Transition to hospital process orientation : The case of regional hospitals in Latvia

Management of processes instead of functions has growing importance into the health care. Transition to hospital process orientation (HPO) changes the way physicians and other health professionals have used to practice before. Study was performed to explore factors affecting introduction of HPO in Latvian hospitals responding to significant external pressures during the years of economic crisis to detect the best practices used for process management implementation in clinical setting. To reach the research goal dissimilarities between current performance and management of hospitals were explored. As changes in hospital reimbursement system demand improved efficiency, hospital’s performance was measured by decrease in avoidable hospitalisations, and increase in usage of more cost effective alternatives to a full hospitalisation. A regression analysis was performed to evaluate correlations of hospitalisation rates in Latvian hospitals to various outpatient health services utilisation indicators. This was done to exclude influence of external factors on hospital performance and to prove the positive impact of HPO initiatives on hospitalisation rate. Afterward the performance of all regional hospitals was compared and the two most distinct hospitals were selected for further in depth analysis. Operational data of the selected hospitals and a set of structured interviews outlined the differences between both hospital’s managerial practices and factors affecting the introduction of process oriented initiatives. The theoretical research together with comparative analysis of approaches used in both hospitals served as a basis for elaboration of recommendations towards development of HPO and facilitation of the development of self-management competence of health professionalspublishersversionPeer reviewe

Towards a more effective hospital: helping health professionals to learn from their own practice by developing an easy to use clinical processes querying language

Application of complex socio-technical systems theory to optimization of clinical processes in hospitals highlights the importance of the acceptance and promotion of responsible autonomy among health professionals. Therefore the independent ability for clinicians to search for answers to questions which are outside the scope of pre-made reports is important. However, the ad-hoc data querying process is slow and error prone due to inability of health professionals to access data directly without involving IT experts. The problem lies in the complexity of means used to query data. We propose a new natural language- and star ontology-based ad-hoc data querying approach which reduces the steep learning curve required to be able to query data. The proposed approach would significantly decrease the time needed to master the ad-hoc data querying and to obtain direct access to data by health professionals

Comparative Analysis of the Most Important Cardiovascular Risk Factors Based on Cross-Sectional Studies in the Population of Latvia

Background and Objectives: The aim of the study was to analyze the prevalence of cardiovascular risk factors (RFs) in Latvia from the population-based cross-sectional study performed in 2019–2020 and to compare the results with a similar study done in 2009–2010. Materials and Methods: The target sample of 6000 individuals representing a cross-section of Latvia’s inhabitants (aged 25–74) was formed using stratified two-stage cluster sampling. The survey had two components: (1) an interview using a pre-specified questionnaire and (2) physical examination (height, weight, arterial pressure) and collection of venous blood samples to measure levels of fasting glucose (Glu), total cholesterol (TC), high and low-density lipoprotein cholesterol (HDL-C/LDL-C), and triglycerides (Tg). In total, 4070 individuals were interviewed (32% non-response), from which 2218 (55%) individuals underwent physical examination and collection of blood samples. Results: The most frequently observed RFs were high LDL-C (62.0%), smoking (45.3%), and arterial hypertension (36.8%), while the prevalence of self-reported high cholesterol and hypertension was 19.3 and 18.6%, respectively. A decrease in the prevalence of hypertension, high LDL-C, and Glu was noted. Smoking decreased in younger men. The mean number of five most important cardiovascular RFs was 2.0 (95% confidence interval (CI) 2.0, 2.1); 2.3 (95% CI 2.2, 2.4) for men and 1.8 (95% CI 1.7, 19) for women. The average number of RFs has decreased by 0.3 in 10 years, t(5883) = −7.2, p Conclusions: Although the prevalence of cardiovascular RFs remains noteworthy, an improvement in the risk profile of the Latvian population has been observed over the past decade. The study shows subjective self-underestimation of cardiovascular risk