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Bryce M, Hanks S, Burns L, Zahra D, Gale T. Mutual recognition of qualifications, health workforce migration, and graduate outcomes: a comparative mapping study of undergraduate dental education in Europe. HUMAN RESOURCES FOR HEALTH 2024; 22:37. [PMID: 38835022 DOI: 10.1186/s12960-024-00918-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/16/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND The resource needs of health services are served by the recognition of qualifications across borders which allows professionals to migrate between countries. The movement of dentists across the European Union (EU), especially into the United Kingdom (UK), has provided a valuable boost to workforce supply. Recent changes to policy recognising overseas qualifications have brought attention to the equivalence of qualifications awarded in EU countries. Professional regulators need to be confident that dentists who qualified elsewhere have the appropriate knowledge, skills and experience to practise safely and effectively. The aim of this study was to compare UK and EU dental curricula, identify any differences, and compare the extent of pre-qualification clinical experience. METHODS This was a mixed methods study comprising a questionnaire and website searches to identify information about curricula, competences, and quality assurance arrangements in each country. The questionnaire was sent to organisations responsible for regulating dental education or dental practice in EU member states. This was supplemented with information obtained from website searches of stakeholder organisations for each country including regulators, professional associations, ministries, and providers of dental education. A map of dental training across the EU was created. RESULTS National learning outcomes for dental education were identified for seven countries. No national outcomes were identified 13 countries; therefore, learning outcomes were mapped at institution level only. No information about learning outcomes was available for six countries. In one country, there is no basic dental training. Clinical skills and communication were generally well represented. Management and leadership were less represented. Only eight countries referenced a need for graduates to be aware of their own limitations. In most countries, quality assurance of dental education is not undertaken by dental organisations, but by national quality assurance agencies for higher education. In many cases, it was not possible to ascertain the extent of graduates' direct clinical experience with patients. CONCLUSIONS The findings demonstrate considerable variation in learning outcomes for dental education between countries and institutions in Europe. This presents a challenge to decision-makers responsible for national recognition and accreditation of diverse qualifications across Europe to maintain a safe, capable, international workforce; but one that this comparison of programmes helps to address.
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Affiliation(s)
- Marie Bryce
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
- Peninsula Dental School, University of Plymouth, Plymouth, United Kingdom
| | - Sally Hanks
- Peninsula Dental School, University of Plymouth, Plymouth, United Kingdom
| | - Lorna Burns
- Peninsula Dental School, University of Plymouth, Plymouth, United Kingdom.
| | - Daniel Zahra
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - Thomas Gale
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
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Leslie K, Bourgeault IL, Carlton AL, Balasubramanian M, Mirshahi R, Short SD, Carè J, Cometto G, Lin V. Design, delivery and effectiveness of health practitioner regulation systems: an integrative review. HUMAN RESOURCES FOR HEALTH 2023; 21:72. [PMID: 37667368 PMCID: PMC10478314 DOI: 10.1186/s12960-023-00848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/23/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions. METHODS We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework. FINDINGS This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures-processes-outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners. CONCLUSION We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.
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Affiliation(s)
- Kathleen Leslie
- Athabasca University, Athabasca, Canada.
- Canadian Health Workforce Network, Ottawa, Canada.
| | - Ivy Lynn Bourgeault
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | - Anne-Louise Carlton
- Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
| | - Madhan Balasubramanian
- College of Business, Government and Law, Flinders University, Adelaide, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Raha Mirshahi
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | | | - Jenny Carè
- University of Technology Sydney, Sydney, Australia
| | | | - Vivian Lin
- University of Hong Kong, Hong Kong, China
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Tsagkaris C, Trygonis N, Spyrou V, Koulouris A. Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities. Cancers (Basel) 2023; 15:3700. [PMID: 37509361 PMCID: PMC10378403 DOI: 10.3390/cancers15143700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP). METHODS This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits. CONCLUSIONS Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.
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Affiliation(s)
- Christos Tsagkaris
- European Student Think Tank, Public Health and Policy Working Group, 1058 DE Amsterdam, The Netherlands
| | - Nikolaos Trygonis
- Department of Orthopaedics, University Hospital of Heraklion, 70013 Heraklion, Greece
| | - Vasiliki Spyrou
- Post Covid Department, Theme Female Health, Karolinska University Hospital, 14157 Stockholm, Sweden
| | - Andreas Koulouris
- Department of Oncology-Pathology, Karolinska Institute, 17176 Stockholm, Sweden
- Thoracic Oncology Center, Theme Cancer, Karolinska University Hospital, 17177 Stockholm, Sweden
- Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
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Hortsch M, Girão-Carmona VCC, de Melo Leite ACR, Nikas IP, Koney NKK, Yohannan DG, Oommen AM, Li Y, Meyer AJ, Chapman J. Teaching Cellular Architecture: The Global Status of Histology Education. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1431:177-212. [PMID: 37644293 DOI: 10.1007/978-3-031-36727-4_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Histology or microanatomy is the science of the structure and function of tissues and organs in metazoic organisms at the cellular level. By definition, histology is dependent on a variety of microscope techniques, usually light or more recently virtual, as well as electron microscopy. Since its inception more than two centuries ago, histology has been an integral component of biomedical education, specifically for medical, dental, and veterinary students. Traditionally, histology has been taught in two sequential phases, first a didactic transfer of information to learners and secondly a laboratory segment in which students develop the skill of analyzing micrographic images. In this chapter, the authors provide an overview of how histology is currently taught in different global regions. This overview also outlines which educational strategies and technologies are used, and how the local and cultural environment influences the histology education of medical and other students in different countries and continents. Also discussed are current trends that change the teaching of this basic science subject.
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Affiliation(s)
- Michael Hortsch
- Departments of Cell and Developmental Biology and of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA.
| | | | | | - Ilias P Nikas
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Nii Koney-Kwaku Koney
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Korle Bu, Ghana
| | - Doris George Yohannan
- Government Medical College, Thiruvananthapuram, Kerala, India
- Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Aswathy Maria Oommen
- Government Medical College, Thiruvananthapuram, Kerala, India
- Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Yan Li
- Department of Human Anatomy, Histology and Embryology, Fudan University, Shanghai, China
| | - Amanda J Meyer
- Department of Anatomy, Physiology, and Human Biology, School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - Jamie Chapman
- Tasmanian School of Medicine, University of Tasmania, Hobart, TAS, Australia
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Yakubu K, Durbach A, van Waes A, Mabunda SA, Peiris D, Shanthosh J, Joshi R. Governance systems for skilled health worker migration, their public value and competing priorities: an interpretive scoping review. Glob Health Action 2022; 15:2013600. [PMID: 35037590 PMCID: PMC8765257 DOI: 10.1080/16549716.2021.2013600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Governments worldwide participate in skilled health worker (SHW) migration agreements to protect access to health services in their countries. Previous studies have described the value offered by these agreements in separate source and destination country perspectives. OBJECTIVE We sought to identify and summarise existing literature on shared value creation for both source and destination countries. METHOD We conducted a systematic scoping review of health databases and grey literature. Using Mark Moore and Colin Talbot frameworks, we summarised the public value propositions in migration agreements and how state actors addressed competing priorities. RESULTS Most articles (34/63, 53.9%) reported transnational SHW mobility as the public value proposition for source and destination countries. Fewer articles, 14 (22.2%) and 9 (14.3%) articles, respectively, referred to achieving health workforce sustainability and building capacity for SHW migration governance as shared public values. The most identified competing public value (CPV) was an overriding focus on addressing SHW shortages in destination countries (20/63, 37.7%). Efforts to address this CPV include mitigation of the adverse effects of migration (43/63, 68.3%) and promoting health workforce development in source countries (15, 23.8%). At the same time, state actors retained regulatory discretion for protecting their country's public health interest (34, 54%). Most articles reported the lack of funds (15/63, 23.8%) and implementation mechanisms (19/63, 30.2%) as constraints on the authorising environment and the operational capacity of SHW migration governance systems. CONCLUSION Regarding SHW migration governance, the literature reports shared public value propositions for source and destination countries. It also shows how the value-creating process in the management of SHW migration favours destination countries. Future studies will need to explore shared value creation models that ensure equity in the governance of SHW migration.
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Affiliation(s)
- Kenneth Yakubu
- Faculty of Medicine, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Andrea Durbach
- Australian Human Rights Institute, Faculty of Law and Justice, University of New South Wales, Sydney, Australia
| | | | - Sikhumbuzo A. Mabunda
- Faculty of Medicine, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - David Peiris
- Faculty of Medicine, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Janani Shanthosh
- Faculty of Medicine, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
- Australian Human Rights Institute, Faculty of Law and Justice, University of New South Wales, Sydney, Australia
| | - Rohina Joshi
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
- Health Systems Science, The George Institute for Global Health India, New Delhi, India
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Ţigănaşu R, Simionov L, Lupu D. European Governments' Responses to the COVID-19 Pandemic during the First Wave: Resetting Governance Systems to Cope More Effectively with Future Shocks. APPLIED SPATIAL ANALYSIS AND POLICY 2022; 16:1-39. [PMID: 36160294 PMCID: PMC9484356 DOI: 10.1007/s12061-022-09481-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/15/2022] [Indexed: 06/07/2023]
Abstract
The emergence of the current global crisis induced by the rapid spread of the COVID-19 pandemic brings about an urgent need to rethink and reshape recovery strategies adapted to this specific challenging context. Neglecting this reconfiguration could lead to system lockdown, affecting all sectors, both on medium and long term. The coronavirus has penetrated various countries with different degrees of intensity, thus being spatially diversified; even within the same country, with the same lockdown measures, an enormous variety in cases is encountered. Subsequently, even if crises may manifest heterogeneously and the long-term impact of implementing recovery policies cannot be accurately known ex ante by governments, institutions could adapt themselves to changing circumstances and respond promptly and appropriately to emerging shocks only if their functioning framework had been well set up by the outbreak of the crisis. Considering these aspects, the main questions that this paper aims to answer are: How effective have governmental measures in European countries been in combating the COVID-19 crisis?; Could the solutions offered by the European states' governments have an influence on diminishing the intensity of negative effects of a possible more serious return of this health crisis? What more could national authorities and international actors do to control the epidemiological evolution of SARS-CoV-2? Is a generic European Union policy helpful or should there be a case for local policy? Based on these issues, a comprehensive picture of the differences between the East and the West of Europe in terms of some medical, socio-economic, institutional and cultural factors will be outlined, in order to emphasize which of the two groups better-handled the COVID-19 situation in the first wave, covering the lockdown period (March 1, 2020 - June 1, 2020) and the relaxation period (June 1, 2020 - September 1, 2020); at the same time, some policy recommendations on how governments should more effectively manage future similar crises to generate a higher resilience of the systems will be provided.
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Affiliation(s)
- Ramona Ţigănaşu
- Centre for European Studies, “Alexandru Ioan Cuza” University of Iasi, Iasi, Romania
| | - Loredana Simionov
- Centre for European Studies, “Alexandru Ioan Cuza” University of Iasi, Iasi, Romania
| | - Dan Lupu
- Faculty of Economics and Bussiness Administration, Alexandru Ioan Cuza University of Iasi, Iasi, Romania
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Endaryanto A, Dewi A, Kusbaryanto, Nugraha RA. Pediatric Residency Training amid the COVID-19 Pandemic: Exploring the Impact of Supervision and Clinical Practice Guidelines on Clinical and Financial Outcomes. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2495064. [PMID: 36148017 PMCID: PMC9489417 DOI: 10.1155/2022/2495064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022]
Abstract
Objective This study is aimed at calculating the magnitude of the effect of clinical practice guidelines (CPG) and supervision in inhibiting the negative impact of the COVID-19 pandemic on clinical and financial outcomes of non-COVID-19 inpatient care by pediatric residents in academic medical center (AMC) hospitals during the COVID-19 pandemic. Methods The cohort retrospective study was conducted. This study collected patient data from pediatric residency programs. A research cohort consisted of non-COVID-19 pediatric patients at Dr. Soetomo General Academic Hospital. This study compared the subgroup of patients treated during the pandemic with those treated before the pandemic. The results were analyzed using SPSS 26.0 and Smart-PLS. Results There was a 41.4% decrease in pediatric inpatients during the pandemic with an increased severity level and complexity level, a reduction of 7.46% availability of supervisors, an increase of 0.4% in readmission < 30 days, an increase of 0.31% in-hospital mortality, an increase the total costs of care, and a decrease of insurance claim profit. CPG did not moderate the effect of the COVID-19 pandemic on the clinical outcomes (β = -0.006, P = 0.083) but moderated the financial outcomes (β = -0.022, P = 0.000), by reducing the total cost of care and increasing insurance claim profit. Supervision moderated the effect of the COVID-19 pandemic on the clinical outcomes (β = 0.040, P = 0.000) by increasing aLOS and on the financial outcomes (β = -0.031, P = 0.000) by reducing the total cost of care and increasing insurance claim profit. This study model had a 24.0% variance of explanatory power for clinical outcomes and 49.0% for financial outcomes. This study's structural model effectively predicted clinical outcomes (Q 2 = 0.238) and financial outcomes (Q 2 = 0.413). Conclusion Direct supervision inhibited the negative impact of the COVID-19 pandemic on both clinical and financial outcomes of non-COVID-19 inpatient care by pediatric residents, while CPG only inhibited the negative impact on financial outcomes. Implication of This Study. In a disaster, the availability of CPG and direct supervision makes AMC hospitals able to inhibit the negative impact of disasters on clinical and financial outcomes.
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Affiliation(s)
- Anang Endaryanto
- Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta 55183, Indonesia
- Department of Child Health, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya 60285, Indonesia
| | - Arlina Dewi
- Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta 55183, Indonesia
| | - Kusbaryanto
- Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta 55183, Indonesia
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya 60285, Indonesia
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Kuhlmann E, Behrens GMN, Cossmann A, Homann S, Happle C, Dopfer-Jablonka A. Healthcare Workers' Perceptions and Medically Approved COVID-19 Infection Risk: Understanding the Mental Health Dimension of the Pandemic. A German Hospital Case Study. Front Public Health 2022; 10:898840. [PMID: 35669735 PMCID: PMC9163950 DOI: 10.3389/fpubh.2022.898840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/29/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction This study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organizational measures. The aim is to explore “blind spots” of pandemic protection and make mental health needs of HCWs visible. Methods We have chosen an “optimal-case” scenario of a high-income country with a well-resourced hospital sector and low HCW infection rate at the organizational level to explore governance gaps in HCW protection. A German multi-method hospital study at Hannover Medical School served as empirical case; document analysis, expert information and survey data (n = 1,163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care. Results The results reveal a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed “some” to “very strong” fear of acquiring infection at the workplace. Individual protective behavior and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived “no” or “little” protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behavior, but nursing was correlated with higher levels of personal risk estimations and fear of infection. Conclusions A strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through better information, training/education and risk communication and through investment in mental health and inclusion in pandemic preparedness plans.
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Affiliation(s)
- Ellen Kuhlmann
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Georg M N Behrens
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany.,German Center for Infection Research (DZIF), Braunschweig, Germany
| | - Anne Cossmann
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Stefanie Homann
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Christine Happle
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Alexandra Dopfer-Jablonka
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany.,German Center for Infection Research (DZIF), Braunschweig, Germany
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Bera S, Kumar P, Bhattacharya S. A study on how to achieve flexibility in healthcare process: a simulation-based approach. INTERNATIONAL JOURNAL OF PRODUCTIVITY AND PERFORMANCE MANAGEMENT 2022. [DOI: 10.1108/ijppm-06-2021-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe paper aims to investigate the cardiology department’s operational system for improving flexibility by minimizing the patient waiting time and simultaneously maximizing the utilization of service capacity in an uncertain environment. This article also proposes a policy framework that suggests a pool of additional resources and inter-firm collaboration can boost healthcare service delivery excellence.Design/methodology/approachA discrete event simulation (DES) approach is followed for modeling patient flow and determining the service capacity to respond to demand variability and uncertainty. The model's outputs are used to minimize patient waiting time, maximize the utilization of the resources and match the service capacity with the patient demand.FindingsThis research has tested two hypotheses and proved that an increase in waiting time decimates the throughput rate, and additional resources deployment in bottleneck activity positively impacts the throughput rate. The simulated scenarios prescribe an enhanced service capacity with quality care and further contribute to operational performance in reduced waiting time and cost. The results indicate that flexibility reduces the patient waiting time and maximizes the throughput rate.Practical implicationsThe study guides the healthcare policymakers to develop flexible competence and facilitate service mechanisms that are adaptive and robust while operating under a volatile environment. The article contributes to the healthcare literature that conjoins flexibility through simulation and resource utilization.Originality/valueThis research is based on real-life primary data collected from healthcare providers. This study adds value to the healthcare systems to adopt strategic decisions to build flexibility through resource allocation, sharing and coordinated care.
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