The number of missed appointments in healthcare institutions in Nigeria caused problems, hence the need
for integrated healthcare system to intervene and provide seamless care for patients. Appointment
scheduling system lies at the intersection of providing efficiency and timely access to health services. This
research presents an online National Health Insurance Scheme (NHIS) Outpatient Medical Appointment
Booking System where NHIS patients can access and view any available personnel or doctor schedule in
order to book an appointment with the corresponding time as specified by the available doctor. The system
was developed using PhP, macromedia dreamweaver, apache and MYSQL. This is to ensure that the
application is robust, cheap and is able to run on different platforms. The system provides the platform to
facilitate the booking and management of patients’ appointment bookings. Patients can also view their
appointment reports. It also provides the healthcare workers an easy access to manage patients’
appointments and to generate relevant reports.
The influence of clients’ perceived quality on health care utilizationSYCHRISTO
The document discusses a study on the influence of clients' perceived quality of healthcare on utilization of health services in Ghana. The study analyzed data from 400 clients accessing care at 10 health facilities. Major findings included: 1) Most clients reported waiting over 3 hours to receive care; 2) Over 75% reported satisfaction as good or excellent with care quality; 3) While most clients could easily access medicines, over a third did not receive all prescribed drugs. The study concludes that clients' perceptions of quality influence their use of health insurance and that improving quality could increase insurance enrollment and utilization.
Determine the Patients' Satisfaction Concerning In-hospital Information Progr...iosrjce
The document describes a study that aimed to determine patients' satisfaction with an in-hospital information program for coronary artery disease. Sixty patients were divided into a study group that received the information program and a control group. The study group showed improved satisfaction with health status, medication, lifestyle, diet and post-attack information compared to the control group. The results indicate that patient satisfaction is related to nurse quality of care, which improved more for the study group than the control group after the program. The study concluded that patients generally lack sufficient in-hospital information and recommended establishing standardized education programs and rehabilitation centers.
The document examines the implementation of patient safety and patient-centeredness strategies in 84 Iranian hospitals based on a survey completed by hospital and nursing managers in 2009-2010. It finds that the majority of hospitals reported implementing 84% of patient safety strategies and 72% of patient-centeredness strategies. Implementation of most strategies was generally unrelated to hospital characteristics like type, ownership, teaching status, or annual evaluation grade, with some exceptions. Overall implementation of strategies was substantial but there is still room for improvement, including enforcing standards, increasing organizational responsiveness, and partnering with patients.
Nursesí practices and perception of delirium in the intensive care units of ...Alexander Decker
This document summarizes a study that assessed critical care nurses' practices and perceptions of delirium among critically ill patients in Egyptian intensive care units. The study found that nurses ranked delirium assessment as their fourth priority and that more than half of nurses never assessed for delirium in patients. All nurses reported never receiving training on assessing or managing delirium. While delirium is common in ICU patients and associated with poor outcomes, the study results indicate that it remains under-recognized and under-assessed among ICU patients in Egypt due to lack of protocols, tools, and education for nurses. The study highlights the need to incorporate delirium assessment and management into nursing education and daily ICU care to improve outcomes for critically ill patients.
This document summarizes a DNP project that evaluated the implementation of a sedation vacation protocol in a medical intensive care unit (MICU). The purpose was to determine if the protocol reduced pneumonia incidence, intubation duration, and ICU length of stay. A literature review found support for daily sedation vacations, spontaneous breathing trials, and ventilator bundle care. Chart reviews of 33 patients in 2014 found the protocol was ordered for all patients but only documented for 67% of patients. Results were inconclusive on outcomes. Barriers to full protocol compliance were identified.
Medical Students in Global Neurosurgery: Rationale and RoleAhmad Ozair
Approximately 5 million essential neurosurgical cases are unmet each year, all in low- and middle-income countries (1). After the Lancet Commission on Global Surgery described the absence of global surgery from global health discourse in January 2014 (2), the field of neurosurgery quickly recognized the importance of increasing equity in care globally (3-5). Although existing initiatives in global neurosurgery have focused on neurosurgeons and trainees, medical students represent a promising group for sustainable long-term engagement. We characterize why medical students are fundamental to success, outline the importance of incorporating medical students, and delineate how to increase medical student interest and participation in global neurosurgery.
The influence of clients’ perceived quality on health care utilizationSYCHRISTO
The document discusses a study on the influence of clients' perceived quality of healthcare on utilization of health services in Ghana. The study analyzed data from 400 clients accessing care at 10 health facilities. Major findings included: 1) Most clients reported waiting over 3 hours to receive care; 2) Over 75% reported satisfaction as good or excellent with care quality; 3) While most clients could easily access medicines, over a third did not receive all prescribed drugs. The study concludes that clients' perceptions of quality influence their use of health insurance and that improving quality could increase insurance enrollment and utilization.
Determine the Patients' Satisfaction Concerning In-hospital Information Progr...iosrjce
The document describes a study that aimed to determine patients' satisfaction with an in-hospital information program for coronary artery disease. Sixty patients were divided into a study group that received the information program and a control group. The study group showed improved satisfaction with health status, medication, lifestyle, diet and post-attack information compared to the control group. The results indicate that patient satisfaction is related to nurse quality of care, which improved more for the study group than the control group after the program. The study concluded that patients generally lack sufficient in-hospital information and recommended establishing standardized education programs and rehabilitation centers.
The document examines the implementation of patient safety and patient-centeredness strategies in 84 Iranian hospitals based on a survey completed by hospital and nursing managers in 2009-2010. It finds that the majority of hospitals reported implementing 84% of patient safety strategies and 72% of patient-centeredness strategies. Implementation of most strategies was generally unrelated to hospital characteristics like type, ownership, teaching status, or annual evaluation grade, with some exceptions. Overall implementation of strategies was substantial but there is still room for improvement, including enforcing standards, increasing organizational responsiveness, and partnering with patients.
Nursesí practices and perception of delirium in the intensive care units of ...Alexander Decker
This document summarizes a study that assessed critical care nurses' practices and perceptions of delirium among critically ill patients in Egyptian intensive care units. The study found that nurses ranked delirium assessment as their fourth priority and that more than half of nurses never assessed for delirium in patients. All nurses reported never receiving training on assessing or managing delirium. While delirium is common in ICU patients and associated with poor outcomes, the study results indicate that it remains under-recognized and under-assessed among ICU patients in Egypt due to lack of protocols, tools, and education for nurses. The study highlights the need to incorporate delirium assessment and management into nursing education and daily ICU care to improve outcomes for critically ill patients.
This document summarizes a DNP project that evaluated the implementation of a sedation vacation protocol in a medical intensive care unit (MICU). The purpose was to determine if the protocol reduced pneumonia incidence, intubation duration, and ICU length of stay. A literature review found support for daily sedation vacations, spontaneous breathing trials, and ventilator bundle care. Chart reviews of 33 patients in 2014 found the protocol was ordered for all patients but only documented for 67% of patients. Results were inconclusive on outcomes. Barriers to full protocol compliance were identified.
Medical Students in Global Neurosurgery: Rationale and RoleAhmad Ozair
Approximately 5 million essential neurosurgical cases are unmet each year, all in low- and middle-income countries (1). After the Lancet Commission on Global Surgery described the absence of global surgery from global health discourse in January 2014 (2), the field of neurosurgery quickly recognized the importance of increasing equity in care globally (3-5). Although existing initiatives in global neurosurgery have focused on neurosurgeons and trainees, medical students represent a promising group for sustainable long-term engagement. We characterize why medical students are fundamental to success, outline the importance of incorporating medical students, and delineate how to increase medical student interest and participation in global neurosurgery.
This document outlines the doctoral thesis of Dr. Svin Deneckere on improving teamwork and preventing burnout through the use of care pathways. It discusses the growing need for teamwork in healthcare due to factors like increasing specialization and fragmented structures. Care pathways are presented as a tool to improve teamwork by facilitating communication, coordinating roles, and documenting care processes. The thesis involved 4 studies: 1) developing a set of indicators for measuring teamwork; 2) a literature review finding care pathways can improve teamwork; 3) a cluster randomized controlled trial finding care pathways positively impact teamwork; and 4) process evaluations of implementation. The thesis examines how care pathways can enhance teamwork in healthcare organizations.
Saleh Neama Hassan has over 20 years of experience as a Nursing Supervisor in Bahrain. He obtained several nursing qualifications including a Diploma in Practical Nursing, A/D in General Nursing, Diploma in Psychiatric Nursing, B.Sc. in Nursing, and M.Sc. in Health Care Management. Throughout his career, he has conducted numerous studies and implemented various projects focused on improving nursing practices and patient care. He has held several leadership roles serving on committees to advance nursing policies and research.
Impact of a designed nursing intervention protocol on myocardial infarction p...Alexander Decker
This study examined the impact of a designed nursing intervention protocol on myocardial infarction patients' outcomes at a university hospital in Egypt. Forty adult myocardial infarction patients were included. The study found that after exposure to the nursing intervention protocol, patients had significantly higher total mean knowledge scores and total mean practice scores. It also found that patients had medium to high levels of compliance to lifelong instructions. The results support the hypotheses that the nursing intervention protocol improved patients' knowledge, practices, and compliance. The study concluded that a nursing intervention protocol can have a positive impact on myocardial infarction patient outcomes.
This document proposes a prospective study to scale up surgical care at a rural hospital in Nepal using the WHO's Integrated Management for Emergency and Essential Surgical Care (IMEESC) model plus additional community follow-up and quality improvement methods. The study aims to rigorously evaluate this innovative model, pilot an implementation research methodology, and generate data to inform larger scale-up of surgical care worldwide. Specific objectives include describing the implementation process and measuring quality through adherence to protocols, follow-up rates, and complication rates. Metrics are proposed for evaluating pre-op, intra-op, post-op, facilities/supplies, and community follow-up. The study seeks to provide needed research on deploying surgical care in low-
INFLUENCE OF HEALTH SERVICE PROVIDER COMPETENCY ON UTILIZATION OF UNIVERSAL H...Premier Publishers
This study assessed the influence of healthcare provider competency on universal health coverage utilization in Seme Sub-County, Kenya. A cross-sectional study was conducted using a sample of 377 community members and 8 health facility managers. Logistic regression found that healthcare provider competency statistically influenced utilization of universal health coverage. Respondents who perceived that providers had adequate health knowledge were over twice as likely to use universal health coverage services. Those who experienced misdiagnosis were half as likely to solely rely on universal health coverage. Most respondents agreed that providers had sufficient knowledge, though some raised concerns about competency in pharmacy departments due to staffing shortages. In conclusion, healthcare provider competency levels significantly impact utilization of universal health coverage.
Abstract— Picture of public district hospitals is usually is as underused, inefficient and providing poor quality care. So this study was aimed to assess patient load at district level hospital. For the study purpose a district hospital of Eastern-northern Rajasthan was selected and this study was conducted in year 2014 at R.K. Joshi District hospital Dausa (Rajasthan) India. Information about general activities like outdoor, indoor, operations, investigations etc were collected. Other activities like reproductive and child health activities, family welfare activities, immunization activities, Zanani Suraksha Yozana activities etc were also collected. It was found in this study that total 454596 outdoor cases and 31706 indoor cases of various diseases were attended in this year. Bed occupancy rate was 334.64 with average hospital stay 3.2 days. Total 151127 laboratory tests were done in hospital. Total 3003 minor and 474 major operations were performed. In this year 251 Laparoscopic Sterilization, 5 Tubectomies and 4 Vasectomies were done along with other family welfare activities. Total 5312 institutional deliveries were performed and these women were benefited by ZSY.
Evaluation of a tool for assessing clinical competence of msc nurse studentsAlexander Decker
The document reports on the first phase of a study which evaluated an existing clinical competence assessment tool used for MSc nurse students in Kenya. Twenty-seven nurse experts participated in the study and found that the existing tool had low content validity and needed revision. Specifically, the study found that only 7 of 34 items met the minimum content validity index threshold, and the tool had an average congruency percentage of only 60%. This indicates a need to revise the tool by adding and removing some competencies to better assess clinical competence.
- A study compared rates of preventable adverse drug events (ADEs) in intensive care units (ICUs) vs. non-ICUs at two hospitals over 6 months.
- The unadjusted ADE rate was twice as high in ICUs, but when adjusted for number of drugs, there was no difference between ICUs and non-ICUs.
- Preventable ADEs occurred due to normal systems failures like poor communication rather than overworked individuals, showing the need for systems solutions over blaming individuals.
Organizational Structure Of A Hospital[1]jawadorak
The organizational structure of a hospital facilitates efficient management by establishing lines of authority and accountability. Larger hospitals have more complex structures than smaller facilities. Hospital departments are generally grouped into administration services, informational services, therapeutic services, diagnostic services, and support services. Administration oversees budgets, policies and public relations. Informational services handle admissions, billing, records and technology. Therapeutic services provide treatment. Diagnostic services determine causes of illness or injury. Support services maintain supplies and the facility. Understanding the organizational chart helps navigate a hospital's departments and staff.
IRJET-Improving Patient Compliance to Achieve Satisfation: The Case of Low Ba...IRJET Journal
This document discusses a study that investigated determinants of patient compliance and satisfaction with physiotherapy for low back pain (LBP) in Kuwait. The study used a survey of 342 LBP patients who had received physiotherapy in public and private clinics. The results found that goal attainment was the main determinant of satisfaction in public clinics, while physical environment quality most influenced satisfaction in private clinics. Overall, communication skills, motivation programs, and compliance influenced goal attainment and satisfaction. The study recommends that clinics improve communication and motivation to increase compliance and better patient outcomes.
The document proposes developing an occupational therapy outreach service for elderly patients being discharged from medical assessment wards. Research shows elderly patients are often unprepared for discharge and lack communication between health services. The outreach program aims to facilitate smooth transitions, reduce readmissions, and relieve hospital bed pressures through home-based rehabilitation and empowering patients. Outcomes would be measured through tools like the Barthel Index to evaluate the program's effectiveness.
Effect of nursing intervention on clinical outcomes and patient satisfaction ...Alexander Decker
1) The study aimed to determine the effect of nursing intervention on clinical outcomes and patient satisfaction among patients with upper gastrointestinal bleeding.
2) A quasi-experimental study was conducted on 50 patients divided into a study group that received nursing intervention and a control group.
3) Statistically significant differences were found between the groups in clinical outcomes like bleeding, vital signs, and lab tests as well as higher patient satisfaction scores in the study group compared to the control group, showing that nursing intervention improved patients' outcomes and satisfaction.
Scaling up ems under universal health insurance scheme in thailandThira Woratanarat
This document summarizes the scaling up of emergency medical services (EMS) in Thailand under the universal health insurance scheme. It describes how Thailand addressed obstacles to developing effective EMS through incremental initiatives focused on trauma care since the 1990s. Universal health insurance and health system reforms created opportunities to develop sustainable EMS. Key initiatives included establishing standardized EMS training programs, an emergency call number, and integrated trauma care systems in provinces like Khon Kaen that served as models for EMS development in Thailand.
The document discusses the development of post-graduate programs in emergency medicine in India. It provides an overview of the current status of emergency medicine in India, noting that it is a nascent specialty with few formally trained emergency physicians. It also outlines some of the key milestones in the development of emergency medicine services in India, including emergency medicine being recognized as a separate specialty by the Medical Council of India in 2009. The document examines the limited number of post-graduate seats for emergency medicine programs compared to other specialties and the large scope for further growth of emergency medicine in India given the country's health needs.
This document discusses approaches to improving emergency department (ED) throughput and addressing overcrowding. It provides background on the problem of ED overcrowding, including factors contributing to increased patient volumes and decreased bed capacity. Common models for improving throughput focus on separating patients by acuity, expediting diagnostics, and using technology. The document also discusses a conceptual model of ED crowding involving input, throughput, and output phases. Key approaches to improving throughput discussed are patient-specific flow models, rapid triage, providers in triage, flow expeditors, and technology. The significance of addressing overcrowding relates to accreditation standards, hospital finances, and patient satisfaction.
The perceived global impact of the COVID-19 pandemic on doctors medical and s...Ahmad Ozair
Introduction: The COVID-19 pandemic has resulted in a significant burden on healthcare systems causing disruption to medical and surgical training of doctors globally. Aims and objectives: This is the first international survey assessing the perceived impact of the COVID-19 pandemic on training of doctors of all grades and specialties. Methods: An online global survey was disseminated using Survey Monkey® between 4th August 2020 and 17th November 2020. A global network of collaborators facilitated participant recruitment. Data was collated anonymously with informed consent and analysed using univariate and adjusted multivariable analysis. Results: 743 doctors of median age 27 (IQR: 25-30) were included with the majority (56.8%, n=422) being male. Two-thirds of doctors were in a training post (66.5%, n=494), 52.9% (n=393) in a surgical specialty and 53.0% (n= 394) in low- and middle-income countries. Sixty-nine point two percent (n=514) reported an overall perceived negative impact of the COVID-19 pandemic on their training. A significant decline was noted among non-virtual teaching methods such as face-to-face lectures, tutorials, ward-based teaching, theatre sessions, conferences, simulation sessions and morbidity and mortality meetings (p≤0.05). Low or middle-income country doctors' training was associated with perceived inadequate supervision while performing invasive procedures under general, local or regional anaesthetic. (p≤0.05) CONCLUSION: In addition to the detrimental impact of the COVID-19 pandemic on healthcare infrastructure, this international survey reports a widespread perceived overall negative impact on medical and surgical doctors' training globally. Ongoing adaptation and innovation will be required to enhance the approach to doctors' training and learning in order to ultimately improve patient care.
The document summarizes 15 research articles that evaluated the accuracy of the Confusion Assessment Method for the ICU (CAM-ICU) in identifying delirium in adult ICU patients compared to practitioner judgment. The majority of studies were quasi-experimental and found that the CAM-ICU more accurately identified delirium than practitioner judgment alone. However, the CAM-ICU had lower sensitivity than specificity, so it could potentially under-identify delirium. The studies concluded that while the CAM-ICU is currently the most accurate tool, it should be used along with practitioner judgment until a screening tool with higher sensitivity is developed.
The document discusses the organizational structure of hospitals. It explains that organizational structure refers to the levels of management and helps establish the chain of command. The structure differs between large and small hospitals. Hospital departments are grouped according to similarity of duties into administrative services, informational services, therapeutic services, diagnostic services, and support services. Each category and its constituent departments are described.
This document summarizes an online calendar and appointment booking application that allows patients to search for doctors, view their profiles and ratings, book 15-minute appointments via an online calendar, and have video consultations. It provides login credentials for doctors and patients to demo the platform and outlines the steps for patients to book appointments and doctors to accept requests and set their schedules.
Jamie A Cowan, Timendo - Solocal Group UK Event "How To Drive Online Traffic ...Solocal Group UK
The document describes an online appointment booking solution called Timendo. It discusses how the solution allows businesses to convert more website visitors into sales by enabling visitors to directly book appointments online anytime, even outside of business hours. Key features highlighted include appointment confirmations by email and SMS, reminders, and a reported 80% reduction in no-shows. The company claims it has booked over 32 million appointments to date across 1 million users. Implementation and customer support services are also summarized.
1. The new process for booking passport appointments online automatically assigns appointment dates and times based on availability. Payment of fees is now mandatory before booking.
2. There are three payment options: internet banking, debit/credit card, or bank challan. For internet banking or card payments, the system redirects to an online payment portal. For challans, a payment receipt is printed and taken to an SBI branch with cash.
3. Appointments can only be cancelled or rescheduled twice per application reference number (ARN). The rescheduled appointment must be within one year of the original date.
This document outlines the doctoral thesis of Dr. Svin Deneckere on improving teamwork and preventing burnout through the use of care pathways. It discusses the growing need for teamwork in healthcare due to factors like increasing specialization and fragmented structures. Care pathways are presented as a tool to improve teamwork by facilitating communication, coordinating roles, and documenting care processes. The thesis involved 4 studies: 1) developing a set of indicators for measuring teamwork; 2) a literature review finding care pathways can improve teamwork; 3) a cluster randomized controlled trial finding care pathways positively impact teamwork; and 4) process evaluations of implementation. The thesis examines how care pathways can enhance teamwork in healthcare organizations.
Saleh Neama Hassan has over 20 years of experience as a Nursing Supervisor in Bahrain. He obtained several nursing qualifications including a Diploma in Practical Nursing, A/D in General Nursing, Diploma in Psychiatric Nursing, B.Sc. in Nursing, and M.Sc. in Health Care Management. Throughout his career, he has conducted numerous studies and implemented various projects focused on improving nursing practices and patient care. He has held several leadership roles serving on committees to advance nursing policies and research.
Impact of a designed nursing intervention protocol on myocardial infarction p...Alexander Decker
This study examined the impact of a designed nursing intervention protocol on myocardial infarction patients' outcomes at a university hospital in Egypt. Forty adult myocardial infarction patients were included. The study found that after exposure to the nursing intervention protocol, patients had significantly higher total mean knowledge scores and total mean practice scores. It also found that patients had medium to high levels of compliance to lifelong instructions. The results support the hypotheses that the nursing intervention protocol improved patients' knowledge, practices, and compliance. The study concluded that a nursing intervention protocol can have a positive impact on myocardial infarction patient outcomes.
This document proposes a prospective study to scale up surgical care at a rural hospital in Nepal using the WHO's Integrated Management for Emergency and Essential Surgical Care (IMEESC) model plus additional community follow-up and quality improvement methods. The study aims to rigorously evaluate this innovative model, pilot an implementation research methodology, and generate data to inform larger scale-up of surgical care worldwide. Specific objectives include describing the implementation process and measuring quality through adherence to protocols, follow-up rates, and complication rates. Metrics are proposed for evaluating pre-op, intra-op, post-op, facilities/supplies, and community follow-up. The study seeks to provide needed research on deploying surgical care in low-
INFLUENCE OF HEALTH SERVICE PROVIDER COMPETENCY ON UTILIZATION OF UNIVERSAL H...Premier Publishers
This study assessed the influence of healthcare provider competency on universal health coverage utilization in Seme Sub-County, Kenya. A cross-sectional study was conducted using a sample of 377 community members and 8 health facility managers. Logistic regression found that healthcare provider competency statistically influenced utilization of universal health coverage. Respondents who perceived that providers had adequate health knowledge were over twice as likely to use universal health coverage services. Those who experienced misdiagnosis were half as likely to solely rely on universal health coverage. Most respondents agreed that providers had sufficient knowledge, though some raised concerns about competency in pharmacy departments due to staffing shortages. In conclusion, healthcare provider competency levels significantly impact utilization of universal health coverage.
Abstract— Picture of public district hospitals is usually is as underused, inefficient and providing poor quality care. So this study was aimed to assess patient load at district level hospital. For the study purpose a district hospital of Eastern-northern Rajasthan was selected and this study was conducted in year 2014 at R.K. Joshi District hospital Dausa (Rajasthan) India. Information about general activities like outdoor, indoor, operations, investigations etc were collected. Other activities like reproductive and child health activities, family welfare activities, immunization activities, Zanani Suraksha Yozana activities etc were also collected. It was found in this study that total 454596 outdoor cases and 31706 indoor cases of various diseases were attended in this year. Bed occupancy rate was 334.64 with average hospital stay 3.2 days. Total 151127 laboratory tests were done in hospital. Total 3003 minor and 474 major operations were performed. In this year 251 Laparoscopic Sterilization, 5 Tubectomies and 4 Vasectomies were done along with other family welfare activities. Total 5312 institutional deliveries were performed and these women were benefited by ZSY.
Evaluation of a tool for assessing clinical competence of msc nurse studentsAlexander Decker
The document reports on the first phase of a study which evaluated an existing clinical competence assessment tool used for MSc nurse students in Kenya. Twenty-seven nurse experts participated in the study and found that the existing tool had low content validity and needed revision. Specifically, the study found that only 7 of 34 items met the minimum content validity index threshold, and the tool had an average congruency percentage of only 60%. This indicates a need to revise the tool by adding and removing some competencies to better assess clinical competence.
- A study compared rates of preventable adverse drug events (ADEs) in intensive care units (ICUs) vs. non-ICUs at two hospitals over 6 months.
- The unadjusted ADE rate was twice as high in ICUs, but when adjusted for number of drugs, there was no difference between ICUs and non-ICUs.
- Preventable ADEs occurred due to normal systems failures like poor communication rather than overworked individuals, showing the need for systems solutions over blaming individuals.
Organizational Structure Of A Hospital[1]jawadorak
The organizational structure of a hospital facilitates efficient management by establishing lines of authority and accountability. Larger hospitals have more complex structures than smaller facilities. Hospital departments are generally grouped into administration services, informational services, therapeutic services, diagnostic services, and support services. Administration oversees budgets, policies and public relations. Informational services handle admissions, billing, records and technology. Therapeutic services provide treatment. Diagnostic services determine causes of illness or injury. Support services maintain supplies and the facility. Understanding the organizational chart helps navigate a hospital's departments and staff.
IRJET-Improving Patient Compliance to Achieve Satisfation: The Case of Low Ba...IRJET Journal
This document discusses a study that investigated determinants of patient compliance and satisfaction with physiotherapy for low back pain (LBP) in Kuwait. The study used a survey of 342 LBP patients who had received physiotherapy in public and private clinics. The results found that goal attainment was the main determinant of satisfaction in public clinics, while physical environment quality most influenced satisfaction in private clinics. Overall, communication skills, motivation programs, and compliance influenced goal attainment and satisfaction. The study recommends that clinics improve communication and motivation to increase compliance and better patient outcomes.
The document proposes developing an occupational therapy outreach service for elderly patients being discharged from medical assessment wards. Research shows elderly patients are often unprepared for discharge and lack communication between health services. The outreach program aims to facilitate smooth transitions, reduce readmissions, and relieve hospital bed pressures through home-based rehabilitation and empowering patients. Outcomes would be measured through tools like the Barthel Index to evaluate the program's effectiveness.
Effect of nursing intervention on clinical outcomes and patient satisfaction ...Alexander Decker
1) The study aimed to determine the effect of nursing intervention on clinical outcomes and patient satisfaction among patients with upper gastrointestinal bleeding.
2) A quasi-experimental study was conducted on 50 patients divided into a study group that received nursing intervention and a control group.
3) Statistically significant differences were found between the groups in clinical outcomes like bleeding, vital signs, and lab tests as well as higher patient satisfaction scores in the study group compared to the control group, showing that nursing intervention improved patients' outcomes and satisfaction.
Scaling up ems under universal health insurance scheme in thailandThira Woratanarat
This document summarizes the scaling up of emergency medical services (EMS) in Thailand under the universal health insurance scheme. It describes how Thailand addressed obstacles to developing effective EMS through incremental initiatives focused on trauma care since the 1990s. Universal health insurance and health system reforms created opportunities to develop sustainable EMS. Key initiatives included establishing standardized EMS training programs, an emergency call number, and integrated trauma care systems in provinces like Khon Kaen that served as models for EMS development in Thailand.
The document discusses the development of post-graduate programs in emergency medicine in India. It provides an overview of the current status of emergency medicine in India, noting that it is a nascent specialty with few formally trained emergency physicians. It also outlines some of the key milestones in the development of emergency medicine services in India, including emergency medicine being recognized as a separate specialty by the Medical Council of India in 2009. The document examines the limited number of post-graduate seats for emergency medicine programs compared to other specialties and the large scope for further growth of emergency medicine in India given the country's health needs.
This document discusses approaches to improving emergency department (ED) throughput and addressing overcrowding. It provides background on the problem of ED overcrowding, including factors contributing to increased patient volumes and decreased bed capacity. Common models for improving throughput focus on separating patients by acuity, expediting diagnostics, and using technology. The document also discusses a conceptual model of ED crowding involving input, throughput, and output phases. Key approaches to improving throughput discussed are patient-specific flow models, rapid triage, providers in triage, flow expeditors, and technology. The significance of addressing overcrowding relates to accreditation standards, hospital finances, and patient satisfaction.
The perceived global impact of the COVID-19 pandemic on doctors medical and s...Ahmad Ozair
Introduction: The COVID-19 pandemic has resulted in a significant burden on healthcare systems causing disruption to medical and surgical training of doctors globally. Aims and objectives: This is the first international survey assessing the perceived impact of the COVID-19 pandemic on training of doctors of all grades and specialties. Methods: An online global survey was disseminated using Survey Monkey® between 4th August 2020 and 17th November 2020. A global network of collaborators facilitated participant recruitment. Data was collated anonymously with informed consent and analysed using univariate and adjusted multivariable analysis. Results: 743 doctors of median age 27 (IQR: 25-30) were included with the majority (56.8%, n=422) being male. Two-thirds of doctors were in a training post (66.5%, n=494), 52.9% (n=393) in a surgical specialty and 53.0% (n= 394) in low- and middle-income countries. Sixty-nine point two percent (n=514) reported an overall perceived negative impact of the COVID-19 pandemic on their training. A significant decline was noted among non-virtual teaching methods such as face-to-face lectures, tutorials, ward-based teaching, theatre sessions, conferences, simulation sessions and morbidity and mortality meetings (p≤0.05). Low or middle-income country doctors' training was associated with perceived inadequate supervision while performing invasive procedures under general, local or regional anaesthetic. (p≤0.05) CONCLUSION: In addition to the detrimental impact of the COVID-19 pandemic on healthcare infrastructure, this international survey reports a widespread perceived overall negative impact on medical and surgical doctors' training globally. Ongoing adaptation and innovation will be required to enhance the approach to doctors' training and learning in order to ultimately improve patient care.
The document summarizes 15 research articles that evaluated the accuracy of the Confusion Assessment Method for the ICU (CAM-ICU) in identifying delirium in adult ICU patients compared to practitioner judgment. The majority of studies were quasi-experimental and found that the CAM-ICU more accurately identified delirium than practitioner judgment alone. However, the CAM-ICU had lower sensitivity than specificity, so it could potentially under-identify delirium. The studies concluded that while the CAM-ICU is currently the most accurate tool, it should be used along with practitioner judgment until a screening tool with higher sensitivity is developed.
The document discusses the organizational structure of hospitals. It explains that organizational structure refers to the levels of management and helps establish the chain of command. The structure differs between large and small hospitals. Hospital departments are grouped according to similarity of duties into administrative services, informational services, therapeutic services, diagnostic services, and support services. Each category and its constituent departments are described.
This document summarizes an online calendar and appointment booking application that allows patients to search for doctors, view their profiles and ratings, book 15-minute appointments via an online calendar, and have video consultations. It provides login credentials for doctors and patients to demo the platform and outlines the steps for patients to book appointments and doctors to accept requests and set their schedules.
Jamie A Cowan, Timendo - Solocal Group UK Event "How To Drive Online Traffic ...Solocal Group UK
The document describes an online appointment booking solution called Timendo. It discusses how the solution allows businesses to convert more website visitors into sales by enabling visitors to directly book appointments online anytime, even outside of business hours. Key features highlighted include appointment confirmations by email and SMS, reminders, and a reported 80% reduction in no-shows. The company claims it has booked over 32 million appointments to date across 1 million users. Implementation and customer support services are also summarized.
1. The new process for booking passport appointments online automatically assigns appointment dates and times based on availability. Payment of fees is now mandatory before booking.
2. There are three payment options: internet banking, debit/credit card, or bank challan. For internet banking or card payments, the system redirects to an online payment portal. For challans, a payment receipt is printed and taken to an SBI branch with cash.
3. Appointments can only be cancelled or rescheduled twice per application reference number (ARN). The rescheduled appointment must be within one year of the original date.
automated doctor appointment and prescription management systemluckymoni76
This document presents an automated doctor appointment and patient prescription management system. The system aims to design and develop a web-based system to allow patients to easily book appointments and for administrators to manage schedules and patient information. It reviews similar existing systems and identifies problems such as excess workload for doctors. The proposed solution separates doctor and administrator roles and includes user accounts. The system will be developed using an incremental methodology and utilize MySQL, Notepad++, Xampp server, and a web browser. Screenshots of the home, patient, doctor, and admin panels are included.
Practo Ray is a practice management solution that has scheduled over 16 million appointments for over 8 million patients managed by more than 120,000 doctors. It offers smart appointment booking, electronic medical records, comprehensive billing and finance, quick analytics, and on-the-go access to patient information and records. Practo Ray is trusted by over 35,000 doctors across 8 countries to improve efficiency, enhance the patient and doctor experience, and increase practice effectiveness and productivity.
P ERFORMANCE M EASUREMENTS OF F EATURE T RACKING AND H ISTOGRAM BASED T ...ijcsit
In this paper, feature tracking based and histogram
based traffic congestion detection systems are
developed. Developed all system are designed to run
as real time application. In this work, ORB (Orien
ted
FAST and Rotated BRIEF) feature extraction method h
ave been used to develop feature tracking based
traffic congestion solution. ORB is a rotation inva
riant, fast and resistant to noise method and conta
ins the
power of FAST and BRIEF feature extraction methods.
Also, two different approaches, which are standard
deviation and weighed average, have been applied to
find out the congestion information by using
histogram of the image to develop histogram based t
raffic congestion solution. Both systems have been
tested on different weather conditions such as clou
dy, sunny and rainy to provide various illumination
at
both daytime and night. For all developed systems p
erformance results are examined to show the
advantages and drawbacks of these systems.
Innovex aims to merge all improvement projects into the business excellence framework to achieve integration, improve project quality, motivate employee participation in continuous improvement, and create an innovation culture. An award night called Innovex recognizes the best teams for their projects based on return on investment, with over 6000 projects filtered down to 22 winners who are celebrated with their spouses.
The Impact of Frequent Use Email When Creating Account at the Websites on the...ijcsit
This research aims to measure the impact of frequent use of emails when creating account at the websites
on the privacy and security of the user (a survey study conducted on a sample of email users' views). The
sample, 200 people of the Jordanian society, includes employees of commercial and communication
companies, banks, university students, employees and faculty members as well as computer centers at
universities. All have emails and are able to use the computer and internet. A questionnaire has been
prepared for this purpose aims to measure the variables of the study. SPSS program was used to analyze
the results. The study revealed the existence of a statistical significant impact of frequent use of email
account when creating an account at the Internet sites on the security and privacy of the user. The study
concluded a number of conclusions and recommendations
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Change management and version control of Scientific Applicationsijcsit
The development process of scientific applications is largely dependent on scientific progress and the
experimental research results. Thus, dealing with frequent changes is one of the main problems faced by
the developers of scientific software. Taking into account the results of the survey conducted among
scientists in the HP-SEE project, the implementation of change management and version control software
processes is inevitable. In this paper, we propose software engineering principles that should be included
in the development process to improve the version control and change management. Moreover, we give
some specific recommendations for their implementation, thereby making a slight modification of already
generally accepted templates and methods. The development steps practiced by scientists should not be
replaced completely, but they need to be supplemented with appropriate practices, documents and formal
methods. We also emphasize the reasons for the inclusion of these two processes and the consequences that
may arise as a result of their non-application.
Artificial intelligence handling through teaching and learning process and it...ijscai
According to this fact that educational system is the base of constant development in every country and this
system educates human-forces and this forces,are accelerators and a factor, of achieving the goals of
development,the educational system can play, Major role in the context economic behavior, in this context
some concepts are regarded as behavioral targets and performance.In educational system, handling
artificial intelligence, in teaching and learning process, had a surprising evolution through educational
advantages, making job, respecting customers rights and customer relationship management, to assist
priority and citizenship, correct investment through formal markets. Science-Based economy, resistible
economy and a positive view to job and Iran capital,including concepts which can be institutionalize in to
the educational system. In this paper it is decided to pose a new method, creating a proper cultural and
scientific bed, this helps.That the educational system behavioral goals, better and stable being achieved.
The method presented in this paper is general and based on handling artificial intelligence, information
technology and electronic content management that means in an intelligent educational system.The
educational goals can be better achieved and managed by new technology of education.
Evaluation of image segmentation and filtering with ann in the papaya leafijcsit
Precision agriculture is area with lack of cheap technology. The refinement of the production system brings
large advantages to the producer and the use of images makes the monitoring a more cheap methodology.
Macronutrients monitoring can to determine the health and vulnerability of the plant in specific stages. In
this paper is analyzed the method based on computational intelligence to work with image segmentation in
the identification of symptoms of plant nutrient deficiency. Artificial neural networks are evaluated for
image segmentation and filtering, several variations of parameters and insertion impulsive noise were
evaluated too. Satisfactory results are achieved with artificial neural for segmentation same with high
noise levels.
Clustering of Deep WebPages: A Comparative Studyijcsit
The internethas massive amount of information. This information is stored in the form of zillions of
webpages. The information that can be retrieved by search engines is huge, and this information constitutes
the ‘surface web’.But the remaining information, which is not indexed by search engines – the ‘deep web’,
is much bigger in size than the ‘surface web’, and remains unexploited yet.
Several machine learning techniques have been commonly employed to access deep web content. Under
machine learning, topic models provide a simple way to analyze large volumes of unlabeled text. A ‘topic’is
a cluster of words that frequently occur together and topic models can connect words with similar
meanings and distinguish between words with multiple meanings. In this paper, we cluster deep web
databases employing several methods, and then perform a comparative study. In the first method, we apply
Latent Semantic Analysis (LSA) over the dataset. In the second method, we use a generative probabilistic
model called Latent Dirichlet Allocation(LDA) for modeling content representative of deep web
databases.Both these techniques are implemented after preprocessing the set of web pages to extract page
contents and form contents.Further, we propose another version of Latent Dirichlet Allocation (LDA) to the
dataset. Experimental results show that the proposed method outperforms the existing clustering methods.
Median Landscape in Indonesia
A 5-minute presentation material of Indonesian Contingent in Media and Information Discussion Group (DG-8) at the 41st Ship for Southeast Asian and Japanese Youth Programme (SSEAYP) 2014
Operartions research in US Healthcare IndustryPrasant Patro
1. This document describes how operations research (OR) models can help reduce delays in healthcare. It identifies three major sources of delays: emergency department delays, delays for medical appointments, and delays for nursing care.
2. Within emergency department delays, it notes long wait times to see physicians and delays in getting inpatient beds once admitted. For medical appointments, it describes waits of several weeks on average to see primary care physicians. Delays for nursing care can compromise patient safety due to insufficient staffing levels.
3. It argues that healthcare delays remain prevalent because they have not been well measured or reported, hospitals face cost pressures to maximize occupancy, and national shortages of healthcare professionals exacerbate delays. OR models have
The document is a presentation about polyclinic waiting time problems and solutions at Tawam Hospital in the UAE. It introduces the presenter and states that the presentation will be divided into four parts: an overview, study results, current and proposed processes, and recommendations/conclusions. It provides background on Tawam Hospital and defines waiting time. It discusses implementation of a Health Information System (HIS) and benefits, as well as research aims, methodology involving questionnaires, and results showing specialists are satisfied with HIS but it is not the main cause of delays. Results of patient questionnaires show waiting times at various stages with most waiting over 60 minutes for required service.
The effect of Nurse Staffing on Quality of Care and Patient Satisfaction in t...AJHSSR Journal
ABSTRACT:Nurse staffing is an important component in determining patient care quality and satisfaction.
This study was aimed at assessing the effect of nurse staffing on quality of care and patient satisfaction in the
medical and surgical wards in the public hospitals in Fako.This retrospective and analytic cross-sectional study
used the hospital administrative data to gather staffing information (the number of nurses, the nursing staff
constitution) and data was collected from patients in the medical and surgical wards in public hospitals in Fako
using an adapted “Karen-patient instrument for measuring quality of care” and the “Patient Satisfaction with
Nursing Care Quality Questionnaire” over a period of 2 months. The probability proportionate to size sampling
was applied to get the appropriate sample size. Data collected was analysed using SPSS version 25.The overall
nurse to patient ratio was 1:9.2.Based on the mean score, 47.1% of patients had good quality of nursing care
while 52.9% had poor quality of nursing care. Half of the participants (50.4%) were satisfied with the overall
nursing services while 49.6% were not satisfied. There was a significant relationship between mean patient to
nurse ratio and quality of care as well as patient satisfaction (p<0.001 and p=0.02 respectively).The overall
nurse to patient ratio was 1:9.2. The overall quality of nursing care was poor and patient satisfaction was
moderate. The study found a relationship between staffing and quality of care as well as patient satisfaction.
Keywords:Nurse Staffing, Patients, Patient’s Satisfaction, Quality of Care
1) The document evaluates integrating HIV care (ART clinics) with regular outpatient care (OPD) in a clinic in Zambia. Data was collected before and after integration on waiting times.
2) Preliminary results found ART patient processing times were longer, and waiting times increased for both patient types after integration. However, more analysis was needed to account for other changing factors.
3) Simulation results also initially found ART waiting times increased after integration, even when controlling for staffing levels. Further simulation informed how and when best to integrate clinics based on patient mix and other factors.
Alycia Albers
CTU
Phase 4 IP
Healing Hands Hospital’s Future
Future Health care Trends
Reform Realities:-Pay-for-performance systems are set to be implemented.
IT upgrades:- better care delivery is accompanied by offering patients technology which supports that care.
Involves the introduction of electronic medical records.
It’s now shifting to ORs.
Introducing patients to personalized medicine.
Reform Realities-Pay-for-performance systems are set to be implemented meaning hospitals along with health systems will have to be more accountable than they have been. Every hospital facility has to come up with better strategies of tracking performance and the manner in which it provides its services.
IT upgrades-making better care delivery is accompanied by offering patients technology which supports that care. This has already begun with the introduction of electronic medical records and it’s now shifting to hybrid ORs. Besides, hospitals have to introduce patients to personalized medicine such as using their smart phones in tracking their heart rate and sending the data to their care providers’ mobile devices (In Geisler, In Krabbendam & In Schuring, 2003).
2
Contd.
Billing will shift to value from volume-in future.
New payment mechanisms:-risk sharing, capitation agreement, bundling agreements.
Health systems super-size- consolidation of various health care units.
Billing will shift to value from volume-in future, healthcare systems will have to focus on high quality, improved outcomes, as well as, greater satisfaction. There will be new payment mechanisms which will include risk sharing along with capitation agreement, as well as, bundling agreements.
Health systems super-size-it is projected that as a result of the lower costs, increased efficiencies and better quality; the hospitals, pharmaceutical suppliers, health systems and other participants within the health care are set to consolidate within the next decade. The resultant mega-sized entities are set to cause the end of stand-alone hospitals (Spekowius & Wendler, 2007).
3
Technologies
Telemedicine-is expected to facilitate the delivery of cost effective health care in the coming future.
This is due to the fact that technology is not only cheaper but also much easier to utilize.
Electronic health data evolution- it is now possible to work with outside apps.
The easy accessibility of medical data makes greater the knowledge depth.
Telemedicine-is expected to facilitate the delivery of cost effective health care in the coming future. This is due to the fact that technology is not only cheaper but also much easier to utilize and various options are becoming available for every patient. Medical staff can connect with their patients through the internet by utilizing webcams.
Electronic health data evolution-as health records become electronic, it is now possible to work with outside apps, which play a significant role in cap.
This document summarizes a study that uses genetic algorithms to optimize patient scheduling and resource utilization in hospitals. It describes using genetic algorithms to generate appointment schedules and evaluate them based on minimizing patient wait times, doctor idle times, and overtime. The study simulates patient arrivals and service times over thousands of simulated days to evaluate different scheduling rules, including individual blocks and variable interval rules. The goal is to balance wait times, idle times, and overtime to find optimal scheduling of patients.
This document discusses factors that contribute to long wait times for patients at hospitals in India and how wait times impact patient satisfaction. It finds that Indian hospitals often have long wait times at registration, between appointments and consultations, and for feedback due to understaffing, a lack of scheduling, and overreliance on paper systems. The document aims to identify reasons for high wait times and provide suggestions to optimize wait times like increasing pharmacy counters, allocating more staff, and leveraging technology. Reducing wait times through improved systems and resources could help raise patient satisfaction in India.
This document discusses how bedside shift report and hourly rounding can improve patient safety and satisfaction. It defines bedside shift report as the exchange of information between nurses at the patient's bedside, which allows patients to participate and clarify information. Hourly rounding involves addressing patient needs like pain, bathroom needs, positioning and possessions every hour. Studies showed these practices reduced errors, falls and improved satisfaction scores by increasing communication and addressing issues proactively.
12
Capstone Project
Olivia Timmons
Department of Nursing. St. Johns River State College
NUR 4949: Nursing Capstone
Dr. C. Z. Velasco
November 14, 2021
Capstone Project
There is a saying that states one can only learn through doing it, practically and physically. It is the explanation as to why it is very important to implement the skills acquired in theory into practice to ascertain one’s competence. This is even more crucial in the medical field as they have no choice but just to be perfect at what they are doing, the only secret is through practice. Practicums connect the two worlds of theory and classwork, thus breaking the monotony alongside connecting what was taught in class with what happens in the field. They are important as apart from sharpening the student’s skills, they also open a window of opportunity and build up connections that will come in handy for the student later on. They will feel the experience and the pressure that comes with it thus preparing themselves accordingly.
Statement of the Problem
Timing is essential in the nursing field and the Emergency Room is notorious for its long wait times. The goal of a clinical laboratory is to deliver medically useful results for patients on a timely basis. This goal can be hindered by the new paradigm of the modern laboratory – “do more with less" (Lopez, 2020). When implementing new care models for patients, the patient perspective is critical. The objective of this study was to describe and develop an understanding of the information needs of patients in the ED waiting room concerning ED wait time notification (Calder, 2021). As a patient arrives at the ER waiting area, it's critical to have lab results for the provider to evaluate. I can give you an example of a patient that waited in the waiting room for over 3 hours, no labs were completed because they were waiting for the patient to go back into a room. The patient was suffering from a heart attack and his troponins were elevated and no one knew until 3 hours later. If POC labs were done on all patients as soon as they arrived, mistakes like these can be avoided. Completed POC blood can cut the wait times in half and the laboratory also won't be backed up on resulting lab specimens.
PICOT Question
Question: Is there a significant decrease in Emergency Department patient length of stay (LOS) for those whose blood was analyzed using POC testing versus those whose blood was analyzed using laboratory testing?
· P-Population= emergency room patients
· I-Intervention or Exposure= POC testing of blood specimens
· C-Comparison= Laboratory blood specimens
· O-Outcome= Decrease patient stay in the emergency room
· T-Time = N/A
History of the Issue
The length of patient stay in the emergency department (ED) is an issue that not only increases the severity of illnesses but also reduces the quality of patient care. Serious health conditions including diabetes and hypertension can worsen while patients are ...
12
Capstone Project
Olivia Timmons
Department of Nursing. St. Johns River State College
NUR 4949: Nursing Capstone
Dr. C. Z. Velasco
November 14, 2021
Capstone Project
There is a saying that states one can only learn through doing it, practically and physically. It is the explanation as to why it is very important to implement the skills acquired in theory into practice to ascertain one’s competence. This is even more crucial in the medical field as they have no choice but just to be perfect at what they are doing, the only secret is through practice. Practicums connect the two worlds of theory and classwork, thus breaking the monotony alongside connecting what was taught in class with what happens in the field. They are important as apart from sharpening the student’s skills, they also open a window of opportunity and build up connections that will come in handy for the student later on. They will feel the experience and the pressure that comes with it thus preparing themselves accordingly.
Statement of the Problem
Timing is essential in the nursing field and the Emergency Room is notorious for its long wait times. The goal of a clinical laboratory is to deliver medically useful results for patients on a timely basis. This goal can be hindered by the new paradigm of the modern laboratory – “do more with less" (Lopez, 2020). When implementing new care models for patients, the patient perspective is critical. The objective of this study was to describe and develop an understanding of the information needs of patients in the ED waiting room concerning ED wait time notification (Calder, 2021). As a patient arrives at the ER waiting area, it's critical to have lab results for the provider to evaluate. I can give you an example of a patient that waited in the waiting room for over 3 hours, no labs were completed because they were waiting for the patient to go back into a room. The patient was suffering from a heart attack and his troponins were elevated and no one knew until 3 hours later. If POC labs were done on all patients as soon as they arrived, mistakes like these can be avoided. Completed POC blood can cut the wait times in half and the laboratory also won't be backed up on resulting lab specimens.
PICOT Question
Question: Is there a significant decrease in Emergency Department patient length of stay (LOS) for those whose blood was analyzed using POC testing versus those whose blood was analyzed using laboratory testing?
· P-Population= emergency room patients
· I-Intervention or Exposure= POC testing of blood specimens
· C-Comparison= Laboratory blood specimens
· O-Outcome= Decrease patient stay in the emergency room
· T-Time = N/A
History of the Issue
The length of patient stay in the emergency department (ED) is an issue that not only increases the severity of illnesses but also reduces the quality of patient care. Serious health conditions including diabetes and hypertension can worsen while patients are ...
This summarizes a document about examining the queuing system at the consultation rooms and surgical units of The Aga Khan University Hospital in Nairobi, Kenya. The study found that using all 11 consultation rooms instead of 8 reduced the average waiting time to almost zero. It was concluded that employing more surgeons would improve efficiency and economical operation of the hospital. Previous studies on queuing systems and appointment scheduling were also reviewed.
This document provides background information on a study being conducted at Jimma University Medical Center in Ethiopia. It discusses factors that influence patient satisfaction, including tangibles like quality of equipment, reliability of services, responsiveness, assurance, empathy, and access in terms of cost and time. Previous studies on patient satisfaction in Ethiopia and other countries found varying levels of satisfaction, from 22% to 93%, with issues like disrespectful treatment, long wait times, and lack of drug availability influencing satisfaction. The significance of studying patient satisfaction is that it allows patients' voices to be heard to improve healthcare planning and measure hospital quality.
When most patients visit physicians in a clinic or a hospital, they are asked about their medical history and related medical tests’ results which might not exist or might simply have been lost over time. In emergency situations, many patients suffer or sadly die because of lack of pertinent medical information. Patient’s Health information (PHI) saved by Electronic Medical Record (EMR) could be accessible only by a hospital using their EMR system. Furthermore, Personal Health Record (PHR) information cannot be solely relied on since it is controlled solely by patients. This paper introduces a novel framework for accessing, sharing, and controlling the medical records for patients and their physicians globally, while patients’ PHI are securely stored and their privacy is taken into consideration. Based on the framework, a proof of concept prototype is implemented. Preliminary performance evaluation results indicate the validity and viability of the proposed framework.
Introduction: The patient’s perception of quality of care is fundamental to utilization of health services. Health utilization would partly depend on clients’ perception of the quality of care.
Methods: A cross-sectional study involving health clients (18 to 70 years) who accessed health services in the Bantama submetro
in the Kumasi metropolis was conducted. A total of 400 clients were recruited from ten health facilities for the study.
Data was collected through interviewing using semi-structured questionnaires using SPSS and analyzed into descriptive and
inferential statistics with STATA 11.
Results: Majority of subscribers assessed healthcare with their National Health Insurance (NHI) cards. Eight percent (8%) had
never accessed healthcare with their NHIS cards. Respondents’ reasons included not falling sick and low quality of healthcare
under the NHIS. Respondents 216 (54%) indicated delays in seeing a doctor, getting laboratories done, and accessing health care as a whole. Seventy-four percent (74%) of the entire population attributed both NHIS and cash and carry systems as the
payment methods associated with delays in health facilities. Clients who viewed the overall the quality of health provision as good or very good were more likely to access healthcare with NHIS card as compared to those who rated the overall health provision as poor or very poor (OR=2.1; p<0.01).
Conclusion: Clients’ perceptions and experiences with quality of health provision influence their utilization of healthcare under the NHIS scheme. Increased enrolment in the scheme should be supported with provision of quality services to enhance clients’ satisfaction.
Whitepaper: Hospital Operations Management reduces wait states and replaces d...GE Software
No Wait States … in pursuit of the frictionless patient experience. Electronic health records have fallen short. Patients continue to wait. Costs remain high. Why focusing on operational management can help hospitals make things right … starting now.
The document discusses proposed actions to improve emergency room wait times in Nova Scotia hospitals. It identifies several key issues contributing to long wait times, including a shortage of hospital beds, increased use of emergency rooms by aging patients and alternate level of care (ALC) patients, and government funding cuts. It then proposes several multi-pronged strategies to address wait times by improving patient flow, reducing overcrowding and overuse of emergency rooms, and decreasing the number of ALC patients. Specifically, it suggests implementing triage-driven patient placement, expanding fast-track areas, improving access to diagnostics, and enhancing patient transfers to reduce backlogs in emergency rooms.
Relationships of Providers’ Accountability of Nursing Documentations in the C...IJEAB
Documentation demonstrates the unique contribution of nursing to the care of clients. This study investigated the relationships of Providers accountability of nursing documentations in the clinical settings. Judgmental and simple random sampling techniques were used to select documented nursing actions for 264 clients. One research question and four null hypotheses guided the study. The instrument used for data collection was checklist on Nursing documentation in the clinical setting. Descriptive statistics of frequency, means and standard deviation (SD) were used to summarize the variables. Pearson Product Moment correlation was used to answer the research question, while analyses of variance (ANOVA) was adopted in testing the null hypotheses at 0.05 level of significance. The result indicated that significant correlation existed between legal implications of nursing documentation and the core principles of nursing documentation. Significant differences were also observed among providers’ accountability of nursing documentations with regard to promotion of interdisciplinary communication, legal implications of documentation, impacts on quality assurance and nursing science.
Assignment 1Part 1 Defining the ProblemProblem Identification.docxtrippettjettie
Assignment 1
Part 1: Defining the Problem
Problem Identification
According to Ludwick and Doucette (2009), one of the primary issues in healthcare is the reduced standard of patient care due to the continued non-integration of technology in medical-based facilities. The result is a poor entry of patient data, coupled with a system that cannot be relied upon in the long term. In this context, Black et al. (2011) are of the opinion that it is mandatory for all healthcare facilities to incorporate electronic health records systems and shift from the use of manual-based recording strategies.
Comment by Author: Use all of participating authors the first time listing
Problem Statement
The continued utilization of manual health-based recording system in the contemporary society leads to reduced efficiency. It also negatively affects the overall outcome of healthcare delivery at the expense of the patient.
Problem Description
The continued use of paper-based records in the modern society is inefficient as compared to hospices that use electronic-based recording system. First, the use of the latter focuses on patient-centered care whereby there it leads to reduced repetition of tests, as there is no scattering of test results in various hospitals. In addition, the paper-based recording system is redundant as the access to a patient’s records by a medical health provider is limited by the location of the doctor as well as the time they can access the hospital (Black et al. 2011). However, the latter is not limited by the mentioned entities since data can be sent electronically at any time and place to the doctor. The problem is directly related to my discipline since patients that undergo recording of their personal information through the manual-based recording system are prone to medical errors. According to Ludwick and Doucette (2009), such errors may involve poor drug administration, especially if a patient may prove allergic to various subscribedprescribed medications. Besides, the electronic-based records will result in increased monitoring of a patient, which leads to faster healthcare delivery, which is the objective of studying my discipline.
Purpose Statement
The reduced efficiency coupled with the adverse outcome caused by paper-based recording systems will be obliterated upon the incorporation of the electronic-based recording system. The objective related to the implementation of the project is increased efficiency and improved quality of healthcare delivery to the patients.
Part 2: Defining a Searchable, Answerable Question:
Population/Patient Problem:
1. What are the efficiency rates concerning number of patients that are bound to benefit from the incorporation of the electronic-based records?
Comment by Author: Needs to clarify what the rates are referring? Efficiency of what?
2. Does the electronic health recording provide any unique advantages over the manual recording system regarding the health status, of a patient?
Interventio ...
Towards EHR Interoperability in Tanzania Hospitals : Issues, Challenges and O...IJCSEA Journal
This study aimed at identifying the issue, challenges and opportunities from the health consumers in Tanzania towards interoperability of electronic health records. Reaching that level of seamless data sharing among Hospitals needs the cooperation of all stakeholders especially the health consumer whose data are the ones to be shared. Without their acceptance that means there is nothing to share. Recognizing that we conducted a study in Tanzania to identify the challenges, issues and opportunities towards health information exchange through interoperable EHRs. The study was conducted in three major cities of Tanzania to identify the security, privacy and confidentiality issues of information sharing together with related challenges to data sharing. This was in order to come up with a clear picture of how to implement some EHRs that will be trusted by health consumers. The participants (n=240) were surveyed on computer usage, EHRs knowledge, demographics, security and privacy issues. A total of 200 surveys were completed and returned (83.3% response rate). Among them 67.5% were women, 62.6% had not heard of EHRs, 73% were highly concerned about the privacy and security of their information. 75% believed that introduction of various security mechanisms will make EHRs more secure and thus better. We conducted a number of chi-square tests (p<0.05) and we realized that there was a strong relationship among the variable of age, computer use, EHRs knowledge and the concerns for privacy and security. The study also showed that there was just a small difference of 8.5% between those people who think EHRs are safer than paper records and those who think otherwise. The general observation of the study was that in order to make EHRs successful in our Hospitals then the issue of security, and health consumer involvement were they two key towards the road of successful EHRs in our hospitals practices and that will make consumers more willing to allow their records to be shared among different health organizations. So besides the issues identified, this study helped us to identify the key requirements which will be implemented in our proposed framework
Computer Technology’S Effect On The Practice Of Nursing EssayJessica Deakin
Computer technology has significantly impacted the practice of nursing. At one hospital, nurses use electronic documentation to record patient information and chart vital signs, medications, and other care. Computerized systems integrate various functions like lab results, prescribing medications, and patient tracking. While this hospital currently uses paper charting, it plans to implement online computerized documentation and physician order entry within a year to further improve patient care.
Similar to Dependable online appointment booking (20)
Connector Corner: Seamlessly power UiPath Apps, GenAI with prebuilt connectorsDianaGray10
Join us to learn how UiPath Apps can directly and easily interact with prebuilt connectors via Integration Service--including Salesforce, ServiceNow, Open GenAI, and more.
The best part is you can achieve this without building a custom workflow! Say goodbye to the hassle of using separate automations to call APIs. By seamlessly integrating within App Studio, you can now easily streamline your workflow, while gaining direct access to our Connector Catalog of popular applications.
We’ll discuss and demo the benefits of UiPath Apps and connectors including:
Creating a compelling user experience for any software, without the limitations of APIs.
Accelerating the app creation process, saving time and effort
Enjoying high-performance CRUD (create, read, update, delete) operations, for
seamless data management.
Speakers:
Russell Alfeche, Technology Leader, RPA at qBotic and UiPath MVP
Charlie Greenberg, host
This talk will cover ScyllaDB Architecture from the cluster-level view and zoom in on data distribution and internal node architecture. In the process, we will learn the secret sauce used to get ScyllaDB's high availability and superior performance. We will also touch on the upcoming changes to ScyllaDB architecture, moving to strongly consistent metadata and tablets.
"Scaling RAG Applications to serve millions of users", Kevin GoedeckeFwdays
How we managed to grow and scale a RAG application from zero to thousands of users in 7 months. Lessons from technical challenges around managing high load for LLMs, RAGs and Vector databases.
Have you ever been confused by the myriad of choices offered by AWS for hosting a website or an API?
Lambda, Elastic Beanstalk, Lightsail, Amplify, S3 (and more!) can each host websites + APIs. But which one should we choose?
Which one is cheapest? Which one is fastest? Which one will scale to meet our needs?
Join me in this session as we dive into each AWS hosting service to determine which one is best for your scenario and explain why!
5th LF Energy Power Grid Model Meet-up SlidesDanBrown980551
5th Power Grid Model Meet-up
It is with great pleasure that we extend to you an invitation to the 5th Power Grid Model Meet-up, scheduled for 6th June 2024. This event will adopt a hybrid format, allowing participants to join us either through an online Mircosoft Teams session or in person at TU/e located at Den Dolech 2, Eindhoven, Netherlands. The meet-up will be hosted by Eindhoven University of Technology (TU/e), a research university specializing in engineering science & technology.
Power Grid Model
The global energy transition is placing new and unprecedented demands on Distribution System Operators (DSOs). Alongside upgrades to grid capacity, processes such as digitization, capacity optimization, and congestion management are becoming vital for delivering reliable services.
Power Grid Model is an open source project from Linux Foundation Energy and provides a calculation engine that is increasingly essential for DSOs. It offers a standards-based foundation enabling real-time power systems analysis, simulations of electrical power grids, and sophisticated what-if analysis. In addition, it enables in-depth studies and analysis of the electrical power grid’s behavior and performance. This comprehensive model incorporates essential factors such as power generation capacity, electrical losses, voltage levels, power flows, and system stability.
Power Grid Model is currently being applied in a wide variety of use cases, including grid planning, expansion, reliability, and congestion studies. It can also help in analyzing the impact of renewable energy integration, assessing the effects of disturbances or faults, and developing strategies for grid control and optimization.
What to expect
For the upcoming meetup we are organizing, we have an exciting lineup of activities planned:
-Insightful presentations covering two practical applications of the Power Grid Model.
-An update on the latest advancements in Power Grid -Model technology during the first and second quarters of 2024.
-An interactive brainstorming session to discuss and propose new feature requests.
-An opportunity to connect with fellow Power Grid Model enthusiasts and users.
Discover top-tier mobile app development services, offering innovative solutions for iOS and Android. Enhance your business with custom, user-friendly mobile applications.
How information systems are built or acquired puts information, which is what they should be about, in a secondary place. Our language adapted accordingly, and we no longer talk about information systems but applications. Applications evolved in a way to break data into diverse fragments, tightly coupled with applications and expensive to integrate. The result is technical debt, which is re-paid by taking even bigger "loans", resulting in an ever-increasing technical debt. Software engineering and procurement practices work in sync with market forces to maintain this trend. This talk demonstrates how natural this situation is. The question is: can something be done to reverse the trend?
Must Know Postgres Extension for DBA and Developer during MigrationMydbops
Mydbops Opensource Database Meetup 16
Topic: Must-Know PostgreSQL Extensions for Developers and DBAs During Migration
Speaker: Deepak Mahto, Founder of DataCloudGaze Consulting
Date & Time: 8th June | 10 AM - 1 PM IST
Venue: Bangalore International Centre, Bangalore
Abstract: Discover how PostgreSQL extensions can be your secret weapon! This talk explores how key extensions enhance database capabilities and streamline the migration process for users moving from other relational databases like Oracle.
Key Takeaways:
* Learn about crucial extensions like oracle_fdw, pgtt, and pg_audit that ease migration complexities.
* Gain valuable strategies for implementing these extensions in PostgreSQL to achieve license freedom.
* Discover how these key extensions can empower both developers and DBAs during the migration process.
* Don't miss this chance to gain practical knowledge from an industry expert and stay updated on the latest open-source database trends.
Mydbops Managed Services specializes in taking the pain out of database management while optimizing performance. Since 2015, we have been providing top-notch support and assistance for the top three open-source databases: MySQL, MongoDB, and PostgreSQL.
Our team offers a wide range of services, including assistance, support, consulting, 24/7 operations, and expertise in all relevant technologies. We help organizations improve their database's performance, scalability, efficiency, and availability.
Contact us: info@mydbops.com
Visit: https://www.mydbops.com/
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Dependable online appointment booking
1. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
DEPENDABLE ONLINE APPOINTMENT BOOKING
SYSTEM FOR NHIS OUTPATIENT IN NIGERIAN
TEACHING HOSPITALS
Adebayo Peter Idowu1, Olajide Olusegun Adeosun2, and Kehinde Oladipo Williams3
1Department of Computer Science & Engineering, Obafemi Awolowo University, Ile-Ife, Nigeria
2Computer Science & Engineering Dept., Ladoke Akintola University of Technology, Ogbomoso,
Nigeria
3Department of Phyiscal and Computer Sciences, College of Natural and Applied Sciences,
McPherson University, Ajebo, Ogun State, Nigeria.
ABSTRACT
The number of missed appointments in healthcare institutions in Nigeria caused problems, hence the need
for integrated healthcare system to intervene and provide seamless care for patients. Appointment
scheduling system lies at the intersection of providing efficiency and timely access to health services. This
research presents an online National Health Insurance Scheme (NHIS) Outpatient Medical Appointment
Booking System where NHIS patients can access and view any available personnel or doctor schedule in
order to book an appointment with the corresponding time as specified by the available doctor. The system
was developed using PhP, macromedia dreamweaver, apache and MYSQL. This is to ensure that the
application is robust, cheap and is able to run on different platforms. The system provides the platform to
facilitate the booking and management of patients’ appointment bookings. Patients can also view their
appointment reports. It also provides the healthcare workers an easy access to manage patients’
appointments and to generate relevant reports.
KEYWORDS
NHIS, Medical Appointment, Booking system, Healthcare System.
1. INTRODUCTION
In this fast driven society, where the current climate in the healthcare sector demands efficiency
and patients’ satisfaction in medical care delivery. The numbers of missed appointments,
unnecessary waste of patient’s appointment time have caused an impending problem for
healthcare institutions (Chua, 2010). Hence, there is need for integrated healthcare system to
intervene and provide seamless care for both inpatients and outpatients. Therefore, an
appointment booking system lies at the intersection of providing efficient and timely access to
health services. Outpatient appointment booking is a subject of great interest to hospitals and
other medical institutions (Koole, 2007).
The research on appointment scheduling has a long history, starting with the work of Welch and
Bailey (1952). Their most famous result is the so-called Bailey-Welch appointment schedule,
which states that two patients should be planned at the start of the day, and the other patients
evenly spaced throughout the day, to offset the bad effects of no-shows and patient lateness
DOI:10.5121/ijcsit.2014.6405 59
2. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
(Welch and Bailey, 1952). Bailey (1952) already announced that an appointment system is a
trade-off between doctors’ and patients’ waiting times. Although outpatient clinic’s average
internal waiting times are long, doctors frequently have idle time. Patients who do not show up or
who are late for their appointments cause idle time for doctors, leading to temporary
underutilization of the outpatient clinic’s capacity. Gaps in the appointment schedules also cause
underutilization of the doctor’s time (Bailey, 1954).
Research on outpatient clinics shows that waiting times are patients’ main dissatisfaction with
hospital services (Huang, 1994). According to doctors and personnel, overtime and peak
workloads are potential threats for the quality of care and the quality of labor, because they
increase stress and time pressure. This research focuses on outpatient scheduling as a means to
solve these problems for outpatient clinics. According to Cayirli (2003), access time is the time
between the patient’s request for an appointment and his arrival at the outpatient clinic. A
patient’s internal waiting time is the period between the scheduled starting time and the actual
starting time of his consultation. Waiting time due to a patient’s early arrival is extracted from the
internal waiting time, since it is not a consequence of the appointment system (Veral, 2003).
Accessibility to healthcare at affordable cost constitutes a high challenge in Nigerian like most
African countries. The provision of quality, accessible and affordable healthcare remains a
serious problem (Oba, 2008) and due to this fact, Nigerian was ranked to be low in healthcare
delivery by international organisations. In other to address the situation in the health sector, and
to provide universal access to quality healthcare service in the country, National Health Insurance
Scheme (NHIS) was introduced in Nigeria (Johnson, 2009); with the aim of providing universal
access to quality healthcare to all Nigerians. In 1993, the Federal Government directed the
Federal Ministry of Health to start the scheme in the country in 1999 and the scheme was
modified to cover more people (Adesina, 2009). NHIS became operational after it was officially
launched by the Federal Government in 2005 (Kannegiesser, 2009).
The purpose of NHIS is to ensure the provision of health insurance “which shall entitle insured
persons and their dependents the benefit of prescribed good quality and cost effective health
services” (NHIS, 1999). Because of the cost effective of the scheme, there are more beneficiary
that are entitle to the medical benefit and this cause some problem in the Nigerian teaching
hospital, because there are many outpatients that will be on queue at the clinic to compete for the
limited appointments opportunity with physician (Arodiogbu, 2005). As a result of this, there is
long waiting time before an NHIS outpatient can have access to see the Doctor or Physician. Thus
access and appointment availability become the key component of outpatient satisfaction within
the NHIS medical system.
Due to the major problem of long waiting time facing by many outpatient and most especially the
NHIS outpatient in the Nigerian Teaching Hospitals (Thatcher, 2005). There is need to develop a
web based NHIS outpatient medical appointment booking system to help patients to book
appointment and access their medical records online. It aims to reduce the number of missed
appointments, unnecessary outpatient queue at the clinics, and long waiting time of NHIS
outpatients at the clinics. The system will enable the NHIS outpatients to login with their NHIS
number to appointment booking interface and view the scheduling calendar for the available
physicians, available time and room number of the available physicians. Then book an
appointment by selecting from the list of available personnels that conform to the patient time.
This paper presents a web based NHIS outpatient medical appointment booking system which
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3. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
creates a user friendly environment for patients and healthcare personnels to use. The aim is to
empower the patient to book and manage their own appointments at their convenience, shortening
the unnecessary waiting time for consultation.
2. LITERATURE REVIEW
2.1 Waiting Time
Waiting time simply means a period of time which one must wait in order for a specific action to
occur, after that action is requested or mandated (Fernandes et al., 1994). Patients’ waiting time
has been defined as “the length of time from when the patient entered the outpatient clinic to the
time the patient actually received his or her prescription” (Jamaiah, 2003). It is defined as the
total time from registration until consultation with a doctor. There were two waiting times, the
first is time taken to see a physician and the second is time to obtain medicine (Suriani, 2003).
This paper deals with the waiting time to see physicians.
Long waiting times are a serious problem for patients using urban health centre’s in developing
countries (Bachmann, 1998). A block appointment system was introduced and evaluated in a
large South African health centre. Waiting times of all patients were measured over one-week
period before and after the implementation of appointments. Focus groups and individual
interviews were conducted with staff and patients. After introducing appointments, patients with
acute and chronic illnesses and having appointments had significantly shorter waits time than
similar patients without appointments (Mahomed, 1998).
Appointments had no benefits for patients not seeing doctors or collecting repeat medication.
There was, however, an overall increase in patients' waiting times after introducing the system,
mainly due to one typical day in the follow-up study. Focus groups and interviews revealed that
staff were skeptical at baseline but at follow-up were positive about the system. Patients were
enthusiastic about the appointment system at all stages. The study shows that block appointments
can reduce patients’ waiting times for acute patients, but may not be suitable for all patients. Staff
and patients had different views, which converged with experience of the new system (Mahomed,
1998).
2.2 Patients’ Appointment System
A patient appointment system or appointment schedule for health care center started long time
ago (Harper, 2003). Management of patients’ appointments has earlier works and has developed
simplified queuing models and fairly static scheduling conditions. Another attempt was made to
calculate the waiting time between patient and doctor using the mathematical queuing models to
minimize waiting time (Gamlin, 2003). However; traditionally the appointment system has
considered that the doctor time is more important than patient time (Wijewickrama, 2005). So an
appointment system was designed to minimize the doctor idle time but current designing of an
appointment system is based on decisive factors with respect to both the patient and doctor
(Takakuwa, 2005).
The patient appointment system has complex structures because it represents the patient
appointment time in the healthcare center and controls the patient waiting time based on the type
and the period of patient appointment (Gamlin, 2003). Moreover, a patient appointment system is
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4. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
meant for: managing doctor’s time, reducing patient’s waiting time, reducing doctor’s idle time,
reducing nurse’s idle time, and improving the quality of service in the health care (Harper, 2003).
2.2.1 Appointment Delay
Past research shows that the longer the appointment delay which is defined as the time between
the day a patient requests an appointment and her actual appointment date, the higher the chances
that he/she will cancel or not show up (Gallucci et al. 2005). This suggests an obvious way of
minimizing no-shows and cancellations: this is done by asking the patients to come right away or
make appointment requests on the day they want to be seen (Murray, 2000). This is called an
open access (OA) or advanced access policy (Tantau, 2000), and of late it has become a popular
paradigm in practice and the subject of active research. Several authors report on their
experiences in implementing OA, both positive and negative (Dixon et al. 2006). Some
practitioners strongly advocate OA (Murray and Tantau 2000), and there are some who are
strongly against it (Lamb, 2002).
2.2.2 Managing Patients’ Appointment system
According to Dexter (1999), managing patient appointment system is a computer application used
to manage and reduce the patient waiting time in the health care center. Some health care centers
do not use any appointment system. So it has a longer average patients’ waiting time than the
health care center that adopts the patients’ appointment system. While patients can wait for more
than one hour to be attended to by a physician in a health care center, they also can feel that they
are being disregarded and treated unfairly. So when patients are given the time of appointment in
a health care centre, they can evaluate the quality of service in the centre (Dexter, 1999).
Hence, developing patients’ appointment process for health care centres necessitates the use of a
sophisticated queuing model that captures much of the real system’s features (saving time,
reducing idle time, etc). Therefore the appointment schedule represents the real situation in the
health care centre faced by patient appointment schedulers (Rohleder, 2002). On the other hand,
the standard practice for scheduling and processing patient appointments are based on the nature
of treatments of the patients and that better approaches more sensitive to patient needs are
desirable (Klassen, 2002).
2.3 Online Booking System
An online system is also known as a web based system. A web is made up of page that is
commonly known as web page or web site, and a web site is a computer program that runs a web
server that provides access to a group of related web pages (Alex, 2000). A system is a set of
independent components working together to achieve a common objective. Therefore a web
based system is a system that is accessible over the internet by a user in order to achieve a
particular task for a given purpose. The Internet is a system that is use to connect computers and
computer networks. It helps to link millions of computer networks all over the world and it allows
the users to get information stored on other computers from a long distance (James, 1999).
According to Chua (2010) the public demand for better healthcare system and the alarming
number of missed appointments have forced the healthcare sector to recognize how they deliver
care services. With the advance of IT technology today and seen healthcare system as a critical
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5. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
system, appointment booking system lies at the intersection of delivering efficient, dependable
and timely access to health services. The conventional way of appointment booking is via fax,
phone or email. But with the growing internet penetration, healthcare industry is moving towards
the use of an online appointment booking system.
A web-based appointment system is used in Taiwan; everyone is required to enroll in the national
health insurance program. When one needs health service, he shows his health insurance card to
doctors in an hospital to start with. There are several ways of making an appointment. A person
can either go to the hospital directly for consultation day by day or make an appointment from
home through phone call or email if his condition is not emergent (Gruca, 2004). The Internet
provides a wide range of technologies that enable hospitals to communicate with their patients.
Recently, as the prevalence of Internet increasing, many hospitals initiated the website
appointment system. Electronic patient-provider communication promises to improve efficiency
and effectiveness of clinical care (Wakefield, 2004).
2.4 Existing Hospital Appointment Schemes
One application developed to manage patients’ appointment scheduling has used exponential
enter arrival times. This model assumes that the exponential enter arrival times could not be
directly validated by date, and it is limited due to the nature of the appointment scheduling
(Rohleder, 2002). Since appointments are scheduled in the future, the exact model of call arrivals
will only have limited impact on measures related to the time between the call and the
appointment time. For this reason, the challenge for making appointment system is designing a
suitable system based on the health care procedure environment (Klassen, 2002). Hence, the
appointment provider in the health care center can schedule a patient into an appropriate time slot
on a given day.
Klassen (2004) developed another method for managing patients’ appointment using multiple
schedule appointment in multiple period environments. Patients can call for any appointment time
but if the period time is full, they should replace the appointment to another time. Moreover,
various combinations for multi appointment and double booking are measured and recommended
for different operational use depending on the health care environment because the varying
appointment request has little effect on appointment system performance, especially maintaining
acceptable performance, except when the system has the overloaded option (Rohleder, 2004).
Many studies about patients’ appointment have found that there are rules or policies for
scheduling appointment system such as no scheduling for more than 20 or 30 clients and the best
schedule is to place two patients in the first appointment and spread the rest consistently over a
period based on average service times (Klassen, 2004). On the other hand, a patient can call for
an appointment without knowledge of the type of appointment and appointment queue number
and the patient is not aware whether the appointment is variable or not. Sometimes the exact
duration for each patient can be known but at other times this is unknown (Rohleder, 2004).
Another system developed by Mustafa, (2004) allows a registered patient, having user name and
password, to access and explore the list of physicians alphabetically and select a physician whose
email contact and profile are also provided. A patient can also view the physician working
calendar to find out his/her working and non working day to make an appointment. When the
patient selects, view calendar the patient can then choose any valid day in any month to make an
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6. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
appointment (Mustafa, 2004). After that, the patient will receive an e-mail from the system to
confirm the appointment time or to inform the patient that the selected time is already taken by
another patient or blocked by the physician. In general, the patient appointment system provides
all the choices and the capabilities to the patients, such as selecting a physician, selecting the time
of appointment, and allows them to access the health care system day or night and schedule their
own appointments using the Internet without spending time holding for a nurse or having lengthy
phone calls.
Wijewickrama and Takakuwa (2005) opine that the health care operating time (due time) is from
8:30 am to 5:30 pm during the week days. Throughout this period, four types of patients arrive to
have a consultation appointment in the health care center-appointed patients, same day
appointment patients (walk-ins), patients who come for a medical test and new patients
(Wijewickrama, 2005). Patients who have appointments are given priority over those who walk-in
for consultation. Consequently, these latter patients have to wait a long time in the waiting
64
room to meet a doctor even if the consultation time only last few minutes (Takakuwa, 2005).
Porta-Sales et al. (2005) developed another system. The main concept of the system is contacting,
screening and scheduling appointment with the health care center initially by an expert nurse and
the patient initiating contacting with the health care center using the telephone. Moreover, the
health care center can be accessible from different places. So there should be PC resources and
PC consultations to be accessed from different sources, from other hospitals, from general
practitioners, or even from the patients themselves. Porta-Sales et al. (2005) studied 534 patients
for a period exceeding one year. After the first visit, 195 patients did not return for the second
scheduled appointment and 203 patients had progressed on to the third scheduled visit. The main
reason given for the scheduled visits was admission into the health care; the median time-lapse
between the first and second visit was 21 days, between the second and third was 27.5 days and
between the first and third was 48 days. Comparing patients, who did not attend the three
consecutive visits with those who did, indicated that the former had (at the first visit) a lower
performance status.
Su et al. (2003) studied in a private hospital which has several clinics. For each clinic, the average
patient load is 20 per consultation section (morning or afternoon) and the health care system
adopts both a patient appointment model and patient registration model. The system allows
patients to have self-selected specific physicians for consultation and registration (Shih, 2003).
The management appointment system studied by Su and Shih, (2003) is based on the first 20
reserved for scheduled patients, after that, only seven are offered for scheduling. Odd numbers
after 20 are left for walk-ins. The arrival time of the first patient is assumed to be the same as the
clinic starting time. The scheduled patients are assigned based on 3- main intervals and are also
informed about their appointed arrival times (Su, 2003). If the scheduled patient does not appear
on time, the next available patient receives consultation immediately. The management operating
philosophy of services here is based on “first in, first seen” to limit patient waiting time.
Therefore, patients can walk-in to see a physician, when patient shows up at the appointed time
(Shih, 2003).
Some of the existing appointment booking system have some limitations and the system
developed in this research eradicate the limitations of the existing system in confirming patient
medical appointment by sending an email to the patient if the appointment have being confirmed
or not. It will also enable the patients to view and monitor their medical records online.
7. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
65
3. METHOD
In order to achieve the objectives of this research, the researchers personally went to three
Nigerian teaching hospitals within south western Nigeria with focus on NHIS patients and
observed the appointment schedule in those hospitals. Also as a follow up, the researchers
interviewed 4 physicians and 10 patients in each of the teaching hospitals in order to assess the
manual appointment and booking method. In addition, data on appointment booking and schedule
were collected through structured and unstructured personal interview. Some of the forms used in
the outpatient clinics on appointment booking were also collected and were used as a guide in
order to develop the online medical appointment booking system for NHIS patients in Nigeria.
Database was developed using MySQL for the system. In the process of developing medical
appointment booking system for NHIS patients, records were stored in the database. MySQL in
wampserver was used to create and populate the database. The medical appointment booking
system for NHIS patients in Nigeria was implemented using dream weaver, and PHP. Apache
was used as the server to provide basic functionality of the web GIS. PHP was used as a scripting
language to program the server side that manipulates the knowledge in the database.
4. SYSTEM ARCHITECTURE AND USE CASE DIAGRAM
4.1 System Architecture
The architecture is structured to allow users to make use of portable computer system, desktop
computer system, and mobile phone as web browser to access the booking system. Client-server
architecture was used and we used thin client-server. The medical appointment booking system
has two components namely: the server-side and client-side that run on the browser.
In the client approach almost all the processing work was done on demand at the server end and
the client task was to display data and information on the screen. While in thin client-server
architecture, the web browser is the client. This architecture was used because with it users will
not be required to install any software on their PCs expect a standard web browser, which often
come, with most PC operating system and almost all the current standard mobile phone.
Clients would also not require any powerful PC; users can use any PC with a web browser such
as laptop/notebook, mobile phone, and desktop PC. The servers would require higher
configuration (in terms of hardware) because it would be regularly subjected to heavy load.
Figure 1 depicts the medical appointment booking system architecture.
4.2 Use Case Diagram
The use case diagram is used in presenting the system requirements of any proposed system. A
use case is a realistic description of the workflow of the system and it is used to explicitly
describe the intentions and actions of users. The use case diagram, which present the system
requirements are used to show how the proposed system work in practice. The interaction
between actor and use cases are also described using use case diagram. The use case diagram of
the medical appointment booking system is presented in figure 2.
8. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
66
Figure 1: Medical Appointment Booking System architecture
9. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
67
Figure 2: Web Based Medical Appointment Booking System
5. THE ONLINE MEDICAL APPOINTMENT BOOKING SYSTEM
The user interface allows the user to navigate the system and communicate with the database. The
system interface design is simple enough to be the use for anyone with little knowledge of
computer operation and the system is user friendly and made easy to use through the use of
Windows, Interface Menu and Pointing devices (WIMP) which is very important in computer
graphics design. The inputs to the online medical appointment booking system are captured
through the user interfaces available in administrator’s web account and the individual patient’s
web account. A login Menu, which contains a user-friendly interface for capturing valid
registration code, username and password, is available for each patient to logging in to their
various accounts. In each patient account, data pertain to the patient and available doctor are
entered and appointment booked are submitted. All these captured data are stored in the database.
5.1 Patient Registration Menu
There is need for every new patient to register before they can access the system, a patient must
have a username and password which they will use to login before they can book for medical
appointment. Any patient that does not register will not be allowed to access appointment
booking Menu because to login to the appointment Menu requires a username and a password.
Figure 3 shows the patient registration Menu and after the patient has successfully registered as a
10. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
new user to use the system. This is the Menu that will be display as a confirmation Menu for the
registration and this Menu can be print out by the patient and this is depicted in figure 4.
68
Figure 3: Patient Registration Menu
Figure 4: Output of Patient Registration
5.2 Patient Activity Menu
The patient activity Menu which is depicted in figure 5 displays the list of link of operation that a
patient can perform with the system; the following are the activities a patient can perform.
• Appointment Booking
• View Appointment Report
• Log Out
11. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
69
Figure 5: Patient Activity Menu
5.3 Weekly Calendar
This enables the patients to book for medical appointment by clicking on the link and the above
Menu will be display. This Menu enables the patient to view the calendar as scheduled by the
system administrator based on the weekly activities of the doctors at the Obafemi Awolowo
University Teaching Hospital complex. When a patient view this calendar then he/she will know
the doctor that is available at a particular time and make his/her appointment based on the
schedule. After viewing the calendar, the patient can then clink on next button to continue with
the appointment and this is shown in figure 6.
Figure 6: Weekly Calendar
5.4 Patient Appointment Menu
The patient appointment Menu depicted in figure 7 is to allow the patient to book for medical
appointment based on the calendar already viewed. All the fields provided must be entered and
then clink on submit button, the output Menu will be display. The appointment output Menu
depicted in figure 8 shows the confirmation of the appointment already booked by a patient with a
12. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
doctor. The appointment will then be treated by the administrator for final confirmation, the
appointment can then be approved or disapproved based on the doctor availability. The patient
can also print as a confirmation for their appointment. The patient can then view the appointment
status weither the appointment has been approved or not. The patient can clink on the link name
to view appointment report and the following Menu will be display.
70
Figure 7: Patient Appointment Menu
Figure 8: Appointment Output Menu
5.5 Patient Report Menu
The patient report Menu depicted in figure 9 allows the patient to view their medical report by
selecting their patient ID and then clink on the search button in other to view their appointment
status from their account as alternative means of viewing their appointment status instead of
going to their emails. This status can as well be view from their email but in other to save time,
the patient status can be view directly from the user account. When the search button is clink,
then the output Menu will be display.
13. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
The menu shows the patient appointment report where the patient can view the status of their
appointment. If their appointments have been confirmed by the system administrator from the
admin Menu, the status column will indicate it and a shot message will be displayed at message
column. The Menu depicted in figure 10 can be printed out by the patient.
71
Figure 9: Patient Report Menu
Figure 10: Patient Appointment Report Menu
5.6 Administrator login Menu
The administrator interface allows the administrator to be able to implement editing, inserting,
deleting and to check the overall result of all registered outpatients. An administrator could be a
doctor or nurse who is able to schedule appointment, generate appointment report and view the
appointment report of patients that has registered all the necessary information needed. The
patient has a patient identification number in order to search for the information stored in the
database of the system. The information available will be displayed to the user by the system if he
had entered valid registration number. Figure 11 shows the administration login Menu. When an
administrator login the following menu displays.
This Administrator activity menu represented in figure 12 shows the activities that the
administrator can perform and the following activities can be performed
14. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
72
· Check Appointment (Approved or Disapproved)
· Cancelled Appointment
· Prepared Doctor’s Roaster
· Generate Appointment Report
Figure 11: Administrator Menu
Figure 12: Administrator Activity Menu
6. CONCLUSION
With the development of web based NHIS medical appointment booking system, patients are able
to book and manage their own appointment with ease. They will be reminded of their
appointments via SMS/email that will be promptly sent to them before their appointment date.
The system itself also provides a quick view of their appointment at the Home page. These
functions could indirectly help to reduce the number of missed medical appointments and patients
no-show up for their appointment. Patients would be notified via SMS/email if their appointment
were affected, when there is urgent needs of the service provider at other place or in case of any
situation that can result to the absence of the service provider.
15. International Journal of Computer Science & Information Technology (IJCSIT) Vol 6, No 4, August 2014
Patients could also track and monitor their own appointment record with this system. However,
the display of bio-data such as X-rays and laboratory results are not included in the system due to
technical constrain. The system will not be able to diagnose or prescribe drug for usage. The
system is mainly designed to facilitate appointment booking between the patient and the health
personnel. In compensation, additional modules such as Announcement, Medical case record and
block/unblock schedule will further enhance the usability and functionality of the system and
allow a flexible management of patients appointment.
The system delegates some administrative work to the patients by allowing them to manage their
own appointment and personal profiles. Time will not be wasted on converting paper-based
appointment record into electronic-based. The system further helps to reduces healthcare
personnel workload by allowing them to generate medical reports easily. They could now
maximize their competence and allocate more time to maximize service quality.
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