Understanding the factors that contribute to the willingness of HCP to report to work during an influenza public health emergency is critical to emergency planning and preparedness. Information from this review can guide emergency policy makers, planners, and implementers in both understanding and influencing the willingness of HCP to work during an influenza public health emergency.
The gap between implementers and researchers of quality improvement (QI) has hampered the degree and speed of change needed to reduce avoidable suffering and harm in health care. Underlying causes of this gap include differences in goals and incentives, preferred methodologies, level and types of evidence prioritized and targeted audiences. The Salzburg Global Seminar on ‘Better Health Care: How do we learn about improvement?’ brought together researchers, policy makers, funders, implementers, evaluators from low-, middle- and high-income countries to explore how to increase the impact of QI. In this paper, we describe some of the reasons for this gap and offer suggestions to better bridge the chasm between researchers and implementers. Effectively bridging this gap can increase the generalizability of QI interventions, accelerate the spread of effective approaches while also strengthening the local work of implementers. Increasing the effectiveness of research and work in the field will support the knowledge translation needed to achieve quality Universal Health Coverage and the Sustainable Development Goals.
People living with HIV/AIDS (PLHA) while availing anti-retroviral therapy (ART) services face administrative and procedural problems in hospitals which affect their level of satisfaction with service providers. There is very little information available regarding quality of services provided at ART centers in India. Hence this study was conducted between July 2007 and December 2008 at ART Center, Chandigarh to analyse the user's perception about quality of services provided and factors associated with satisfaction level. For this prospective cross-sectional study, 100 PLHA were randomly recruited at ART Center. Exit interviews were conducted with structured questionnaire containing four groups of questions and questions on waiting time and satisfaction level. A scoring system was devised. The satisfaction level was cross matched with group questions. Mean age of 100 PLHA was 36.46 years (SD = 8.46), 22% were females, 55% from rural background and 67% educated above primary level. The mean group scores of four groups of questions were: Information, access and guidance (58.8%), Interaction with service providers (92.96%), Physical facilities (70.85%), Confidentiality, discrimination and grievance redressal (70.31%). Eighty-eight per cent rated satisfaction level as satisfactory or above (30% very satisfactory, 58% satisfactory), 10% indifferent and 2% dissatisfied. Factors found to be associated with satisfaction level were patient provider interaction (p=0.002) [behaviour of staff (p=0.005)], physical facilities (p=0.005) [cleanliness (0.002), drinking water (0.006)], confidentiality (p=0.004), waiting time to meet the doctor (p=0.03) and total time spent in hospital (p < 0.001). Problem areas identified were low availability of signage, low awareness of grievance redressal system, sanitation/toilets, drinking water, waiting time to meet the doctor (mean = 53.3 minutes), and "total time spent in hospital" (mean = 143 minutes). Study provided user's perspective about quality of ART services provided in a tertiary care hospital of India and revealed the factors associated with PLHA satisfaction level. Better quality ART Services can be provided to PLHA by addressing these factors.
Introduction: Inadequate hand-washing facilities have been reported as a barrier to hand washing. This study aimed to evaluate the availability and accessibility of hand-washing facilities and supplies of hand-washing agents in the outpatient department (OPD) complex of a tertiary care teaching hospital. Methodology: A checklist containing 13 variables was prepared and all rooms of direct patient care in the OPD were assessed on one occasion. Results: Out of 211 rooms surveyed, a hand-washing facility was available in 209 (99.05%) rooms. Among these, 206 (98.56%) sinks were easily accessible and were placed close to users. Almost all sinks (99.5%) had hand-operated taps. Thirty-five (16.75%) sinks had no soap stand, and at 21 (10.5%) sinks, soap stands were found to be broken. At 14 (6.70%) sinks, soap bars were not available, while an antiseptic agent was available at 6 (2.87%) sinks. Four (1.91%) sinks had no towel stand, and at 8 (3.83%) sinks the towel stands were broken. At 43 (20.57%) sinks no towel was available, and at 23 (11%) sinks the towels provided were dirty. No sink drain was found to be blocked. No sink had hand-washing instructions displayed demonstrating the correct technique of hand washing. Conclusion: Physical facilities required for hand washing were adequate though not perfect. There is a need to shift from hand-operated taps to non-manual taps and from cloth towels to paper towels. Hospital managers in developing countries should continuously strive to provide the best possible hand-washing facilities within their financial resources.
The ABC and VED (vital, essential, desirable) analysis of the pharmacy store of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, was conducted to identify the categories of items needing stringent management control. The annual consumption and expenditure incurred on each item of pharmacy for the year 2007-08 was analyzed and inventory control techniques, i.e. ABC, VED and ABC-VED matrix analysis, were applied. The drug formulary of the pharmacy consisted of 421 items. The total annual drug expenditure (ADE) on items issued in 2007-08 was Rs. 40,012,612. ABC analysis revealed 13.78%, 21.85% and 64.37% items as A, B and C category items, respectively, accounting for 69.97%, 19.95% and 10.08% of ADE of the pharmacy. VED analysis showed 12.11%, 59.38% and 28.51% items as V, E, and D category items, respectively, accounting for 17.14%, 72.38% and 10.48% of ADE of the pharmacy. On ABC-VED matrix analysis, 22.09%, 54.63% and 23.28% items were found to be category I, II and III items, respectively, accounting for 74.21%, 22.23% and 3.56% of ADE of the pharmacy. The ABC and VED techniques need to be adopted as a routine practice for optimal use of resources and elimination of out-of-stock situations in the hospital pharmacy.
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