Process of posthospital care involving telemedicine solutions for patients after total hip arthroplasty

The importance of telemedicine technologies around the world has been growing for many years, and it turned out to be a particularly important issue for conducting some medical procedures during the SARS-CoV-2 pandemic. It is necessary to create interdisciplinary teams to design and implement improved procedures using telemedicine tools. The aim of the article is to develop original, improved posthospital patient care process after total hip arthroplasty (THA) with the use of telemedicine technologies. In the study, a literature review and empirical research were used. The conducted research resulted in the designing an original posthospital patient care process after THA that uses telematics technologies. Due to the use of analyzed telemedicine technologies, the designed patient care process brings a possibility to increase the patient′s safety by monitoring life parameters, allowing for regular, remote contact with specialists and to be supervised remotely. All this may contribute to shortening the convalescence time, reducing the risk of complications, as well as reducing treatment costs. The designed model is ready for further clinical research with the participation of medical staff, patients after THA and patient caregivers

Priority Setting in the Polish Health Care System According to Patients’ Perspective

Identification of health priorities is concerned with equitable distribution of resources and is an important part of strategic planning in the health care system. The aim of this article is to describe health priorities in the Polish health care system from the patients’ perspective. The study included 533 patients hospitalized in the Lodz region. The average age of the respondents was 48.5 years and one third (36.6%) had university education. Most of the respondents (64.9%) negatively assessed the functioning of the health care system in Poland. Most of them claimed the following aspects require improvements: financing health services (85.8%), determining priorities in health care (80.3%), the role of health insurance (80.3%), and medical education (70.8%). Over 70% of the respondents agreed the role of politicians in designing and implementing health system reforms should be limited. The fact that the respondents so negatively assessed the Polish health care system implies there is a need for full discussion on redefining health priorities

The way the quality of health services is perceived and treated by the managerial personnel of public hospitals

Background: Managerial knowledge and skills as well as profound understanding of goals and objectives of management determine the effectiveness and efficiency in all areas of managerial activities. In particular, this applies to the quality of healthcare services, perceived as a compliance between the effects (of medical treatment) and the assumed relevant objectives (defined/desired health condition). The aim of the research was to distinguish and define the way the health service quality is perceived by the hospital managerial personnel. Material and Methods: The questionnaire was mailed to 836 members of the managerial personnel of public hospitals in the Łódź province. Of this number 122 questionnaires were returned. Results: Only 22 (18.49%) of respondents presented the definition of quality. Attempts to meet patients’ expectations and to satisfy them were found to be the prevailing perception of the healthcare quality and 96.64% of respondents considered competences of medical staff contributory. Almost 64% of respondents disagree with the opinion that the number of medical staff does not affect the service quality. According to the respondents, a 46% increase in financial resources on average could significantly improve the quality of healthcare services. More than half (66.76%) of respondents claim that healthcare services that are available cover 82% of patients’ needs. Almost 57% (56.52%) of respondents consider that the subordinate- superior relationship influences their work involvement. According to 42.61% of respondents, the offered incentives encourage actions for the quality improvement. Conclusions: The results of the research indicate the need to develop a clear cut definition of the health service quality by the managerial personnel of public hospitals and to change their understanding, perception and treatment of the discussed issue, which provides a basis for the effective and efficient hospital management. Med Pr 2016;67(3):365–37

Organizational and financial changes in the work of primary health care workers during the COVID-19 pandemic in Poland

W związku z wybuchem pandemii COVID-19 cele systemu ochrony zdrowia musiały zostać dostosowane do zmieniającego się otoczenia, aby zrealizować potrzeby zdrowotne pacjentów i wypełnić oczekiwania personelu medycznego dotyczące zapewnienia bezpiecznych warunków pracy w zaistniałej sytuacji kryzysowej. Zmiany działalności personelu medycznego, które wynikają przede wszystkim ze zmian organizacyjno-finansowych, dotyczą systemów ochrony zdrowia na całym świecie i wpływają na funkcjonowanie wszystkich form opieki zdrowotnej. Celem tego artykułu jest wskazanie zmian organizacyjnych i finansowych wynikających z wprowadzonych od ogłoszenia przez WHO pandemii do 8 maja 2021 r. aktów prawnych i zaleceń wpływających na warunki pracy personelu medycznego podstawowej opieki zdrowotnej (POZ) w Polsce. Przegląd wprowadzonych działań w zakresie zapewnienia stabilności funkcjonowania POZ w warunkach pandemii pozwala stwierdzić, że sytuacja zagrożenia zdrowia publicznego ujawniła znaczną potrzebę wprowadzenia zmian organizacyjno-finansowych. Skutkiem zmian wynikających z legislacji oraz dobrych praktyk o istocie medycznej, organizacyjnej i finansowej są modyfikacje systemu ochrony zdrowia w Polsce, które mogą w nim pozostać. Warto jednak podkreślić, że jednym z istotnych wyzwań w zakresie przyszłych reakcji systemu ochrony zdrowia, w tym POZ, na stany zagrożenia zdrowia publicznego jest zachowanie spójności zmian organizacyjnych i finansowych wpływających na płynność oraz skuteczność działań podejmowanych przez personel POZ, a więc również na warunki jego pracy. Punktem wyjścia projektowania takich zmian powinna być analiza rozwiązań wprowadzonych od początku pandemii w Polsce. Można do nich zaliczyć nowe wymagania o charakterze organizacyjnym (warunki lokalowe, organizacja i stanowiska pracy, przepływ informacji czy sposób zaopatrzenia pacjenta) i zmiany finansowe (mobilizację dodatkowych zasobów finansowych w różnych formach). W artykule przedstawiono wiele pytań badawczych, które są warte rozważenia przy ustalaniu problemów i priorytetów w przyszłości, ponieważ zaistniałe zmiany i wnioski sformułowane na podstawie ich analizy mogą przyczynić się do wprowadzenia stałych modyfikacji funkcjonowania POZ w Polsce i ułatwić jej ewentualne dostosowanie do stanów ryzyka zdrowotnego. Med. Pr. 2021;72(5):591–604Following the outbreak of the COVID-19 pandemic, the objectives of the health care system had to be adapted to the changing circumstances, in order to meet the health needs of patients, but also the expectations of medical workers related to ensuring safe working conditions in the crisis situation. The activities of medical staff are greatly affected by organizational and financial changes in health care systems, which affect both the health care systems all over the world and the functioning of all forms of health care. The article examines the organizational and financial changes resulting from the introduction of regulations affecting the conditions of primary health care (PHC) workers in Poland from the beginning of the COVID-19 pandemic to May 8, 2021. The findings regarding measures taken to ensure the stability of PHC functioning during the pandemic highlight that the public health emergency exposed a significant need to introduce organizational and financial changes in PHC. The changes arising from legislation and good practices of medical, organizational and financial character resulted in health care system modernizations in Poland. It is worth stressing, however, that there is a great need to maintain coherence when implementing organizational and financial changes affecting the fluidity and effectiveness of the actions taken by PHC personnel, and thus their working conditions, when implementing future responses to public health emergencies. Such changes should be based on an analysis of the solutions introduced since the beginning of the pandemic in Poland: these include organizational changes such as housing conditions, organization of work and workplaces, flow of information and way of supplying the patient, and financial changes involving mobilization of additional financial resources. The article presents a list of future research questions that merit consideration when setting problems and priorities: these can be used to guide the introduction of permanent modifications to the functioning of PHC in Poland and to facilitate possible future adaptation in times of emergency. Med Pr. 2021;72(5):591–60

Implementation of Lean Management in a Multi-Specialist Hospital in Poland and the Analysis of Waste

At the beginning of the 21st century, Lean Management (LM) tools were introduced into the healthcare sector around the world. In Poland, there are still few LM implementations, and they are not of a comprehensive nature. The aim of this article is to present the application of the LM concept in a hospital in Poland as a tool for the identification and analysis of waste and its impact on the process of organizing the provision of medical services on the example of improvements in the process of patient admission. In the period from 1 July 2019 to 31 December 2019, a project of LM implementation was carried out at the Provincial Specialist Hospital in Wroclaw. The project was based on the method of value-stream mapping and 5Why. Standardized interviews (before and after the project) were conducted with people from the hospital management and middle-level managers. The implementation of LM tools resulted in the identification of a number of wastes, which have been divided into groups. The most important waste was paper medical documentation. Its change to an electronic form allowed for a better use of human capital resources; savings included 2.3 nursing positions and 1.09 medical staff positions

Implementation of Lean Management Tools Using an Example of Analysis of Prolonged Stays of Patients in a Multi-Specialist Hospital in Poland

Healthcare institutions in Poland constantly encounter challenges related both to the quality of provided services and to the pressures associated with treatment effectiveness and economic efficiency. The implemented solutions have a goal of improving the service quality of lowering the continuously increasing operational costs. The aim of this paper is to present the application of Lean Management (LM) tools in a Polish hospital, which allowed for the identification of prolonged stays as one of the main issues affecting the service costs and the deteriorating financial results of the hospital. The study was conducted in the neurology department and involved an analysis of data for the whole of 2019 and the first half of 2022. In addition, surveys were conducted among the medical staff to help identify the main causes of prolonged stays. Methods of data analysis and feasible solutions were developed in order to improve the economic efficiency of the unit. The analysis shows that the application of LM tools may contribute to improvement in the functioning of hospitals and that further studies should focus on the development of the method to evaluate efficiency of the implemented solutions intended at shortening the hospital stays of the patients

Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty

For many years, the importance of using telematic technologies in medicine has been growing, especially in the period of the coronavirus pandemic, when direct contact and supervision of medical personnel over the patient is difficult. The existing possibilities of modern information and communication technologies (ICTs) are not fully used. The aim of the study is to identify the telemedicine technologies that can be used in future implementation projects of the posthospital patient care process after total hip arthroplasty (THA). The literature search is reported according to PRISMA 2020. The search strategy included databases and gray literature. In total, 28 articles (EMBASE, PubMed, PEDro) and 24 records from gray literature (Google Search and Technology presentations) were included in the research. This multi-source study analyzes the possibilities of using different technologies useful in the patient care process. The conducted research resulted in defining visual and wearable types of telemedicine technologies for the original posthospital patient care process after THA. As the needs of stakeholders in the posthospital patient care process after THA differ, the awareness of appropriate technologies selection, information flow, and its management importance are prerequisites for effective posthospital patient care with the use of telemedicine technologies. Protocol Registration PROSPERO 2022 #CRD4202232049