5^th International Congress on Healthcare & Hospital Management December 03-04, 2018 | Rome, Italy

Biography:

Nicole Gerber is a Senior Research Associate and Project Leader at the Institute of Facility Management (IFM) at Zurich University of Applied Sciences (ZHAW), leading different research and development projects with a focus on healthcare. She can draw on various professional and entrepreneurial experience in different industries in addition to her MSc degree in Business Administration and MAS in Information Systems.

Abstract:

Statement of the Problem: Like in other industries, digitalization causes increased dependency on IT Services in hospitals. In healthcare, IT as a discipline and IT as departments were often seen more as a necessary evil than as an enabler or partner in the past. In hospitals, this firstly led to an unaligned, redundant, hard to maintain and thus costly development of the IT infrastructure and software landscape with many legacy systems and secondly to unclear service provisions without clear service level agreements and non-transparent pricing. Particularly with increasing cost pressure and higher need of compliance and risk management, IT departments in hospitals need clear IT Service Catalogues in order to provide the specific services needed and also in order to have more transparency of cost.

Methodology & Theoretical Orientation and Findings: In an iterative, consortial research approach including a University of Applied Sciences, consulting firms and several hospital IT experts, an IT Service Catalogue for Hospitals was developed based on existing literature but adding specific aspects for the hospital context. The main goal was a pragmatic approach in order to ensure implementation in practice.

Conclusion & Significance: The IT Service Catalogue for Hospitals provides a good practice standard for IT departments in hospitals taking into account the specific needs for the hospital industry and thus enables hospitals to do benchmarking due to the common understanding and definition of the catalogued services.

Biography:

Zaina Theresa has a Masters in International Hospitality Management from Auckland University of Technology and is working towards a PhD from Universiti Teknologi Mara. She has hospitality industry experience in both India and New Zealand. Her research interests are in the education and qualifications of hospitality managers and the value of hospitality qualifications. She focusses on exploring the scope of hospitality and widening the employability of hospitality graduates.

Abstract:

The authors of this paper noted the rapid growth of large retirement villages in Auckland, New Zealand. Many of these have several hundred units ranging from independent living to care home facilities. A number of large corporate organisations have become major players in this sector. Similarities were noted between how these operate and hotel corporations managing resort properties. The researchers therefore wanted to investigate who the people who are managing these facilities are, what their roles involve, and where they have come from in terms of educational background and industry experience. As there has been very little academic work done in this area from a hospitality management perspective, the researchers conducted an exploratory study gathering qualitative data through five in-depth interviews with the ‘village managers’ in charge of these retirement complexes. A range of organisations were included in this purposive sample from large international providers to an independent charity with one site. Findings were that managers were mostly well-qualified with degrees or post-graduate qualifications. Many had hospitality industry experience. None had a medical background although they all acknowledged the importance of the clinical services manager who reported to them. All emphasized the importance of a strong and committed team of staff, and the importance of building long-term professional relationships with residents who are well-educated professionals with high expectations. All of them expressed high levels of satisfaction with their roles and concern about the ability to recruit staff for the future.

Biography:

Alberto Budía has his expertise in the diagnosis and treatment of urinary lithiasis and endourologic procedures. He has developed a total quality management project based on process management, patient safety, care quality and efficiency analysis since 2012. In January 2018 this project got the ISO 9001:2015 and UNE: 179003 management certification. This project has improved the activity indicators, the patient safety (FEAM model), the efficiency (cost-effective algorithms) and patient quality perception. His model is based on continuous improvement creates new pathways for enhanced healthcare in public health systems. He has built this model after years of experience in research, evaluation and management in a Lithotripsy and Endourological Unit at a Spanish tertiary public hospital.

Abstract:

Statement of the Problem: The application of this methodology to the management of health services is very appropriate in times of crisis when demand continues to grow and there is no longer a growing funding that can adapt to this demand. The foundation of this methodology is the reduction of costs, the improvement of the feedback between the health personnel, the increase in the care and production quality, the decrease in the proportion of patients who do not show up at scheduled appointments, the improvement in the main indicators, as well as the reduction of human and system errors.

Purpose: The purpose of this work is to evaluate whether the application of the lean healthcare methodology is sustainable in a tertiary department of a Spanish health service public hospital looking for improving efficiency.

Methodology & Theoretical Orientation: The implementation of the lean healthcare methodology in a urology department was conducted by carrying out the five consecutive steps described in this methodology. This was applied in three non-sequential phases: team training, process management and continuous improvement. The main source of information is the balanced scorecard for health systems management (CUIDISS). The comparison with other national urology departments was performed through the same platform (IASIST).

Findings: The implementation of this methodology translated into high practitioner satisfaction, increased the care production and improved quality indicators, mainly risk-adjusted length of stay, risk-adjusted complication index and risk adjusted mortality rate. The readmissions rate was the only indicator above the standard due to the adjusted length of stay. The application of this methodology resulted essential to improve the efficiency of the service and hospital.

Conclusion & Significance: The implementation of the lean healthcare methodology is possible in the Spanish public health care; however its sustainability depends on a parallel increase of resources to the care production and an intrinsic and extrinsic recognition of the unit, service or center that has incorporated it.

Biography:

Erum Gonsalves is a Manager, Business Process Reengineering at The Aga Khan University, a leading tertiary care 660 bedded hospital in a large metropolis, where demand for high quality healthcare is on the rise. She has been actively involved with major projects in the University hospital aimed at improving efficiency, eliminating bottlenecks and improving service quality to maximize value for patients. Streamlining the Inpatient Discharge Process was a major project she successfully implemented, facilitating annual bed hour savings of over 100,000 through reduction in discharge process time. This project was also awarded a gold award in innovation in hospital management category at the Hospital Management Asia Aug, 2017. Currently she is working with the hospital’s Emergency Department to increase patient throughput and Outpatient Clinics to minimize turnaround times. Besides her BPR centric work at the hospital, she has also been involved in various projects with the University.

Abstract:

Situated in the densely populated metropolis of Karachi, the Emergency Department(ED) at The Aga Khan University Hospital is arguably one of the most complex clinical settings, catering to the highest acuity patients. Inefficient processes in the ED delayed key activities resulting in a high average LOS of 10.3 hours for admitted patients, and 3.25 hours for discharged patients (2017). Consequently, the number of times an ED bed could be turned over in 24 hours went as low as 4 restricting ED bed supply. Hence in 2017: 4,741 patients left ED because of unavailability of bed (LBUEB) leading to a potential revenue loss of $2.8 million to the hospital.

 A thorough data analysis and time and motion study by the Business Process Reengineering (BPR) team revealed that wastages in the existing processes prolonged decision and transfer times to 4.75hours and 1.8hours respectively. To achieve faster throughput, it was imperative that clinical decisions were accelerated, staff roles were reorganized and manual activities were eliminated from work flows.

The project aimed to achieve a ‘leaner ED’ by aligning existing systems to meet user requirements, automating the bed tracking and standardizing the patient transfer process (SBAR). Furthermore, inter-disciplinary communication within ED staff was improved by introducing nursing team-leads in each area and a non-clinical shift-lead to expedite operational activities and reinforce smoother communication between ED and Inpatient Area.

 As a result, length of stay reduced by 1.7hours for an admitted patient and 0.25hours for a discharged patient. Subsequently, overcrowding reduced: 84% of P1 patients were assigned an ED bed within 10mins of Triage and LBUEB reduced by 44%.

Sustaining these results will potentially yield 50,200 additional ED bed hours annually. Capitalizing on 75% of these hours ED can potentially admit 20 more patients per day, earning the hospital an annual revenue of $4.1million.

Biography:

Emad Esmat is the professor & Head of General Surgery Department and Chief Clinical Surgical Departments at Theodor Bilharz Research Institute (TBRI). He was responsible for TBRI hospital management for more than 10 years and for the private hospital sector for 6 years. He has the "high diploma of hospital management" & he is an "international certified Lead auditor" (IRCA-UK) for the ISO 9001/2015 in addition of being International Assessor for Human Resources (SHL-UK). He has been included in Who's Who biography 2009 and also been nominated for many unique biographical centers like Who's Who in medicine and health care and the 2000 outstanding intellectuals of the 21st century 2009-2010, and in the top 100 health professional 2009, and also nominated as one of 2000 international profiles of accomplished leaders and great minds of the 21st century by American Biographical Institute.

Abstract:

The aim of this study is to assess the pattern of change in utilization and performance in GSD after implementing the new policies and procedures.

Methodology: This is a retrospective observational study. Electronic data were collected from the medical record unit of TBRI from the year 2001 until 2016. Hospital utilization indices; admission, surgical operations, and bed utilization indices; average length of stay (ALOS), bed occupancy rate (BOR), bed turnover rate (BTR) and mortality rate (MR) were calculated before and after implementing the new policies and procedures as from 2007 onwards.

Results: the shift to more skilled and major surgical operations were doubled, the increase of elective surgeries >3 folds of emergency operations, the increased outpatient flow >3 folds, decreased mortality rate, and the improvement in hospital bed indices; decreased ALOS, increased BOR and increased BTR, are the indicators used to show the raise of performance in GSD. The year 2016 showed the optimization of all hospital indices: ALOS 5.5, BOR 74.2, BTR 48.9, and MR 0.1.

In conclusion: Although quality improvement may not appear in the initial years of a program, persistent implementation of hospital quality policies will ultimately lead to future better quality of patient care.

Biography:

Steffi Jerry Mammen is currently pursuing her MHA Degree along with clinical duties at the Inamdar Multispeciality Hospital. She is a budding Researcher having her expertise in pharmacology. Interacting with other healthcare professionals, providing knowledge, information, patient counseling and awareness in a country where pharmacy is under-rated profession is a part of her work profile. She has published research papers in various national and international journals

Abstract:

Purpose: The purpose of this work is to study the adverse drug reactions (ADR’s) reported from wards and critical units at a tertiary care hospital in Pune. The adverse drug reactions were analyzed by Naranjo’s algorithm scale and Hartwig severity assessment scale and the outcomes were studied.

Methodology: This observational and interventional study was conducted for 6 months from November 2016-May 2017 in an inpatient setting at a tertiary care hospital in Pune. The data was captured only in wards and critical units. Patients of all age groups and either sex were included in this study. The adverse drug reactions were checked for their causality and severity by performing the Naranjo’s algorithm scale and Hartwig’s scale respectively. The outcomes were studied. Data analysis was done by descriptive statistics.

Results: Total of 50 adverse drug reactions were reported from wards and critical units. 21-30 years age group was reported to have more adverse drug reactions. The most common organ affected is the skin 32 (71.11%), followed by respiratory system 3 (6.66%) and nervous system 3 (6.66%). Vancomycin 5 (20%) was the drug having majority of the ADR’s. The commonly reported ADR in this study was rash and itching 29 (64.44%). According to Naranjo’s algorithm scale, 23 (51.11%) suspected ADR’s were probable, 17 (37.77%) ADR’s were possible and 5 (11.11%) were definite. As per Hartwig’s severity assessment scale, majority of the ADR’s were mild 21 (46.66%), followed by moderate 20 (44.44%) and severe 4 (8.88%). The outcome of the ADR’s was all recovered 38 (84.44%) during the study period.

Conclusions: There is a need for more spontaneous reporting. After an ADR has occurred, patient counseling is mandatory. The active involvement of a clinical pharmacist to capture ADR’s and awareness given via training to other health care professionals can help change the scenario in under-reported hospitals

Biography:

Aydin Teymourifar completed his BSc in Statistics at Tabriz University, Iran (2005–2009) and achieved MSc in Industrial Engineering from Anadolu University, Turkey (2011–2014). He is a Ph.D. candidate in Industrial Engineering at the Eskisehir Technical University. His research interests are production scheduling, simulation, and healthcare management.

Abstract:

Efficiency measurement of health organizations using the Data Envelopment Analysis (DEA) has gained importance with increasing spending on health services. The aim of this study is to analyze the efficiency of 10 surgical services of a hospital and also to offer suggestions for increasing their productivity. At first, as seen in Figure 1, decision-making units, model, input and output of some previous studies are summarized. Then, the input-oriented model of the DEA method under Variable Returns to Scale (VRS) is used to measure the efficiency of sections. The model has 2 inputs, i.e. the number of personnel and beds, and also 2 outputs, i.e. capacity utilization rate, the total number of operations. Data Envelopment Analysis Toolbox of MATLAB and Excel are used to analyze the data. After recognizing the efficient and inefficient sections, the efficient ones are ranked with Andersen and Petersen model, Tone’s SBM model and cross efficiency evaluation, whose advantages and drawbacks for the ranking are discussed. The results prove that it is possible to increase the efficiency of the sections with efficient using the current resources and without increasing costs