public opinions from 1,700,886 documents comprising SNS, blogs, news, and discussions.

Keywords: big data, social network analysis, text mining, topic modeling

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Authors: Marcos Centurion-Vicencio

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This study discusses the idea of ‘dominance’ in economic policy and its practical influence over monetary decisions. The discretionary use of repurchase agreements in Brazil over the period 2006-2016 and its effects on the overall price level are the specific issues we will be focusing on. The set of in-depth interviews carried out with public servants at the Brazilian central bank and national treasury, alongside data collected from the National Institution of Statistics (IBGE), suggest that monetary and fiscal dominance do not differ in nature once the assumption of depoliticized central bankers is relaxed. In both regimes, the pursuit of private gains via public institutions affects price stability. While short-sighted politicians in the latter are at the origin of poor monetary decisions, the action of short-sighted financial interest groups is likely to generate a similar outcome in the former. This study then contributes to rethinking monetary policy theory as well as the nature of public borrowing.

Keywords: fiscal and monetary interactions, interest groups, monetary capture, public borrowing

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Authors: Zemenu Yohannes

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Introduction: The pandemic overstretched the weak health systems in developing countries, including Ethiopia. This study aims to assess and explore the effect of COVID-19 on antenatal care (ANC) provision. Methods: A concurrent mixed methods study was applied. An interrupted time series design was applied for the quantitative study, and in-depth interviews were implemented for the qualitative research to explore maternity care providers' perceptions of ANC provision during COVID-19. We used routine monthly collected data from the health management information system (HMIS) in fifteen hospitals in the Sidama region, Ethiopia, from March 2019 to February 2020 (12 months) before COVID-19 and from March to August 2020 (6 months) during COVID-19. We imported data into STATA V.17 for analysis. ANC provision's mean monthly incidence rate ratio (IRR) was calculated using Poisson regression with a 95% confidence interval. The qualitative data were analysed using thematic analysis. Findings from quantitative and qualitative elements were integrated with a contiguous approach. Results: Our findings indicate the rate of ANC provision significantly decreased in the first six months of COVID-19. This study has three identified main themes: barriers to ANC provision, inadequate COVID-19 prevention approach, and delay in providing ANC. Conclusion and recommendation: Based on our findings, the pandemic affected ANC provision in the study area. The health bureau and stakeholders should take a novel and sustainable approach to prevent future pandemics. The health bureau and hospital administrators should establish a task force that relies on financial self-reliance to close gaps in future pandemics of medical supply shortages. Pregnant women should receive their care promptly from maternity care providers. In order to foster contact and avoid discrimination the future pandemics, hospital administrators should set up a platform for community members and maternity care providers.

Keywords: ANC provision, COVID-19, mixed methods study, Ethiopia

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Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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Authors: Taner Cindik, Ferya Tas Ciftci

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Mobbing in the public sector and specific issues (i.e., the demand for non-pecuniary damages) regarding mobbing have become very important in the light of the precedents constituted by the Turkish Council of State in 2010. The legal scope of mobbing is not able to be determined since the concept of mobbing is not defined in Turkish law system. This study aims to reveal three major problems caused by the lack of laws related to mobbing in the Turkish legal system. First, the absence of an arrangement for disciplinary penalties leads that general provisions in the disciplinary law are implemented. This situation, therefore, causes difficulties in practice. Second, not being drawn of the lines in the topic concerning mobbing in public sector leads confusions in being direction of hostility. Third, the fact that there is a legal gap on seeking non-pecuniary compensation when employees in public sector are exposed to mobbing might make it difficult to obtain non-pecuniary compensation. Within the context of these major problems, civil servants in Turkey do not have enough protection mechanism. However, some possible legal arrangements will help civil servants to protect against mobbing. This study may be considered important because of the fact that mobbing in the public sector is at a significant level and has not been evaluated in this context before. This research is mainly a study of Turkish legal system and evaluates critically law case to determine legal problems. As a result of this study, three main problems might be identified because there is legal gap regarding mobbing in the public sector. In conclusion, the introduction of the major problems related to mobbing in this study might shed light on making the proper regulations of this subject in Turkish law system. In this respect, the plaintiff will be provided convenience in the point of non-pecuniary damages and this study will guide the assessment of legal liability of those who implement mobbing.

Keywords: human rights violations, mobbing, public sector, direction of hostility, non-pecuniary compensation, disciplinary law

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Authors: Lamia Bouzgarrou, Amira Omrane, Leila Mrabet, Taoufik Khalfallah

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Background and aims: School accidents are one of the leading causes of morbidity and mortality among pupils and students. Indeed, they may induce an elevated number of lost school days, heavy emotional and physical disabilities, and financial costs on the victims and their families. This study aims to evaluate the annual incidence of school accidents in the central Tunisian governorate of Mahdia and to identify the epidemiological profile of victims and risk factors of these accidents. Methods: A retrospective study was conducted over the period of 5 school years, focusing on school accidents that occurred in public educational institutions (primary, basic, secondary and university) in the governorate of Mahdia (area = 2 966 km² and number of inhabitants in 2014 = 410 812). All accidents declared near the only official insurance of this type of injuries (MASU: Mutual School and University Accidents), and initially taken in charge at the University Hospital of Mahdia were included. Data was collected from the MASU reporting forms and the medical records of emergency and other specialized hospital departments. Results: With 3248 identified victims, the annual incidence of school accidents was equal to 0.69 per 100 pupils and students per year. The average age of victims was 14.51 ± 0.059 years and the sex ratio was 1.58. Pupils aged between 12 and 15 years, were concerned by 46.7% of the identified accidents. The practice of sports was the most relevant circumstances of these accidents (76.2 %). In 56.58 % of cases, falls were the leading mechanism. Bruises and fractures were the most frequent lesions (32.43 % and 30.51 %). Serious school accidents were noted in 28% of cases with hospitalization in 2.27 % of them. The average lost school days, was 12.23±1.73 days. Accidents occurring during sports or leisure activities were significantly more serious (p= 0.021). Furthermore, the frequency of hospitalization was significantly higher among boys (2.81% vs. 1.43%; p= 0.035), students ≤11 years (p= 0.008), and following crush trauma (p= 0.000). In addition, the surgical interventions were statistically more frequent among male victims (p=0.00), accidents occurring during physical education sessions (p=0.000); those associated to falls (p=0.000) and to crushes mechanisms (p=0.002), and injuries affecting lower limbs (p=0.000). Following this Multi-varied analysis concluded that the severity of school accident is correlated to the activity practiced during the trauma and the geographical location of the school. Conclusion: Children and adolescents are one of the most vulnerable groups against incidents with the risk of permanent disability, mainly related to the perturbation of the growth process and physiological limitations. Our five-year study, objectified a real elevate incidence of school accident among children and adolescents, with a considerable rate of severe injuries. In any community, the promotion of adolescents and children’s health is an important indicator of the public health level. Thus, it’s important to develop a multidisciplinary prevention strategy of school accident, based on safety and security rules and adapted to the specificity of our context.

Keywords: children and adolescents, children health, injuries and disability, school accident

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Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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Authors: Justin Ntokamunda Kadima, Christian Ahadi Irenge, Patient Birindwa Mulashe, Félicien Mushagalusa Kasali, Patient Wimba

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Background: Bacterial strains carrying multidrug resistance traits are gaining ground worldwide, especially in countries with limited resources. This study aimed to evaluate the spreading of multidrug-resistant bacteria strains in Bukavu city hospitals in the Democratic Republic of Congo. Methods: We analyzed 758 antibiogram data recorded in files of patients consulted between January 2016 and December 2017 at three reference hospitals selected as sentinel sites, namely the Panzi General Reference Hospital (HGP), BIO -PHARM hospital (HBP), and Saint Luc Clinic (CSL). Results: Of 758 isolates tested, the laboratories identified 12 bacterial strains in 712 isolates, of which 223 (29.42%) presented MDR profile, including Escherichia coli (11.48%), Klebsiella pneumonia (6.07%), Enterobacter (5.8%), Staphylococcus aureus and coagulase-negative Staphylococci (1.58%), Proteus mirabilis (1.85%), Salmonella enterica (1.19%), Pseudomonas aeruginosa (0.53%), Streptococcus pneumonia (0.4%)), Citrobacter (0.13%), Neisseria gonorrhea (0.13%), Enterococcus faecalis (0.13%), and Morganella morganii (0.13%). Infected patients were significantly more adults (73.1% vs. 21.5%) compared to children and mainly women (63.7% vs. 30.9%; p = 0.001). Conclusion: The observed expansion requires that hospital therapeutic committees set up an effective clinical management system and define the right combinations of antibiotics.

Keywords: multidrug resistance, bacteria, antibiogram, Bukavu

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Authors: Lonna Mabandla, Godfrey Musvoto

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Transportation is a catalytic feature in cities. Transport and land use activity are interdependent and have a feedback loop between how land is developed and how transportation systems are designed and used. This recursive relationship between land use and transportation is reflected in how public transportation routes internal to the inner-city enhance accessibility, therefore creating spaces that are conducive to business activity, while the business activity also informs public transportation routes. It is for this reason that the focus of this research is on public transportation within inner-city areas where the dynamic is evident. Durban is the chosen case study where the dominating form of public transportation within the central business district (CBD) is minibus taxis. The paradox here is that minibus taxis still form part of the informal economy even though they are the leading form of public transportation in South Africa. There have been many attempts to formalise this industry to follow more regulatory practices, but minibus taxis are privately owned, therefore complicating any proposed intervention. The argument of this study is that the application of collaborative planning through a sustainable partnership between the public and private sectors will improve the social and environmental sustainability of public transportation. One of the major challenges that exist within such collaborative endeavors is power dynamics. As a result, a key focus of the study is on power relations. Practically, power relations should be observed over an extended period, specifically when the different stakeholders engage with each other, to reflect valid data. However, a lengthy data collection process was not possible to observe during the data collection phase of this research. Instead, interviews were conducted focusing on existing procedural planning practices between the inner-city minibus taxi association (South and North Beach Taxi Association), the eThekwini Transport Authority (ETA), and the eThekwini Town Planning Department. Conclusions and recommendations were then generated based on these data.

Keywords: collaborative planning, sustainability, public transport, minibus taxis

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Authors: Christian T. Lystbaek

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Background: The importance of innovation management has traditionally been ascribed to private production companies, however, there is an increasing interest in public services innovation management. One of the major theoretical challenges arising from this situation is to understand public values justifying public services innovation management. However, there is not single and stable definition of public value in the literature. The research question guiding this paper is: What is the supposed added value operating in the public sphere? Methodology: The study takes an action research strategy. This is highly contextualized methodology, which is enacted within a particular set of social relations into which on expects to integrate the results. As such, this research strategy is particularly well suited for its potential to generate results that can be applied by managers. The aim of action research is to produce proposals with a creative dimension capable of compelling actors to act in a new and pertinent way in relation to the situations they encounter. The context of the study is a workshop on public services innovation within elderly care. The workshop brought together different actors, such as managers, personnel and two groups of users-citizens (elderly clients and their relatives). The process was designed as an extension of the co-construction methods inherent in action research. Scenario methods and focus groups were applied to generate dialogue. The main strength of these techniques is to gather and exploit as much data as possible by exposing the discourse of justification used by the actors to explain or justify their points of view when interacting with others on a given subject. The approach does not directly interrogate the actors on their values, but allows their values to emerge through debate and dialogue. Findings: The public values related to public services innovation management in elderly care were identified in two steps. In the first step, identification of values, values were identified in the discussions. Through continuous analysis of the data, a network of interrelated values was developed. In the second step, tracking group consensus, we then ascertained the degree to which the meaning attributed to the value was common to the participants, classifying the degree of consensus as high, intermediate or low. High consensus corresponds to strong convergence in meaning, intermediate to generally shared meanings between participants, and low to divergences regarding the meaning between participants. Only values with high or intermediate degree of consensus were retained in the analysis. Conclusion: The study shows that the fundamental criterion for justifying public services innovation management is the capacity for actors to enact public values in their work. In the workshop, we identified two categories of public values, intrinsic value and behavioural values, and a list of more specific values.

Keywords: public services innovation management, public value, co-creation, action research

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Authors: Yi-Chu Liu, Hsiu-Huei Hung, Li-Hui Yang, Ming-Jyh Chen

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introduction: To promote environmental sustainability, the hospital formed a corporate volunteer team in 2016 to build the Green Experiential Education Center. Our green creation center utilizes attic space to achieve sustainability objectives such as energy efficiency and carbon reduction. Other than executing sustainable plans, the center emphasizes experiential education. We invite our community to actively participate in building a sustainable, economically viable environment. Since 2020, the China Medical University Hospital has provided medical care to the Tgbin community in Taichung City's Heping District. The tribe, primarily composed of Atayal people, the elderly comprise 18% of the total population, and these families' per capita income is relatively low compared to Taiwanese citizens elsewhere. Purpose / Methods: With the experiences at the Green Experiential Education Center, CMUH team identifies the following objectives: Create an aquaponic system to supply vulnerable local households with food. Create a solar renewable energy system to meet the electricity needs of vulnerable local households. Promote the purchase of green electricity certificates to reduce the hospital's carbon emissions and generate additional revenue for the local community. Materials and Methods: In March 2020, we visited the community and installed The aquaponic system in January 2021. CMUH spent 150,000NT (approximately 5000US dollars) in March 2021 to build a 100-square-meter aquaponic system. The production of vegetables and fish caught determines the number of vulnerable families that can be supported. The aquaponics system is a kind of Low energy consumption and environmentally friendly production method, and can simultaneously achieve energy saving, water saving, and fertilizer saving .In September 2023, CMUH will complete a solar renewable energy system. The system will cover an area of 308 square meters and costs approximately NT$240,000 (approximately US$8,000). The installation of electricity meters will enable statistical analysis of power generation. And complete the Taiwan National Renewable Energy Certificate application process. The green electricity certificate will be obtained based on the monthly power generation from the solar renewable energy system. Results: I Food availability and access are crucial considering the remote location and aging population. By creating a fish and vegetable symbiosis system, the vegetables and catches produced will enable economically disadvantaged families to lower food costs. In 2021 and 2022, the aquaponic system produced 52 kilograms of vegetables and 75 kilograms of catch. The production ensures the daily needs of 8 disadvantaged families. Conclusions: The hospital serves as a fortress for public health and the ideal setting for corporate social responsibility. China Medical University Hospital and the Green Experiential Education Center work to strengthen ties with rural communities and offer top-notch specialty medical care. We are committed to assisting people in escaping poverty and hunger as part of the 2030 Sustainable Development Goals.

Keywords: environmental education, sustainability, energy conservation, carbon emissions, rural area development

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Authors: Marie E. Docken

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At some point in the lifecycle of a country, patterns of political and social unrest of varying degrees are observed. Events involving public disorder or civil disobedience may produce effects that range a wide spectrum of varying outcomes, depending on the level of unrest. Many previous studies, primarily theoretical in nature, have attempted to measure public disorder in answering why or how it occurs in society by examining causal factors or underlying issues in the social or political position of a population. The main objective in doing so is to understand how these activities evolve or seek some predictive capability for the events. In contrast, this research involves the fusion of analytics and social studies to provide more knowledge of the public disorder and civil disobedience intensity in populations. With a greater understanding of the magnitude of these events, it is believed that we may learn how they relate to extreme actions such as mass migration or violence. Upon establishing a model for measuring civil unrest based upon empirical data, a case study on various Latin American countries is performed. Interpretations of historical events are combined with analytical results to provide insights regarding the magnitude and effect of social and political activism.

Keywords: public disorder, civil disobedience, Latin America, metrics, data analysis

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Authors: Mehmet Sener, Emre Kishali

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The establishment of republic brought radical changes related to the modernization of life in early republican Turkey considering the revolutions in socio-economical, cultural and political aspects. These changes also had many influences on the formation of city planning and architectural medium that the arrangements related with health facility production had an important place amongst them. While the health services were witnessing great transformations with all its sides, socio-cultural and architectural framework of these facilities necessitated the adaption of new conceptual approaches which led to the construction new hospital buildings by the republican state with a name ‘Sample Hospital’. In this period, the state constructed sample hospitals in some cities (Adana, Ankara, Erzurum, İstanbul, Konya, Sivas and Trabzon) for the aim of being a good example for further hospitals sheltering all the characteristics of a contemporary health complex for that day. In this study, these six hospitals will firstly be elucidated considering their historical evaluations and current situations. Then, being one of the most significant modern heritages of republican history, the ways to provide the interrelationship of these complexes with the rapidly evolving current world will be discussed by proposing solutions or approaches coming from the fields of city planning, architectural preservation, engineering and architectural history together with an awareness of the socio-economic conditions, health services and architectural medium of Turkey. These hospitals are complexes composed of building ensembles which have functional relationships with each other. So, some strategies will be proposed for the preservation, renovation, and refurbishment of these complexes with an awareness of the possibility of the conflict between conservation practices and today’s health facility standards. Accordingly, the addition or removal of some elements in the complex or the suggestion of some architectural changes for the modernization of these health facilities will be investigated considering the requirements of the contemporary architectural design of health facilities. Since these hospitals are highly complex structures and have vastly changing design and construction standards, they cannot be used without adopting necessary architectural and technological interventions. So, the adaptive re-use of these buildings instead of demolition or the preservation of their overall characteristics becomes inevitable for the sustaining of these health facility heritages in Turkey. In this context, a multidisciplinary analysis will be made in this study on ‘Sample Hospital’ concept and buildings existing in Turkish modern architectural history within the framework of the adaptive reuse of these health complexes.

Keywords: adaptive re-use, conservation, early republican Turkey, sample hospital

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Authors: Kamonwat Suksumek, Seeronk Prichanont

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Access block refers to the situation where Emergency Department (ED) patients requiring hospital admission spend an unreasonable holding time in an ED because their access to a ward is blocked by the full utilization of the ward’s beds. Not only it delays the proper treatments required by the patients, but access block is also the cause of ED’s overcrowding. Clearly, access block is an inter-departmental problem that needs to be brought to management’s attention. This paper focuses on the analysis of strategies to address the access block problem, both in the operational and intermediate levels. These strategies were analyzed through a simulation model with a real data set from a university hospital in Thailand. The paper suggests suitable variable levels for each strategy so that the management will make the final decisions.

Keywords: access block, emergency department, health system analysis, simulation

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Authors: Fuad Alzahrani, Yiannis Kyratsis

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Although emergency nurses, being the frontline workers in mass-gatherings, are essential for providing an effective public health response, little is known about the skills that emergency nurses have, or require, in order to respond effectively to a disaster event. This paper is designed to address this gap in the literature by conducting an empirical study on emergency nurses’ preparedness at the mass-gathering event of Hajj in Mecca city. To achieve this aim, this study conducted a cross-sectional survey among 106 emergency department nurses in all the public hospitals in Mecca in 2014. The results revealed that although emergency nurses’ role understanding is high; they have limited knowledge and awareness of how to respond appropriately to mass-gathering disaster events. To address this knowledge gap, the top three most beneficial types of education and training courses suggested are: hospital education sessions, the Emergency Management Saudi Course and workshop; and short courses in disaster management. Finally, recommendations and constructive strategies are developed to provide the best practice in enhancing disaster preparedness. This paper adds to the body of knowledge regarding emergency nurses and mass gathering disasters. This paper measures the level of disaster knowledge, previous disaster response experience and disaster education and training amongst emergency nurses in Mecca, Saudi Arabia. It is anticipated that this study will provide a foundation for future studies aimed at better preparing emergency nurses for disaster response. This paper employs new strategies to improve the emergency nurses’ response during mass gatherings for the Hajj. Increasing the emergency nurses’ knowledge will develop their effective responses in mass-gathering disasters.

Keywords: emergency nurses, mass-gatherings, hajj, disaster preparedness, disaster knowledge, perceived role, disaster training, previous disaster response experience

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Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Edward Hwang

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The efficiency of public policies depends on customer's satisfaction, and the change directions of public policies hinge on customer's assessment; i.e., the performance of public policies in governments is decided by the citizen's administrative satisfaction! The governments in all levels must heave their efficiency and effectiveness of public services to meet the people's substantially multiple needs in order to make citizens trust the governmental operation styles. To pursue the societal equality and justice, governments should treat people equally and provide more services for the disadvantages. The recent Dapu protest event involves Miaoli county Magistrate Liu cheng-hung who arbitrarily demolished houses and destroyed farmlands, and it shifts his popularity into disaffection. Liu case tells us that the political events are lethal to politicians; it cut almost 20% satisfaction degree for Magistrate Liu and hurt KMT support levels nationally. In terms of administrative satisfaction levels, political factors do matter, especially for the derogated events.

Keywords: local politics, administrative satisfaction, Taiwan, customer satisfaction

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Authors: Aisyiyah Fauziah Rahmah

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Generally, an urban city has a rapid growth, it has frequent a variety of problems, especially of convenience in public space usage. The density of population in urban areas and the high activity is also indicated as a cause of urban resident lifestyle for the worse in social relationships and allow for the stress. Streets and green space (parks) are the only public space in a residential area which is used as a place to build social activity, to meet and interact with the other housing dweller. The high level of activity and social interaction that occurs will affect the spatial arrangement. It can be effected the space structures in housing more complex. Ease in access to public space is the reason many dweller prefer doing social activities there. Hillier in Carmona et al (2003) explains that the pattern and intensity of movement of individuals is influenced by the configuration of space, even the space structure can be regarded as the single most influential determinant of movements in the space. Whyte in Zhang and Lawson (2009) also suggest some factors such as seats, trees, water and legibility of space encourage people to stay in public outdoor space. Furthermore this activities can attract more activities. Villa Bukit Tidar is a housing in Lowokwaru District which highest number of people in Malang City, so social activity is also high there. It has natural and recreational concept and provided with view of Malang City from heights. This potential is able to attract the people who live there to stay in public outdoor space and doing activities there. From this study we can find whether the ease of access to public space and visual satisfaction of Villa Bukit Tidar housing affect the usage of public space. This study was carried out by observing the streets pattern and plot pattern to know the configuration space of Villa Bukit Tidar housing through values of connectivity and integrity by resulting from space sintax analysis. Distributing questionnaires also carried out to determine the level of satisfaction and importance perception of visual condition in the public space in Villa Bukit Tidar housing through Important Performance Analysis (IPA). Results of this research indicated that the public spaces in Villa Bukit Tidar housing who has high connectivity and integrity is considered to be visually satisfied and it has a higher public space usage than has low connectivity and integrity are considered to be visually dissatisfied.

Keywords: configuration space, visual perception, social activities, public space usage

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Authors: Larissa Kamdjong

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The purpose of this research is to introduce inclusive leadership as a distinct theoretical framework to understand its meaning and functions in advancing gender equality and empowerment in public relations leadership. By proposing women inclusive leadership theoretical model, we explored the roles of inclusive leadership in fostering an organization’s diverse climate and facilitating its practice of participative leadership in empowering women in public relations to reach their full potential in leadership advancement. Moreover, our results confirmed both direct and indirect impacts inclusive leadership could have on women’s perceptions of continued career growth opportunities. Our findings provide theoretical implications and practical solutions to address women’s leadership challenges through an inclusive leadership lens.

Keywords: inclusiveness, empowerment, leadership, career opportunities

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Authors: Wudneh Asegedech Ayele

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Background: Dietary diversity is strongly related with non-communicable disease (NCDs). Diet plays a key role as a risk factor for hypertension. Diets rich in fruits, vegetables, and low-fat dairy products that include whole grains, poultry, fish, and nuts, that contain only small amounts of red meat, sweets, and sugar-containing beverages, and that contain decreased amounts of total and saturated fat and cholesterol have been found to have a protective effect against hypertension. Methods: hospital based Cross-sectional study design was employed from June 1-June 25, 2021. Sampling technique was Systematic random sampling and data were collected using an interview method. Data were entered into Epi Data version 3.1 and exported to SPSS version 25 for processed and analysis respectively. Descriptive statistics were used to summarize data. Bivariate and multivariate logistic regression will employed to determine dietary diversity among hypertension patients. Results: Adequate dietary diversity score were 96 (24.68%). Most of them cereal, white roots and tubers, dark green leafy vegetables, Vitamin A rich fruits ,meat, egg and coffee or tea more intakes. Hypertensive patients who didn’t consume cereals four times less likely adequate dietary diversity than who consumed cereals [AOR= 4.083, 95%: CI (2.096 -7.352)]. Hypertensive patients who didn’t consume white roots and tubers 14 times less likely adequate dietary diversity than who consumed white roots and tubers [AOR= 13.733, 95% CI: (5.388-34.946)]. Conclusion and recommendation the study showed one of fourth part reported adequate dietary diversity score. Cereals, fruits, vegetables and milk and milk products were statistically associated with dietary diversity practice. Health education about dietary modifications and behavioral change to dietary diversity

Keywords: dietary diversity practice and associated facrors among hypertension patients at tirunesh beijing hospital, hypertension, dietary, diversity and tirunesh beijing hospital, associated facrors among hypertension patient, at tirunesh beijing hospita

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Authors: Ayat Ayman Abdelaziz Ibrahim Amayem, Hassan Abdel-Salam, Zeyad El-Sayad

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Nowadays, ICTs have spread extensively in everyday life in an unprecedented way. A great attention is paid to the ICTs while ignoring the social aspect. With the immersive invasion of internet as well as smart phones’ applications and digital social networking, people become more socially connected through virtual spaces instead of meeting in physical public spaces. Thus, this paper aims to find the ways of implementing ICTs in public spaces to regain their status as attractive places for people, incite meetings in real life and create sustainable lively city centers. One selected example of urban space in the city center of Alexandria is selected for the study. Alexandria represents a large metropolitan city subjected to rapid transformation. Improving the quality of its public spaces will have great effects on the whole well-being of the city. The major roles that ICTs can play in the public space are: culture and art, education, planning and design, games and entertainment, and information and communication. Based on this classification various examples and proposals of ICTs interventions in public spaces are presented and analyzed to encourage good old fashioned social interaction by creating the New Social Public Place of this Digital Era. The paper will adopt methods such as questionnaire for evaluating the people’s willingness to accept the idea of using ICTs in public spaces, their needs and their proposals for an attractive place; the technique of observation to understand the people behavior and their movement through the space and finally will present an experimental design proposal for the selected urban space. Accordingly, this study will help to find design principles that can be adopted in the design of future public spaces to meet the needs of the digital era’s users with the new concepts of social life respecting the rules of place-making.

Keywords: Alexandria sustainable city center, digital place-making, ICTs, social interaction, social networking, urban places

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Authors: Recep Keşli, Gülşah Aşık, Cengiz Demir, Onur Türkyılmaz

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Objective: Proteus mirabilis (P. mirabilis) is one of Gram-negative pathogens in human and it causes urinary tract and nosocomial infections. P. mirabilis is susceptible to β-lactams, aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. It was aimed to investigate the resistance status to antimicrobial agents of Proteus mirabilis strains produced from samples sent to Afyon Kocatepe University, ANS Research and Practice Hospital, Microbiology Laboratory from different clinics and polyclinics during the period of 24 months. Methods: Between October 2013 and September 2015, a total of 30 Proteus were isolated from clinical samples of patients were hospitalized in intensive care units and in various departments of Afyon Kocatepe University, ANS Research and Practice Hospital. Identification of the bacteria was determined by conventional methods and VITEK 2 system (bioMérieux, France) was used additionally. Antibacterial susceptibility tests were performed by Kirby Bauer disc (Oxoid, Hempshire, England) diffusion method following the recommendations of CLSI. Results: Of the total 30 Proteus strains isolated from clinical samples, 19 from urine, 7 from wound, 4 from tracheal aspiration materials were isolated. Antimicrobial resistant for these strains were determined to 24,3% for meropenem, 26.2% for imipenem, 20.2% for amikacin 10.5% for cefepim, 33.3% for ciprofloxacin and levofloxacine, 31.6% for ceftazidime, 20% for ceftriaxone, 15.2% for gentamicin and 26.6% for amoxicillin-clavulanate, 26.2% trimethoprim-sulfamethoxale. Conclusion: In the present study, the highest number of clinical isolates of P. mirabilis were isolated from urine (63,3%), followed by the others (36,6%). The distribution of samples P. mirabilis strains to the clinics were as fallows; 16,8% intensive care unit (ICU), 29,9% polyclinics, 53,3% hospital service units The most effective antibiotic on the total of strains were found to be cefepim, the least effective antibiotics on the total of strains were found to be trimethoprim-sulfamethoxale.

Keywords: proteus mirabilis, antibiotic resistance, intensive care unit, Proteus spp.

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Authors: Alvian R. E. Purnomo, K. Noni Srijati, Hernawan Adi

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Government regulation is a result of agreement on the struggle of ideas, interests, and ideologies among elites in state institution. The polemic about death penalty policy in Indonesia is still becoming an interesting discussion and also a complex issue. There are pros/ cons of whether the policy is humane or not. Indonesia becomes the concern of the world’s community because the policy of death penalty applied is considered not reflecting the values of Indonesian culture including tolerance, mutual cooperation, and love. This paper examines them using literature study on how public policy theories respond to humanity issues and how Indonesian government should take steps to the issue of the death penalty that has become polemic until now.

Keywords: government regulation, public policy, death penalty policy, humanity

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Authors: K. Genise, S. Murthy

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Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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Authors: Hamad Albadr

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Joint Commission International (JCI) accreditation process intent to improve the safety and quality of care in the international community through the provision of education, publications, consultation, and evaluation services. These standards apply to the entire organization as well as to each department, unit, or service within the organization. Medical Technology that contains both medical equipment and devices, is an essential part of health care. Appropriate management of equipment maintenance for ensuring medical technology safe, the equipment life is maximized, and the total costs are minimized. JCI medical technology evaluation and accreditation use standards, intents, and measurable elements. The paper focuses on evaluation of JCI standards for medical technology in Saudi Arabian hospitals: a Study Case of PSMMC that define the performance expectation, structures, or functions that must be in place for a hospital to be accredited by JCI through measurable elements that indicate a score during the survey process that identify the requirements for full compliance with the standard specially through Facility Management and Safety (FMS) section that require the hospital establishes and implements a program for inspecting, testing, and maintaining medical technology and documenting the results, to ensure that medical technology is available for use and functioning properly, the hospital performs and documents; an inventory of medical technology; regular inspections of medical technology; testing of medical technology according to its use and manufacturers’ requirements; and performance of preventive maintenance.

Keywords: joint commission international (JCI) accreditation, medical technology, Saudi Arabia, Saudi Arabian hospitals

Procedia PDF Downloads 547