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Assessing the performance of rural hospitals.

https://arctichealth.org/en/permalink/ahliterature186289
Source
Healthc Manage Forum. 2002;Suppl:27-34
Publication Type
Article
Date
2002
Author
Patricia J Martens
David K Stewart
Lori Mitchell
Charlyn Black
Author Affiliation
Manitoba Centre for Health Policy.
Source
Healthc Manage Forum. 2002;Suppl:27-34
Date
2002
Language
English
Publication Type
Article
Keywords
Bed Occupancy
Efficiency, Organizational
Health services needs and demand
Hospitals, Rural - organization & administration - standards - statistics & numerical data
Humans
Manitoba
Patient Admission
Patient Discharge
Quality Indicators, Health Care - statistics & numerical data
Abstract
This study developed population-based and hospital-based indicators to examine the performance of Manitoba's 68 rural hospitals. Analyses of the indicators revealed considerable differences in the populations served and their use of rural hospital services. Hospital type was also an important factor for performance. The rural hospital indicators would be useful to hospital planners and regional policy makers for comparison purposes and for highlighting issues that need to be addressed.
PubMed ID
12632679 View in PubMed
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Between nations: delivering services on an island native reserve. Interview by Matthew D. Pavelich.

https://arctichealth.org/en/permalink/ahliterature218369
Source
Leadersh Health Serv. 1994 May-Jun;3(3):37-9, 44
Publication Type
Article

Career satisfaction among general surgeons in Canada: a qualitative study of enablers and barriers to improve recruitment and retention in general surgery.

https://arctichealth.org/en/permalink/ahliterature120301
Source
Acad Med. 2012 Nov;87(11):1616-21
Publication Type
Article
Date
Nov-2012
Author
Najma Ahmed
Lesley Gotlib Conn
Mary Chiu
Bochra Korabi
Adnan Qureshi
Avery B Nathens
Simon Kitto
Author Affiliation
Department of Surgery, Division of General Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. ahmedn@smh.ca
Source
Acad Med. 2012 Nov;87(11):1616-21
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Cooperative Behavior
Cross-Cultural Comparison
General Surgery - manpower
Hospital Administrators
Hospitals, Rural - organization & administration
Hospitals, Urban - organization & administration
Humans
Interdisciplinary Communication
Interprofessional Relations
Job Satisfaction
Medically underserved area
Personnel Selection - organization & administration
Personnel Turnover
Physician-Patient Relations
Professional Autonomy
Social Support
Work Schedule Tolerance
Abstract
To understand what influences career satisfaction among general surgeons in urban and rural areas in Canada in order to improve recruitment and retention in general surgery.
Semistructured interviews were conducted with 32 general surgeons in 2010 who were members of the Canadian Association of General Surgeons and who currently practice in either an urban or rural area. Interviews explored factors contributing to career satisfaction, as well as suggestions for preventive, screening, or management strategies to support general surgery practice.
Findings revealed that both urban and rural general surgeons experienced the most satisfaction from their ability to resolve patient problems quickly and effectively, enhancing their sense of the meaningfulness of their clinical practice. The supportive relationships with colleagues, trainees, and patients was also cited as a key source of career satisfaction. Conversely, insufficient access to resources and a perceived disconnect between hospital administration and clinical practice priorities were raised as key "systems-level" problems. As a result, many participants felt alienated from their work by these systems-level barriers that were perceived to hinder the provision of high-quality patient care.
Career satisfaction among both urban and rural general surgeons was influenced positively by the social aspects of their work, such as patient and colleague relationships, as well as a perception of an increasing amount of control and autonomy over their professional commitments. The modern general surgeon values a balance between professional obligations and personal time that may be difficult to achieve given the current system constraints.
PubMed ID
23018322 View in PubMed
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The closure of rural hospitals in Saskatchewan: method or madness?

https://arctichealth.org/en/permalink/ahliterature194889
Source
Soc Sci Med. 2001 Jun;52(11):1689-707
Publication Type
Article
Date
Jun-2001
Author
R. Lepnurm
M K Lepnurm
Author Affiliation
Health Policy Analyst, Institute for Health & Outcomes Research, University of Saskatchewan, Canada. lepnurm@commerce.usask.ca
Source
Soc Sci Med. 2001 Jun;52(11):1689-707
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Decision Making, Organizational
Discriminant Analysis
Health Care Rationing - organization & administration
Health Facility Closure - methods - statistics & numerical data - trends
Health Facility Size - statistics & numerical data
Health Policy
Health Services Misuse - statistics & numerical data
Health Services Research
Hospital Bed Capacity - statistics & numerical data
Hospitals, Rural - organization & administration
Humans
Politics
Population Growth
Predictive value of tests
Residence Characteristics - statistics & numerical data
Saskatchewan
Abstract
On April 14, 1993 the Minister of Health of the Province of Saskatchewan announced the closure of 52 of the 112 small hospitals using the criteria of: size, utilization for two consecutive years and distance to the nearest-neighbouring hospital. Amazingly, that government was re-elected. This study compared two models of reasons for hospital closure: the government criteria; and historical population, resource, and utilization factors, gathered for the year prior to closure and a decade earlier. Of the 112 small hospitals in Saskatchewan, the 10 hospitals in the frontier area were not included. Hospitals in the settled part of the province were divided into two distinct zones. The Northern zone, with 53 hospitals is characterized by rich dark soil and prosperous trade centres and the Southern zone, with 49 hospitals is characterized by light brown sandy soil and oil and gas exploration centres. Two discriminant models were developed. The government model consisted of size, two years of utilization and distance. The historical model consisted of population, resource, and utilization factors for the years 1981/1982 and 1991/1992. The dependent variable for both models was hospital status (open = 1 and closed = 0). The government model accurately predicted 91.18% of the closure decisions. The historical model had a classification accuracy of 95.10% for the whole of settled Saskatchewan, 96.23% for the Northern zone, and 95.92% for the Southern zone. The historical model was more accurate than the government model. Closing a hospital is a sad event. The manner in which the government closed nearly half of the small hospitals in Saskatchewan and gained re-election is an important account of responsible public policy. The historical model developed to examine this story takes public policy one step further in that it is possible for governments to recognize signals that indicate when communities should undertake orderly transitions in the operation of their health services facilities.
PubMed ID
11327141 View in PubMed
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[Current issues in municipal health services].

https://arctichealth.org/en/permalink/ahliterature183528
Source
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2003 Jul-Aug;(4):25-7
Publication Type
Article
Author
O P Shchepin
Iu G Tregubov
E A Aslanian
S I Isaenko
S S Rytvinskii
Source
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2003 Jul-Aug;(4):25-7
Language
Russian
Publication Type
Article
Keywords
Catchment Area (Health)
Health Services Needs and Demand - trends
Hospital Bed Capacity
Hospitals, Rural - organization & administration - supply & distribution - utilization
Hospitals, Urban - organization & administration - supply & distribution - utilization
Humans
Morbidity - trends
Russia - epidemiology
Abstract
A study, held in the Krasnodar Territory in 1994-2002, showed an increasing morbidity in residents of all age-categories. Essential differences in the prevalence of registered pathologies and in the nature of their dynamics were registered in some districts. An optimized structure of hospital beds resulted, in the above Territory, in a reduced quantity of beds, primarily in rural areas, and in their more effective utilization. More rural citizens applied for medical care to urban and territorial patient-care facilities, by 1.5 and 1.4 times respectively. Such reduction of hospital beds is possible only after advancing appropriately the regular medical check-ups and clinical care and after diminishing the need in the treatment of patients at hospitals. The data of sociological questioning of residents and of doctors held in three municipal entities by using the method of monitoring are presented. It was demonstrated that promotion of inter-district diagnostic centers, priority development of regular medical check-ups and purpose-oriented measures of reprofiling the specialized bed funds are topical issues in promoting the municipal medical care.
PubMed ID
14513496 View in PubMed
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A door-to-needle time of 30 minutes or less for myocardial infarction thrombolysis is possible in rural emergency departments.

https://arctichealth.org/en/permalink/ahliterature154934
Source
CJEM. 2008 Sep;10(5):429-33
Publication Type
Article
Date
Sep-2008
Author
Dean Vlahaki
Majed Fiaani
William Ken Milne
Author Affiliation
University of Queensland, Brisbane, Australia.
Source
CJEM. 2008 Sep;10(5):429-33
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Electrocardiography
Emergency Service, Hospital - organization & administration
Female
Hospitals, Rural - organization & administration
Humans
Male
Middle Aged
Myocardial Infarction - drug therapy
Ontario
Patient Discharge - statistics & numerical data
Retrospective Studies
Thrombolytic Therapy
Time Factors
Time and Motion Studies
Abstract
The Canadian Emergency Cardiac Care Coalition, the American Heart Association and similar groups have established a benchmark for the administration of thrombolytics in acute myocardial infarction (AMI) care as a door-to-needle (DTN) time of 30 minutes or less. Previous research suggests that this goal is not being achieved in Canada. The purpose of this study was to determine whether the target DTN time of 30 minutes or less for thrombolysis could be met in 2 rural Ontario emergency departments (EDs).
We conducted a retrospective chart review and obtained descriptive data for each case, including demographic information and the Canadian Emergency Department Triage and Acuity Scale (CTAS) score. Visit timeline data were also collected and included the time during which patients saw a physician, had an electrocardiogram (ECG), received thrombolytic therapy and were discharged from the ED. Relevant time intervals, such as the median DTN time, were calculated.
A total of 454 charts were reviewed for patients with a diagnosis of AMI who were seen between 1996 and 2007. The final sample consisted of 101 patients who received thrombolytics (63% men) whose median age was 67 years and median CTAS score was Level II (Emergent). The median door-to-ECG time was 6 minutes, door-to-physician time was 8 minutes and DTN time was 27 minutes; 58% of patients received thrombolytics within 30 minutes.
A DTN time of 30 minutes or less is achievable in rural EDs.
PubMed ID
18826730 View in PubMed
Less detail

34 records – page 1 of 4.