Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
1,630
result(s) for
"Large hospitals"
Sort by:
A constellation of vital phenomena : a novel
In a rural village in December 2004 Chechnya, a failed doctor Akhmed harbors the traumatized 8-year-old daughter of a father abducted by Russian forces and treats a series of wounded rebels and refugees while exploring the shared past that binds him to the child.
Book
The situation and influencing factors of outpatient satisfaction in large hospitals: Evidence from Henan province, China
Background
The level of outpatient satisfaction plays a significant role in improving the quality and utilization of healthcare services. Patient satisfaction gives providers insights into various aspects of services including the effectiveness of care and level of empathy. This study aimed to evaluate the level of patient satisfaction in the outpatient department and to explore its influencing factors in large hospitals (accommodating over 1000 beds) of Henan province, China.
Methods
We analyzed data from Henan Large Hospitals Patient Satisfaction Survey conducted in the year 2018 and included 630 outpatients. Structural Equation Model (SEM) was used to explore the relationship among evaluation indicators of outpatient satisfaction levels. We used Dynamic Matter-Element Analysis (DMA) to evaluate the status of outpatient satisfaction. Binary Logistic Regression (BLR) was adopted to estimate the impact of personal characteristics towards outpatient satisfaction.
Results
The overall score for outpatient satisfaction in large hospitals was 66.28±14.73. The mean outpatient satisfaction scores for normal-large, medium-large, and extra-large hospitals were 63.33±12.12, 70.11±16.10, 65.41±14.67, respectively, and were significantly different (
F
= 11.953,
P
< 0.001). Waiting time, doctor-patient communication, professional services, and accessibility for treatment information were shown to have directly positive correlations with outpatient satisfaction (
r
= 0.42, 0.47, 0.55, 0.46, all
P
< 0.05). Results from BLR analysis revealed that patients’ age and frequency of hospital visits were the main characteristics influencing outpatient satisfaction (
P
< 0.05).
Conclusions
The outpatient satisfaction of large hospitals is moderately low. Hospital managers could shorten the waiting time for outpatients and improve the access to treatment information to improve the satisfaction of outpatients. It is also necessary to enhance service provision for outpatients under the age of 18 as well as the first-time patients.
Journal Article
Differences in Traffic Attraction and Mechanisms of Influencing Factors for Two Types of Large Hospitals in China
Large hospitals in China typically face high-density patient flows, highly concentrated medical service demands, and significant impacts on surrounding transportation systems. To explore this issue in depth, this study selected a sample of 135 hospitals from the Beijing–Tianjin–Hebei region and constructed a structural equation model based on multi-source data to empirically analyze the key factors and mechanisms influencing traffic attraction for different types of hospitals. The findings reveal that medical level is the most critical factor affecting hospital traffic attraction, with significant differences in the factor pathways between general hospitals and specialized hospitals. For general hospitals, hospital size remains an important factor, but the influence of traffic attraction has shifted from traditional static indicators such as construction area and number of beds to more dynamic service diversity indicators, such as the number of medical departments. For specialized hospitals, the second most influential factor is traffic accessibility, particularly the availability of parking spaces, which significantly impacts their traffic attraction, reflecting patients’ strong demand for convenient transportation when accessing specialized care. This study highlights the dynamic evolution of traffic attraction factors across different hospital types and provides new insights and theoretical support for optimizing hospital transportation planning and resource allocation.
Journal Article
Developing and Organizing an Analytics Capability for Patient Flow in a General Hospital
Much of the information produced in hospitals is clinical, and stored for the purposes of documentation. In practice, most of it is never used. The potential of analytics is to reuse this information for other purposes. This is easier said than done, because of technical, semantic, legal and organizational hindrances. In particular, hospitals are not organized to leverage the value of big data. In this study we ask, how can we conceptualize analytics as an integrated part of hospital processes? And, how can we develop and organize an analytics capability in a large hospital? Our empirical evidence is a longitudinal study in a high-tech hospital in Norway, where we followed the development of an analytics capability, and assessed the organizational benefits. We offer two findings. First, we show how the analytics process interacts with the hospital logistics processes in a sense- and respond cycle. Second, we demonstrate how analytics capability is built on the institutionalized network of technology, an analytics team and the administrative and clinical decision makers.
Journal Article
Occupational Violence and Staff Safety in Health-Care: A Cross-Sectional Study in a Large Public Hospital
Physical and psychological workplace violence in health-care settings has serious implications for the health of workers, as well as a negative effect on productivity and health-care quality.
A cross-sectional study was conducted from May to July 2018 among physicians and nurses using a convenience sample (n = 213) for the previous 12 months at a tertiary hospital in Dammam, Saudi Arabia. The participants completed a self-administered questionnaire that assessed their personal and professional characteristics, whether they had experienced physical violence (assault) or psychological violence as health-care practitioners, and whether they had reported the incidents.
Among the respondents, 57% had experienced psychological violence, 6% had experienced physical violence, and 37% had experienced both psychological and physical violence in the previous 12 months. Shiftwork and working in the inpatient department were associated with a significant increase in the risk of physical violence. However, these factors showed no difference with regard to psychological violence. Both physical and psychological violence had diverse causes, without any single predominant cause. Similarly, both forms of violence occurred in multiple departments. Many of the incidents were unreported (75% of incidents involving psychological violence and 39% involving physical violence).
Physical and psychological violence against health-care workers (HCWs) in the hospital under study was found to be very common. The results of this study suggest the need to develop and evaluate a violence prevention program to achieve quality health-care services.
Journal Article
Evaluation of Trauma Care Capabilities in Four Countries Using the WHO‐IATSIC Guidelines for Essential Trauma Care
Background We sought to identify affordable and sustainable methods to strengthen trauma care capabilities globally, especially in developing countries, using the Guidelines for Essential Trauma Care. These guidelines were created by the World Health Organization (WHO) and the International Society of Surgery and provide recommendations on elements of trauma care that should be in place at the range of health facilities globally. Methods The guidelines were used as a basis for needs assessments in 4 countries selected to represent the world’s range of geographic and economic conditions: Mexico (middle income; Latin America); Vietnam (low income; east Asia); India (low income; south Asia); and Ghana (low income; Africa). One hundred sites were assessed, including rural clinics (n = 51), small hospitals (n = 34), and large hospitals (n = 15). Site visits utilized direct inspection and interviews with administrative and clinical staff. Results Resources were partly adequate or adequate at most large hospitals, but there were gaps that could be improved, especially in low‐income settings, such as shortages of airway equipment, chest tubes, and trauma‐related medications; and prolonged periods where critical equipment (e.g., X‐ray, laboratory) were unavailable while awaiting repairs. Rural clinics everywhere had difficulties with basic supplies for resuscitation even though some received significant trauma volumes. In all settings, there was a dearth of administrative functions to assure quality trauma care, including trauma registries, trauma‐related quality improvement programs, and regular in‐service training. Conclusions This study identified several low‐cost ways in which to strengthen trauma care globally. It also has demonstrated the usefulness of the Guidelines for Essential Trauma Care in providing an internationally applicable, standardized template by which to assess trauma care capabilities.
Journal Article
Analysis of interception problems in donning and doffing personal protective equipment in a large cabin hospital during the COVID-19 pandemic: a real world study
Although proper donning and doffing of personal protective equipment (PPE) is critical for infection prevention, detailed characterization of problems encountered during these processes in real-world settings during large-scale infectious disease outbreaks remains insufficient. This study aimed to analyze the characteristics and distribution of interception problems in the process of donning and doffing process in a large cabin hospital during the 2022 COVID-19 pandemic in Shanghai. A prospective, real-world study was designed to collect and analyze data on irregularities observed during personal protective equipment (PPE) donning procedures in cabin hospital operations. The proportion of problems encountered during donning PPE was 5.29% (246/4,652), while during doffing PPE, it was 8.44% (382/4,525) (
P
< 0.001). The primary problem during donning PPE was related to problems with protective clothing, followed by problems with respirators. There was no significant difference in problem distribution among different posts (
P
= 0.459). The problems related to protective clothing mainly focused on loose fitting around the head and neck, making them prone to exposure during donning (56.25%, 99/176) and contamination of the inner surface of protective clothing during doffing (46.43%, 91/196). Respirator-related problems included failure of the seal test during donning PPE (61.54%, 24/39) and shifting or loosening of the respirator during PPE doffing (73.68%, 14/19). These findings identify critical gaps in PPE procedures and highlight the need for targeted training to address these issues, thereby reducing the risk of infection among healthcare personnel in mobile cabin hospitals.
Journal Article
Has China’s Healthcare Reform Reduced the Number of Patients in Large General Hospitals?
Many studies have shown that the new round of healthcare reform launched by the Chinese government in 2009 has not effectively solved the problem in which patients more readily choose large general hospitals. We aimed to find out if this situation exists in every department of a large general hospital. This study collected the outpatient data of 24 departments for a large general hospital in Beijing. By calculating the average growth rate of outpatients in each department from 2014 to 2019, and the utilization rate of outpatient appointments in different departments in 2020, we found that the average growth rate of outpatients in 4 departments (16.6%) was negative, and the utilization rate of outpatient appointments in 13 departments (54.16%) was less than 80%. This shows that the number of patients in some departments is declining, and that there is an inefficient use of doctor resources. Obviously, this is inconsistent with people’s current beliefs. Therefore, it is not entirely true that China’s healthcare reform has not reduced the number of patients in large general hospitals. At the same time, the inefficient use of outpatient doctor resources is a phenomenon worthy of attention; if it persists, it will result in significant waste in the healthcare system. We suggest that policy makers and hospital managers in China, and countries similar to China, can attract attention and take measures.
Journal Article
Ratification of IATSIC/WHO’s Guidelines for Essential Trauma Care Assessment in the South American Region
Background
The purpose of the present study was to evaluate the usefulness of the International Association for Trauma Surgery and Intensive Care (IATSIC)/World Health Organization (WHO)’s
Guidelines for Essential Trauma Care
(
EsTC Guidelines
) in providing an internationally applicable and standardized template to assess trauma care capabilities in the South American Region.
Methods
Field assessment was conducted in seven provinces (urban and rural, pop. 2,239,509) and 24 facilities (5 large hospitals (LH); 15 small hospitals (SH); 4 basic hospitals (BH)) in Ecuador using EsTC criteria. A total of 260 individual items in Human Resources (HR– availability, clinical knowledge, skills) and physical resources (PR) were evaluated via inspection, review of local statistics, and administrative and staff interviews. EsTC was evaluated on a scale as follows: 0 (absent); 1(inadequate; < 50%); 2 (partly adequate > 50%); 3 (adequate–100%).
Results
210,045 Emergency Department (ED) visits and 61,365 (29%) ED trauma visits were recorded (incidence rate 2,740/100,000 population). Deficits were noted in prehospital trauma care (inadequate coordination, communication), education and training (ATLS < 30%, TNCC 0%), facility based trauma care (poor physical resources [PR] and human resources [HR]), and quality assurance (1/27 hospitals).
Conclusions
The IATSIC/WHO
EsTC Guidelines
provide a simple and useful template to assess trauma care capability in variable facilities and international settings, and they could serve as a valuable tool for trauma system development. Endorsement of
EsTC Guidelines
by the Panamerican Health Organization and lead trauma societies (the Panamerican Trauma Society) should be considered.
Journal Article
Medication non-adherence and its associated factors among kidney transplant patients in a large teaching hospital in Ethiopia
Background
This study examines medication adherence among kidney transplant patients at St. Paul’s Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, focusing on the level of adherence and associated factors to immunosuppressant medicines.
Methods and materials
A cross-sectional study was conducted on 270 patients from October 2021 to January 2022 using a structured questionnaire analyzed with SPSS version 26. The prevalence of medication adherence was computed, and a binary logistic regression was fitted to estimate the association. Medication adherence level measurement in post-kidney transplant patients was assessed using the Simplified Medication Adherence Questionnaire (SMAQ) and Basel Adherence Assessment Scale in Immunosuppressants (BAASIS). A 95% confidence interval and
p
-value < 0.05 were used for statistical significance.
Results
The study found that 71.5% of kidney transplant patients were male, with a median age of 37 and a mean duration of 3.55 years. Medication adherence in post-kidney transplant patients was 81.9%. Post-transplant duration above 5 years and missing follow-up visits more than two times was associated with a 92.6% and 91.2% in medication non-adherence rate respectively. Additionally, forgetfulness was associated with a 90.6%, non-adherence level compared to drug unavailability and financial reasons.
Conclusion and recommendation
The study indicates that our patients exhibit higher medication adherence than WHO-measured levels, suggesting the need for healthcare providers to strengthen their intervention, especially for those above 5 years post-kidney transplant. The reason for increased adherence could be explained by the health education program about the medication name, dosing, frequency of ingestion and adverse effects of the drug, and effects of non-adherence.
Journal Article