Subject(s)
Child Health/history , Hospitals, Convalescent/history , Hospitals, Pediatric/history , Rehabilitation Centers/history , Adolescent , Child , Child, Preschool , History, 20th Century , Hospitals, Convalescent/organization & administration , Hospitals, Pediatric/organization & administration , Humans , Infant , Rehabilitation Centers/organization & administration , VirginiaSubject(s)
Health Facility Environment/standards , Hospitals, Convalescent/organization & administration , Professional-Patient Relations , Quality Assurance, Health Care/organization & administration , California , Hospitals, Convalescent/standards , Humans , Organizational Case Studies , Organizational Culture , Personnel Staffing and Scheduling , Quality Assurance, Health Care/methods , Quality Assurance, Health Care/standardsABSTRACT
BACKGROUND: The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. METHODS: A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). RESULTS: Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. CONCLUSION: QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size - the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals.
Subject(s)
Attitude of Health Personnel , Hospital Administrators/psychology , Hospitals, Convalescent/standards , Management Audit , Nurse Administrators/psychology , Nursing Service, Hospital/standards , Total Quality Management/organization & administration , Chronic Disease/nursing , Disabled Persons , Female , Guidelines as Topic , Hospitals, Convalescent/organization & administration , Humans , Job Satisfaction , Lithuania , Male , Nursing Homes/organization & administration , Nursing Homes/standards , Nursing Service, Hospital/organization & administration , Public Health Administration , Surveys and QuestionnairesABSTRACT
This paper reports on research into admission practices at a sub acute extended care hospital. A system dynamics simulation model of the patient flow from feeder hospitals to the hospital was built to show the impact of the local rules used by the medical registrar. Local rules are behaviours that are local, and often idiosyncratic, adaptations to the local environment. The model showed these adaptations had a significant impact on the acuity of patients being admitted as a result of the separation policies of the feeder hospitals. This patient mix in turn affected the hospital ability to meet its budget.
Subject(s)
Admitting Department, Hospital/organization & administration , Computer Simulation , Hospitals, Convalescent/statistics & numerical data , Patient Admission , Subacute Care/statistics & numerical data , Systems Theory , Community-Institutional Relations , Diagnosis-Related Groups , Hospitals, Convalescent/organization & administration , Humans , Models, Organizational , Patient Discharge , Social Environment , Subacute Care/organization & administration , VictoriaSubject(s)
Hospitals, Convalescent , Aftercare , Hospitals, Convalescent/economics , Hospitals, Convalescent/organization & administration , Hospitals, Convalescent/statistics & numerical data , Hospitals, County/economics , Hospitals, County/organization & administration , Hospitals, County/statistics & numerical data , Patient Discharge , SwedenABSTRACT
Rehab, psychiatric, respiratory, OB/GYN, oncology, in fact MOST specialty hospitals, have seen continued growth during recent times of economic strain on health care providers.
Subject(s)
Hospitals, Special/organization & administration , Income , Investments , Female , Hospitals, Convalescent/organization & administration , Humans , Lung Diseases/therapy , Rehabilitation Centers/organization & administration , United States , Women's Health Services/organization & administrationABSTRACT
This article describes a Geriatric Self-Care Unit in a 92 bed Rehabilitation Convalescent Hospital. Ten beds are set aside for this unit. The overall goal of the Self Care Unit (S.C.U.) is to facilitate the patients' discharge into the community. This pilot project has been in effect for six months with 47 patients having completed the program. Results of the program, its problem areas and progress are outlined.
