Development of the workflow kine systems for support on KAIZEN

In this paper, we introduce the new workflow line system consisted of the location and image recording, which led to the acquisition of workflow information and the analysis display. From the results of workflow line investigation, we considered the anticipated effects and the problems on KAIZEN. Workflow line information included the location information and action contents information. These technologies suggest the viewpoints to help improvement, for example, exclusion of useless movement, the redesign of layout and the review of work procedure. Manufacturing factory, it was clear that there was much movement from the standard operation place and accumulation residence time. The following was shown as a result of this investigation, to be concrete, the efficient layout was suggested by this system. In the case of the hospital, similarly, it is pointed out that the workflow has the problem of layout and setup operations based on the effective movement pattern of the experts. This system could adapt to routine work, including as well as non-routine work. By the development of this system which can fit and adapt to industrial diversification, more effective "visual management" (visualization of work) is expected in the future.     

New Technology in Home Help Services — A Tool for Support or an Instrument of Subordination?

The implementation of information and communication technologies (ICT) is in line with a general transformation of the work of home help services in Sweden. One strong motivation behind the introduction of new technology was to change the ways of working towards greater efficiency in order to reduce costs and at the same time raise the value of care‐giving work. This article discusses the introduction of ICT in home help services as a part of the increasing rationalization of care‐giving work and its consequences for the workers. The results of an ethnographic study of the introduction of hand‐held computers in a working team in home help services in Sweden shows that the motives for the implementation of ICT run counter to the basic norms that are supposed to govern care‐giving work. The technology participates in reproducing the subordinate position of care‐giving work as well as that of the front‐line workers. The workers act according to personal decision‐making ability and show a form of limited resistance to the technology while, at the same time, taking part in their own subordination.     

Fuzzy modelling and efficiency in health care systems

American Medical Institute reports that each year, because of the medical error, minimum fifty thousand people are dead. For a safety and quality medical system, it is important that information systems are used in health care systems. Health information applications help us to reduce the human error and to support patient care systems. Recently, it is reported that medical information systems applications have also some negative effect on all medical integral elements. The cost of health care information systems is about 4.6% of the total cost. In this paper, it is tried a risk determination model according to principles of fuzzy logic. The improvement of health care systems has become a very popular topic in Turkey recent years. Using necessary information system; it became possible to care patients in a safer way. However, using the necessary HIS tools to manage of administrative and clinical processes at hospitals became more important than before. For example; clinical work flows and communication among pharmacists, nurses and physicians are still not enough investigated. We use fuzzy modeling as a research strategy and developed sum fuzzy membership functions to minimize human error. In application in Turkey the results are significantly related with each other. Besides, the sign differences in health care information systems strongly effects of risk magnitude. The obtained results are discussed and some comments are added.     

The Placement History Chart: A Tool for Understanding the Longitudinal Pattern of Foster Children's Placements

Despite growing concerns about foster placement instability, little information is available regarding the longitudinal patterns of placement histories among foster children. The purpose of the present study was to develop a charting system using child welfare records to facilitate a better understanding of longitudinal patterns of placement history for 117 foster children. The resulting Placement History Chart included all placements that occurred during the observed time period and accounted for various dimensions: number, length, type, and sequence of placements; timing of transitions; and total time in out-of-home care. The Placement History Chart is an effective tool for placing foster care experiences within a broader developmental context. As such, the Placement History Chart can be a valuable research tool for understanding various dimensions and variations of placement transitions among foster children by capturing sequences and cumulative risks over time. Furthermore, this chart can facilitate the development of intervention programs that are developmentally sensitive and effectively address particularly vulnerable subpopulations of foster children.     

借鉴国外先进经验 推动上海健康服务业发展

健康服务产业是指与人类健康相关的产业的统称。由于提供卫生保健服务的成本逐年增高,发达国家信息及通讯技术（ICT）为开展个性化、以病人为中心的保健以及家庭保健提供了新途径,如电子病历、远程医疗、整合支付手段等,并出现了新的商业业态和商业模式。ICT广泛应用使医疗服务外包发展迅速,发达国家制定了与之相适应的许多政策措施,上海应充分借鉴美国等发达国家的先进经验,大力发展健康服务业。     

Changing Relationships Between Nonprofit and For-profit Human Service Organizations Under the Long-Term Care System in Japan

In Japan, a nonprofit organization system enacted in the late 1990s and the later introduction of privatization policies in human services were expected to overturn government dominance of nonprofit organization activities. By focusing on the long-term care insurance (LTCI) system, which privatized public human services for the first time in the country, this study empirically examines whether, and to what extent, nonprofit–government relationships in Japan have actually changed as a result of this new system. In addition, because LTCI newly allows for-profit organizations to provide services, the influence of such organizations were incorporated into the analysis. The outcomes of this study demonstrate that the government continues to extend its sphere of influence over nonprofit and for-profit organizations through LTCI. In addition, for-profit organizations appear to be more successful than nonprofit organizations, in that the former organizations have overcome their lack of experience as public service providers by taking over the roles that nonprofit organizations have traditionally occupied.     

Using HIT to deliver integrated care for the frail elderly in the UK: current barriers and future challenges

In this paper we briefly describe the results of a 3 year project examining the use of Health Information Technologies (e.g., electronic patient record systems) to deliver integrated care. In particular, we focus on one group of patient (the frail elderly) and efforts to design an e-health supported healthcare pathway (the frail elderly pathway--FEP). The aim of FEP is to bring together clinicians and staff from health and social care and allow them to share patient information. Our findings show that progress in delivering a fully-supported and working FEP has been slow, not least because of the difficulties experienced by healthcare staff in using current IT systems. In addition, there are many strategic and technical issues which remain unresolved (e.g., systems interoperability).     

Do Family Meetings Improve Measurable Outcomes for Patients,Carers, or Health Systems? A Systematic Review

Abstract

Family meetings are a common intervention in acute and subacute inpatient care settings. The aim of this systematic review was to investigate the quantitative research exploring the impact of inpatient family meetings on patient, carer, or service outcomes. A search of electronic databases (Medline, Cinahl, Embase, PubMed, and Psychinfo) was conducted from the earliest available time until July 2012. Inclusion and exclusion criteria were applied, and quality assessment of included articles was conducted. Eight studies were included in the final selection. Results indicate that there is some low-to-moderate quality evidence that inpatient family meetings reduce psychological distress of family carers and assist in meeting their information and support needs. There is weak evidence that inpatient family meetings may help to reduce readmission rates and facilitate entry to continuing care programs.     

Interventions to prevent needle stick injuries among health care workers

Needle stick injuries (NSIs) are frequently reported as occupational injuries among health care workers. The health effects of a NSI can be significant when blood-to-blood contact occurs from patient to health care worker. The objective of this study was to evaluate whether the number of NSIs decreased among health care workers at risk in one Dutch academic hospital after introduction of injection needles with safety devices in combination with an interactive workshop. In a cluster three-armed randomized controlled trial, 23 hospital divisions (n=796 health care workers) were randomly assigned to a group that was subjected to the use of a 'safety device plus workshop', to a group that was subjected to a 'workshop only' or to a control group with no intervention. The combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention. For practice, the use of relatively simple protective needle safety devices and interactive communication are effective measures for reducing NSI's.     

Computerization of Psychosocial Services in the General Hospital

The present paper describes the process by which a multiple-level collaborative database system was designed. By clearly elaborating the various design goals it was possible to build a system through which ongoing program evaluation efforts can be easily managed without disrupting the service delivery process. At the same time, both departmental information needs and service-specific needs can be met in an efficient manner.     

Issues in the Introduction of Computer and Information Technology in Human Services

Abstract

The introduction of computers and information technology into the human services requires that particular attention be paid to a number of issues. These include the need for mastery of substantive content prior to introduction of the technology, the definition of computer literacy appropriate to the field, the relative importance of micro- and mainframe computing for practitioners, creation of an adequate reward system for system development, and proper consideration for the sensitive issue of who controls the technology within human services.     

Variables Affecting Patient Satisfaction with Health Care Services in the College Health Setting

Abstract

Patient satisfaction with health care services is an important factor in health care delivery. It will significantly influence whether or not a patient seeks medical care, complies with prescribed treatment, and/or maintains a continuing relationship with a medical practitioner.

A survey questionnaire, relating patient satisfaction with a number of variables identified through a literature review, was mailed to a random sample of 500 students utilizing Student Health Service (SHS) at Kent State University (KSU) during the five week study period. The data obtained would be utilized to help with planning future health care services and staff inservice education programs.

The findings of this survey indicate that patient satisfaction has a statistically significant correlation with perceived technical competence of the practitioner and perceived adequacy of the interpersonal aspects of the practitioner-patient relationship. A significant relationship did not exist between satisfaction and expectations the patient holds of the practitioner's role performance. A statistically significant relationship was found to exist between receiving health information/education related to diagnosis, prognosis, and treatment plan and satisfaction with health care services. This relationship did not hold for health information/education related to activity restrictions or preventive measures. The study also revealed that time waited during the medical care encounter was inversely related to satisfaction. Last, stepwise regression found that perceived technical competence of the practitioner was the most important variable influencing patient satisfaction with health care services.

This study provides data about factors important to personal satisfaction with health care services for a selected group of college students.     

Temporary Labour–Migration System and Long–term Residence Strategies in the United Arab Emirates

The United Arab Emirates’ migration system, the sponsorship–based kafala system, is defined as a temporary labour–migration regime. Although there are policies making permanent residence unattainable for virtually all migrants, it is still relevant to explore the temporality of migrations in the UAE. The purpose of this study is to investigate developments in migration, migration policies and population trends in the country, including trends that concern the duration of migrants’ stay. We also identify some of the major strategies used by migrants to prolong their sojourn in the UAE. It is maintained that the migrant stock has increased continuously in the last decades and that a large number of migrants devise strategies to continue their residence and remain in the country for years. The authors also identify and discuss migrants’ transition within and in-between regularity and irregularity, and analyse the reasons for utilizing different strategies over time.     

The Impact of Clinical Information Systems on Human Service Organizations

Summary

Human service organizations are beginning to utilize computerized information systems for a variety of purposes. This new information technology is expected to have a major impact on human service organizations. However, work to date has explored the impact of information systems designed for administrative and managerial tasks while clinical information systems focusing on direct practice have yet to be studied systematically. In this paper, is described the impact of a clinical information system on the work of line workers and the HSO as a whole. Five stages in the problem solving process are identified: Information collection, information processing, professional judgment, decision making, and action. They are viewed as stages in a feedback loop such that die action sequence of one cycle leads to an information collection stage in the subsequent cycle and so on. The possible impact of a CIS on practitioners at all levels from line worker to HSO clinical leadership is analyzed at each of these five stages. A case example of the CIS developed for the foster care service in Israel is utilized as an illustrative example.     

Are we investing less in the next generation? Historical trends in time spent caring for children

Historical and current data sets are used to trace the time married women and men spend caring for their own children on a daily basis. The data are also used to estimate the total time parents spend in raising two children to the age of 18. The analysis is restricted to primary child care time; i.e., the actual, direct administration of personal care, including physical care (feeding, bathing, dressing, putting to bed) and such other direct personal care as teaching, chauffering, supervising, counseling, managing, training, amusing, and entertaining. Secondary parental child care time is not studied. Although white married women spent about. 56 hours per day per child in primary child care in the 1924–1931 period, by 1981, the time had decreased to about 1.00 hour per day per child. Married men spent 0.25 hours per day per child in 1975, the first year for which national data exists. By 1981, this figure had increased to 0.33 hours per day per child. Raising two children to age 18 required about 5,789 hours of a white, employed, married woman's time and 14,053 hours of a white, unemployed, married woman's time in 1981. Husbands of white, employed married women spent about 1,500 more hours in raising two children to age 18 than the husbands of white, unemployed married women.His research interests include the economics of family time use, household production, consumption, and demand.Her research interests include household production, family structure and family well-being, and family policy.     

Care in a Time of Austerity: the Electronic Monitoring of Homecare Workers’ Time

Austerity places intense pressures on labour costs in paid care. In the UK, electronic monitoring technology has been introduced to record (and materially reduce) the working time and wages of homecare workers. Based on empirical findings, we show that, in a ‘time of austerity’, care is reductively constructed as a consumption of time. Service users are constructed as needy, greedy, time‐consumers and homecare workers as resource‐wasting time‐takers. We point to austerity as a temporal ideology aimed at persuading populations that individual deprivation in the present moment, self‐sacrifice and the suppression of personal need in the here and now is a necessary requirement to underpin a more secure national future. Accordingly, women in low‐waged care work are required to eschew a rights‐bearing, present‐tense identity and are assumed willing to suppress their entitlements to lawful wages as a sacrifice to the future. By transforming our understandings of ‘care’ into those of ‘time consumption’, and by emphasizing the virtue of present‐tense deprivation, a politics of austerity appears to justify time‐monitoring in care provision and the rationing of homecare workers’ pay.     

Social Context and Personal Expenditures for Health Care: Federal Policy and the Experience of Older Adults in the 1970s

The relationship between the intent and the outcome of legislated social policy is discussed. Specifically, this study documents some effects of federal health reimbursement and income policy in the late 1960s and early 1970s on health care behavior and expenditures in the decade 1970-1980. The Longitudinal Retirement History Study (LRHS), containing information on a panel of 6,270 men and unmarried women aged 58 to 63 in 1969, was used to provide information on the personal health expenditures in this decade. Medicare and Medicaid and the indexing of Social Security became operational at the beginning of the study, which permitted the exploration of intended and observed effects of legislation designed to make health care more accessible and affordable for older adults. As policy intended, utilization increased over the decade as indicated by both increases in the number of panelists with health care bills and increases in the size of total bills (constant dollars). Consistent with federal policy to reduce personal costs, out-of-pocket expenditures and the proportion of total bills paid out of pocket decreased. However, the effects of these federal policy initiatives were constrained by reimbursement rules and the social location of users. For instance, even at the end of the 1970s, out-of-pocket health care expenditures across subpopulations persisted. The 1980s and early 1990s have brought increased concern over the cost of health care and renewed concern over access. Data suggest that future proposals aimed at providing universal coverage along with high out-of-pocket costs may not result in equitable programs, and are likely to have a limited impact on constraining health care costs. The LRHS data indicate that utilization increased despite continued high out-of-pocket costs for all except the lower-income groups, who may be limited in their ability to purchase increasingly costly care.     

Psychiatric Information Systems: An Analysis of Inpatient and Outpatient Unit Capabilities

This paper describes how a sample of inpatient and out-patient psychiatric treatment units use technology to aid in patient care through scheduling, tracking, billing, and documenting clinical services. We conducted semi-structured interviews (n = 68) at four inpatient and four outpatient psychiatric facilities in Oregon. Results indicate psychiatric facilities are assembling systems for managing information that include a combination of electronic linked clinical records, paper records, and unit-specific, unlinked databases. Barriers remain in (1) improving the sophistication of psychiatric information systems, (2) improving linkages of behavioral health with other medical information systems, and (3) increasing information technology support.     

Co-production of ICT and children at risk: The introduction of the Child Index in Dutch child welfare

This article studies the construction of children at risk in the introduction process of a novel ICT system in Dutch child welfare, the Child Index. This early warning electronic information system enables early reporting of children at risk to stimulate multidisciplinary collaboration among the different professionals involved with a particular child. We followed the introduction of the Child Index in practice. Our empirical analysis provides insight into the co-production of this ICT system and risk in child welfare practices. The analysis shows that the interaction between local and national, and disciplinary and organisational differences induces various constructions of risk, making the decision to signal and the act of signalling risk complex and the status of a signalled risk vague. Moreover, the analysis illustrates that the Child Index's goal of early signals for all children at risk does not fit professionals' daily practices and highlights the need to discuss whether the risk signalling ambitions of the Child Index are not a larger risk to children than the risks that are being targeted.