Asia-Pacific Journal of Health Management (ACHSM)
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Vision Care as A Strategy to Prevent Falls Among People with Moderate or Severe Intellectual Disability in the Hostel Setting in Hong Kong: - SHAPE Health Conference In Hong Kong 8-9 July 2024
No full textBackground: Factors contributing to the higher fall risk among people with intellectual disabilities (PIDs) are complex due to their discrete patterns of multimorbidity. Visual impairment, such as cataract, was common at old age and could be a crucial risk factor. Given the insufficient evidence regarding this relationship, the present study aimed at investigating this issue in a hostel setting in Hong Kong.
Methods: This study was conducted in four hostels which served people with moderate to severe intellectual disability. Health data of residents collected in the year of 2022-23 was utilized for the current analysis. Data included fall risk, assessed by Morse Fall Scale, as well as other health conditions (osteoporosis, osteoarthritis, cataract) and demographics (age and gender) among residents.
Results: The sample consisted of 199 residents (85 were males and 114 females), with an age range of 22 to 76 years. Around 40% (85; 42.7%) of them aged above 45 years old. Among the whole sample, cataract was the most common health condition and its prevalence reached 27.14%. Those who aged 45-year or above were 4.61 times (95%CI 2.09-11.07) more likely to have cataract. Bivariate analysis results showed that presence of fall risk was associated with older age (above 45 years old; OR 2.38; 95%CI 1.28-4.49), diagnosis of cataract (OR 3.3; 95%CI 1.71-6.33) and osteoarthritis (OR 12.68; 95%CI 1.70-564.75). Logistic regression analysis further illustrated that cataract (p = 0.04) remained as a significant predictor of fall risk after controlling age, gender, osteoarthritis and osteoporosis in the model.
Conclusion: Our data showed that presence of cataract diagnosis was significantly associated with higher fall risk among PIDs in hostel setting. Given cataract was a prevalent condition especially among aging PIDs, early screening and intervention could be crucial components of fall prevention strategy in a hostel setting
Access to Generic Medicines through the People’s Medicine Centre (PMC) in Odisha, India: A qualitative study: - SHAPE Health Conference In Hong Kong 8-9 July 2024
No full textIntroduction: Access to medicine is a concern in India and developing countries. In India, Pradhan Mantri Bhartiya Janaushadhi Priyojana (PMBJP) helps, to a certain extent, provide medicines to people experiencing poverty. PMBJP is India’s central government scheme hosted by the Department of Pharmaceuticals, which comes under the Ministry of Chemicals and Fertilizers. The scheme was uniformly introduced in all the states of the country to benefit the people at large in 2008. The objective of the scheme is to provide high-quality medication to everyone belonging to different strata of the population, especially underprivileged and impoverished people. The state has high regional inequality where few districts are economically developed while many others are economically backward, and access to medicine remains a challenge.
Objective: This paper explores the knowledge and awareness of the scheme among PMC owners, grievances, and market competition of PMCs.
Methods: This study adopted a qualitative research method to understand the concerns of pharmacists and PMCs. An interview schedule was used to assess the situation. The research revolves around subjects such as proprietorship, motivational aspects, monetary provision, faith, satisfaction, perceived benefits, and challenges of the stakeholders. Therefore, open-ended, in-depth interviews were best suited for the study. PMC pharmacists were the only participants in the study. The data collection took place in January and February 2023.
Results: The results are presented under three themes pertaining to the PMC business: awareness, grievances, and market competition. The study revealed that the ownership of the PMCs was of two types in the state of Odisha: one was an old PMC that started between 2008 and 2015, and the other type was a new PHC that started after 2015. In 2015, radical changes were brought into the scheme. The popularity of the scheme among private pharmacists became a phenomenon after 2015; earlier, it was under the control of the government and the District Red Cross (DRC). The scheme was made open for all independent private pharmacists in 2015. The risk of expired stocks constantly loomed over the PMC business. PMC owners discussed expired drug management mechanisms. Market competition was very much in favor of the PMC owners, as their products were much cheaper than the branded market products. However, they reel under small earnings due to the low price of their products.
Conclusion: Disseminating information about the PMBJP scheme is currently limited to existing pharmacists. The scheme could be promoted to recent graduates with D. Pharma or B to expand its reach. Pharma degrees, encouraging them to become independent PMC pharmacists. Additionally, enhancing mechanisms for managing expired drugs would make the PMC business more appealing. Reforms are also needed for older PMCs (established between 2008 and 2015) to prevent conflicts with authorities and other schemes. While PMCs benefit from lower product prices, they must increase sales volume to achieve satisfactory income, which should be considered to improve the financial outcomes for PMC owners
Book Review - Strategic Healthcare Management: Planning and Execution by Stephen L. Walston
No full textStrategic health service management combines aspects of traditional management with an emphasis on long-term strategies and adaptation to dynamic changes in the health environment [1]. It aims to improve service quality, operational efficiency, and overall population health results [2, 3]. This is what was explored by Walston (2023) in his book Strategic Healthcare Management: Planning and Execution, Third Edition....
Dealing with Mental Health Problems and Work Performance Among Frontline Healthcare Workers Through the Influence of Digital Platform in Malaysian Private Hospitals: A conceptual analysis
No full textThe purpose of this study to examine mental health problems of frontline healthcare workers and their impact on work performance through exploring the influence of digital platforms in Malaysian private hospitals. This research is essential in addressing previous knowledge and theoretical gaps on the antecedents that denote to mental health problems and how digital platforms are used to improve mental health wellbeing. Basically, this study discusses the impact of four independent variables which are categorized as depression, anxiety, insomnia and distress factors whereas dependent variable is work performance. This study also will discuss problems concerning work performance of frontline healthcare workers (doctors, nurses, medical assistance, pharmacists and HR Management), specifically on poor service quality, turnover intention, work-related burnout, and exhaustion in Malaysian private hospitals. Hence, this study explores new solutions on the employees’ work performance related issues to create awareness for the Malaysian private hospitals in improving mental health issues among front-line healthcare workers to enhance their work performance through the influence of digital platforms. Private hospitals in Malaysia are experiencing critical situations related to poor employees’ performance which indirectly influence the overall productivity. Thus, private hospitals need to provide serious attention towards these related issues. A conceptual framework was formulated based on identified research gaps through the literature review. It is expected that this study will enhance the awareness for the management in Malaysian private hospitals on dealing with mental health problems which impacts work performance by exploring digital platforms as a solution
Investigating Leadership: Reflections on the methodological choices used to research how allied health clinicians are enabled to step into health systems leadership roles
No full textThis article examines the methodological choices made for a research study into Health Systems Leadership. Reflections on key learnings are provided as a way of offering insight for researchers navigating these decisions for the first time. Embarking on qualitative research to effect change is purposeful but challenging; choosing the most appropriate methodology and methods can often be confounding and stressful for new researchers. This article explores the decision to use Interpretive Descriptive methodology with an Appreciative Inquiry lens and makes visible decision junctures in the development of this research. Literature provides a wealth of expert guidance and excellent insights into research methodology and methods. However, very little expounds on the learnings of those who have gone before and what their insights and learnings may be. Research into allied health clinicians and their journey into health systems leadership roles provides an opportunity to reflect on an applied research journey
Improving Accuracy of Discharge Summary Medication Lists – A Comprehensive Electronic Medical Record Quality Improvement Project
No full textBackground: Discharge summaries (DSs) are an important communication tool between hospital and community clinicians however errors in these documents are common. To improve the accuracy of DS information, our health network implemented a suite of quality improvement projects that promoted “More Efficient Documentation (of patient information) for Improved Care” (MEDIC).
Objective: The aim of this study was to determine if DSs post-implementation of the MEDIC program of work were associated with lower rates of medication errors.
Design: A retrospective pre- (March 2021) post- (March 2022) medical record audit was conducted at five public hospitals. Patients were included chronologically based on discharge date until the target sample size was reached (100 per group). For each patient, the DS medication list was compared to the pharmacy generated patient friendly medication list or interim medication administration chart and any discrepancies were considered errors. Utilisation of electronic Clinical Decision Support (CDS) was evaluated via review of the EMR.
Main Outcome Measure: Medication errors
Results: The mean number of DS medication errors was lower in the post-intervention group (3.0 vs 1.4, p<0.01). Fewer patients in the post-intervention group had one or more DS medication errors (59% vs 39%, p<0.01). Patients in the post-intervention group were less likely to have one or more high-risk medication errors (20% vs 10% p=0.048). There were 437 individual errors (pre=298, post=139). Omitted medications were less common in the post-intervention group (127 vs 11). Utilisation of EMR home medication CDS was higher in the post-intervention group (54% vs 69%, p=0.005). Pooled data from both groups showed completion of discharge medication reconciliation CDS was associated with a lower number of errors on DSs (mean: 3.7 vs 1.4, p<0.001, DS with one or more errors: 68% vs 39%, p<0.001).
Conclusion: The MEDIC program of work was associated with improved DS medication list accuracy
Ethical Principles of Autonomy for Hypertension Patients : A concept analysis.
No full textBackground: Autonomy is a fundamental ethical principle within the nursing profession. It plays a significant role in patients' decision-making processes when seeking nursing interventions. In the context of hypertensive individuals, autonomy pertains to their capacity to manage and regulate their hypertensive condition. This encompasses the independent decision-making related to medications, lifestyle adjustments, and overall care.
Method: The method utilized for this analysis is the Walker & Avant approach (2011). The concept analysis was conducted by consulting literature on autonomy sourced from Google Scholar and Preplexity databases. The search keywords employed were "concept of autonomy" and "hypertension sufferers".
Results: The concept analysis followed the 8-step method outlined by Walker and Avant. This systematic approach, which involves identifying the attributes, antecedents, and consequences of autonomy, leads to the development of an operational definition. Autonomy is defined as the capacity of an individual to make decisions independently, without external influence, to manage themselves and take responsibility for the outcomes of those decisions.
Conclusion: the results of the analysis it was found that autonomy is very beneficial for hypertension sufferers because a person can make decisions, so that they have self-satisfaction, increased motivation and clear life goals. Autonomy grants nurses the freedom to make clinical decisions based on their professional knowledge and skills. Nurses can determine the best course of action for patients without having to wait for instructions from a doctor, while still being accountable for their decisions and ready to explain their actions within the context of ethics and law
Sustainability of Hospital Accreditation Programs in Low and Middle-Income Countries: Lessons learned from Sri Lanka: - SHAPE Health Conference In Hong Kong 8-9 July 2024
No full textObjective: Many hospital accreditation programs developed for or implemented in Low and Middle-Income Countries (LMICs), including Sri Lanka, have been discontinued due to multiple factors. This study was conducted to elicit and analyse factors influencing the Sri Lankan hospital accreditation program that was initiated in 2015.
Design: This case study employed document reviews and 18 key informant interviews with stakeholders involved in Sri Lanka's accreditation program. Collected data were thematically analysed.
Setting: Sri Lankan healthcare system.
Main outcome measures: Data extraction was guided by the constructs of the ACES-GLEAM Framework, which was developed based on the results of a scoping review.
Results: Barriers identified were frequent changes in the leadership and strategic plans, lack of awareness and competencies on accreditation among local stakeholders, and non-alignment of accreditation standards with the local health system context hampered by resource and infrastructure constraints. Enablers for program development commonly raised were the commitment of stakeholders, the availability of institutional structures for quality assurance, donor funding from the World Bank, and technical expertise and surveyor training by the Australian Council on Healthcare Standards International.
Conclusions: The study identified that multiple factors contributed to the poor sustainability of the Sri Lankan accreditation program. These findings can be useful reflections and guidelines for the accreditation stakeholders to establish sustainable and effective programs in LMICs
Supportive Leadership for Impact on Building Organisation Resilience
No full textThe health, aged and social care service sectors routinely need to deal with the consequences of stress in the delivery of care and support services; trauma; interpersonal conflict; accidents; rationing; and sustainability. For sustained and healthy functioning health workers need intrinsic and extrinsic support for resilience or the ability to maintain confident, steady and healthy functioning in response to such consequences of stress [1]. Those providing direct and indirect care [2] and those working in varied and challenging areas and location of care delivery [3] need constructs and skills to build and deal with resilience individually as well as in conjunction with collective opportunities within their organisations (teams, units, groups and organisations)....
Quality of Health Care Services of Emergency Departments Between Public and Private Sectors from The Patients’ Companions Experiences
No full textBackground: People frequently choose private hospitals despite public healthcare services are provided free of charge in the Kurdistan Region. We assessed quality of health services of emergency departments (EDs) between public and private sectors.
Methods: In this comparative cross-sectional study, individuals who received health services from either public or private ED in the Kurdistan Region of Iraq were personally invited.
Results: Most of the admitted patients in both private and public EDs were in the middle age group, female and were from urban areas. A greater proportion of government employees sought care at public EDs (20.0%) than at private ones. A considerable percentage of patients did not trust the competence of medical staff in both public and private ED. But a lower percentage of trust was found in the public ED (35.67% vs. 53.67%; P<0.0001, respectively) compared to the patients in the private ED. The patients in the private ED significantly received great attention from the medical staff, were taken seriously by the medical staff, the medical staff listened to their medical conditions, the patients had better clarity of explanations of the results of examinations. Also, the private ED had better state of seriously taken by medical staff, hygiene, and care rapidity, assessment, and clarity of explanations of the health problem. However, the private ED had worse condition about the information by medical staff on readmission in case of health problems.
Conclusion: This study indicated that the private EDs provide higher quality services across various aspects compared to public EDs