Health promotion as the nexus of public health and clinical care: the case of a district hospital in southern Ghana.

This study explored the extent to which health promotion techniques and activities are incorporated into public health and clinical care at a District Hospital in the Greater Accra Region of Ghana, as well as the challenges that this process faces. Information was obtained at the hospital facility through direct observation, interviews and open-ended questionnaires. Findings showed that the process of incorporating health promotion activities into public health and clinical care at the hospital was underdeveloped. The challenges this process faces based on the research findings include structural challenges, inadequate logistics, increased workload, insufficient human resource capacity, lack of motivation for staff, lack of cooperation, teamwork and consultation, inadequate management and enforcement support, prolonged hospital hours for healthcare workers and patients, and inadequate knowledge of health promotion and training. To address these challenges, suggested measures include promoting teamwork and collaboration among healthcare professionals, training and continuous education, government involvement and enforcement of health promotion integration at the hospital, hospital management involvement, media sensitization and advocacy, provision of financial, material and human resources, motivation and encouragement of the process of health promotion integration, and patient involvement. Further research is also recommended to broaden the scope of this study by involving other health practitioner categories and health promotion stakeholders.

Reconfiguring the health-promoting hospital: the role of chaplaincy in England.

This paper seeks to explore how hospitals can be reconfigured to adopt more 'health-promoting' approaches and values. Specifically, the paper focuses on the role of hospital chaplaincy and argues that spiritual care should be considered alongside other health domains. Using semi-structured interviews, the aim of the paper is to explore the experiences of patients who accepted (n = 10) and declined (n = 10) hospital chaplaincy services. Data were analysed drawing on principles of interpretative phenomenological analysis (IPA). The findings suggested that participants who accessed chaplaincy services reported using the chaplains for pastoral, religious and spiritual care which contributed positively to their sense of well-being. This included religious rituals and supportive conversations. The majority of these participants had existing links with a faith institution. Participants who declined chaplaincy services reported having personal religious or spiritual beliefs. Other reasons cited, included: that the offer was made close to discharge; they had different support mechanisms; they were unaware of what the chaplaincy service offered. Participants identified a number of skills and attributes they associated with chaplains. They perceived them as being religious but available to all, somebody to talk to who was perceived as impartial with a shared knowledge and understanding. The paper concludes by highlighting the important role of chaplaincy as part of a holistic health-promoting hospital. This has implications not only for the design, delivery and promotion of chaplaincy services but also for health promotion more broadly to consider spiritual needs.

Health promoting hospital: A practical strategy to improve patient loyalty in public sector.

Background: The Health-Promoting Hospital (HPH) aims to improve the overall quality of health services for patient, families, and the community as a whole, with assessment and intervention as the essential components. In hospitals, this activity needs to be vigorously developed through interdisciplinary teamwork, shared decision-making process, and by involving patients and families during treatment and through the delivery of an evidence-based health promotion process. Previous studies analyzed some steps to improve patient loyalty through the HPH. However, limited studies were carried out on its use in the public sector. This study, therefore, aims to analyze the impact of HPHs to improve patient loyalty in the public sector. Design and Methods: The simple random sampling method was used to obtain data from 101 respondents in a public hospital, with the cross-sectional design used to gain a better understanding of patient loyalty. Results: The result showed that HPHs influenced patient expectations (P=0.030), which in turn affected perceived value (P=0.014) and satisfaction (P=0.002). In addition, perceived value and satisfaction have effects on patients' loyalty (P=0.001). Conclusion: In conclusion, HPHs have a positive impact on patient loyalty. Therefore, the public sector needs to enhance its services in accordance with the standards and guidelines.

Health promoting hospitals in Iran: A review of the current status, challenges, and future prospects.

Background: Health promoting hospitals (HPHs), in addition to their routine diagnosis and treatment services, concentrate on health enhancement and disease prevention. This study was conducted to systematically review studies conducted in the field of health promoting hospitals (HPH) in Iran to achieve HPH standards. Methods: Electronic search was conducted from October to February 2016 in Persian and English databases. Search was done IranMedex, SID, ISI Web of Knowledge, ScienceDirect, PubMed, and Google Scholar with the following keywords: Health promotion hospital (s), health promoting hospital (s), health promotion hospitals, HPH, and Iran. Based on inclusion and exclusion criteria and the aim of the study, 10 studies were selected to be reviewed. Results: The results showed that HPH standards in studied hospitals were very poor in overall standard and that the standard of management policy had the lowest mean. Studies conducted in the order modeling HPH in Iran showed that factors of patient empowerment and society had the greatest impact and needs assessment had the lowest impact. The results of interventional studies were reviewed in this study and it was found that implementing standards of HPH and educational interventions increase the standard of HPH. Conclusion: The review of the HPH studied indicated that the most important challenge in achieving the standards of health promotion hospitals is Iran's hospital policy, which is more treatment-oriented.

Hospital climate actions and assessment tools: a scoping review protocol.

INTRODUCTION: Health and climate change are inexorably linked through the exacerbation of health risks and the contribution of the health sector to greenhouse gas emissions. Climate action in healthcare settings is critical to reduce risks and impacts of climate change through the smarter use of energy, minimising waste and enhancing disaster preparedness. Globally, hospital climate action is growing; however, the potential for further progress and impacts remains. The literature on this topic lacks synthesis, and this poses challenges for hospital leadership in tracking the impact of climate action. This scoping review will summarise the current knowledge about hospital climate action and existing tools to measure progress in this area. METHODS AND ANALYSIS: This scoping review will be conducted applying the six-stage protocol proposed by Arksey and O'Malley. The study includes literature of how hospitals have addressed climate change (mitigation and adaptation) since the Kyoto Protocol was signed in 1997. All identified studies indexed in Medline, Scopus, Embase and CINAHL will be examined. The search strategy will also include Google Scholar to capture relevant grey literature. Quantitative and thematic analysis will be used to evaluate and categorise the study results. ETHICS AND DISSEMINATION: This scoping review is part of the climate-smart healthcare initiative which will provide a valuable synthesis to aid understanding of hospitals' climate actions, and tools used to measure its implementation. As such it will contribute to mobilising and accelerating the implementation of climate action in hospitals. The findings will be disseminated with all members of the International Health Promoting Hospital and Health Services (HPH) and the Global Green and Healthy Hospital network. Dissemination will occur through peer-reviewed publications; and with the HPH and GGHH members through its annual conference and newsletter.

Hospitals reorientation towards health promotion: A qualitative study of barriers to and strategies for implementation of health promotion in hospitals of Isfahan, Iran.

CONTEXT: The World Health Organization (WHO) has emphasized the need for reorientation of hospitals toward health promotion (HP). AIMS: This study explores health-care professionals' perception of barriers and strategies to implementing HP in educational hospitals of Isfahan Province in Iran. SETTINGS AND DESIGN: The study settings included four selective educational hospitals and the Treatment Administration affiliation to the Isfahan University of Medical Sciences. SUBJECTS AND METHODS: A qualitative content analysis approach was employed in this study, with semi-structured in-depth interviews. Eighteen participants from hospital and accreditation managers, nurses, community medicine specialist, and directors of health-care quality improvement and accreditation participated in the study by purposeful sampling method. The data were analyzed using content analysis method. RESULTS: The barriers can be categorized into the following areas: (1) barriers associated with patient and community, (2) barriers associated with health-care professionals, (3) barriers associated with the organization, and (4) external environment barriers. The results were summarized into four categories as strategies, including: (1) marketing the plan, (2) identifying key people and training, (3) phasing activities and development of feasible goals, and (4) development of strategic goals of health promoting hospitals and supportive policies. CONCLUSIONS: The interactions of individual, organizational, and external environmental factors were identified as barriers to implementation of HP in hospitals. To hospital reorientation toward HP, prioritizing the barriers, and using the proposed strategies may be helpful.

Self-assessment of health promoting Hospital's activities in the largest heart Hospital of Northwest Iran.

BACKGROUND: Health Promoting Hospitals are among the major health promoters of the society. To acquire Health Promoting Hospital (HPH) status, a hospital must self-assess to know their inadequacies and then lay the foundation for improvements. This study has been performed with the aim of assessing readiness of the largest heart hospital of northwestern Iran regarding the HPH standards. METHODS: This cross-sectional study was conducted through the participation of 270 administrative and clinical staff of the largest heart hospital of northwestern Iran. Data were gathered using self-assessment tool for health promoting hospitals including demographics and the HPH standards. HPH standards' dimensions were Management policy, Patient assessment, Patient information and intervention, Promoting a healthy workplace, and Continuity and cooperation. Analysis was performed by SPSS v. 16 with a significance level of 0.05. RESULTS: The participants included clinical (67.4%) and administrative (32.6%) staff. Among the HPH standards, the lowest score belonged to the management policy (1.44 ± 0.53) and the highest one to the patient information and intervention (1.72 ± 0.47). The average score of compliance with the HPH standards was 1.60 ± 0.40 which shows moderate progress of the hospital towards the HPH standards. CONCLUSION: Regarding the moderate situation of the hospital in HPH standards and the low score of the management policy, the studied hospital should enforce the standards, especially in the management policy. Also, there is a need for health promotion programs in all three levels of prevention with the participation of the staff and the patients as much as possible.

[What does "Smoke-free Hospital" mean?] / Co znamená "Nekurácká nemocnice"?

"Smoke-free Hospital" is the name of a gradual and long-term project, with the really smoke-free hospital as the final goal. The project is based on the process itself that leads to such a status. European Network of Smoke-free Hospitals (ENSH, www.ensh.org) provides detailed instructions and recommendations regarding actions to be implemented. The main objective of the network is "to deliver safe quality care in relation to tobacco for every service user, every time and everywhere".Each hospital could identify its own sub-goals and methods of implementation, but it is important to assess the achieved steps regularly. It is advisable to focus attention e.g. to introduction of non-smoking areas, monitoring tobacco use among both patients and staff, providing brief interventions in smoking cessation as well as intensive tobacco dependence treatment, training of staff in intervening, organizing health promoting events both for the staff and the public. Several actions in 2016 connected with ENSH in the Czech Republic and on the international level are listed. The new Czech legislation regarding smoking in hospitals is also mentioned.

Workplace violence against nurses--prevalence and association with hospital organizational characteristics and health-promotion efforts: Cross-sectional study.

PURPOSE/OBJECTIVES: To determine the prevalence of workplace violence and explore the role of hospital organizational characteristics and health promotion efforts in reducing hospital violence among nurses in Taiwan. DESIGN: Cross-sectional survey. SETTING: One hundred hospitals across Taiwan. SAMPLE: The final sample in our study comprised responses from 26,979 nurses. METHODS: The data were obtained from a nationwide hospital survey, Physical and Mental Health and Safety Needs in Full-Time Health Care Staff, which was developed and conducted by the Bureau of Health Promotion, Taiwan, in 2011. MAIN RESEARCH VARIABLES: The main dependent variable was whether nurses had experienced violence within the past year. Physical violence, threatened or intimidated personal safety, verbal violence or sexual harassment were all included. FINDINGS: Of the 26,979 nurses, 13,392 nurses (49.6%) had experienced at least one episode of any type of violence in the past year; 5150 nurses (19.1%) had been exposed to physical violence, and 12,491 nurses (46.3%) had been exposed to non-physical violence. The prevalence of having experienced any violence varied widely and ranged from the highest (55.5%) in an emergency room or intensive care unit to the lowest (28.3%) among those aged 55-65 years. After adjusting for other characteristics, younger nurses were significantly more likely to be exposed to any violent threat. Nurses working in public hospitals had a significantly higher risk of workplace violence than those working in private hospitals. Significant variations were also observed among work units. Although nurses working in a certified health promoting hospital (HPH) did not have a lower risk of workplace violence, those working in an outstanding HPH had a significantly lower risk of workplace violence. A similar pattern was observed for non-physical violence. CONCLUSIONS: Workplace violence is a major challenge to workplace safety for nurses in hospitals. This large scale nurse survey identified individual, work and hospital characteristics associated with workplace violence among hospital nurses. Preventive efforts in reducing hospital violence shall be targeted these high risk groups and settings. IMPLICATIONS FOR NURSING: This nationwide nurse survey assisted us in more clearly understanding the scope of the hospital violence facing nurses and identifying critical risk factors. The findings not only identified the most common locations of violence in hospitals but also suggested that extensive investments and efforts by hospitals in health promotion are crucial.

Health promotion initiatives: An experience of a Well Women's Clinic.

BACKGROUND: Army Medical Corps provides comprehensive health care services to troops and their dependents. This approach is in consonance with the concept of Health Promoting Hospitals (HPH) initiative introduced by WHO in 1986. However, the concept is still at an infancy stage in civil health care system in India. This article describes the experiences and advantages of establishing a Well Women's Clinic (WWC) in a station of North India. METHODS: A system analysis approach was followed for analyzing input, process and output of the WWC during 2007-2009. Inputs included manpower and material i.e public health expert, non medical attendant and a nursing officer charts, poster, models, Television with Compact Disc (CD) player and CDs etc. Health promotion activities were conducted in the form of lectures, demonstrations, workshops, training, screening of movies, quiz, essay writing and declamation contests etc. RESULTS: Overall 385 lectures, 12 competitions, 07 training capsules were conducted. Coverage of target population was 92%. First aid training workshop trained 300 women. Six percent of the counseled women opted for tubectomy. Twelve new cases of diabetes and four new cases of hypertension were detected through screening. Seventy-two women were referred for dental treatment after a dental screening camp. CONCLUSION: Establishment of WWC using HPH approach was quite cost effective.

The development of health-promoting hospitals using the Primary Care Award (PCA) standard in Muang District, Phitsanulok, Thailand

The purposes of this descriptive study were to : (1) determine the level of understanding of hospital personnel using the Primary Care Award (PCA) standard, and (2) determine the progress of implementation of the standard. The instruments used a questionnaire and a semi-structured interview form. The questionnaire was composed of three parts: the demographic data; the opinionaire focused on the implementation of the PCA and the roles of the stakeholders; and the evaluation of progress of implementing the PCA Standards. Respondents were hospital personnel working in each of the twenty four hospitals in Muang district, Phitsanulok province, Thailand. The results of the study revealed that the opinion of the hospital regarding the implementation of the PCA in all dimensions was high, however the actual implementation was at intermediate level. The Ministry of Public Health (MOPH) had high commitment towards the implementation of the PCA, while the provincial health office and the district health office had medium level of commitment. The participation of the local government and the village health volunteers were at the low level.

Development history of and prospects for health promoting hospitals / 中华医院管理杂志

The concept of the health promoting hospital, a modern mode of medical service that has turned from the formerly unitary pattern of medical treatment to the health promoting and life quality improving pattern of medical treatment, prevention and health care, was proposed by modern medical institutions so as to keep up with the change in medical modes and medical socialization. In recent years, many countries in the world have adopted the advanced service ideas of the health promoting hospital and conducted active research on various specific subjects. The paper gives an account of the concept, basic theories, development history, and latest progress both at home and abroad of the health promoting hospital so as to give an impetus to health education and health promotion in China.