Day 1 :
Ministry of Health, Bahrain
Ahmed Husain Ebrahim is currently working as the Head of Rehabilitation in Bahrain’s Ministry of Health. His areas of interest and professional expertise encompass quality of life, strategic management in healthcare and medical tourism development.
Medical tourism, a rapidly growing market, has been recognized by many countries as a potential sector for economic diversification. Although Singapore stands out as one of the top destinations of medical tourism, investigation regarding its competitiveness has been limited and narrow in scope. This case study takes a qualitative approach to identify and analyze the factors that keeps Singapore, as a competitive medical tourism destination. Based on a holistic approach, this study has shown that integrating diverse strategies for medical tourism development with sound government policies and proactive management practices have led to significant positive outcomes towards mutual success of tourism, healthcare and other economic sectors of Singapore. Additionally, the study provides strategic insights to drive lasting improvements in both public and private sectors of aspiring countries through efficient management and intelligent utilization of resources within and outside the medical tourism sector. Based on this study, medical tourism competitiveness can be defined as the ability to strategically plan, set viable policy goals, establish effective multi-stakeholder partnerships, maintain an attractive environment and ensure that all of these capabilities are harmonized to optimize the delivery of medical services that rank high on parameters of quality, innovativeness, affordability and safety. The content of this definition is relevant to Singapore's medical tourism experience analyzed in this study. Policy makers, interested in medical tourism development, need to put into account not only a synchronized pattern of actions needed between government agencies and relevant private stakeholders to improve the performance of the sector, but to ensure that long-term measures undertaken by the public sector are viable and can diversify the tourism sector. Additionally, there must exist a robust public interest to create an environment that empowers private enterprise. This absolutely necessitates integrated strategic planning, a successful execution strategy and continuous improvement and development solutions.
Pondicherry Institute of Medical Sciences, India
Rebecca Samson is a peer team member for the National Assessment and Accreditation Council and on the board of faculty selection for various institutions/universities. She has also presented numerous papers and given keynote addresses and has organized workshops and conferences at state, national and international level. She has authored three books besides being Editor of two journals, developed four manuals in clinical nursing and has received seven awards from various organizations including the prestigious-National Florence Nightingale award from President of India in 2016 and the recent one as Best Educationist in 2017.
Statement of the Problem: Testing of an integrated model of nursing education, clinical practice and management through nursing research. Despite education and practice being viewed as inseparable concepts, an education-practice gap still exists in nursing. Bridging the nursing education, practice and management through nursing research will build a positive work culture among educators and practitioners which would lift up the standard of patient care. The purpose of this study is to strengthen the quality of patient care through integration of nursing education, service, management and enhancing evidence based nursing practice (EBP).
Methodology & Theoretical Orientation: The objectives of the study were to assess the existing nursing service in the hospital, to develop a model with integrated approach, to test the integrated model for its effectiveness and to stabilize the pattern of integrated practice based on the results of the study. An integrated framework was utilized to focus on the interaction between the administrators and the nursing personnel to understand the relationship and the context in which the integrated model works for better quality patient care.
Findings: Implementation of integrated model in nursing brought out the following important outcomes. Improved patient care, emotional safety for nursing personnel, earlier identification of changes in patient’s condition, reduced workload for clinicians as they care for the same patients, better communication among disciplines and with physicians.
Conclusion & Significance: The organization felt a need for continuing this integrated model to implement evidence based practice through nursing research. The institution has become a role model for many other medical college attached hospitals in South India and in particular Puducherry and Tamil Nadu.
Dubai Health Authority, UAE
Kadhim Alabady is a Fellow of the Royal College of Physicians and Surgeons of Glasgow. He has completed his Doctorate degree in Public Health and Epidemiology, Master’s degree in Clinical Epidemiology (MSc), Master’s degree in Public Health (MPH), all from The Netherlands universities with broad experience driving research and development (R&D) strategies and operations. He has been registered as an Epidemiologist Grade A with The Netherlands Epidemiological Society. He has numerous publications in the UK in mental illnesses, cancer, cardiovascular diseases, diabetes, dementia, autism, COPD, population health, road casualties and others.
Background & Aim: The workplace stress survey was conducted online between March 1 to April 30, 2016 among adults aged 18+ years who work for Dubai Health Authority are either employed full-time or part-time employed. The survey conducted by Public Health and Safety Department as part of DHA 2016-21 Strategy Initiative (3.2 develop and implement a strategy for Occupational Health and Therapy/under Public Health and Safety program).
Method: The design of the survey is cross-sectional studies that provides a snapshot of the frequency of a work stress and related characteristics without retrospectively or prospectively follow up investigations. Participation in the workplace stress survey was completely voluntary. Individuals have the right to participate and freedom to refuse. The survey questionnaire based on a questionnaire developed by The American Institute of stress (AIS) Workplace Stress Survey. Respondents for this survey are given the opportunity to complete the survey in English and Arabic version. The two versions were identical. The results from the two datasets were combined into one database for the analysis. Results were calculated as needed by age band, sex, occupation, sectors, etc.
Results: The response rate based on DHA employee’s registry for 2014 estimated to be around 10.9%. Around 389 employees who work as clerks or in similar jobs that might have on access to computer and therefore cannot participate in the survey. The workplace stress survey responders were more likely to be female. Over 70% of the respondents were females (881, 73.3%) compared to 321 (26.7%) were males. Overall, majority of responders can handle stress at work. 76.9% of respondents can handle stress in work, 15.9% of them can handle stress well and 61% moderately well. Only 22.8% of participants have some difficulties by encountering problems that need to be resolved. Males have slightly higher rate than females for encountering problems that need to be resolved but not statistically significantly difference. A relatively large percentage of people working in administrative jobs who were encountering problems that need to be resolved but the results show that nurses are the best in dealing with stress then physicians. Employees aged 25-49 years have the highest rate of encountering problems that need to be resolved. Further analysis shows that people aged 45-49 have the highest rate than other age categories of this group or to the overall group, all survey respondents.
Conclusion & Recommendations: The next step is to review program and policy options that might be applied within Dubai Health authority (DHA) to identify effective prevention approaches and programs to target high risk employees. Implementing measures to prevent work-related stress can benefit employees and the workplace by creating a safe and healthy working environment. Create a work environment that promotes employees well-being.
Health Care Informed, Ireland
Sweeney John Sweeney Y is the Director of Research and Development with the Irish Health Services Accreditation Board. He is Lecturer of the Royal College of Surgeons in Ireland. He has acted as the Technical Advisor to the International Society for Quality in Healthcare (ISQua) on external evaluation. In 2012, he was appointed as an International Society for Quality in Healthcare (ISQua) Expert and in 2013 he was elected to the Board of ISQua.
Fundamentally the process of accreditation has not changed since its emergence in the 1960’s in the US, that being a ‘Stop-Start’ process where organizations pour enormous resources into on-site surveys, only to tread water between these visits and allow the implementation requirements to build up. Monitoring compliance via on site snap shots is supported by some accreditors by required reporting and submissions but is this enough to ensuring continual assurance of patient safety? The research shows several difficulties in this approach not least of which is the lack of sustained improvement in patient safety. This presentation identifies that the cost of the current models are often unsustainable due to the significant costs experienced by both the accreditor and as a result, the accredited organization because of the need for so much onsite surveys. Change the concept of accreditation, from snap shot review, to continuous access monitoring by the accreditors and the model opens up huge potential to have a more effective and efficient, impact on patient safety. This paper presents a proposal to make this a possibility by allowing the accrediting body access to the organizations own internal systems to externally view big data in real time. Access provides the accreditor with a window into the soul of the organization, allowing for continual monitoring as deemed required. Continuous organizational access by accrediting bodies and similar external regulators is the next major step forward for patient safety evaluation. It is recognized that to achieve this, a change is required in the relationship between the accreditor and the accredited–with organizations required to show an open hand with evaluators working towards a more supportive role to assist organizations to get it right in real time
- Healthcare Services | Medical Tourism and Public Health | Chronic Diseases | Healthcare Innovation
Ajman University, UAE
Alaa Al Amiry has vast experience in clinical and academic fields. She is also exposed to the administrative tasks through committees at her academic career, where she was assigned to put financial and strategic plans for her department. She has obtained her MS degree from UMBC, USA on Emergency Healthcare Services.
The Year of Innovation (2015) has certainly paved the way for UAE organizations to integrate mobile apps into business operations for smart solutions. Strategically, many different industries have extensively utilized information technology (IT) as a tool for innovation in their operations. Smart apps are perceived as an inevitable hard trend that can effectively reform healthcare, which are already utilized by the healthcare industry worldwide. Literature review has revealed many examples of brilliant medical and healthcare related apps that are already on action. Although it is realized that pre-hospital settings or emergency medical services (EMS) are a vital part of the wider continuum of healthcare, we did not find any theoretical or empirical study on innovation in this field. We identify this as a gap in literature. The case of Emergency Medical Services (EMS): EMS is not entitled only to locals, as it caters International tourists and guests found in emergencies. In pre-hospital settings, it is especially important to have solutions for data accessibility that are reliable and effective in the versatile functions of EMS systems. Despite the lack of independent scientific research on mobile apps' impact on EMS systems, literature review has revealed many websites, articles and documents interested in such topic. There are vast numbers of mobile apps especially dedicated to EMS personnel; however, the majority of them are ready-to-use apps that are not designed by EMS systems themselves. This work will provide a glance at several examples of mobile apps in the healthcare industry and explore some at EMS. Moreover, it will exclusively provide examples of smart apps that are in use at healthcare facilities in Dubai.
Amani Abdelrahman has her expertise in education and passion in improving the health and wellbeing of women and young children. Her work in community medicine and breastfeeding promotion, protection and support. Being an assistant professor in community medicine and International board certified lactation consultant (IBCLC) qualified her to work for the health of the community as a whole and infants, young children and women in particular
Background: In the developing world exclusive breastfeeding remains a challenge. Strengthening exclusive breastfeeding promotion is a necessity, in addition to capacity-building of the health care providers.
Aim & Methods: This is a quasi-experimental (non-randomized controlled) study, conducted in the Military Maternity Hospital in Omdurman, Sudan in 2014. The study aimed at assessing the knowledge, attitude and skills of the health care providers regarding breastfeeding before and after training (workshops and bed side training). The effect on the trend of exclusive breastfeeding was then assessed. Alribat Hospital was used as control. Total coverage of the health care providers was done (107 from the military and 61 from Alribat Hospital). The skills of 22 and 16 midwives were assessed. A systematic random sample of mothers was evaluated to detect the effect of training on the exclusive breastfeeding trend. Data was collected from the health care providers by pre and post-test, observation check list for the skills of the midwives. Questionnaire was structured for the mothers after delivery and the follow-up phone questionnaires.
Results: The health care providers from the study and control hospital were comparable. Statistical analysis revealed insignificant differences between the two groups before training (P>0.05). Training resulted in significant improvement in health care providers’ knowledge and attitude toward breastfeeding (P<0.05). The skills of the midwives in breastfeeding support improved dramatically after training. There were statistically significant differences in the trends of exclusive breastfeeding as was shown by Z-test and P values <0.0001.
Conclusion: Breastfeeding training in the Military Maternity Hospital resulted in significant improvement in health care providers’ knowledge, skills and attitude toward breastfeeding. This was reflected positively on the exclusive breastfeeding trend.
University of Venda, South Africa
Manganye Bumani Solomon has obtained his Bachelor of Nursing Science from the University of Venda in 2006. He is currently pursuing PhD in the field of Mental Health and has published two papers in the international journal.
Background: HIV and AIDS are increasing rapidly in Africa with South Africa being one of the countries with a high incidence of the disease and highest number of people on ante-retroviral treatment. People who are infected need to be cared for by nurses in hospital until their condition is satisfactory or they are discharged from the ward. The way health care professional’s view patient with HIV and AIDSs can determine the quality of care that professional nurses provide to patients with the disease.
Aim & Methods: A qualitative, exploratory and descriptive study was conducted with the purpose of exploring and describing the views of professional nurses towards caring for HIV and AIDS patients in hospitals in Vhembe district in Limpopo province. The study population consisted of professional nurses who have undergone HIV and AIDS related courses or training in the three hospitals in Vhembe district of Limpopo province. Participants and wards were purposively selected and convenient sampling was used to selected participants for focus group. Semi-structured interviews, focus group interview and key informant interviews were conducted and a guide was followed throughout the interview.
Results: Professional nurses caring for HIV and AIDS patients expressed the fact that HIV is no longer a dangerous disease due to the availability antiretroviral treatment while on the other side professional nurses now understand HIV and treat it like any other general medical condition such as hypertension. The attitudes of professional nurses were found to be positive and their perceptions good towards HIV positive patients in hospitals. Data analysis revealed that professional nurses have positive attitudes and perceptions towards HIV and AIDS patients in hospitals where patients are being provided with nursing care that is of quality from nurses.
Conclusions: Suggested solutions included that nurses need to be supported in all ways by their supervisors. This will include mentoring and establishing support groups for nurses caring for HIV and AIDS patients to ensure that quality care is continuously provided to HIV positive patients in the hospital.
Ethiopia Public Health Institute, Ethiopia
Amelework Yilema has completed her MSc in Medical Microbiology from Gondar University, Ethiopia. She is an Assistant Researcher of HIV Reference Laboratory, has one published papers in journal and has been serving as Technical Expert.
Background: Enterococci become clinically important especially in immune-compromised patients and important causes of nosocomial infections. Data on the prevalence, antimicrobial susceptibility patterns and associated factors of enterococci are scarce in Ethiopia.
Aim & Methods: A hospital based cross-sectional study was conducted at the University of Gondar Teaching Hospital from February 28, 2014 to May 1, 2014. Pre-tested structured questionnaire was used to collect socio-demographic data and possible associated factors of enterococci infections. Clinical samples including urine, blood, swabs and other body fluids from patients requested by physician for culture and antimicrobial susceptibility test during the study period were included. A total of 385 patients were included in the study. Data were entered and analyzed using SPSS Version 20. P values <0.05 were considered as statistically significant.
Result: The overall prevalence of enterococci infection was 6.2% (24/385). The commonest sites of infections were urinary tract followed by wound and blood. Among the 24 isolates, 33.3% (8/24) were resistant to all tested antimicrobial agents. 41.7% (10/24) of the enterococci isolates were Vancomycin resistant enterococci (VRE). Moreover, two third of the isolates were multidrug resistant (MDR) enterococci. In multivariate analysis, duration of hospital stays for two days and more than two days with infection rate: 17/32 (53.1%), previous history of any antibiotics (AOR= 9.13; [95% CI; 2.01-41.51], P=0.00) and history of urinary catheterization (AOR=8.80; [95% CI; 1.70-45.64], P=0.01) were associated with presence of higher enterococci infections than their respective groups.
Conclusion: The prevalence of enterococci infections among patients with UTIs, wound infections and sepsis were higher than the other patients. Multi-drug resistant enterococci including VRE were isolated from clinical samples in the study area. Being hospitalized for ≥48 hours, having history of any antibiotic administration and catheterization were associated factors for enterococci infections. Presence of VRE indicates decreased antibiotic treatment options of multidrug resistant enterococci. Therefore, efforts should be made to prevent enterococci infections and emergency of multidrug resistant enterococci. Moreover, species identification and detailed study using genotypic methods are needed.
Ethiopia Public Health Institute, Ethiopia
Eleni Kidane has completed BEd degree in Biology from Dire Dawa University in 2009. She has then joined the School of Graduate Studies of Haramaya University to pursue MSc in Applied Biology and completed in 2012. Presently she is an Associate Researcher at Ethiopia Public Health Institute.
The present study was to determine prevalence of intestinal parasitic infections and their associations with anthropometric measurements among school children of Wukro town, Eastern Tigray, Ethiopia. The design of the study was a cross-sectional epidemiological investigation involving a sample population of 384 school children from grade one to grade eight in two purposively selected primary schools located in Wukro town during March-May 2011/2012. A total of 384 fresh stool samples of school-children were examined using direct wet-mount technique. The overall prevalence of intestinal parasitic infection was 60.7% (58.2% in males and 62.8% in females). Multiple infections with two and above parasites were found in 7.5% (29) of the positive stool samples. The prevalence of protozoan parasites, E. histolytica, G. lamblia and I. beli was 23.2%, 16.9% and 4.4%, respectively. Similarly, the prevalence of helminth infections, A. lumbricoides, Hookworm, T. trichiura, S. mansoni, E. vermicularis, H. nana and Teania saginata was 5.7%, 3.9%, 3.1%, 3.1%, 1.3%, 1% and 0.8%, respectively. The prevalence of intestinal parasitic infections was significantly associated with some of risk factors, such as family size, source of water and its handling and availability of latrines (p=0.000, p=0.003 and p=0.001, respectively). Even though there were high parasitic infections, they were not statistically associated with some socio-demographic factors, such as parents educational level, personal hygiene, life skills, awareness to parasitic infections, residence and wearing shoe or not. A significant association was found between intestinal parasitic infections and underweight students (p=0.002). Underweight school-children (34.6%) had a higher prevalence of parasitic infection as compared with other anthropometric indices (wasting and stunting). In summary, intestinal parasitic protozoan infections represent a public health problem in the school-children of Wukro town. Local health sector and any concerned bodies should collaborate with school health program for delivering health education to increase the knowledge, attitude and practice of school children as to how transmission of intestinal parasitic infection is prevented such as improvement of personal hygiene and environmental sanitation and shoe wearing habit.
All India Institute of Medical Sciences, India
Hansmukh Jain is presently working as an Assistant Professor, Department of Nursing, All India Institute of Medical Sciences Patna, India under Ministry of Health Family Welfare, Government of India. He is a Researcher, Reviewer & Member of National Advisory Board in International Journal of Pediatric Nursing, Member of National Journal of Geriatric, Evaluation, Teaching and Administration both in hospital and Nursing Education. He is the Master Trainer (TOT) for strengthening midwifery education in Bihar by JHAPIEGO USAID, USA; Master Trainer for basic life support course at All India Institute of Medical Science, Patna. Further, he has a Life Membership of various associations such as Trained Nurses Association of India, New Delhi, Nursing Research Society of India, (NRSI) and Member of Academic Committee for Post Basic BSc Nursing Course at Indira Gandhi Open University.
Statement of Problem: Medication error in pediatric outpatient prescription in a tertiary care institute, the dosing error is more common in children than adults because of weight base dose calculation, fractional dosing (e.g., mg vs. gm) and the need for decimal points. Previous study has been shown that dosing errors occurs in up to 17.8% of hospitalized children.
Objective: To determine the medication errors in pediatric outpatient practice at a tertiary care institute, East Indian Design: Hospital based cross sectional study. Setting of study: pediatric outpatient department of the All India Institute of Medical Sciences, Patna, 2014 May and June.
Methodology: 40 outpatient pediatric prescriptions were evaluated for drug dosage error.
Results: Out of 40 prescriptions, in 4 (10%) papers, there was no mention of provisional clinical diagnosis and 7 papers (17%) had dosage error. In 21 (52.5%) cases there was no mention of route of administration of the drugs. For an effective utilization of resource spent on drugs it is essential that the prescribing and administration of the drug must be evaluated from time to time to quantify the error in it and to look for possible solution for it. The error of omission is where prescription is incomplete in some ways, whereas, error of commission containing incorrect information.
Conclusion: Dosing error in pediatric outpatient department is a common problem. Training regarding writing of prescription is essential for the residents before they are posted in pediatrics OPD. Intermittent continuous medical education of residents is required on regular basis. The nurses should update knowledge in medication error which is one of the most common types of medical error that contribute to the morbidity of children in outpatient department. It is common in children than adults because of weight base dose calculation, fractional dosing (e.g., mg vs. gm) and the need for decimal points.
Universidad Distrital Francisco José de Caldas, Colombia
Lilia E Aparicio is a Telemedicine and Tele-informatics Teacher at Universidad Distrital Bogota, Colombia. She has built a telemedicine model after years of experience in research with referenced groups and estate offices evaluating, teaching and administrate different projects coaching groups at several Colombian institutions.
Cobbled streets and the white facades in Villa de Leyva receive travelers arriving at this Boyacense municipality which is part of the heritage towns-network of Colombia, where you can arrive from Bogotá the Capital City of Colombia, in a land trip by three hours. Founded in June 12, 1572 and recognized by its colonial architecture and as a high international tourist attraction, which offers hospitality and landscapes, but it lacks protocol for medical attention for tourist, service which is covered by insurance policies but it does not include an immediate attention and a faster protocol to resolve issue. For this reason, we propose a specialist telemedicine consultation that satisfies the expectations and needs of tourists under any eventuality, using teleconsultation as an alternative of innovation in medicine. According to the Colombian Health Tourism Association (2014), the most requested treatments and procedures are esthetic and wellness medicine, because of the low costs compared with other countries and the quality of services. In terms of wellness medicine (inspired wellness), Colombia has an important advantage in ecosystems which serve as welfare for tourists, this advantage in association with procedures and treatments of alternative medicine (drugs without chemicals), provides a growth opportunity in the coming years. For the above reasons, it has been selected as first teleconsultation service as the alternative medicine and consequently the offer of another type of teleconsultation as esthetic medicine or emergency teleconsultation as telecardiology or teleginecology.