Search results for: organization of multi-field hospital’s

Authors: Yuhan Wu, CTB (Kees) Ahaus, Martina Buljac-Samardzic

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Patient aggression and violence is a complex occupational hazards for physicians working in hospitals, and it can have multiple severe negative effects for physicians and hospitals. Although there is a range of interventions in the healthcare sector applied in various countries, China lacks a comprehensive set of interventions at the hospital level in this area. Therefore, due to cultural differences, this study investigates whether international interventions are important and feasible in the Chinese cultural context by conducting a Delphi study. Based on a literature search, a list of 47 hospital interventions to prevent and manage patient aggression and violence was constructed, including 8 categories: hospital environment design, access and entrance, staffing and work practice, training and education, leadership and culture, support, during/after-the-event actions, and hospital policy. The list of interventions will be refined, extended and brought back during a three-round Delphi study. The panel consists of 17 Chinese experts, including physicians experiencing patient aggression and violence, hospital management team members, scientists working in this research area, and policymakers in the healthcare sector. In each round, experts will receive the possible interventions with the instruction to indicate the importance and feasibility of each intervention for preventing and managing patient violence and aggression in Chinese hospitals. Experts will be asked about the importance and feasibility of interventions for patient violence and aggression at the same time. This study will exclude or include interventions based on the score of importance. More specifically, an intervention will be included after each round if >80% of the experts judged it as important or very important and excluded if >50% judged an intervention as not or moderately important. The three-round Delphi study will provide a list of included interventions and assess which of the 8 categories of interventions are considered as important. It is expected that this study can bring new ideas and inspiration to Chinese hospitals in the prevention and management of patient aggression and violence.

Keywords: patient aggression and violence, hospital interventions, feasibility, importance

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Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

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Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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Authors: Mohammed Gamil Montasser, Angelo Battaglia

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Entrepreneurship is mostly related to the beginning of organization. In growing business organizations, entrepreneurship expands its conceptualization. It reveals itself through new business creation in the active organization, through renewal, change, innovation, creation and development of current organization, through breaking and changing of established rules inside or outside the organization and becomes more flexible, adaptive and competitive, also improving effectiveness of organization activity. Therefore, the topic of entrepreneurship, relates the creation of firms to personal / individual characteristics of the entrepreneurs and their social context. This paper is an empirical study, which aims to address these two gaps in the literature. For this endeavor, we use the latest available data from the Global Entrepreneurship Monitor (GEM) project. This data set is widely regarded as a unique source of information about entrepreneurial activity, as well as the aspirations and attitudes of individuals across a wide number of countries and territories worldwide. This paper tries to contribute to fill this gap, by exploring the key drivers of innovative entrepreneurship in the tourism sector. Our findings are consistent with the existing literature in terms of the individual characteristics of entrepreneurs, but quite surprisingly we find an inverted U-shape relation between human development and innovative entrepreneurship in tourism sector. It has been revealed that tourism entrepreneurs are less likely to have innovative products, compared with entrepreneurs in medium developed countries.

Keywords: GEM, human development, innovative entrepreneurship, occupational choice, tourism

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Authors: Marzena Hajduk-Stelmachowicz

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This paper presents the reasons why the implementation of the organizational eco-innovation (based on requirements of the International Standard ISO 14001) can be an expression of a strategic organization approach. An elaboration about different issues associated with the Environmental Management Systems are given.

Keywords: envionmental management system, ISO 14001, organizational ecoinnovativeness, ecoinnovation

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Authors: Harvard Najoan, Sarwono Sutikno, Yusep Rosmansyah

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Most enterprises are now using information technology services as their assets to support business objectives. These kinds of services are provided by the internal service provider (inside the enterprise) or external service provider (outside enterprise). To deliver quality information technology services, the service provider (which from now on will be called ‘organization’) either internal or external, must have a standard for service management system. At present, the standard that is recognized as best practice for service management system for the organization is international standard ISO/IEC 20000:2011. The most important part of this international standard is the first part or ISO/IEC 20000-1:2011-Service Management System Requirement, because it contains 22 for organization processes as a requirement to be implemented in an organizational environment in order to build, manage and deliver quality service to the customer. Assessing organization management processes is the first step to implementing ISO/IEC 20000:2011 into the organization management processes. This assessment needs Process Assessment Model (PAM) as an assessment instrument. PAM comprises two parts: Process Reference Model (PRM) and Measurement Framework (MF). PRM is built by transforming the 22 process of ISO/IEC 20000-1:2011 and MF is based on ISO/IEC 33020. This assessment instrument was designed to assess the capability of service management process in Divisi Teknologi dan Sistem Informasi (Information Systems and Technology Division) as an internal organization of PT Pos Indonesia. The result of this assessment model can be proposed to improve the capability of service management system.

Keywords: ISO/IEC 20000-1:2011, ISO/IEC 33020:2015, process assessment, process capability, service management system

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Authors: Vineet Agrawal, Deepanjali S., Medha R., Subitha L.

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Background. Hospital malnutrition is a highly prevalent issue and is known to increase the morbidity, mortality, length of hospital stay, and cost of care. In India, studies on hospital malnutrition have been restricted to ICU, post-surgical, and cancer patients. We designed this study to assess the impact of hospital malnutrition on 30-day post-discharge and in-hospital mortality in patients admitted in the general medicine department, irrespective of diagnosis. Methodology. All patients aged above 18 years admitted in the medicine wards, excluding medico-legal cases, were enrolled in the study. Nutritional assessment was done within 72 h of admission, using Subjective Global Assessment (SGA), which classifies patients into three categories: Severely malnourished, Mildly/moderately malnourished, and Normal/well-nourished. Anthropometric measurements like Body Mass Index (BMI), Triceps skin-fold thickness (TSF), and Mid-upper arm circumference (MUAC) were also performed. Patients were followed-up during hospital stay and 30 days after discharge through telephonic interview, and their final diagnosis, comorbidities, and cause of death were noted. Multivariate logistic regression and cox regression model were used to determine if the nutritional status at admission independently impacted mortality at one month. Results. The prevalence of malnourishment by SGA in our study was 67.3% among 395 hospitalized patients, of which 155 patients (39.2%) were moderately malnourished, and 111 (28.1%) were severely malnourished. Of 395 patients, 61 patients (15.4%) expired, of which 30 died in the hospital, and 31 died within 1 month of discharge from hospital. On univariate analysis, malnourished patients had significantly higher morality (24.3% in 111 Cat C patients) than well-nourished patients (10.1% in 129 Cat A patients), with OR 9.17, p-value 0.007. On multivariate logistic regression, age and higher Charlson Comorbidity Index (CCI) were independently associated with mortality. Higher CCI indicates higher burden of comorbidities on admission, and the CCI in the expired patient group (mean=4.38) was significantly higher than that of the alive cohort (mean=2.85). Though malnutrition significantly contributed to higher mortality on univariate analysis, it was not an independent predictor of outcome on multivariate logistic regression. Length of hospitalisation was also longer in the malnourished group (mean= 9.4 d) compared to the well-nourished group (mean= 8.03 d) with a trend towards significance (p=0.061). None of the anthropometric measurements like BMI, MUAC, or TSF showed any association with mortality or length of hospitalisation. Inference. The results of our study highlight the issue of hospital malnutrition in medicine wards and reiterate that malnutrition contributes significantly to patient outcomes. We found that SGA performs better than anthropometric measurements in assessing under-nutrition. We are of the opinion that the heterogeneity of the study population by diagnosis was probably the primary reason why malnutrition by SGA was not found to be an independent risk factor for mortality. Strategies to identify high-risk patients at admission and treat malnutrition in the hospital and post-discharge are needed.

Keywords: hospitalization outcome, length of hospital stay, mortality, malnutrition, subjective global assessment (SGA)

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Authors: Sonny Nyeko, Moses Niwe

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Purpose: This research paper examined the mediation effect of organization culture in the relationship between information technology (IT) competence and IT governance effectiveness in Ugandan public universities. The purpose of the research paper is to examine the role of organizational culture in the relationship between IT competence and IT governance effectiveness. Design/methodology/approach: The paper adopted the MedGraph program, Sobel tests and Kenny and Baron Approach for testing the mediation effects. Findings: It is impeccable that IT competence and organization culture are true drivers of IT governance effectiveness in Ugandan public universities. However, organizational culture reveals partial mediation in the IT competence and IT governance effectiveness relationship. Research limitations/implications: The empirical investigation in this research depends profoundly on public universities. Future research in Ugandan private universities could be undertaken to compare results. Practical implications: To effectively achieve IT governance effectiveness, it means senior management requires IT knowledge which is a vital ingredient of IT competence. Moreover, organizations today ought to adopt cultures that are intended to have them competitive in their businesses, with IT operations not in isolation. Originality/value: Spending thousands of dollars on IT resources in advanced institutes of learning necessitates IT control. Preliminary studies in Ugandan public universities have revealed the ineffective utilization of IT resources. Besides, IT governance issues with IT competence and organization culture remain outstanding. Thus, it’s a new study testing the mediating outcome of organization culture in the association between IT competence and IT governance effectiveness in the Ugandan universities.

Keywords: organization culture, IT competence, IT governance, effectiveness, mediating effect, universities, Uganda

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Authors: Alexandre Bédard, Caroline Coulombe, Jonathan Harvey

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Envisioning process (EP) in medium enterprises is treated equally in very small enterprises. Building on the concept of social construction, this study aims to explore how envisioning is constructed in a medium enterprise in which stakeholders are involved and how it is influenced. We use a unique case method based on qualitative data collected through 11 interviews representing various members of the organization. Through the discussion of the findings, we were able to confirm the social construction of the EP and to identify three main stakeholders responsible for the construction of the vision, mainly political and social powers, actors of the organization, and financial providers. Moreover, EP is influenced by external factors; in this case, the history of the organization and the value and importance of the art and the culture for Cambodians.

Keywords: envisioning process, social constructivism, medium enterprise, legitimacy

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Authors: Faramarz Khosravi, Gokhan Izbirak

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A weighted statistical stochastic based Analytical Hierarchy Process (AHP) model for modeling the potential barriers and enablers of sustainability for measuring and assessing the sustainability level is proposed. For context-dependent potential barriers and enablers, the proposed model takes the basis of the properties of the variables describing the sustainability functions and was developed into a realistic analytical model for the sustainable behavior of an organization. This thus serves as a means for measuring the sustainability of the organization. The main focus of this paper was the application of the AHP tool in a statistically-based model for measuring sustainability. Hence a strong weighted stochastic AHP based procedure was achieved. A case study scenario of a widely reported major Canadian electric utility was adopted to demonstrate the applicability of the developed model and comparatively examined its results with those of an equal-weighted model method. Variations in the sustainability of a company, as fluctuations, were figured out during the time. In the results obtained, sustainability index for successive years changed form 73.12%, 79.02%, 74.31%, 76.65%, 80.49%, 79.81%, 79.83% to more exact values 73.32%, 77.72%, 76.76%, 79.41%, 81.93%, 79.72%, and 80,45% according to priorities of factors that have found by expert views, respectively. By obtaining relatively necessary informative measurement indicators, the model can practically and effectively evaluate the sustainability extent of any organization and also to determine fluctuations in the organization over time.

Keywords: AHP, sustainability fluctuation, environmental indicators, performance measurement

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Authors: Ming Qian, Davis Qian

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This study compares the different organization structures of Chinese and English writing discourses in the engineering and scientific fields, and recommends approaches for translators to convert the organization structures properly. Based on existing intercultural communication literature, English authors tend to deductively give their main points at the beginning, following with detailed explanations or arguments afterwards while the Chinese authors tend to place their main points inductively towards the end. In this study, this hypothesis has been verified by the authors’ Chinese-to-English translation experiences in the fields of science and engineering (e.g. journal papers, conference papers and monographs). The basic methodology used is the comparison of writings by Chinese authors with writings of the same or similar topic written by English authors in terms of organization structures. Translators should be aware of this nuance, so that instead of limiting themselves to translating the contents of an article in its original structure, they can convert the structures to fill the cross-culture gap. This approach can be controversial because if a translator changes the structure organization of a paragraph (e.g. from a 'because-therefore' inductive structure by a Chinese author to a deductive structure in English), this change of sentence order could be questioned by the original authors. For this reason, translators need to properly inform the original authors on the intercultural differences of English and Chinese writing (e.g. inductive structure versus deductive structure), and work with the original authors to maintain accuracy while converting from one structure used in a source language to another structure in the target language. The authors have incorporated these methodologies into their translation practices and work closely with the authors on the inter-cultural organization structure mapping. Translating discourse organization structure should become a standard practice in the translation process.

Keywords: discourse structure, information structure, intercultural communication, translation practice

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Authors: Saurav Dhawan, Sanchit Bansal

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Background T-MACS is a computer-based decision aid that ‘rules in’ and ‘rules out’ ACS using a combination of the presence or absence of six clinical features with only one biomarker measured on arrival: hs-cTnT. T-MACS had 99.3% negative predictive value and 98.7% sensitivity for ACS, ‘ruling out’ ACS in 40% of patients while ‘ruling in’ 5% at the highest risk. We aim at benchmarking the use of T-MACS which could help to conserve healthcare resources, facilitate early discharges, and ensure safe practice. Methodology Randomized retrospective data collection (n=300) was done from ED electronic records across 3 hospital sites within MFT over a period of 2 months. Data was analysed and compared by percentage for the usage of T-MACS, number of admissions/discharges, and in days for length of stay in hospital. Results MRI A&E had the maximum compliance with the use of T-MACS in the trust at 66%, with minimum admissions (44%) and an average length of stay of 1.825 days. NMG A&E had an extremely low compliance rate (8 %), with 75% admission and 3.387 days as the average length of stay. WYT A&E had no TMACS recorded, with a maximum of 79% admissions and the longest average length of stay at 5.07 days. Conclusion All three hospital sites had a RAG rating of ‘RED’ as per the compliance levels. The assurance level was calculated as ‘Very Limited’ across all sites. There was a positive correlation observed between compliance with TMACS and direct discharges from ED, thereby reducing the average length of stay for patients in the hospital.

Keywords: ACS, discharges, ED, T-MACS

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Authors: Julian Donovan, Jessica Brealey, Matthew Bowker, Marianne Feghali, Gregory Smith, Lee Thompson, Deborah Henderson

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This article details the development of the X-ray response team (XRT), a service that utilises innovative technology to safely deliver acute and elective imaging and medical assessment service in the pre-hospital and community setting. This involves a partnership between Northumbria Healthcare NHS Foundation Trust’s Radiology and Emergency Medicine departments and the North East Ambulance Service to create a multidisciplinary prehospital team. The team committed to the delivery of a two-day acute service every week, alongside elective referrals, starting in November 2020. The service was originally made available to a 15-mile radius surrounding the Northumbria Hospital. Due to demand, this was expanded to include the North Tyneside and Northumberland regions. The target population was specified as frail and vulnerable patients, as well as those deemed to benefit from staying in their own environment. Within the first two months, thirty-six percent of patients assessed were able to stay at home due to the provision of off-site imaging. In the future, this service aims to allow patient transfer directly to an appropriate ward or clinic, bypassing the emergency department to improve the patient journey and reduce emergency care pressures.

Keywords: frailty, imaging, pre-hospital, X-ray

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Authors: Ramin Shadani

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This study introduces adaptive performance as a key organizational performance dimension and explores the relationship between the dimensions of a learning organization and adaptive performance. A survey was therefore conducted using the dimensions of the Learning Organization Questionnaire (DLOQ), followed by factor analysis and structural equation modeling in order to investigate the dynamics between learning organization practices and adaptive performance. Results confirm that adaptive performance is indeed one important dimension of organizational performance. The study also shows that perceived knowledge and adaptive performance mediate the positive relationship between the practices of a learning organization with perceived financial performance. We extend existing DLOQ research by demonstrating that adaptive performance, as a nonfinancial organizational learning outcome, has a significant impact on financial performance. Our study also provides additional validation of the measures of DLOQ's performance. Indeed, organizations need to take a glance at how the activities of learning and development can provide better overall improvement in performance, especially in enhancing adaptive capability. The study has provided requisite empirical support that activities of learning and development within organizations allow much-improved intangible performance outcomes, especially through adaptive performance.

Keywords: adaptive performance, continuous learning, financial performance, leadership style, organizational learning, organizational performance

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Authors: Paul Saah, Charles Mbohwa, Nelson Sizwe Madonsela

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Organisations that want to have a competitive edge over their rivals in their industry are becoming more and more aware of the value of staff training and development programs. This conceptual study's primary goal is to determine how staff development and training affect an organization's ability to succeed. A non-empirical methodological approach was chosen because this was a conceptual study, and a thorough literature analysis was conducted to determine the contribution of staff training and development to the performance of a commercial organization. Twenty of the 100 publications about employee training and development that were obtained from Google Scholar and regarded to be more pertinent were examined for this study. The impact of employee training and development in an organization was found and documented during the analyses. According to the study's findings, some of the major advantages of staff development and training include greater productivity, the discovery of employee potential, job satisfaction, the development of skills, less supervision, a decrease in turnover and absenteeism as well as less supervision and reduction of errors and accidents. The findings show that organisations that make significant investments in the training and development of their personnel are more likely to succeed than those who do not.

Keywords: impact, employment, training and development, success, business, organization

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Authors: Zouhour Neji Ben Salem

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Microscopic evacuation focuses on the evacuee behavior and way of search of safety place in an egress situation. In recent years, several models handled microscopic evacuation problem. Among them, we have proposed Artificial Neural Network (ANN) as an alternative to mathematical models that can deal with such problem. In this paper, we present two ANN models: SOM map and Hopfield Network used to predict the evacuee behavior in a disaster situation. These models are tested in a real case, the second floor of Tunisian children hospital evacuation in case of fire. The two models are studied and compared in order to evaluate their performance.

Keywords: artificial neural networks, self-organization map, hopfield network, microscopic evacuation, fire building evacuation

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Authors: Khayrullina Yulia Sergeevna, Tokareva Goulsine Shavkatovna

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The article analyzes the modern major railway hubs as a main part of the Urban Nodal Area (UNA). The term was introduced into the theory of urban planning at the end of the XX century. Tokareva G.S. jointly with Gutnov A.E. investigated the structure-forming elements of the city. UNA is the basic unit, the "cell" of the city structure. Specialization is depending on the position in the frame or the fabric of the city. This is related to feature of its organization. Spatial and functional features of UNA proposed to investigate in this paper. The base object for researching are railway hubs as connective nodes of inner and extern-city communications. Research used a stratified sampling type with the selection of typical objects. Research is being conducted on the 14 railway hubs of the native and foreign experience of the largest cities with a population over 1 million people located in one and close to the Russian climate zones. Features of the organization identified in the complex research of functional and spatial characteristics based on the hypothesis of the existence of dual characteristics of the organization of urban nodes. According to the analysis, there is using the approximation method that enable general conclusions of a representative selection of the entire population of railway hubs and it development’s area. Results of the research show specific ratio of functional and spatial organization of UNA based on railway hubs. Based on it there proposed typology of spaces and urban nodal areas. Identification of spatial diversity and functional organization’s features of the greatest railway hubs and it development’s area gives an indication of the different evolutionary stages of formation approaches. It help to identify new patterns for the complex and effective design as a prediction of the native hub’s development direction.

Keywords: urban nodal area, railway hubs, features of structural, functional organization

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Authors: Y. Y. Babanyara, D. B. Ibrahim, T. Garba

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Proper management of medical waste is a crucial issue for maintaining human health and the environment. The waste generated in the hospitals has the potential for spreading infections and causing diseases. The study is aimed at assessing the medical waste management practices in Nigeria. Three instruments, questionnaire administration, in-depth interview and observation method for data collection were adopted in the study. The results revealed that the hospital does not quantify medical waste. Segregation of medical wastes is not conducted according to definite rules and standards. Wheeled trolleys are used for on-site transportation of waste from the points of production to the temporary storage area. Offsite transportation of the hospital waste is undertaken by a private waste management company. Small pickups are mainly used to transport waste daily to an off-site area for treatment and disposal. The main treatment method used in the final disposal of infectious waste is incineration. Non-infectious waste is disposed off using land disposal method. The study showed that the hospital does not have a policy and plan in place for managing medical waste. The study revealed number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collections and disposal of waste, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting the bags to only one colour for all waste, the absence of a dedicated waste manager, and no committee responsible for monitoring the management of medical waste. Recommendations are given with the aim of improving medical waste management in the hospital.

Keywords: medical waste, treatment, disposal, public health

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Authors: Nida Amin, Fahad Tanveer, Hina Shabbir, Ayesha Saeed, Attiqa Riaz

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The gradual progression of corneal disorder keratoconus significantly impairs eyesight and quality of life, increasing the likelihood of depression. Using the Hospital Anxiety and Depression Scale (HADS) at the AL-Ibrahim Eye Hospital in Karachi, this study aimed to evaluate the occurrence of depression and anxiety symptoms in patients with keratoconus and to suggest better treatment. A descriptive-analytical study was conducted at Al-Ibrahim Eye Hospital Karachi from March to April 2022, and patients diagnosed with symptomatic keratoconus were recruited using a non-probability convenient sampling technique. After obtaining written informed consent from patients, keratoconus severity was assessed using visual acuity and corneal topography. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression (HADS) Scale. The data were analyzed using SPSS version 20.0. Spearman correlation coefficient. Of the 108 participants, 60 (56%) were female and 48 (44%) were male. Using the HADS scale, 44 (40.7%) patients were classified as normal with a HADS score of (0-7), 23 (21.3%) as borderline with a HADS score of (8-10) and 41 (38%) patients were diagnosed with anxiety and depression with a HADS score of (11-21). Depression and anxiety are highly prevalent among patients in advanced stages of the disease.

Keywords: cornea, keratoconus, anxiety, depression, corneal topography, mental health

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Authors: Yonathan Audhitya Suthihono, Ratih Dyah Kusumastuti

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The radiology department in a tertiary referral hospital faces service operation challenges such as huge and various patient arrival, which can increase the probability of patient queuing. During the COVID-19 pandemic, it is mandatory to apply social distancing protocol in the radiology department. A strategy to prevent the accumulation of patients at one spot would be required. The aim of this study is to identify an alternative solution which can reduce the patient’s waiting time in radiology department. Discrete event simulation (DES) is used for this study by constructing several improvement scenarios with Arena simulation software. Statistical analysis is used to test the validity of the base case scenario model and to investigate the performance of the improvement scenarios. The result of this study shows that the selected scenario is able to reduce patient waiting time significantly, which leads to more efficient services in a radiology department, be able to serve patients more effectively, and thus increase patient satisfaction. The result of the simulation can be used by the hospital management to improve the operational performance of the radiology department.

Keywords: discrete event simulation, hospital management patient queuing model, radiology department services

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Authors: Tebeu Pierre Marie

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Introduction: WHO defines community participation as a process in which the local population, take responsibility in planning for their health, participates in the strategy’s development for implementation and accessibility to physical, moral and social well-being. For the purpose of dealing with health, the community participation is made through the organization called health Centre committee leader (HCCL/COSA) for Integrated health Center and District hospital committee leaser (HDCL/COGES) for District Hospital. Little is known about the effective participation of the community in health related activities in Ignié-Ngabé-Mayama health district. Objective: This study aimed at assessing the involvement of community in the health system running at the Ignié-Ngabé-Mayama health district. Methods: This was a qualitative cross-sectional study conducted in the Ignié-Ngabé-Mayama health district from 15 December 2020 to 30 April 2021. The study population consisted of 10 HCCL and one District hospital committee leaser (DHCL). Data were collected using a pretested questionnaire and validated by the investigating team. The variables of interest were; effective existence of HCCL/DHCL, their involvement HCCL/DHCL in health related activities, their financing management, planning of activities and leadership. Results: A total of 11 participants were interviewed, including 10 HCCL and 1 DHCL. The Sex-Ratio was 9/11; with primary level 6/11 and were mostly farmers 6/11. Analyzing the involvement of the HDCL/DHCL in health promotion and preventive activities; this was effective only for two of them (2/11). Analyzing the barriers for their involvement, the leaders reported the lack of financial support by the state, lack NGO support. Additionally, they reported to have been very active when there was Performance Based Founding Project in the District. Conclusion: Only two of the (HDCL/HCCL) out of 11 were really functioning. Reported barriers to their running were: lack of state/NGOs support and ending of PBF Project. There is a need to organize a tripartite forum including stats, NGOs and Community for boosting the community participation in health related activities in Ignié-Ngabé-Mayama health district.

Keywords: health district committee, health Centre committee, community participation, Brazzaville, Congo

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Authors: P. Řehoř, D. Holátová, V. Doležalová

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Paper deals with analysis of strategic management methods in non-profit making organization in the Czech Republic. Strategic management represents an aggregate of methods and approaches that can be applied for managing organizations - in this article the organizations which associate owners and keepers of non-state forest properties. Authors use these methods of strategic management: analysis of stakeholders, SWOT analysis and questionnaire inquiries. The questionnaire was distributed electronically via e-mail. In October 2013 we obtained data from a total of 84 questionnaires. Based on the results the authors recommend the using of confrontation strategy which improves the competitiveness of non-profit making organizations.

Keywords: strategic management, non-profit making organization, strategy analysis, SWOT analysis, strategy, competitiveness

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Authors: Guo Yu, Haoming Ma, Peiru Zhou

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BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, a decrease in the time in the targeted blood glucose range (TIR) may be associated with an increased risk of death for critically ill patients. However, the relationship between the TIR and mortality may be influenced by the presence of diabetes and glycemic variability. METHODS: A total of 998 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The TIR is defined as the percentage of time spent in the target blood glucose range of 3.9–10.0 mmol/L within 24 hours. The relationship between TIR and in-hospital in diabetic and non-diabetic patients was analyzed. The effect of glycemic variability was also analyzed. RESULTS: The binary logistic regression model showed that there was a significant association between the TIR as a continuous variable and the in-hospital death of severely ill non-diabetic patients (OR=0.991, P=0.015). As a classification variable, TIR≥70% was significantly associated with in-hospital death (OR=0.581, P=0.003). Specifically, TIR≥70% was a protective factor for the in-hospital death of severely ill non-diabetic patients. The TIR of severely ill diabetic patients was not significantly associated with in-hospital death; however, glycemic variability was significantly and independently associated with in-hospital death (OR=1.042, P=0.027). Binary logistic regression analysis of comprehensive indices showed that for non-diabetic patients, the C3 index (low TIR & high CV) was a risk factor for increased mortality (OR=1.642, P<0.001). In addition, for diabetic patients, the C3 index was an independent risk factor for death (OR=1.994, P=0.008), and the C4 index (low TIR & low CV) was independently associated with increased survival. CONCLUSIONS: The TIR of non-diabetic patients during ICU hospitalization was associated with in-hospital death even after adjusting for disease severity and glycemic variability. There was no significant association between the TIR and mortality of diabetic patients. However, for both diabetic and non-diabetic critically ill patients, the combined effect of high TIR and low CV was significantly associated with ICU mortality. Diabetic patients seem to have higher blood glucose fluctuations and can tolerate a large TIR range. Both diabetic and non-diabetic critically ill patients should maintain blood glucose levels within the target range to reduce mortality.

Keywords: severe disease, diabetes, blood glucose control, time in targeted blood glucose range, glycemic variability, mortality

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Authors: Sadegh Abedi, Ali Yaghoubi, Hamidreza Mashatzadegan

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This paper proposes an approach to identify key processes required by an organization in the field of knowledge management and aligning them with organizational objectives. For this purpose, first, organization’s most important non-financial objectives which are impacted by knowledge management processes are identified and then, using a quality house, are linked with knowledge management processes which are regarded as technical elements. Using this method, processes that are in need of improvement and more attention are prioritized based on their significance. This means that if a process has more influence on organization’s objectives and is in a dire situation comparing to others, is prioritized for choice and improvement. In this research process dominance is considered to be an influential element in process ranking (in addition to communication matrix). This is the reason for utilizing DEA techniques for prioritizing processes in quality house. Results of implementing the method in Khuzestan steel company represents this method’s capability of identifying key processes that require improvements in organization’s knowledge management system.

Keywords: knowledge management, organizational performance, fuzzy data, envelopment analysis

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Authors: Caroline Correia, Stefani Perna, John Gaughan, Elizabeth Cerceo

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Introduction: The COVID-19 pandemic has brought unprecedented changes to how hospitals function on a daily basis. Increased personal protective equipment (PPE) usage and measures to pre-package, separate, and decontaminate have the potential to increase the waste load. However, limiting non-essential surgeries drastically reduces operating room (OR) waste, and restricting visitation policies to contain outbreaks may help conserve resources. The impact of these policy changes with increased disposable PPE usage on hospital production of waste is unknown. Methods: Waste produced in pounds (lbs) was measured for January through June during both 2019 and 2020 through Stericycle in Cooper University Hospital in Camden, NJ. This timeframe was selected since the pandemic began in January 2020 in the US. The total waste produced during this time was 328,623 lbs in 2019 and 306,454 lbs in 2020. Using Poisson counts (α=.05), less waste was produced in 2020 (p < 0.001). The amount of sharps and regulated medical waste (grossly bloody items) were both significantly decreased as well (p < 0.0001, p=0.0002), and these account for 10-15% of the total waste produced. Discussion: Despite the increased usage of disposable PPE, overall hospital waste was decreased during the pandemic as compared to prior. As surgeries are estimated to be responsible for up to one-half of waste produced by hospitals, it is possible that constraint on elective procedures contributed to the decreased waste in all three categories; estimates of a 35% decrease in surgical volume would be expected to impact waste production. The effects of the pandemic on waste production should continue to be monitored to understand the environmental impact as health systems resume backlogged surgeries at a higher volume.

Keywords: COVID-19, hospital, surgery, waste

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Authors: Pacharaporn Lekyan

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The purpose of this study is to explore the conflict management affecting the workplace and analyze the ability of the prediction of leadership of the headman and the methods to handle the conflict in an organization. The quantitative research and developed the questionnaire in order to collect information from the respondents from 200 samples from leader or manager who worked in frozen food factories in Thailand. The result analysis shows about the problem of the relationship between conflict management factors, leadership, and the confliction in organization. The emotion of the leader in the organization is not the only factor that can affect conflict management but also the emotion of surrounding people which this factor can happen all the time and shows that four out of five factors of interpersonal conflict management have affected on emotion intelligence and also shows that the behaviors of leadership have an influence on conflict management.

Keywords: conflict management, emotional intelligence, leadership, factories' employee

Procedia PDF Downloads 365

Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

Abstract:

Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Karina Peron, Ricardo Ghelman, Monica Taminato, Katia R. Oliveira, Debora C. A. Rodrigues, Juliana R. C. Mumme, Olga K. M. Sunakozaua, Georg Seifert, Vicente O. Filho

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The nurse is the most available health professional for the interventions of support in the integrative approach in hospital environment, therefore a professional group key to changes in the model of care. The central components in the performance of anthroposophic nursing procedures are direct physical contact, promotion of proper rhythm, thermal regulation and the construction of a calm and empathic atmosphere, safe for patients and their caregivers. The procedures of anthroposophic external therapies (AET), basically composed of the application of compresses and the use of natural products, provide an opportunity to intensify the therapeutic results through an innovative, complementary and integrative model in the university hospital. The objective of this work is to report the implementation of a program of nursing techniques (AET) through a partnership between the Pediatric Oncology Sector of the Department of Pediatrics of the Faculty of Medicine of the University of Sao Paulo and Charite University of Berlin, with lecturers from Berlin's Integrative Hospital Havelhöhe and Witten-Herdecke Integrative Hospital, both in Germany. Intensive training activities of the Hospital's nursing staff and a survey on AET needs were developed based on the most prevalent complaints in pediatric oncology patients in the three environments of the Hospital of Pediatric Oncology: Bone Marrow Transplantation Unit, Intensive Care Unit and Division of Internal Patients. We obtained the approval of the clinical protocol of external anthroposophic therapies for nursing care by the Ethics Committee and the Academic Council of the Hospital. With this project, we highlight the key AET needs that will be part of the standard program of pediatric oncology care with appropriate scientific support. The results of the prevalent symptoms were: vomiting, nausea, pain, difficulty in starting sleep, constipation, cold extremities, mood disorder and psychomotor agitation. This project was the pioneer within the Integrative Pediatrics Program, as an innovative concept of Medicine and Integrative Health presented at scientific meetings.

Keywords: integrative health care, integrative nursing, pediatric nursing, pediatric oncology

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Authors: Afolakemi Helen Olaleye, Ogunjobi A. O

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Since coronavirus disease 2019 (COVID-19) was first reported in Nigeria, the virus has spread to virtually all sub-Saharan Africa (SSA) countries. In Nigeria, government agencies came together to create a goal-driven taskforce in improving our response against the virus. As COVID-19 international spread has been curtailed, community spread became rampant locally, leading to many health authorities raising concerns over the scarcity of medical consumables and supplies. Here at Lagos university teaching Hospital (LUTH), we present data analysis of COVID-19 infections offered at our Hospital (LUTH) and the surrounding communities. In addition, the adopted innovative solution to control the spread of infection, methods used in filling shortages of consumables, personal protective equipment (PPE), and use of mobile video technology in patient’s consultation. The management style and strategy adopted has led to a decline in infection rates in our community and among our front line staff. The current COVID -19 crisis has created an opportunity to test and demonstrate our pandemic response and control of infectious disease along with the revealed unknown potential in our community.

Keywords: COVID-19, preparedness, response, Lagos university teaching hospital

Procedia PDF Downloads 144

Authors: Nicolay Worren, Christopher A. Brown

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Axiomatic design (AD) has mainly been applied to support the design of physical products and software solutions. However, it was intended as a general design approach that would also be applicable to the design of social systems, including organizations (i.e., organization design). In this article, we consider how AD may be successfully transferred to the field of organizational design. On the one hand, it provides a much-needed pragmatic approach that can help leaders clarify the link between the purpose and structure of their organizations, identify ineffective organizational structures, and increase the chance of achieving strategic goals. On the other hand, there are four conceptual challenges that may create uncertainty and resistance among scholars and practitioners educated in the social sciences: 1) The exclusive focus in AD on negative interdependencies ('coupling'); 2) No obvious way of representing the need for integration across design parameters (DPs); 3) A lack of principles for handling control processes that seem to require 'deliberate coupling' of FRs; and 4) A lack of principles for handling situations where conflicting FRs (i.e., coupling) might require integration rather than separation. We discuss alternative options for handling these challenges so that scholars and practitioners can make use of AD for organization design.

Keywords: axiomatic design, organization design, social systems, concept definitions

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Authors: Ngozi N. Sydney-Agbor, Chioma N. Ihegboro

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Stress and personality as factors influencing nurses’ aggressive behaviour were investigated. The participants comprised of one hundred and fifty nurses selected through convenience sampling technique from four (4) private hospitals in Imo State, Nigeria; namely: Eastern Summit Specialist Clinics and Maternity, St. David Hospital, New Cross Hospital, and Christian Teaching Hospital. The nurses were all females with ages between 20–35 and a mean age of 25.10 years and a standard deviation of 4.15. The participants were administered with Job Related Tension Scale, Type A Behaviour Scale and Buss- Perry Aggressive Behaviour Scale. Two hypotheses were postulated and tested. Cross- sectional survey and Regression Analysis were adopted as design and statistics respectively. Results showed that as stress increased, nurses aggression also increased. Personality also predicted nurses aggressive behaviour with Type As’ exhibiting higher aggression than Type Bs’.The study recommended that hospital management board should improve the welfare of the nurses and their morale should be boosted by involving them in policy-making concerning their welfare and care of their patients, this will help minimise situations capable of increasing aggressive behaviour. There should also be sensitization on the negative impact of aggressive behaviour to patients especially amongst the personality Type A’s who are more susceptible to aggression.

Keywords: aggressive behaviour, nurses, personality, stress

Procedia PDF Downloads 341