Improving Service Quality in Long-term Care Hospitals: National Evaluation on Long-term Care Hospitals and Employees Perception of Quality Dimensions

ObjectivesTo investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals.MethodsData collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents’ and organizational characteristics.ResultsThe most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality.ConclusionThe findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employee-perceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in long-term care hospitals and designing more comprehensive national evaluation criteria.     

Remember that patient you saw last week?

Patient outcome feedback has been defined as ‘the natural process of finding out what happens to one's patients after their evaluation and treatment (in the ED)’. It seems likely that emergency medicine trainees and Fellows will improve their diagnostic accuracy if they increase the frequency with which they find out what happens to their patients. Not only does this allow testing of their own diagnosis with the final diagnosis, but also allows meaningful feedback on therapies commenced in the ED. We believe that seeking outcome feedback should be more actively encouraged by the ACEM training programme.     

The implementation of a global fund grant in Lesotho: applying a framework on knowledge absorptive capacity

One of the biggest challenges in scaling up health interventions in sub-Saharan Africa for government recipients is to effectively manage the rapid influx of aid from different donors, each with its own requirements and conditions. However, there is little empirical evidence on how governments absorb knowledge from new donors in order to satisfy their requirements. This case study applies Cuellar and Gallivan's (2006) framework on knowledge absorptive capacity (AC) to illustrate how recipient government organisations in Lesotho identified, assimilated and utilised knowledge on how to meet the disbursement and reporting requirements of Lesotho's Round 5 grant from the Global Fund to Fight AIDS, TB and Malaria (Global Fund). In-depth topic guided interviews with 22 respondents and document reviews were conducted between July 2008 and February 2009. Analysis focused on six organisational determinants that affect an organisation's absorptive capacity: prior-related knowledge, combinative capabilities, motivation, organisational structure, cultural match, and communication channels. Absorptive capacity was mostly evident at the level of the Principal Recipient, the Ministry of Finance, who established a new organisational unit to meet the requirements of Global Fund Grants, while the level of AC was less advanced among the Ministry of Health (Sub-Recipient) and district level implementers. Recipient organisations can increase their absorptive capacity, not only through prior knowledge of donor requirements, but also by deliberately changing their organisational form and through combinative capabilities. The study also revealed how vulnerable African governments are to loss of staff capacity. The application of organisational theory to analyse the interactions of donor agencies with public and non-public country stakeholders illustrates the complexity of the environment that aid recipient governments have to manage.     

The effect of extremely preterm birth on attachment organization in late adolescence

Background Prior studies have examined the impact of preterm birth on the quality of the attachment relationship to the mother in infancy, but few have examined extremely preterm born infants and almost no data have been reported on prematurity and its impact on the attachment organization attained after childhood. Methods Thirty‐nine adolescents born extremely preterm and 39 full‐term born control participants were assessed with the Adult Attachment Interview. Results The prematurely born showed lower scores regarding measures of attachment security and, in particular, a higher proportion of insecure dismissive patterns. This difference seemed to be clear and persistent even when controlled for intelligence and socio‐economic variables. Conclusions Because insecure attachment as well as prematurity may be considered as significant risk factors for developing psychopathology, they deserve careful attention in future research and clinical follow‐ups.     

张浦镇企业食堂2011年推行食品安全承诺备案管理模式绩效评价

目的应用层次分析法综合分析评价张浦镇食品安全承诺备案管理模式绩效。方法将食堂卫生状况诸因素先按支配关系分组,使之成为有序的递阶层次结构,通过两两比较,确定层次诸因素相对重要性,然后综合判断,确定推行承诺备案管理模式后卫生状况是否优于推行前和同期未推行的。结果推行承诺备案管理模式后除场所面积、布局流程两项指标外,其它如专间卫生、三防设施、生熟分开等各项指标合格率均成上升趋势,经层次分析法分析,企业食堂食品卫生状况综合指数V:V已推行(推行后)>V未推行,V推行后>V推行前。结论层次分析法有较大的应用潜力,在进一步推广承诺备案管理模式的同时,仍须全面推行企业食堂食品卫生量化分级管理,促使企业食堂加大硬件设施改造的投入,使场所面积职工用餐人数比、功能区合理布局等硬件设施指标符合国家规定的卫生要求。     

完壁式乳突根治并鼓室成形术治疗慢性化脓性中耳炎的疗效分析

目的探讨完壁式乳突根治并鼓室成形术在治疗慢性化脓性中耳炎的疗效。方法选择2010年1月至2013年6月耳鼻喉科住院手术治疗的慢性化脓性中耳炎患者100例,根据数字列表法随机分为观察组和对照组各50例,观察组采用完壁式乳突根治并鼓室成形术治疗,对照组采用常规手术治疗,比较两种手术方法的治疗有效率、听力改善情况、并发症及平均住院时间。结果①观察组治疗有效率为92.0%,对照组为74.0%,两组比较差异有统计学意义(P0.05),观察组疗效明显;②两组患者术后听力均有改善,以观察组改善明显,与对照组术后听力比较差异有统计学意义(P0.05);③观察组患者平均住院时间低于对照组,比较差异有统计学意义(P0.05)。结论完壁式乳突根治并鼓室成形术治疗慢性化脓性中耳炎疗效显著,听力改善明显,安全性高,平均住院短。     

心电监护仪报警设置的调查与对策

目的了解病房护士使用心电监护仪时报警设置情况。方法采用现况调查法抽查全院14个临床科室使用中的监护仪报警设置情况。结果使用中的心电监护仪报警设置合格率为18.2%~77.8%,ICU合格率最高,存在报警关闭、报警未设置、报警设置不合理等问题。结论病房护士对心电监护报警设置思想上不够重视,必须加强思想教育,重视培训,以提高护士对心电监护仪报警设置的合格率。     

澳大利亚循证卫生保健中心身体约束标准介绍

本文对2013年7月澳大利亚循证卫生保健中心（JBI）在其网站公布的身体约束标准中对身体约束的定义、护士的责任、实施身体约束的原则及管理、身体约束的原因、减少身体约束的措施及对老年人的约束7个方面进行了介绍,以期为我国身体约束的使用提供参考。     

葡萄糖氧化酶双试剂终点法测量模式的系统分析

目的通过系统地评价葡萄糖氧化酶双试剂终点法不同参数设置,寻求终点法最佳参数设置模式。方法比较葡萄糖氧化酶终点法5种模式对4个不同浓度样品的分析结果,评价不同参数限制所起作用的实际表现。结果终点法5种模式中模式1（有效的线性和吸光度限制）能够对不同浓度样品进行准确地分析测量,并能对高值标本的底物耗尽现象进行有效地识别判断,其余4种模式均存在一些缺陷。结论葡萄糖氧化酶双试剂终点法在岛津CL-8000全自动生化分析仪上应用时要重视参数模式的正确选择和运用,尤其是终点吸光度A值的最高检测限额要设置在1300~1400mAbs,线性范围设置在24.5mmol/L左右,才能与实际情况相符。