Search results for: public sector hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9847

Search results for: public sector hospital

9727 Incentivize Contracting Partners of Public Projects

Authors: Sai On Cheung, Qiuwen Ma, Fong Chung Lee

Abstract:

Due to increased project complexity and technological advancement in the last decade, the designers and contractors are expected to put more efforts to achieve project goals. To render extra efforts from the agents, incentivization has become one of the primary strategies for the client. Despite increased academia interest in the design of incentive strategies, there is still a need for discussion about the underlying motivations and favourable conditions to make incentives effective. Therefore, this study focuses on the effects of motivations and favourable conditions for the use of incentives in public projects. Questionnaire survey is used as the data collection tool. The questionnaire survey was piloted through interviews with professionals from Hong Kong public sector. A total of 100 responses were collected for this survey. Accountability and organizational effectiveness were found to be the prime objectives of incentives installed by public clients. Furthermore, a list of favourable conditions for incentivization and its consequent effects on cost, schedule, risk and public opinions were identified. To conclude, this study analyses the means and ends of the use of incentives in public projects in Hong Kong.

Keywords: incentives, public accountability, project effectiveness, public opinions

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9726 The Influence of Job Recognition and Job Motivation on Organizational Commitment in Public Sector: The Mediation Role of Employee Engagement

Authors: Muhammad Tayyab, Saba Saira

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It is an established fact that organizations across the globe consider employees as their assets and try to advance their well-being. However, the local firms of developing countries are mostly profit oriented and do not have much concern about their employees’ engagement or commitment. Like other developing countries, the local organizations of Pakistan are also less concerned about the well-being of their employees. Especially public sector organizations lack concern regarding engagement, satisfaction or commitment of the employees. Therefore, this study aimed at investigating the impact of job recognition and job motivation on organizational commitment in the mediation role of employee engagement. The data were collected from land record officers of board of revenue, Punjab, Pakistan. Structured questionnaire was used to collect data through physically visiting land record officers and also through the internet. A total of 318 land record officers’ responses were finalized to perform data analysis. The data were analyzed through confirmatory factor analysis and structural equation modeling technique. The findings revealed that job recognition and job motivation have direct as well as indirect positive and significant impact on organizational commitment. The limitations, practical implications and future research indications are also explained.

Keywords: job motivation, job recognition, employee engagement, employee commitment, public sector, land record officers

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9725 Juxtaposing South Africa’s Private Sector and Its Public Service Regarding Innovation Diffusion, to Explore the Obstacles to E-Governance

Authors: Petronella Jonck, Freda van der Walt

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Despite the benefits of innovation diffusion in the South African public service, implementation thereof seems to be problematic, particularly with regard to e-governance which would enhance the quality of service delivery, especially accessibility, choice, and mode of operation. This paper reports on differences between the public service and the private sector in terms of innovation diffusion. Innovation diffusion will be investigated to explore identified obstacles that are hindering successful implementation of e-governance. The research inquiry is underpinned by the diffusion of innovation theory, which is premised on the assumption that innovation has a distinct channel, time, and mode of adoption within the organisation. A comparative thematic document analysis was conducted to investigate organisational differences with regard to innovation diffusion. A similar approach has been followed in other countries, where the same conceptual framework has been used to guide document analysis in studies in both the private and the public sectors. As per the recommended conceptual framework, three organisational characteristics were emphasised, namely the external characteristics of the organisation, the organisational structure, and the inherent characteristics of the leadership. The results indicated that the main difference in the external characteristics lies in the focus and the clientele of the private sector. With regard to organisational structure, private organisations have veto power, which is not the case in the public service. Regarding leadership, similarities were observed in social and environmental responsibility and employees’ attitudes towards immediate supervision. Differences identified included risk taking, the adequacy of leadership development, organisational approaches to motivation and involvement in decision making, and leadership style. Due to the organisational differences observed, it is recommended that differentiated strategies be employed to ensure effective innovation diffusion, and ultimately e-governance. It is recommended that the results of this research be used to stimulate discussion on ways to improve collaboration between the mentioned sectors, to capitalise on the benefits of each sector.

Keywords: E-governance, ICT, innovation diffusion, comparative analysis

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9724 Predicting Shortage of Hospital Beds during COVID-19 Pandemic in United States

Authors: Saba Ebrahimi, Saeed Ahmadian, Hedie Ashrafi

Abstract:

World-wide spread of coronavirus grows the concern about planning for the excess demand of hospital services in response to COVID-19 pandemic. The surge in the hospital services demand beyond the current capacity leads to shortage of ICU beds and ventilators in some parts of US. In this study, we forecast the required number of hospital beds and possible shortage of beds in US during COVID-19 pandemic to be used in the planning and hospitalization of new cases. In this paper, we used a data on COVID-19 deaths and patients’ hospitalization besides the data on hospital capacities and utilization in US from publicly available sources and national government websites. we used a novel ensemble modelling of deep learning networks, based on stacking different linear and non-linear layers to predict the shortage in hospital beds. The results showed that our proposed approach can predict the excess hospital beds demand very well and this can be helpful in developing strategies and plans to mitigate this gap.

Keywords: COVID-19, deep learning, ensembled models, hospital capacity planning

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9723 An Empirical Investigation of Factors Influencing Construction Project Selection Processes within the Nigeria Public Sector

Authors: Emmanuel U. Unuafe, Oyegoke T. Bukoye, Sandhya Sastry, Yanqing Duan

Abstract:

Globally, there is increasing interest in project management due to a shortage in infrastructure services supply capability. Hence, it is of utmost importance that organisations understand that choosing a particular project over another is an opportunity cost – tying up the organisations resources. In order to devise constructive ways to bring direction, structure, and oversight to the process of project selection has led to the development of tools and techniques by researchers and practitioners. However, despite the development of various frameworks to assist in the appraisal and selection of government projects, failures are still being recorded with government projects. In developing countries, where frameworks are rarely used, the problems are compounded. To improve the situation, this study will investigate the current practice of construction project selection processes within the Nigeria public sector in order to inform theories of decision making from the perspective of developing nations and project management practice. Unlike other research around construction projects in Nigeria this research concentrate on factors influencing the selection process within the Nigeria public sector, which has received limited study. The authors report the findings of semi-structured interviews of top management in the Nigerian public sector and draw conclusions in terms of decision making extant theory and current practice. Preliminary results from the data analysis show that groups make project selection decisions and this forces sub-optimal decisions due to pressure on time, clashes of interest, lack of standardised framework for selecting projects, lack of accountability and poor leadership. Consequently, because decision maker is usually drawn from different fields, religious beliefs, ethnic group and with different languages. The choice of a project by an individual will be greatly influence by experience, political precedence than by realistic investigation as well as his understanding of the desired outcome of the project, in other words, the individual’s ideology and their level of fairness.

Keywords: factors influencing project selection, public sector construction project selection, projects portfolio selection, strategic decision-making

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9722 Contribution of Supply Chain Management Practices for Enhancing Healthcare Service Quality: A Quantitative Analysis in Delhi’s Healthcare Sector

Authors: Chitrangi Gupta, Arvind Bhardwaj

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This study seeks to investigate and quantify the influence of various dimensions of supply chain management (namely, supplier relationships, compatibility, specifications and standards, delivery processes, and after-sales service) on distinct dimensions of healthcare service quality (specifically, responsiveness, trustworthiness, and security) within the operational framework of XYZ Superspeciality Hospital, situated in Delhi. The name of the Hospital is not being mentioned here because of the privacy policy of the hospital. The primary objective of this research is to elucidate the impact of supply chain management practices on the overall quality of healthcare services offered within hospital settings. Employing a quantitative research design, this study utilizes a hypothesis-testing approach to systematically discern the relationship between supply chain management dimensions and the quality of health services. The findings of this study underscore the significant influence exerted by supply chain management dimensions, specifically supplier relationships, specifications and standards, delivery processes, and after-sales service, on the enhancement of healthcare service quality. Moreover, the study's results reveal that demographic factors such as gender, qualifications, age, and experience do not yield discernible disparities in the relationship between supply chain management and healthcare service quality.

Keywords: supply chain management, healthcare, hospital operations, service delivery

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9721 Contemporary Challenges in Public Relations in the Context of Globalization

Authors: Marine Kobalava, Eter Narimanishvili, Nino Grigolaia

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The paper analyzes the contemporary problems of public relations in Georgia. The approaches to public attitudes towards the relationship with the population of the country are studied on a global scale, the importance of forming the concept of public relations in Georgia in terms of globalization is justified. The basic components of public relations are characterized by the RACE system, namely analyzing research, action, communication, evaluation. The main challenges of public relations are identified in the research process; taking into consideration the scope of globalization, the influence of social, economic, and political changes in Georgia on PR development are identified. The article discusses the public relations as the strategic management function that facilitates communication with the society, recognition of public interests, and their prediction. In addition, the feminization of the sector is considered to be the most important achievement of public relations in the modern world. The conclusion is that the feminization indicator of the field is an unconditional increase in the employment rates of women. In the paper, the problems of globalization and public relations in the industrial countries are studied, the directions of improvement of public relations with the background of peculiarities of different countries and globalization process are proposed. Public relations under globalization are assessed in accordance with the theory of benefits and requirements, and the requirements are classified according to informational, self-identification, integration, social interaction, and other types of signs. In the article, conclusions on the current challenges of public relations in Georgia are made, and the recommendations for their solution, taking into consideration globalization processes in the world, are proposed.

Keywords: public relations, globalization, RACE system, public relationship concept, feminization

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9720 Political will in Fighting Corruption in Vietnam

Authors: Anh Dao Vu, Bill Ryan

Abstract:

The Vietnamese government struggles to grapple with the problem of rampant corruption, one of the most challenging difficulties the country faces. According to Transparency International’s Corruption Perceptions Index (CPI) 2014, Vietnam ranks 119 out of 175 countries. The CPI gives Vietnam a score of 31 on a scale from 0 to 100, where 0 indicates ‘highly corrupt’ and 100 represents ‘very clean’. Corruption eats into the national GDP of Vietnam, causing a loss of 3% to 4% of GDP per annum. In general, the Vietnamese people’s trust in their government to wage an effective fight against corruption, especially in the public sector, has been greatly eroded in recent years. Some substantial public demonstrations persuaded the government to implement strong anti-corruption measures. However, so far those measures have not been particularly successful. One of the main reasons for this shortcoming is that neither the Communist Party of Vietnam nor the government has demonstrated sufficiently strong ‘political will’ in fighting corruption. There remains a large gap between rhetoric and reality. This paper will examine the reasons why insufficient ‘political will’ is displayed in the ostensible fight against public sector corruption, and how certain anti-corruption strategies will both strengthen levels of political commitment to the fight against corruption while enhancing the effectiveness of that essential national endeavor.

Keywords: corruption, political will, Vietnam, anti-corruption

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9719 Evaluation of Food Services by the Personnel in Hospitals of Athens, Greece

Authors: I. Mentziou, C. Delezos, D. Krikidis, A. Nestoridou, G. Boskou

Abstract:

Introduction: The systems of production and distribution of meals can have a significant impact on the food intake of hospital patients who are likely to develop malnutrition. In hospitals, the consequences of food borne infections can range from annoying to life-threatening for a patient, since they can lead up to death in vulnerable groups Aim: The aim of the present study was the evaluation of food safety management systems implementation, as well as the general evaluation of the total quality management systems in Greek hospitals. Methods: This is a multifocal study on the implementation and evaluation of the food safety management systems in the Greek hospitals of Attica region. Eleven hospitals from the city of Athens were chosen for this purpose. The sample was derived from the high rank personnel of the nutritional department (dietician, head-chef, food technologist, public health inspector). Tailor made questionnaires on hygiene regulations were used as tools for the interviews. Results: Overall, 30 employees in the field of hospital nutrition participated. Most of the replies implied that almost always the hygiene regulations are implemented. Nevertheless, only 30% stated that there is a Hazard Analysis Critical Control Points HACCP system (HACCP) in the hospital. In a small number of questionnaires there were proposals for changes by the staff. Conclusion: Measurement of the opinion of the personnel about the provided food services within a hospital can further lead to continuous improvement of the hospital nutrition.

Keywords: evaluation, food service, HACCP, hospital, personnel

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9718 Support Provided by Midwives to Women during Labour in a Public Hospital, Limpopo Province, South Africa: A Participant Observation Study

Authors: Sonto Maputle

Abstract:

Background: Support during labour increase women's chances of having positive childbirth experiences as well as childbirth outcomes. The purpose of this study was to determine the support provided by midwives to women during labour at the public hospital in Limpopo Province. The study was conducted at the Tertiary hospital in Limpopo Province. Methods: A qualitative, participant observation approach was used. Population consisted of all women that were admitted to deliver their babies and the midwives who provided midwifery care in the obstetric unit of one tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data was analysed qualitatively but were presented in the tables and bar graphs. Results: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. Conclusion: The communication was occurring when the midwife was rendering midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers’ participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Keywords: communication between women and midwives, labour pains, informational and emotional support, physical comforting measures

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9717 Development of E-Tendering Models for Nigerian Public Procuring Entities

Authors: Bello Abdullahi, Kabir Bala, Yahaya M. Ibrahim, Ahmed D. Ibrahim

Abstract:

Public sector tendering has traditionally been conducted using manual paper-based processes which are known to be inefficient, less transparent, and more prone to manipulations and errors. However, the advent of the Internet and its associated technologies has led to the development of numerous e-Tendering systems that addressed many of the problems associated with the manual paper-based tendering system. Currently, in Nigeria, the public tendering processes are largely conducted based on manual paper-based system that is bedevilled by a number of problems such as inordinate delays, inefficiencies, manipulation of the tender evaluation process, corruption, lack of transparency and competition, among other problems. These problems can be addressed through the adoption of existing web-based e-Tendering systems which are known to address most of these problems. However, these existing e-Tendering systems that have been developed are not based on the Nigerian legal procurement processes and as such their suitability for local application is very limited. This paper is part of a larger study that attempt to address this problem through the development of an e-Tendering system that is based on the requirements of the Nigerian public procuring entities. In this paper, the identified tendering processes commonly used by Nigerian public procuring entities in the selection of construction sources are presented. A multi-methods research approach was used to identify those tendering processes. Specifically, 19 existing business use cases used by Nigerian public procuring entities were identified and 61 system use cases were prescribed based on the identified business use cases. The use cases were used as the basis for the development of domain and software conceptual models. The models were successfully used to guide the development of an e-Tendering system called NPS-eTender. Ripple and Unified Process were adopted as the software development methodologies.

Keywords: e-tendering, e-procurement, requirement model, conceptual model, public sector tendering, public procurement

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9716 The Role of Goal Orientation on the Structural-Psychological Empowerment Link in the Public Sector

Authors: Beatriz Garcia-Juan, Ana B. Escrig-Tena, Vicente Roca-Puig

Abstract:

The aim of this article is to conduct a theoretical and empirical study in order to examine how the goal orientation (GO) of public employees affects the relationship between the structural and psychological empowerment that they experience at their workplaces. In doing so, we follow structural empowerment (SE) and psychological empowerment (PE) conceptualizations, and relate them to the public administration framework. Moreover, we review arguments from GO theories, and previous related contributions. Empowerment has emerged as an important issue in the public sector organization setting in the wake of mainstream New Public Management (NPM), the new orientation in the public sector that aims to provide a better service for citizens. It is closely linked to the drive to improve organizational effectiveness through the wise use of human resources. Nevertheless, it is necessary to combine structural (managerial) and psychological (individual) approaches in an integrative study of empowerment. SE refers to a set of initiatives that aim the transference of power from managerial positions to the rest of employees. PE is defined as psychological state of competence, self-determination, impact, and meaning that an employee feels at work. Linking these two perspectives will lead to arrive at a broader understanding of the empowerment process. Specifically in the public sector, empirical contributions on this relationship are therefore important, particularly as empowerment is a very useful tool with which to face the challenges of the new public context. There is also a need to examine the moderating variables involved in this relationship, as well as to extend research on work motivation in public management. It is proposed the study of the effect of individual orientations, such as GO. GO concept refers to the individual disposition toward developing or confirming one’s capacity in achievement situations. Employees’ GO may be a key factor at work and in workforce selection processes, since it explains the differences in personal work interests, and in receptiveness to and interpretations of professional development activities. SE practices could affect PE feelings in different ways, depending on employees’ GO, since they perceive and respond differently to such practices, which is likely to yield distinct PE results. The model is tested on a sample of 521 Spanish local authority employees. Hierarchical regression analysis was conducted to test the research hypotheses using SPSS 22 computer software. The results do not confirm the direct link between SE and PE, but show that learning goal orientation has considerable moderating power in this relationship, and its interaction with SE affects employees’ PE levels. Therefore, the combination of SE practices and employees’ high levels of LGO are important factors for creating psychologically empowered staff in public organizations.

Keywords: goal orientation, moderating effect, psychological empowerment, structural empowerment

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9715 Exploring the Knowledge from the Public on Technical and Vocational Education Training (TVET) in Ghana

Authors: Abubakar-Zagoon Adams, Emmanuel Intsiful, Haruna Zagoon-Sayeed

Abstract:

Within the Ghanaian context, the promotion of Technical and Vocational Education and Training (TVET) has been faced with many obstacles which are of great concern to national development. One of the obstacles that have been identified as having some negative impact on TVET promotion is the poor public perception of TVET. Poor public perception, as identified in the sub-sectors report in a number of Ghana Education Service reports, has received little attention in both research and the government’s effort to address the poor performance of the TVET sub-sector. This study investigated TVET stakeholders in the Ayawaso-West Municipality in the Greater Accra Region of Ghana to ascertain knowledge of technical and vocational education in Ghana. This study explored parents’ and students’ views and knowledge about technical and vocational education. The study adopted an exploratory research design and a qualitative research approach. Thirty-six (36) participants were selected by employing a purposive sampling technique. Twelve (ten parents and two school personnel) out of the total sample were engaged in key informant interviews, whereas three focus group discussions were conducted with students, eight in each group. The study found that the public has fair knowledge (positive) about TVET, and the other side of the coin knows that TVET is only meant for school dropouts, underprivileged students, and weak academic students. The study recommended that the government should intensify public education on TVET, deliberate investment should be made in TVET infrastructure, as well as proper regulation of the sub-sector.

Keywords: public perception, TVET promotion, socioeconomic, self-employment

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9714 Design a Network for Implementation a Hospital Information System

Authors: Abdulqader Rasool Feqi Mohammed, Ergun Erçelebi̇

Abstract:

A large number of hospitals from developed countries are adopting hospital information system to bring efficiency in hospital information system. The purpose of this project is to research on new network security techniques in order to enhance the current network security structure of save a hospital information system (HIS). This is very important because, it will avoid the system from suffering any attack. Security architecture was optimized but there are need to keep researching on best means to protect the network from future attacks. In this final project research, security techniques were uncovered to produce best network security results when implemented in an integrated framework.

Keywords: hospital information system, HIS, network security techniques, internet protocol, IP, network

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9713 Investigation on Hand-Woven School Uniform Initiative and Sustainability: The Kerala Model from India

Authors: Abhilash Balan Paleri

Abstract:

Hand woven fabric embellishes an exceptional identity in the social milieu of Kerala; still, the artisans and handloom sector is undergoing crisis due to various reasons. The hand woven school uniform initiative of Govt. of Kerala launched in 2016 aims at enhancing the sector, ensuring sustainability at artisan and end-user levels. The Kerala Government already distributed 23 lakhs meters of cloth (for shirting, suiting, and skirting) woven by 4085 artisans in their traditional looms covering 4.5 lakhs of students in the public education sector which covers cover 3,701 schools in the state. The 2019-20 year production is expected to be 42 Lakhs meters of hand woven clothing catering 8.6 lakhs of students in the primary sector. This particular investigation unveils the upshots of the initiative, and the observations are derived through systematic enquiry with artisans, authorities, and end-users. The findings show a remarkable positive impact in the livelihood of artisans and the entire handloom sector.

Keywords: handloom school uniform initiative of Kerala, hand woven fabric, sustainability, handloom weavers

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9712 Public Private Partnership for Infrastructure Projects: Mapping the Key Risks

Authors: Julinda Keçi

Abstract:

In many countries, governments have been promoting the involvement of private sector entities to enter into long-term agreements for the development and delivery of large infrastructure projects, with a focus on overcoming the limitations upon public fund of the traditional approach. The involvement of private sector through public-private partnerships (PPP) brings in new capital investments, value for money and additional risks to handle. Worldwide research studies have shown that an objective, systematic, reliable and user-oriented risk assessment process and an optimal allocation mechanism among different stakeholders is crucial to the successful completion. In this framework this paper, which is the first stage of a research study, aims to identify the main risks for the delivery of PPP projects. A review of cross-countries research projects and case studies was performed to map the key risks affecting PPP infrastructure delivery. The matrix of mapping offers a summary of the frequency of factors, clustered in eleven categories: Construction, Design, Economic, Legal, Market, Natural, Operation, Political, Project finance, Project selection and Relationship. Results will highlight the most critical risk factors, and will hopefully assist the project managers in directing the managerial attention in the further stages of risk allocation.

Keywords: construction, infrastructure, public private partnerships, risks

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9711 Preparedness of Health System in Providing Continuous Health Care: A Case Study From Sri Lanka

Authors: Samantha Ramachandra, Avanthi Rupasinghe

Abstract:

Demographic transition from lower to higher percentage of elderly population eventually coupled with epidemiological transition from communicable to non-communicable diseases (NCD). Higher percentage of NCD overload the health system as NCD survivors claims continuous health care. The demands are challenging to a resource constrained setting but reorganizing the system may find solutions. The study focused on the facilities available and their utilization at outpatient department (OPD) setting of the public hospitals of Sri Lanka for continuous medical care. This will help in identifying steps of reorganizing the system to provide better care with the maximum utilization of available facilities. The study was conducted as a situation analysis with secondary data at hospital planning units. Variable were identified according to the world health organization (WHO) recommendation on continuous health care for elders in “age-friendly primary health care toolkit”. Data were collected from secondary and tertiary care hospitals of Sri Lanka where most of the continuous care services are available. Out of 58 secondary and tertiary care hospitals, 16 were included in the study to represent each hospital categories. Average number of patient attending for episodic treatment at OPD and Clinical follow-up of chronic conditions shows vast disparity according to the category of the hospital ranging from 3750 – 800 per day at OPD and 1250 – 200 per clinic session. Average time spent per person at OPD session is low, range from 1.54 - 2.28 minutes, the time was increasing as the hospital category goes down. 93.7% hospitals had special arrangements for providing acute care on chronic conditions such as catheter, feeding tube and wound care. 25% hospitals had special clinics for elders, 81.2% hospitals had healthy lifestyle clinics (HLC), 75% hospitals had physical rehabilitation facilities and 68.8% hospitals had facilities for counselling. Elderly clinics and HLC were mostly available at lower grade hospitals where as rehabilitation and counselling facilities were mostly available at bigger hospitals. HLC are providing health education for both patients and their family members, refer patients for screening of complication but not provide medical examinations, investigations or treatments even though they operate in the hospital setting. Physical rehabilitation is basically offered for patients with rheumatological conditions but utilization of centers for injury rehabilitation and rehabilitation of survivors following major illness such as myocardial infarctions, stroke, cancer is not satisfactory (12.5%). Human Resource distribution within hospital shows vast disparity and there are 103 physiotherapists in the biggest hospital where only 36 physiotherapists available at the next level hospital. Counselling facilities also provided mainly for the patient with psychological conditions (100%) but they were not providing counselling for newly diagnosed patients with major illnesses (0%). According to results, most of the public-sector hospitals in Sri Lanka have basic facilities required in providing continuous care but the utilization of services need more focus. Hospital administration or the government need to have initial steps in proper utilization of them in improving continuous health care incorporating team approach of rehabilitation. The author wishes to acknowledge that this paper was made possible by the support and guidance given by the “Australia Awards Fellowships Program for Sri Lanka – 2017,” which was funded by the Department of Foreign Affairs and Trade, Australia, and co-hosted by Monash University, Australia and the Sri Lanka Institute of Development Administration.

Keywords: continuous care, outpatient department, non communicable diseases, rehabilitation

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9710 Timing of Ileostomy Closure Following Rectal Cancer Surgery at an Australian Regional Hospital

Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

Abstract:

Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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9709 Knowledge Management Processes as a Driver of Knowledge-Worker Performance in Public Health Sector of Pakistan

Authors: Shahid Razzaq

Abstract:

The governments around the globe have started taking into considerations the knowledge management dynamics while formulating, implementing, and evaluating the strategies, with or without the conscious realization, for the different public sector organizations and public policy developments. Health Department of Punjab province in Pakistan is striving to deliver quality healthcare services to the community through an efficient and effective service delivery system. Despite of this struggle some employee performance issues yet exists in the form of challenge to government. To overcome these issues department took several steps including HR strategies, use of technologies and focus of hard issues. Consequently, this study was attempted to highlight the importance of soft issue that is knowledge management in its true essence to tackle their performance issues. Knowledge management in public sector is quite an ignored area in the knowledge management-a growing multidisciplinary research discipline. Knowledge-based view of the firm theory asserts the knowledge is the most deliberate resource that can result in competitive advantage for an organization over the other competing organizations. In the context of our study it means for gaining employee performance, organizations have to increase the heterogeneous knowledge bases. The study uses the cross-sectional and quantitative research design. The data is collected from the knowledge workers of Health Department of Punjab, the biggest province of Pakistan. A total of 341 sample size is achieved. The SmartPLS 3 Version 2.6 is used for analyzing the data. The data examination revealed that knowledge management processes has a strong impact on knowledge worker performance. All hypotheses are accepted according to the results. Therefore, it can be summed up that to increase the employee performance knowledge management activities should be implemented. Health Department within province of Punjab introduces the knowledge management infrastructure and systems to make effective availability of knowledge for the service staff. This knowledge management infrastructure resulted in an increase in the knowledge management process in different remote hospitals, basic health units and care centers which resulted in greater service provisions to public. This study is to have theoretical and practical significances. In terms of theoretical contribution, this study is to establish the relationship between knowledge management and performance for the first time. In case of the practical contribution, this study is to give an insight to public sector organizations and government about role of knowledge management in employ performance. Therefore, public policymakers are strongly advised to implement the activities of knowledge management for enhancing the performance of knowledge workers. The current research validated the substantial role of knowledge management in persuading and creating employee arrogances and behavioral objectives. To the best of authors’ knowledge, this study contribute to the impact of knowledge management on employee performance as its originality.

Keywords: employee performance, knowledge management, public sector, soft issues

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9708 Out of Hospital Cardiac Arrest in Kuala Lumpur: A Mixed Method Study on Incidence, Adherence to Protocol, and Issues

Authors: Mohd Said Nurumal, Sarah Sheikh Abdul Karim

Abstract:

Information regarding out of hospital cardiac arrest incidence include outcome in Malaysia is limited and fragmented. This study aims to identify incidence and adherence to protocol of out of hospital cardiac arrest and also to explore the issues faced by the pre-hospital personnel in regards managing cardiac arrest victim in Kuala Lumpur, Malaysia. A mixed method approach combining the qualitative and quantitative study design was used. The 285 pre-hospital care data sheet of out of hospital cardiac arrest during the year of 2011 were examined by using checklists for identify the incidence and adherence to protocol. Nine semi-structured interviews and two focus group discussions were performed. For the incidence based on the overall out of hospital cardiac arrest cases that occurred in 2011 (n=285), the survival rates were 16.8%. For adherence to protocol, only 89 (41.8%) of the cases adhered to the given protocol and 124 did not adhere to such protocol. The qualitative information provided insight about the issues related to out of hospital cardiac arrest in every aspect. All the relevant qualitative data were merged into few categories relating issues that could affect the management of out of hospital cardiac arrest performed by pre-hospital care team. One of the essential elements in the out of hospital cardiac arrest handling by pre-hospital care is to ensure increase of survival rates and excellent outcomes by adhering to given protocols based on international standard benchmarks. Measures are needed to strengthen the quick activation of the pre-hospital care service, prompt bystander cardiopulmonary resuscitation, early defibrillation and timely advanced cardiac life support and also to tackle all the issues highlighted in qualitative results.

Keywords: pre-hospital care, out of hospital cardiac arrest, incidence, protocol, mixed method research

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9707 The Relationship between Value-Added and Energy Consumption in Iran’s Industry Sector

Authors: Morteza Raei Dehaghi, Mojtaba Molaahmadi, Seyed Mohammad Mirhashemi

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This study aimed to explore the relationship between energy consumption and value-added in Iran’s industry sector during the time period 1973-2011. Annual data related to energy consumption and value added in the industry sector were used. The results of the study revealed a positive relationship between energy consumption and value-added of the industry sector. Similarly, the results showed that there is one-way causality between energy consumption and value-added in the industry sector.

Keywords: economic growth, energy consumption, granger causality test, industry sector

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9706 Use of Triclosan-Coated Sutures Led to Cost Saving in Public and Private Setting in India across Five Surgical Categories: An Economical Model Assessment

Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli

Abstract:

Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.

Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures

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9705 Public Debt Shocks and Public Goods Provisioning in Nigeria: Implication for National Development

Authors: Amenawo I. Offiong, Hodo B. Riman

Abstract:

Public debt profile of Nigeria has continuously been on the increase over the years. The drop in international crude oil prices has further worsened revenue position of the country, thus, necessitating further acquisition of public debt to bridge the gap in revenue deficit. Yet, when we look back at the increasing public sector spending, there are concerns that the government spending do not amount to increase in public goods provided for the country. Using data from 1980 to 2014 the study therefore seeks to investigate the factors responsible for the poor provision of public goods in the face of increasing public debt profile. Using the unrestricted VAR model Governance and Tax revenue were introduced into the model as structural variables. The result suggested that governance and tax revenue were structural determinants of the effectiveness of public goods provisioning in Nigeria. The study therefore identified weak governance as the major reason for the non-provision of public goods in Nigeria. While tax revenue exerted positive influence on the provisions of public goods, weak/poor governance was observed to crowd the benefits from increase tax revenue. The study therefore recommends reappraisal of the governance system in Nigeria. Elected officers in governance should be more transparent and accountable to the electorates they represent. Furthermore, the study advocates for an annual auditing of all government MDAs accounts by external auditors to ensure (a) accountability of public debts utilization, (b) transparent in implementation of program support funds, (c) integrity of agencies responsible for program management, and (d) measuring program effectiveness with amount of funds expended.

Keywords: impulse response function, public debt shocks, governance, public goods, tax revenue, vector auto-regression

Procedia PDF Downloads 239
9704 Preliminary Investigation of Hospital Buildings Maintenance Management in Malaysia

Authors: Christtestimony Oluwafemi Jesumoroti, AbdulLateef Ashola Olanrewaju, Khor Soo Cheen

Abstract:

The worth of buildings is known by the quality of the maintenance imbibe in them. Maintenance management being carried out in the hospitals has a direct impact on the performance of the hospital buildings, environment, and sustainable infrastructure, and as such, there is a need to give it adequate attention. The media and reports on hospital buildings maintenance management in Malaysia were not favorable. Hospital buildings in Malaysia need to have proper structure for maintenance management and sustainability as this will enhance the good infrastructure for users and the entire nation. The paper reports the preliminary results of the determinants of maintenance in hospital buildings. To achieve the aim of this research, a survey questionnaire was administered to the users of the hospital buildings. The findings of the study revealed that there are lack of maintenance standard, use of poor quality components and materials, Improper response time, Poor complaint reporting system. Hence, the influent of rework, thorough responsibilities of quality performance of hospital buildings, and others are the results of the investigations.

Keywords: sustainable infrastructure, optimum performance, implementation, key performance indicators, maintenance policies

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9703 Waiting Time Reduction in a Government Hospital Emergency Department: A Case Study on AlAdan Hospital, Kuwait

Authors: Bashayer AlRobayaan, Munira Saad, Alaa AlBawab, Fatma AlHamad, Sara AlAwadhi, Sherif Fahmy

Abstract:

This paper addresses the problem of long waiting times in government hospitals emergency departments (ED). It aims at finding feasible and simple ways of reducing waiting times that do not require a lot of resources and/or expenses. AlAdan Hospital in Kuwait was chosen to be understudy to further understand and capture the problem.

Keywords: healthcare, hospital, Kuwait, waiting times, emergency department

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9702 A Qualitative Inquiry of Institutional Responsiveness in Public Land Development in the Urban Areas in Sri Lanka

Authors: Priyanwada I. Singhapathirana

Abstract:

The public land ownership is a common phenomenon in many countries in the world however, the development approaches and the institutional structures are greatly diverse. The existing scholarship around public land development has been greatly limited to Europe and advanced Asian economies. Inferences of such studies seem to be inadequate and inappropriate to comprehend the peculiarities of public land development in developing Asian economies. The absence of critical inquiry on the public land ownership and the long-established institutional structures which govern the development has restrained these countries from institutional innovations. In this context, this research investigates the issues related to public land development and the institutional responses in Sri Lanka. This study introduces the concept of ‘Institutional Responsiveness’ in Public land development, which is conceptualized as the ability of the institutions to respond to the spatial, market and fiscal stimulus. The inquiry was carried out through in-depth interviews with five key informants from apex public agencies in order to explore the responsiveness of land institutions form decision-makers' perspectives. Further, the analysis of grey literature and recent media reports are used to supplement the analysis. As per the findings, long term abandonment of public lands and high transaction costs are some of the key issues in relation to public land development. The inability of the institutions to respond to the market and fiscal stimulus has left many potential public lands underutilized. As a result, the public sector itself and urban citizens have not been able to relish the benefits of the public lands in cities. Spatial analysis at the local scale is suggested for future studies in order to capture the multiple dimensions of the responsiveness of institutions to the development stimulus.

Keywords: institutions, public land, responsiveness, under-utilization

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9701 Methodology for Diagnosing Architecture Improvements in a Cancer Hospital in Brasilia

Authors: Mariana Sabino, Janes Cleiton de Oliveira, Carlos Luna de Melo

Abstract:

This paper presents a discussion about the importance and influence of the environment in the patient’s recovery process. Some users (employees and patients) were submitted to a questionnaire that helps to diagnoses the major problems of the hospital, specially related to comfort (aesthetic, thermal, acoustic, light, ergonomic), well-being, how does the flow of patients and employees works in the hospital and wayfinding as well. After a short literature review presenting the topic, the hospital will be characterized, showing photos, the projects available and describing the hospital as well (how many rooms, functions of each one, receptions, waiting rooms, between other things.), than the questionnaire will be applied to patients and to the employees. Lastly the results of the answers given will be analyzed in graphics, and it will help to identify which are the major improvements needed immediately. This paper has the intention to propose a methodology to diagnose architecture problems in a cancer hospital in Brasilia, Brazil, besides to open a space to hear the people that use the building to tell about their discomforts and perceptions of the environment, it also will give an opportunity to apply the possible improvements. It is important to tell that it will be considered if the hospital has a healing environment, and it will also be considered the ergonomic issues about comfort and the way the system of this particular hospital works in general.

Keywords: cancer hospital, comfort, diagnose, healing environment

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9700 Classroom Incivility Behaviours among Medical Students: A Comparative Study in Pakistan

Authors: Manal Rauf

Abstract:

Trained medical practitioners are produced from medical colleges serving in public and private sectors. Prime responsibility of teaching faculty is to inculcate required work ethic among the students by serving as role models for them. It is an observed fact that classroom incivility behaviours are providing a friction in achieving these targets. Present study aimed at identification of classroom incivility behaviours observed by teachers and students of public and private medical colleges as per Glasser’s Choice Theory, making a comparison and investigating the strategies being adopted by teachers of both sectors to control undesired class room behaviours. Findings revealed that a significant difference occurs between teacher and student incivility behaviours. Public sector teacher focussed on survival as a strong factor behind in civil behaviours whereas private sector teachers considered power as the precedent for incivility. Teachers of both sectors are required to use verbal as well as non-verbal immediacy to reach a healthy leaning environment.

Keywords: classroom incivility behaviour, glasser choice theory, Mehrabian immediacy theory

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9699 Laboratory-Based Monitoring of Hepatitis B Virus Vaccination Status in North Central Nigeria

Authors: Nwadioha Samuel Iheanacho, Abah Paul, Odimayo Simidele Michael

Abstract:

Background: The World Health Assembly through the Global Health Sector Strategy on viral hepatitis calls for the elimination of viral hepatitis as a public health threat by 2030. All hands are on deck to actualize this goal through an effective and active vaccination and monitoring tool. Aim: To combine the Epidemiologic with Laboratory Hepatitis B Virus vaccination monitoring tools. Method: Laboratory results analysis of subjects recruited during the World Hepatitis week from July 2020 to July 2021 was done after obtaining their epidemiologic data on Hepatitis B virus risk factors, in the Medical Microbiology Laboratory of Benue State University Teaching Hospital, Nigeria. Result: A total of 500 subjects comprising males 60.0%(n=300/500) and females 40.0%(n=200/500) were recruited. A fifty-three percent majority was of the age range of 26 to 36 years. Serologic profiles were as follows, 15.0%(n=75/500) HBsAg; 7.0% (n=35/500) HBeAg; 8.0% (n=40/500) Anti-Hbe; 20.0% (n=100/500) Anti-HBc and 38.0% (n=190/500) Anti-HBs. Immune responses to vaccination were as follows, 47.0%(n=235/500) Immune naïve {no serologic marker + normal ALT}; 33%(n=165/500) Immunity by vaccination {Anti-HBs + normal ALT}; 5%(n=25/500) Immunity to previous infection {Anti-HBs, Anti-HBc, +/- Anti-HBe + normal ALT}; 8%(n=40/500) Carriers {HBsAg, Anti-HBc, Anti-HBe +normal ALT} and 7% (35/500) Anti-HBe serum- negative infections {HBsAg, HBeAg, Anti-HBc +elevated ALT}. Conclusion: The present 33.0% immunity by vaccination coverage in Central Nigeria was much lower than the 41.0% national peak in 2013, and a far cry from the global expectation of attainment of a Global Health Sector Strategy on the elimination of viral hepatitis as a public health threat by 2030. Therefore, more creative ideas and collective effort are needed to attain this goal of the World Health Assembly.

Keywords: Hepatitis B, vaccination status, laboratory tools, resource-limited settings

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9698 Technology and Terror

Authors: Janet D. Fish

Abstract:

This paper will analyze how advanced information technology communications platform’s such as you tube, twitter, Facebook, and websites are being used in marketing cultural diversity on a global scale. The scope of this topic will encompass the use of marketing terror as a tool of educational understanding, accepting, and incorporating other ethnic groups into extremist Islamic cultural practices with an end goal of cultural assimilation. This paper will examine the impacts of various influences, such as globalism and technology on common public values and cultural diversity. Additionally, multiculturalism in public administration settings will be examined across cultures. Communications are a primary focus of review for this paper, the purpose of this review is to see how different technological platforms are currently being used as major tools of influence within the public sector. Technology and terror must become a primary concern for new public administrators in a modern world. While its existence is acknowledged, boundaries of legal recourse are currently few. Public administrators must understand the depth and reach of the future consequences of an unchecked process in the realm of technology and terror on a global scale.

Keywords: inclusionism, exclusionism, technology, terror

Procedia PDF Downloads 364