RESUMO
The Curie Institute exclusively cares for cancer patients, who were considered particularly "vulnerable" from the start of the SARS-CoV 2 pandemic. This pandemic, which took the medical world by surprise, suddenly required the Institute's hospital to undergo rapid and multimodal restructuring, while having an impact on everyone to varying degrees. We will examine here how this hospital has coped, with the concern for a new benefit-risk balance, in times of greater medical uncertainty and scarcity of certain resources, for these "vulnerable" patients but also for their relatives and staff. We will highlight by theme the positive aspects and difficulties encountered, and then what could be useful for other hospitals as the pandemic is ongoing.
Assuntos
COVID-19/epidemiologia , Institutos de Câncer/organização & administração , Pandemias , SARS-CoV-2 , Atenção à Saúde/organização & administração , Ética Médica , Família , Guias como Assunto , Recursos em Saúde/provisão & distribuição , Humanos , Administração de Recursos Humanos em Hospitais , Projetos Piloto , Psicoterapia/organização & administração , Consulta Remota , Pesquisa/organização & administração , Medição de Risco/métodos , Teletrabalho , Comunicação por Videoconferência/organização & administraçãoRESUMO
The onset of the COVID-19 pandemic in March 2020 required hospitals to respond quickly and effectively to ensure the availability of healthcare professionals to care for patients. The Ottawa Hospital in Ottawa, ON, used a five-step process to ensure organizational readiness for redeployment of regulated health professionals as and when necessary: (1) define current scopes of practice; (2) obtain discipline-specific input; (3) develop strategies based on literature review and government dictates; (4) identify potential duties; and (5) ensure support for staff. With hospital management support, this plan was readily implemented. Results are discussed in terms of operational outcomes (e.g., number and type of deployments) and staff experience. Outcomes were positive and led to recommendations for improved organizational readiness.
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COVID-19/epidemiologia , Educação Interprofissional , Administração de Recursos Humanos em Hospitais , Planejamento Hospitalar , Humanos , Educação Interprofissional/métodos , Educação Interprofissional/organização & administração , Liderança , Ontário/epidemiologia , Administração de Recursos Humanos em Hospitais/métodos , Recursos Humanos em Hospital/provisão & distribuiçãoRESUMO
ABSTRACT: To describe and advise on management protocols and infection-protection experience of the radiology department in makeshift hospitals in Wuhan during the coronavirus disease 2019 (COVID-19) outbreak.Based on the literature review and the experience in the frontline, we retrospectively reviewed the configuration of the radiology department, human resource, personal protection, examination procedures for patients confirmed with COVID-19 in Wuhan fangcang shelter hospital.From February 11, 2020 to March 10, 2020, 2730 and 510 CT examinations were performed in the Hanjiang shelter hospital and Hanyang Sports School shelter hospital, respectively, including initial examinations and re-examinations. The maximum number of daily CT examinations reached 289. The CT scanned a patient approximately once every 13 mins.Fangcang shelter radiology department could be powerful components of both global and national responses to the COVID-19 pandemic.
Assuntos
COVID-19/epidemiologia , Controle de Infecções/organização & administração , Unidades Móveis de Saúde/organização & administração , Serviço Hospitalar de Radiologia/organização & administração , Adolescente , Adulto , Idoso , China/epidemiologia , Protocolos Clínicos , Surtos de Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Equipamento de Proteção Individual , Administração de Recursos Humanos em Hospitais , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto JovemAssuntos
Internato e Residência/organização & administração , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/organização & administração , Local de Trabalho/normas , Ansiedade/etiologia , Depressão/etiologia , Humanos , Corpo Clínico Hospitalar/psicologia , Saúde Mental , Administração de Recursos Humanos em HospitaisRESUMO
The new coronavirus disease (Covid-19) pandemic in Italy formally started on 21st February 2020, when a 38-years old man was established as the first Italian citizen with Covid-19 in Codogno, Lombardy region. In a few days, the deadly coronavirus swept beyond expectations across the city of Bergamo and its province, claiming thousands of lives and putting the hospital in Treviglio under considerable strain. Since designated Covid-dialysis hospitals to centrally manage infected hemodialysis patients were not set up in the epidemic areas, we arranged to treat all our patients. We describe the multiple strategies we had to implement fast to prevent/control Covid-19 infection and spread resources in our Dialysis Unit during the first surge of the pandemic in one of the worst-hit areas in Italy. The recommendations provided by existing guidelines and colleagues with significant experience in dealing with Covid-19 were combined with the practical judgement of our dialysis clinicians, nurses and nurse's aides.
Assuntos
COVID-19/prevenção & controle , Falência Renal Crônica/terapia , Pandemias , Diálise Renal , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/mortalidade , Feminino , Administração Hospitalar , Humanos , Itália/epidemiologia , Falência Renal Crônica/complicações , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes/organização & administração , Administração de Recursos Humanos em Hospitais/métodos , Guias de Prática Clínica como Assunto , Avaliação de Sintomas/métodos , Triagem/organização & administraçãoRESUMO
BACKGROUND AND OBJECTIVE: During pregnancy, absence from work increases significantly. Job adjustments have been shown to decrease absences; however, studies show only half of pregnant women who need job adjustments receive them. Little is known about the viewpoints of managers and possible challenges in the management of pregnant employees. The aim of this study was to investigate the experiences and considerations of managers in relation to managing pregnant hospital staff members and to describe the experiences of an active management policy for pregnant individuals. METHODS: A qualitative study based on five focus group interviews was conducted at five public hospitals in Zealand, Denmark with participation of 19 hospital managers, from 17 different wards, representing six different medical specialties. The interviews took place from February to May 2019. Thematic analysis was used to analyze the data. RESULTS: Four themes were identified: (1) The everyday management, (2) Managerial dilemmas, (3) Acknowledging the workplace culture, and (4) Dialogue as a means for the working relationship. The managers' experiences revolved around investing a lot of effort into the working relationship with pregnant staff members by adjusting job tasks and work schedules while balancing work tasks between all staff members. The dialogue was considered central in order to identify the needs of the individual staff member. CONCLUSIONS: Overall, management dialogue constituted a central tool in order to identify the needs of the individual staff member. A proactive and open approach increased the chances of a fruitful dialogue. The individual staff member, the influence of the workplace culture, and the everyday management of the workplace all shaped the experiences of the managers. The concept of an active management policy for pregnant individuals was perceived to entail useful elements, but also as replicating what managers already did.
Assuntos
Pessoal Administrativo/psicologia , Administração de Recursos Humanos em Hospitais/métodos , Recursos Humanos em Hospital , Gestantes , Local de Trabalho/organização & administração , Adulto , Atitude do Pessoal de Saúde , Dinamarca , Feminino , Grupos Focais , Hospitais Públicos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Política Organizacional , Admissão e Escalonamento de Pessoal , Gravidez , Pesquisa QualitativaRESUMO
BACKGROUND: Critical care telemedicine (CCT) has long been advocated for enabling access to scarce critical care expertise in geographically-distant areas. Additional advantages of CCT include the potential for reduced variability in treatment and care through clinical decision support enabled by the analysis of large data sets and the use of predictive tools. Evidence points to health systems investing in telemedicine appearing better prepared to respond to sudden increases in demand, such as during pandemics. However, challenges with how new technologies such as CCT are implemented still remain, and must be carefully considered. OBJECTIVES: This synthesis links to and complements another Cochrane Review assessing the effects of interactive telemedicine in healthcare, by examining the implementation of telemedicine specifically in critical care. Our aim was to identify, appraise and synthesise qualitative research evidence on healthcare stakeholders' perceptions and experiences of factors affecting the implementation of CCT, and to identify factors that are more likely to ensure successful implementation of CCT for subsequent consideration and assessment in telemedicine effectiveness reviews. SEARCH METHODS: We searched MEDLINE, Embase, CINAHL, and Web of Science for eligible studies from inception to 14 October 2019; alongside 'grey' and other literature searches. There were no language, date or geographic restrictions. SELECTION CRITERIA: We included studies that used qualitative methods for data collection and analysis. Studies included views from healthcare stakeholders including bedside and CCT hub critical care personnel, as well as administrative, technical, information technology, and managerial staff, and family members. DATA COLLECTION AND ANALYSIS: We extracted data using a predetermined extraction sheet. We used the Critical Appraisal Skills Programme (CASP) qualitative checklist to assess the methodological rigour of individual studies. We followed the Best-fit framework approach using the Consolidated Framework for Implementation Research (CFIR) to inform our data synthesis. We classified additional themes not captured by CFIR under a separate theme. We used the GRADE CERQual approach to assess confidence in the findings. MAIN RESULTS: We found 13 relevant studies. Twelve were from the USA and one was from Canada. Where we judged the North American focus of the studies to be a concern for a finding's relevance, we have reflected this in our assessment of confidence in the finding. The studies explored the views and experiences of bedside and hub critical care personnel; administrative, technical, information technology, and managerial staff; and family members. The intensive care units (ICUs) were from tertiary hospitals in urban and rural areas. We identified several factors that could influence the implementation of CCT. We had high confidence in the following findings: Hospital staff and family members described several advantages of CCT. Bedside and hub staff strongly believed that the main advantage of CCT was having access to experts when bedside physicians were not available. Families also valued having access to critical care experts. In addition, hospital staff described how CCT could support clinical decision-making and mentoring of junior staff. Hospital staff greatly valued the nature and quality of social networks between the bedside and CCT hub teams. Key issues for them were trust, acceptance, teamness, familiarity and effective communication between the two teams. Interactions between some bedside and CCT hub staff were featured with tension, frustration and conflict. Staff on both sides commonly described disrespect of their expertise, resistance and animosity. Hospital staff thought it was important to promote and offer training in the use of CCT before its implementation. This included rehearsing every step in the process, offering staff opportunities to ask questions and disseminating learning resources. Some also complained that experienced staff were taken away from bedside care and re-allocated to the CCT hub team. Hospital staff's attitudes towards, knowledge about and value placed on CCT influenced acceptance of CCT. Staff were positive towards CCT because of its several advantages. But some were concerned that the CCT hub staff were not able to understand the patient's situation through the camera. Some were also concerned about confidentiality of patient data. We also identified other factors that could influence the implementation of CCT, although our confidence in these findings is moderate or low. These factors included the extent to which telemedicine software was adaptable to local needs, and hub staff were aware of local norms; concerns about additional administrative work and cost; patients' and families' desire to stay close to their local community; the type of hospital setting; the extent to which there was support from senior leadership; staff access to information about policies and procedures; individuals' stage of change; staff motivation, competence and values; clear strategies for staff engagement; feedback about progress; and the impact of CCT on staffing levels. AUTHORS' CONCLUSIONS: Our review identified several factors that could influence the acceptance and use of telemedicine in critical care. These include the value that hospital staff and family members place on having access to critical care experts, staff access to sufficient training, and the extent to which healthcare providers at the bedside and the critical care experts supporting them from a distance acknowledge and respect each other's expertise. Further research, especially in contexts other than North America, with different cultures, norms and practices will strengthen the evidence base for the implementation of CCT internationally and our confidence in these findings. Implementation of CCT appears to be growing in importance in the context of global pandemic management, especially in countries with wide geographical dispersion and limited access to critical care expertise. For successful implementation, policymakers and other stakeholders should consider pre-empting and addressing factors that may affect implementation, including strengthening teamness between bedside and hub teams; engaging and supporting frontline staff; training ICU clinicians on the use of CCT prior to its implementation; and ensuring staff have access to information and knowledge about when, why and how to use CCT for maximum benefit.
Assuntos
Cuidados Críticos/organização & administração , Participação dos Interessados , Telemedicina/organização & administração , Canadá , Cuidados Críticos/métodos , Família , Acesso aos Serviços de Saúde , Humanos , Unidades de Terapia Intensiva , Administração de Recursos Humanos em Hospitais , Recursos Humanos em Hospital/educação , Pesquisa Qualitativa , Rede Social , Estados UnidosRESUMO
The coronavirus 2019 (COVID-19) outbreak poses a serious public health risk. To date, the disease has affected almost all countries in the world. The enormous scale of the outbreak and the relative lack of knowledge and information regarding a new virus, as well as the unpredictability of events, make it challenging for leadership teams to respond. This paper shares how we have reconfigured our radiology leadership team into a smaller disease outbreak task force (DOTF) to respond and coordinate all related efforts during this ongoing COVID-19 pandemic. The DOTF format is modelled after the military with domain groups looking at manpower, intelligence, operations, and logistics matters on a daily basis so that timely decisions can be made and action plans executed promptly. In managing the DOTF, discipline, flexibility, and teamwork are key principles, and these are built upon a strong foundation of focus on infection prevention and control, and patient and staff safety as well as staff well-being. The DOTF has positioned us well to confront the many challenges to date. We believe it will also help us navigate the complex issues that will arise with future surges in cases and in formulating strategies to manage exit from the present and future lockdowns. KEY POINTS: ⢠In a pandemic, regular and directed meetings by a smaller leadership core group are required, for prompt decision making and execution of action plans. ⢠The military format, with domain groups to look at manpower, intelligence, operations, and logistics matters, is useful in managing a pandemic. ⢠Discipline, flexibility, and teamwork with strong focus on infection prevention and control, and patient and staff safety as well as staff well-being are key principles for leadership teams managing a pandemic.
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COVID-19/terapia , Controle de Infecções , Liderança , Serviço Hospitalar de Radiologia/organização & administração , Centros de Atenção Terciária/organização & administração , COVID-19/diagnóstico por imagem , COVID-19/transmissão , Tomada de Decisão Clínica , Infecção Hospitalar/prevenção & controle , Humanos , Pandemias , Administração de Recursos Humanos em Hospitais , SARS-CoV-2 , Singapura/epidemiologiaRESUMO
Approximately 4% of patients with coronavirus disease 2019 (COVID-19) will require admission to an intensive care unit (ICU). Governments have cancelled elective procedures, ordered new ventilators and built new hospitals to meet this unprecedented challenge. However, intensive care ultimately relies on human resources. To enhance surge capacity, many junior doctors have been redeployed to ICU despite a relative lack of training and experience. The COVID-19 pandemic poses additional challenges to new ICU recruits, from the practicalities of using personal protective equipment to higher risks of burnout and moral injury. In this article, we describe lessons for junior doctors responsible for managing patients who are critically ill with COVID-19 based on our experiences at an urban teaching hospital.
Assuntos
COVID-19/terapia , Competência Clínica , Comunicação , Cuidados Críticos , Relações Interprofissionais , Corpo Clínico Hospitalar , Relações Profissional-Família , Esgotamento Profissional/prevenção & controle , Hospitais de Ensino , Hospitais Urbanos , Humanos , Controle de Infecções , Unidades de Terapia Intensiva , Equipe de Assistência ao Paciente , Equipamento de Proteção Individual , Administração de Recursos Humanos em Hospitais , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos , Capacidade de Resposta ante Emergências , Reino UnidoRESUMO
The COVID-19 pandemic has had significant ramifications for provider well-being. During these unprecedented and challenging times, one institution's Department of Surgery put in place several important initiatives for promoting the well-being of trainees as they were redeployed to provide care to COVID-19 patients. In this article, the authors describe these initiatives, which fall into 3 broad categories: redeploying faculty and trainees, ensuring provider safety, and promoting trainee wellness. The redeployment initiatives are the following: reframing the team mindset, creating a culture of grace and forgiveness, establishing a multidisciplinary wellness committee, promoting centralized leadership, providing clear communication, coordinating between departments and programs, implementing phased restructuring of the department's services, establishing scheduling flexibility and redundancy, adhering to training regulations, designating a trainee ombudsperson, assessing physical health risks for high-risk individuals, and planning for structured deimplementation. Initiatives specific to promoting provider safety are appointing a trainee safety advocate, guaranteeing personal protective equipment and relevant information about these materials, providing guidance regarding safe practices at home, and offering alternative housing options when necessary. Finally, the initiatives put in place to directly promote trainee wellness are establishing an environment of psychological safety, providing mental health resources, maintaining the educational missions, solidifying a sense of community by showing appreciation, being attentive to childcare, and using social media to promote community morale. The initiatives to carry out the department's strategy presented in this article, which were well received by both faculty and trainee members of the authors' community, may be employed in other departments and even outside the context of COVID-19. The authors hope that colleagues at other institutions and departments, independent of specialty, will find the initiatives described here helpful during, and perhaps after, the pandemic as they develop their own institution-specific strategies to promote trainee wellness.
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COVID-19/epidemiologia , Internato e Residência , Estresse Ocupacional/prevenção & controle , Pandemias , Administração de Recursos Humanos em Hospitais , Centro Cirúrgico Hospitalar/organização & administração , COVID-19/transmissão , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Liderança , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , SARS-CoV-2 , Apoio SocialAssuntos
COVID-19/epidemiologia , Unidade Hospitalar de Ginecologia e Obstetrícia/organização & administração , Administração de Recursos Humanos em Hospitais/métodos , Recursos Humanos em Hospital/provisão & distribuição , Médicos/provisão & distribuição , SARS-CoV-2 , COVID-19/diagnóstico , COVID-19/prevenção & controle , Teste para COVID-19 , Feminino , Humanos , Cidade de Nova Iorque/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/virologiaAssuntos
Antecipação Psicológica , Betacoronavirus , Infecções por Coronavirus/terapia , Medicina Hospitalar/métodos , Administração de Recursos Humanos em Hospitais/métodos , Pneumonia Viral/terapia , COVID-19 , Infecções por Coronavirus/diagnóstico , Medicina Hospitalar/tendências , Humanos , Pandemias , Administração de Recursos Humanos em Hospitais/tendências , Pneumonia Viral/diagnóstico , SARS-CoV-2 , Fatores de TempoRESUMO
The recent outbreak of coronavirus in Wuhan, China, has imposed challenges on the Chinese medical system. Not only the dramatically increasing number of infected cases and insufficient medical resources, but also the peoples' panic throughout the whole country have made medical services extremely difficult. To respond to these challenges effectively, our hospital implemented an urgent response strategy, including human resources and medical resources preparation and re-allocation, immediate fever screening, strict patient-visiting flow management, and reasonable information communication. Our experience and response measures could provide a reference for other hospitals in the current situation.
Assuntos
COVID-19/epidemiologia , Alocação de Recursos para a Atenção à Saúde/organização & administração , Controle de Infecções/organização & administração , Centros de Atenção Terciária/organização & administração , China/epidemiologia , Epidemias , Equipamentos e Provisões/provisão & distribuição , Humanos , Administração de Recursos Humanos em Hospitais , SARS-CoV-2 , Triagem/organização & administração , Fluxo de TrabalhoRESUMO
BACKGROUND: This study compares perspectives on specialized ophthalmic medical institutions, identifies the gaps in property and geographic offerings, and explores the ways that ophthalmic medical institutions can better allocate resources. The results of this research will increase patient's access to equitable and high-quality ophthalmic care in China. METHODS: The data for this research was gathered from the Survey of China National Eye Care Capacity and Resource for the year 2015. The paper specified the number, professional level of expertise, and educational background of ophthalmic health personnel. The authors of the paper analyzed and compared the differences in ophthalmic care in public vs. private and urban vs. rural regions in China. Descriptive statistics were used. RESULTS: Of the 395 specialized ophthalmic hospitals surveyed, 332 were private medical institutions (84%), and 63 were public (16%). Of the 26 607 ophthalmic personnel surveyed, working in specialized ophthalmic hospitals, 17 561 were in private hospitals (66%) and 9 046 were in public ones (34%). Furthermore, 22 578 of those personnel worked in urban ophthalmic institutions (85%) and 4 029 worked in rural ones (15%). As for regional differences, 14 090 personnel were located in eastern China (53%), 8 828 in central regions (33%), and 3 689 in the western regions (14%). CONCLUSIONS: Public ophthalmic medical institutions still face challenges in providing equitable and widespread care. The availability of well-staffed health centers varies significantly by region. These variations impact resource allocation and directly lead to inequalities and inaccessibility of health services in certain regions of China.
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Pessoal de Saúde/organização & administração , Hospitais Especializados/organização & administração , Hospitais Especializados/estatística & dados numéricos , Oftalmologia/organização & administração , Oftalmologia/estatística & dados numéricos , Pessoal Técnico de Saúde/organização & administração , Pessoal Técnico de Saúde/estatística & dados numéricos , China , Alocação de Recursos para a Atenção à Saúde/organização & administração , Pessoal de Saúde/estatística & dados numéricos , Humanos , Administração de Recursos Humanos em Hospitais/métodos , Administração de Recursos Humanos em Hospitais/estatística & dados numéricos , Setor Privado/organização & administração , Setor Privado/estatística & dados numéricos , Setor Público/organização & administração , Setor Público/estatística & dados numéricos , Serviços de Saúde Rural/organização & administração , Serviços de Saúde Rural/estatística & dados numéricos , Fatores Socioeconômicos , Serviços Urbanos de Saúde/organização & administração , Serviços Urbanos de Saúde/estatística & dados numéricos , Recursos Humanos/organização & administração , Recursos Humanos/estatística & dados numéricosRESUMO
INTRODUCTION: There is a reduction in Foundation trainee applications to speciality training and this is attributed to an administrative job role, with subsequent fears of burnout. This pilot study presents the findings of a real-time self-reporting tool to map a group of Foundation doctors' elective activities. Self-reporting is efficient, low cost to run and allows for repeated measures and scalability. It aimed to example how a time-map could be used by departments to address any work imbalances and improve both well-being and future workforce planning. METHOD: Foundation doctors', at a busy District General Hospital, were asked to contemporaneously report their work activities over an 'elective' day. Outcomes measures included the mean duration per task and the time of day these were performed. RESULTS: Nine Foundation doctors' returned 26 timesheet days. Foundation doctors' time was split between direct patient tasks (18.2%, 106.8 min per day), indirect patient tasks (72.9%, 428.6 min per day) and personal or non-patient activities. Indirect tasks were the most frequent reason for Foundation doctors leaving late. No clinical experience was recorded at all and only an average of 4% (23.4 min per day) of a Foundation doctors' time was spent in theatre. CONCLUSIONS: This particular cohort performed a high proportion of indirect tasks. These have been associated with burnout. Time-mapping is a low-cost, acceptable and seemingly scalable way to elucidate a clearer understanding of the type of activities Foundation doctors may perform. This methodology could be used to modernise the traditional Foundation doctor job description.
Assuntos
Esgotamento Profissional , Corpo Clínico Hospitalar , Assistência ao Paciente , Centro Cirúrgico Hospitalar/organização & administração , Ensino , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Feminino , Relações Hospital-Médico , Hospitais Gerais/organização & administração , Humanos , Masculino , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/organização & administração , Corpo Clínico Hospitalar/psicologia , Avaliação de Resultados em Cuidados de Saúde , Assistência ao Paciente/métodos , Assistência ao Paciente/estatística & dados numéricos , Administração de Recursos Humanos em Hospitais/métodos , Admissão e Escalonamento de Pessoal , Projetos Piloto , Autorrelato , Análise e Desempenho de Tarefas , Ensino/organização & administração , Ensino/normas , Reino Unido , Carga de TrabalhoRESUMO
INTRODUCTION: The role of a foundation year 1 (FY1) doctor has evolved over the years. Many doctors report significant anxiety and stress during this period. In this Quality Improvement Project, we looked at the difficulties FY1s face in their working day and if these issues could be resolved by implementing some structural changes. METHODS: The project was conducted in three cycles, each lasting 5 days (Monday to Friday), over three consecutive weeks. Week 1 consisted of shadowing of Surgical FY1s on wards observing daily routine (arrival, lunch and departure time), communication and handovers. Following this a number of interventions were made to the structure of their daily practice to improve productivity and performance. These improvements were measured in week 2 (as the new model was scaffolded into place) and week 3 (strictly observed). RESULTS: There was no significant difference in number of tasks between week 1, 2 and 3. In week 1, there was no set times for lunch, all of the FY1s lunches were interrupted, there was no structure for handovers and 100% of FY1s stayed at work beyond there contracted hours. In week 2 and 3 there was significant improvement in the number of uninterrupted lunches, amount of time spent beyond contracted hours, number and quality of handovers. The qualitative results collected also suggested positive impact on the working lives of those involved. CONCLUSION: The implementation of structural changes improved the quality of FY1s working day and increased the efficiency of service delivered on the surgical ward.
Assuntos
Esgotamento Profissional , Atenção à Saúde/normas , Corpo Clínico Hospitalar , Assistência ao Paciente , Centro Cirúrgico Hospitalar/organização & administração , Ensino , Adulto , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/organização & administração , Corpo Clínico Hospitalar/psicologia , Assistência ao Paciente/métodos , Assistência ao Paciente/normas , Administração de Recursos Humanos em Hospitais/métodos , Administração de Recursos Humanos em Hospitais/normas , Melhoria de Qualidade , Autorrelato , Análise e Desempenho de Tarefas , Ensino/organização & administração , Ensino/normas , Reino UnidoRESUMO
BACKGROUND: Time management practice can facilitate productivity and success, contributing to work effectiveness, maintaining balance and job satisfaction. Thus, this study aimed to assess time management practices and associated factors among employees of primary hospitals in north Gondar. METHODS: An Institutional based cross-sectional study among primary hospital employees in north Gondar was conducted from March to April 2018. A structured and pre-tested questionnaire was used to collect the data. Simple random sampling technique was utilized to select 422 employees. Bivariate and multivariate logistic regression model were done to identify factors associated with time management practice. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was ascertained to show the strength and direction of association. RESULT: In this study, the prevalence of time management practice was 56.4% (95%CI: 49.3, 61.7). Being satisfied with organizational policies (AOR = 2.16; 95%CI: 1.02-4.68), performance appraisals (AOR: 2.11; 95%CI: 1.32-4.66), compensation and benefits (AOR: 4.18; 95%CI: 2.18-7.99), and planning (AOR: 2.86; 95% CI: 1.42-5.75) were statistically significant factors associated with time management practice. CONCLUSION AND RECOMMENDATION: The overall time management practice among the primary hospital employees was low. Planning, organizational policy, compensation and benefit, performance appraisal, and residence were factors significantly associated with hospital employee's time management practice. Thus managers and employees need to carry out interventions on significant factors to improve the employees' time management practice.
Assuntos
Hospitais , Administração de Recursos Humanos em Hospitais/métodos , Recursos Humanos em Hospital/psicologia , Atenção Primária à Saúde , Gerenciamento do Tempo/organização & administração , Estudos Transversais , Eficiência , Etiópia , Satisfação no Emprego , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Emergency exit and escape routes in public buildings, such as schools, hospitals and administrative offices are controlled by legal rules and regulations. Thereby escape from the building is very well organized in cases of internal threats (e.g. fire, active shooter and hostage situations). Complex buildings with numerous rooms are a special challenge to emergency and law enforcement personnel. Without additional means of orientation a targeted localization of the incident is not possible in many cases. MATERIAL AND METHODS: An extended literature search for guidance and building orientation systems, which enable an intuitive orientation and guidance for emergency personnel was performed. RESULTS: Only three German systems were identified that enable orientation and reliable guidance of emergency personnel within buildings. All three systems, i.e. uniform orientation system schools (EOS), color guidance system (FLS) and the Gütersloh model (GM) were derived from shooting incidents in schools in 2009. Based on a systematic labeling of all rooms, stairways, exits and entrances, ad hoc orientation and guidance of law enforcement and emergency personnel is possible. CONCLUSION: For targeted localization of an internal incident there only seem to be three German systems worldwide that enable an intuitive and immediate orientation and guidance within buildings. An increasing threat of worldwide terrorism and the fact that hospitals are seen as crucial infrastructures for attacks by terrorists make the implementation of guidance and orientation systems in hospitals urgently necessary. This is the first review dealing with this topic.
Assuntos
Capacitação em Serviço/métodos , Aplicação da Lei/métodos , Administração de Recursos Humanos em Hospitais/métodos , Recursos Humanos em Hospital/educação , Violência no Trabalho/prevenção & controle , Planejamento em Desastres/métodos , Emergências , Humanos , Terrorismo/prevenção & controleRESUMO
Patient-care data from the electronic health record systems are increasingly in demand for re-use in administration and resource planning. Nursing documentation with coded concepts is expected to produce more reliable data, fulfilling better requirements for re-use. The aim was to ascertain what kind of relation exist between coded nursing diagnoses, nursing interventions, and nursing intensity and to discuss the possibilities for re-using nursing data for workload design. We analysed the retrospective nursing records of 794 patients documented by the Finnish Care Classification and nursing intensity data assessed by the Oulu Patient Classification over a 15-day period in nine inpatient units at a university hospital. Using the generalised linear mixed model, the clear relationship between the number of coded nursing notes and nursing intensity levels were ascertained. The number of coded nursing notes increases when the nursing intensity increases. The outcomes construct a good basis for continuing elaboration of electronic health record data re-use.
Assuntos
Registros de Enfermagem , Administração de Recursos Humanos em Hospitais , Carga de Trabalho , Interpretação Estatística de Dados , Registros Eletrônicos de Saúde , Finlândia , Humanos , Registros de Enfermagem/estatística & dados numéricos , Administração de Recursos Humanos em Hospitais/métodos , Estudos Retrospectivos , Carga de Trabalho/estatística & dados numéricosRESUMO
OBJECTIVE: To assess the relationship between labor quality of life (LQL) and organizational workers performance (OWP) from seven public hospitals, analyzing the influence of the personnel management (PM) as mediator of this relationship. MATERIALS AND METHODS: A cross-sectional study was conducted in 866 professionals and managers of public hospitals from Tlaxcala and Mexico City. The LQL was assessed with a validated questionnaire, OWP with 34 indicators, and PM with an instrument designed for this study. RESULTS: Mean scores of LQL, were significantly lower among workers from Tlaxcala. Participants who perceived an adequate PM, they increased at 2.7 times their likelihood of having highest LQL, and participants categorized in the high LQL presented 69% higher likelihood of having an adequate OWP. CONCLUSIONS: The appropriate PM was associated with greater LQL, showing to be a mediator variable between the positive relationship of CVL and the OWP.
OBJETIVO: Evaluar la relación entre calidad de vida laboral (CVL) y el desempeño organizacional (DO) de trabajadores de siete hospitales públicos, a partir del análisis de la influencia de la gestión directiva (GD) como mediadora de esta relación. MATERIAL Y MÉTODOS: Se realizó un estudio transversal en 866 profesionales y directivos de hospitales públicos de Tlaxcala y de la Ciudad de México. La CVL fue medida con un instrumento validado, el DO con 34 indicadores y la GD con un instrumento diseñado para este estudio. RESULTADOS: Los puntajes de gestión directiva, CVL, DO y GD fueron sig- nificativamente menores en los trabajadores de Tlaxcala. Los participantes que percibieron adecuada GD incrementaron 2.7 veces más la probabilidad de percibir elevada CVL y los participantes categorizados en elevada CVL presentaron 69% mayor probabilidad de tener adecuado DO. CONCLUSIONES: La adecuada GD se asoció con una mejor CVL, lo que mostró ser una variable mediadora de la relación positiva entre CVL y DO.