Problems, Theory and Solutions in Linear Algebra. An Introduction to Abstract Algebra. Exercises in Statistical Inference.
Principles of Insurance. Matrix Methods and Differential Equations. Introduction to Probability. Random variables I. Partial differential equations and operators. Study notes for Statistical Physics.
Matrix Algebra for Engineers. Ordinary differential equations of first order. Essential Group Theory. Second-order ordinary differential equations. Linear Algebra III. Statistics for Health, Life and Social Sciences. Learn Calculus 2 on Your Mobile Device. Intermediate Maths for Chemists. Analytical Trigonometry with Applications. Mathematical Models in Portfolio Analysis. Sequences and Power Series. Analytic Aids. Global Analysis. Random variables II. Elementary Analytic Functions.
It will introduce the students to the concept of genetic code and concept of heredity. The key emphasis is placed on understanding the basic principles that govern the biological functions of biomolecules. Table of Contents. What is Linear Programming?
A declining ratio number can indicate that an organization is in danger of becoming insolvent. Current ratio x This liquidity indicator shows the number of times short-term obligations can be met from short-term creditors.
Because it provides an indication of the ability to pay liabilities, a high ratio number is one way short-term creditors evaluate their margin of safety. Yes No 3. Are you receiving training as per your training need and job profile?
How many training you have attended till date? Do you feel you need any further training which will help you to perform better? Yes No HR Policies: 1. Are you aware of different HR policies? Are you facing problem regarding your reporting structure?
Are you aware of employee right and responsibility? Are you satisfied of our leave policy? Are you satisfied of our uniform policy? Are you aware of performance appraisal system of organisation? Yes No 7. Are you aware of grievance redressal and disciplinary action policy? Yes No 8. Do you have any grievances? Yes No 9. Are you aware of mediclaim procedure and coverage limit? Yes No Within how much time period your grievance solved?
Are you aware of grooming and dress code system of organisation? Are you regularly following different rules and regulation of organisation? Are you aware of exit procedure? Are you facing punching problem any time? Are you receiving salary on time? Are you satisfied from our recent performance appraisal? Does our performance appraisal programme motivate you?
Are you satisfied with our reward system? Are you aware of different welfare schemes? What do you think about different HR activities? Are you satisfied from our HR department? Are you satisfied from the transparency of HR department? How does HR behave with you when you approach to them? Rate the performance of our HR department. This gap analysis study helps for improvement if any fault is there which leads to improvement in quality and revenues effectiveness of department.
The objective of this study is to evaluate the effectiveness of process improvements on factors, which impact operating room turnaround time and utilisation. A cross-sectional study design was used involving a retrospective direct observation and record review.
In the turnaround time of OT, it is found that out of five steps only one step turnaround time is within the standard operating procedure SOP. Only one null hypothesis is accepted and the remaining four null hypotheses were rejected.
Although the study has a limited sample size, it does appear that the gap analysis has a useful diagnostic role to play in identifying, measuring, analysing and calculating the performance of operation theatre.
This enables the operating room staff to provide quality service and enhance operation theatre efficiency. Healthcare industry is a service-driven, so patient satisfaction plays a prime role in all the domains of healthcare industry.
Operation theatre is one of the critical parts which needs to be standardised and is getting a huge attention in the hospital setup. Enhancing the efficiency of operating theatre has been always a challenging process, especially in a quick changing healthcare sector with increased patient care complexity.
In the modern practice of medicine, the issue of the costs of the medical treatments that physicians provide to patients is constantly influencing medical treatment decisions Eddy, Balancing the needs to satisfy surgeons, support staff and meet the patient high expectations in healthcare would require clinical and cost effectiveness and require critical and close monitoring of revenue management inside the operating theatre to ensure efficient resource maintenance.
Operating theatre management is a very sensitive issue and a complicated one. Many studies endeavoured in assessing efficiency of operating theatres and many formulas were structured to guide in concluding or measuring performance.
Baker and Boyd suggested that activity- based costing should be used in theatres to review theatre performance and to accomplish cost efficiency in four areas, namely performance management and evaluation, strategic planning, managed care contract negotiation and managed care contract management. Turnaround time is defined as the time measured from prior patient out of the operating room suite to succeeding patient in the room for sequentially scheduled patients. Denton et al. Basso discussed the feasibility of organising a system of emergency theatre lists with its costs and gains which can be agreed upon with stakeholders.
Wullink et al. Accurate and real time scheduling assist in predicting staffing needs, ensuring availability of required equipment and supplies and thus contribute to a smooth running operating theatre Malhorta, Schedules need to be rearranged according to agreed-on principles among all surgeons, on condition that guidelines are developed to define elective versus non-elective cases Park et al.
In addition, literature reflected the importance of defining the start time of each surgery and the impact of providing a precise duration to avoid confusion, allow proper allocation and distribution of surgeries and standardise data collection Dexter et al. Macario defined the prolonged turnover time to be more than sixty minutes and this shall not be counted within the regular turnover time.
In addition, Shafer discussed elaborately the impact of cost reduction as a result of reducing the turnover time. Wachtel et al. Calms and Shusterich described the operating theatre management and highlighted the need for a very strong coordination between human and material resources; in addition to the fact that the performance of the operating theatre is measured differently from different perspectives.
Plaster et al. The problem consists of assigning patients to transporters, operating rooms and recovery beds in order to minimise a criterion function of their completion times. A Lagrangian relaxation approach is proposed to determine a near-optimal schedule and a tight lower bound Augusto et al. Mawji et al. The projects stress delivery of cost-effective medical care while reducing preventable adverse events through improved communication, process redesign and evidence-based protocol use.
The operating theatres generally require a significant amount of resources Shah et al. Therefore, operating theatres should be closely monitored for efficiency and quality of care. Monitoring and evaluation of a unit such as an operating theatre requires good quality data which is seldom available in developing countries Littlejohns et al.
In developed countries, hospitals are encouraged to use integrated, computerised theatre management systems to generate theatre schedules and lists, and to manage resources Dowdall, An emergency theatre remains idle waiting for cases, which may or may not happen, thereby affecting the utilisation rate.
The Audit Commission of the United Kingdom also suggested that the expenditure on theatre resources must match the changes in the case-load pattern of the theatre. This allows matching the resource allocation to caseloads as well as to clinical outcomes Audit Commission, Enhancing the profitability is always the key issue discussed by the management of hospital.
But the under- utilisation of operation theatre profits and over-utilisation of time in operation theatre are major issues constantly popping up in board discussions of a hospital. This study will help the hospital to identify various problems with the management of operation theatre which come across by the management. This leads to the poor patient satisfaction and lack of patient turnover ratio to the hospital.
Even for the insured patients, the majority of queries by the insurance company to the hospital are the high bill amount for over utilisation of operation theatre for a standard procedure compared with the standard time of that procedure. This study will help to find the gap analysis for enhancing operating theatre efficiency through turnaround time.
A, This study provides analytical and valuable information regarding the management of operation theatre process which in turn helps the organisation can take valuable managerial decisions.
This will help them to confirm whether the operation theatre is working as per the set standard operating procedures SOPs or it needs further improvement. If it needs improvement, in which area does it need improvement. Balancing the needs to satisfy surgeons, support staff and meet the patient high expectations and cost benefits in healthcare would require clinical and cost effectiveness and require critical and close monitoring of business management inside the operating theatre to ensure efficient resource supply, guarantee quality safe care provided, and maintain fiscal sustainability.
This not only needs careful assessment from the hospital authorities, but also from support staff of all concerns. It is the overall operational pattern or framework of the project that stipulates what information is to be collected from which sources by what procedures.
Testing Hypothesis Transfer of Patient from Ward to Preoperative Room zz H0: Transfer of patient from ward to preoperative room is within the standard time, i.
Hence, null hypothesis may be rejected. Patient Transfer Time from Preoperative Room to Operation Theatre zz H0: Transfer of patient from preoperative ward to operative room is within the standard time, i. Difference between Actual OT Time and OT Starting Time zz H0: There is a time gap between the start of the operation procedure and after receiving the patient in operating theatre within the standard time, i.
Hence, null hypothesis may be accepted. Overall Surgery Time zz H0: The overall surgical procedure is within the standard time. Error Mean Overall Surgery Time 2. So, they forget to inform the registered nurse who is responsible for that particular patient. So, the OT staff members have to inform the nurse to shift the patient, which leads to delay. They do the work slowly by chitchatting with colleagues or nurses. Especially, the laparoscopic surgery was more delayed. Operation theatre process is one of the critical parts which needs to be standardised and is getting a huge attention in the hospital setup.
In this study, it is found that OT is one of the most dissatisfying parameters among the patients. So, a properly defined OT process needs to be required. Here, operation theatre process starts from OT nurse calling the ward nurse for shifting the patient, receiving at preoperative room, thereafter performing the surgery and transferring to post- operative room and finally shifting to the respective ward.
After collecting the data for one and half month and through data analysis, the following things were concluded: zz OT — 3, which was especially for general, laparoscopic and arthroscopic surgeries is So, we conclude that the maximum amount of utilisation is taken by general, laparoscopic and arthroscopic surgeries. So, we can conclude that the ophthalmic and joint replacement surgery was not more performed.
So, we could say that average 4 or 5 surgeries were performed in a day. Adonis LF. Evaluation of the Johannesburg Hospital Operating Theatre. Al-Saffar A. Dublin: Royal College of Surgeons in Ireland 3. Audit Commission, V, Xie. X, Perdomo. O, J Orthop Trumatol, vol.
Calms, S. Physician Executives, Nov-Dec 8. B, Viapiano. J, Vogl. Dexter, F. Anesth Analg, Dowdall JM. The Use of Operating Theatres. Northern Ireland Audit Office. DM, Medicine, Money and Mathematics. ACS Bulletin, vol. Gibbs VC. Surgical Clinics of North America; 85 6 Macario, A. Are your Operating Rooms being Run Efficiently? Medscape Anesthesiology Malhorta, V. What should Anesthesiologists know about Operating Room Management?
Revista medicacane de anestesiologisia, SS88 McIntosh, C. International Anaesthesia Research Society, Park, K. Current Opinion Anaesthesiology, Plasters, C.
Z, Cancellation of Urology Operations. Clinical Governance, vol. Wachtel, R. Anesth Analg, 1 : G, Van Houdenhoven. M, Hans. W, van Oostrum. M, van der Lans. M, Kazemier. G, Based on Parasuraman et al.
Data were collected through field research among patients who are foreign and the Indians working in Saudi Arabia and then the data were analysed using SPSS and Excel. The research problems find out the service quality gap analysis between private hospitals of India and Saudi Arabia of Medical tourists. Overall the results revealed Indian private hospital sector is performing better in encounter dimension, but specific Encounter-Responsiveness Saudi private sector has lowest score.
The paper adds a new perspective towards understanding how the concept of service quality is adopted in a hospital sector.
The author wishes that this study identifies areas of dissatisfaction that can be quickly remedied and ensures improvement in the areas of satisfaction with ongoing notice and importance. As medical costs accelerate, patients are finding alternatives for low-cost treatment and going abroad to get healthy seems very appealing. Lured by the promise of high quality, reliable medical care at a lower cost, patients are flying across the globe for medical treatment that they otherwise would not have access to easily due to prohibitive costs, long waiting time or unavailability of treatment in their home country.
The promise of medical care and the attraction of exotic places are taking people places for medical care. The process of healthcare tourism is jointly facilitated by the corporate sector involved in medical and healthcare as well as the tourism industry — both private and public.
Medical tourism has become a common form of vacationing, and covers a broad spectrum of medical services. Medical tourism mixes leisure, fun and relaxation together with wellness and health care. There is a growing consensus within the NHS of the significance of obtaining feedback from patients in order to improve the quality of health care; consequently, many patient satisfaction surveys are now undertaken by health care sector.
Against a background of growing consumerism, satisfying patients has become a key task for all healthcare activities. Satisfaction in service provision is increasingly being used as a measure of health system performance. Many hospitals apply modern marketing ideas to serve customer markets in a more efficient and effective way.
An important strategic variable in this respect is service quality. This paper attempts to explore the concept of service quality in a health care setting.
Wan Edura Wan Rashid, Hj. Kamaruzaman Jusoff, attempted to explore the concept of service quality in a health care setting. This paper probes the definition of service quality from technical and functional aspects for a better understanding on how consumers evaluate the quality of health care. It adopts the conceptual model of service quality frequently used by the most researchers in the health care sector.
At the end, the researcher concluded that service quality in health care is very complex as compared to other services because this sector highly involves risk. Oswald and Douglas E. Turner investigated the effects of demographic factors on users and observers of perceived hospital quality and noted that previous research suggests the components of perceived service quality are industry specific, and that calls have been made for academics to integrate their theory into practice.
At the end, the researcher found that perceived quality is industry specific, users and observers differ in their perceptions of hospital quality and demographic factors do make a difference in perceived hospital quality. Ioannis E. Chaniotakis and Constantine Lymperopoulos aimed to study the effect of service quality SQ dimensions on satisfaction and word of mouth WOM for maternities in Greece. Ritu Narang intended to measure the perception of patients towards quality of services in public health care centres in rural India.
A item scale that tested well for reliability and construct validity was employed for the study. Mixed sampling technique was employed to select the sample. Education, gender and income were found to be significantly associated with user perception. The questionnaires were distributed in primary healthcare clinics that represent all heath care regions in Kuwait. From the survey result, researchers found that the majority 87 per cent of the patients responded that the time for communication between physician and patient was not enough.
Seventy-nine per cent of the surveyed patients said they would go to the emergency room of the hospital in future if needed instead of going to the primary care clinic.
Regarding the quality of the communication relationship between physician and patients, most of the patients responded negatively. Raman Sharma, Meenakshi Sharma and R. A cross-sectional study was conducted to assess the patient satisfaction level visiting the hospital with the objectives to know the behaviour and clinical care by the clinicians and paramedical staff and in terms of amenities available. A pre-designed and pre-tested structured questionnaire was given to the respondents after the patients had undergone consultation with the doctor.
From the survey result, researchers found that The Government subsidies, fiscal incentives and tax breaks form a major input for the growth. He suggested the promoted measures to improve infrastructure to support the medical tourism industry. Medical tourism is now far more than just an uninsured patient-based consumer issue. State legislators are also beginning to consider the financial benefits of medical tourism. Several corporations are also investigating potential benefits of medical outsourcing because of rising health care costs.
Many major employers are self-insured, and they are considering medical outsourcing as an option for their employees in order to experience significant cost-savings.
The export of patients to international hospitals is primarily based on the significantly lower cost of procedures offered outside the United States; however, the export of patients is just one aspect of this growing medical outsourcing practice. Content validity wording and meaning was checked carefully by experts.
A pre- test was then conducted with a group of patients, and minor changes to the scales were made accordingly to ensure that the questions were not repetitive. The researchers have used 41 structured and paired questions to measure Expectation E and Perception P for service quality of hospitals.
The literature suggests that appearance is important to customers e. Decreasing ALS makes available more pt days Serves as an indicator of hosp efficiency Indicates hosp characteristics bottlenecks and other. Average no. Shows the number of discharges per hospital bed over a given period of time Total no. Hospital Death Hospital death is the death of any admitted patient during his or her stay in the hospital. Deaths occurring in the casualty department or emergency room or in ambulance while on way to hospital are not considered as hospital deaths.
Calculation Net death rate: sometimes referred to as institutional death rate, relates to deaths occurring 48 hours or more after admission. Gross death rate includes all deaths in hospital. Mortality statistics are indirectly related to the management of hospitals. Deaths occurring in the emergency room in the casualty or in the ambulance while on way to hospital are not included in hospital mortality statistics.
All deaths either attributable to to, or precipitated by a surgical operation such as due to hemorrhage, shock, infection, embolism, etc. Maternal Death Rate: Deaths of mother attributable to pregnancy, child birth or its complication including death resulting from abortions No. Neonatal death rate No. Out Patient Services A person attending a PHC unit or outpatient department in an outpatient establishment or hospital and who makes use of the diagnostic or therapeutic service but does not occupy a regular hospital bed.
Outpatient services data is extracted from the registers maintained at the registration counters in the outpatient department, specialty clinics and casualty service. Number of new cases Number of repeat cases Specialty-wise break-up of cases Unit-wise break-up of cases Age and sex distribution of cases Diagnostic statistics.
Total number of outpatient attendance during the period Number of OPD working days during the period Average outpatient attendance per patient Average duration of the spell of sickness treated in OPD Total number of outpatient attendances Total number of new cases Definition of day patient: A patient who does not require inpatient care but who needs specialized observation or health care or treatment from hospital during a limited number of hours of the day and who returns to his home for the the night.
These patients can occupy specialized beds e. If a day patient occupies a regular hospital bed, then this case is not considered as a case of hospitalization and thus consumed bed days are not included in the number of regular days of stay.
Day-patient care is one of the forms of ambulatory care. Surgical Services 1.
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