Validation of a task demand measure for predicting mental workloads of physical therapists

The purpose of this study is to validate an analytical method in assessing demanded mental workloads for physical therapists, and to discuss its possible ergonomics implications on the design of healthcare working systems in which physical therapists are considered as the users. A task analysis was first used to understand the operation steps of three identified physical therapies. Then, the McCracken–Aldrich technique was applied to assign ratings of mental workload demanded for performing each step of the therapies. Finally, the assigned ratings were validated by the analysis of correlation with the answers of the NASA-TLX questionnaire collected from seventeen physical therapists in the rehabilitation center of a university-affiliated hospital. Results showed that the proposed McCracken–Aldrich technique was suitable as an analysis tool for predicting metal workloads of physical therapists. Some possible implications about the information provision and user interface design for reducing therapists' mental workloads on current therapy operations were discussed.Relevance to industryResults of this paper are expected to contribute the research and development in healthcare industry on its system design and workflow analysis.     

A fuzzy framework to evaluate service quality in the healthcare industry: An empirical case of public hospital service evaluation in Sicily

A novel fuzzy evaluation framework is applied in this study to evaluate service quality in the public healthcare sector. In particular, the proposed framework is based on the ServQual disconfirmation paradigm and incorporates the Analytic Hierarchy Process (AHP) method to elicit reliable estimations of service quality expectations. Moreover, degrees of uncertainty, subjectivity and vagueness on the part of stakeholders are addressed via linguistic evaluation scales parameterized by triangular fuzzy numbers. With reference to nine relevant public hospitals in the Sicilian Region (Italy), a detailed case study evaluating four core service criteria and 15 fundamental service items is conducted so as to discern dissatisfying aspects regarding the public healthcare service in the Region. Dissatisfaction reasons with the provided service are identified in the analysis as well, further demonstrating the effectiveness of the proposed approach.     

A H-QoS-demand personalized home physiological monitoring system over a wireless multi-hop relay network for mobile home healthcare applications

For the elderly and chronic patients with cardiovascular disease who live alone, it is necessary to constantly monitor their physiological parameters, especially the electrocardiogram (ECG), to effectively prevent and control their health condition and even to provide urgent treatment or care while an emergency such as the abnormal variation of heart rate (HR) occurs. In this paper, a wireless in-home physiological monitoring system, based on multi-hop relay communications, which can ubiquitously and continuously monitor the patient's ECG at any time or any place at home without space limit and the “dead spot” due to the extended communication coverage by multi-hop wireless connectivity, is proposed. The system consists of a mobile-care device, which is responsible for capturing and wirelessly sending the patient's ECG data, a wireless multi-hop relay network (WMHRN) that is in charge of relaying the data sent by the former, and a residential gateway (RG), which is responsible for gathering and uploading the received ECG data to the remote care server through the Internet to carry out the patient's health condition monitoring and the management of pathological data. However, in order to assure that the ECG data can be effectively and timely forwarded, from the mobile-care device to the RG through the WMHRN, to meet the healthcare quality of service (H-QoS) demand for reliable and real-time end-to-end ECG transmission, the analysis of WMHRN latency in data-forwarding stage and the deployment consideration of wireless relay nodes are investigated in detail in this work. Moreover, an emergency alert service using short message service (SMS), based on the detection of abnormal variation of HR, is also used in the RG to further enhance the healthcare service quality. A prototype of this system has been developed and implemented. Finally, the experimental results are presented to verify the feasibility of the proposed system.     

Practice, systems and technology for seniors

This paper explores how research teams in Intel’s Digital Health Group are using ethnography to identify ‘designable moments’—spaces, times, objects, issues and practices which suggest opportunities for appropriate interventions. It argues that technology innovation should aim to incorporate the views, experiences and practices of users from the start of the design process to support independent living and develop culturally sensitive enhancements that contribute towards wellbeing and a life of quality for local older populations.     

Main and interactive effects of shiftwork, age and work stress on health in an Italian sample of healthcare workers

Among healthcare workers, shiftwork (mostly if nightwork is also included), ageing and work-related stress may be factors leading to impaired health. Such risk factors may also operate in interaction, resulting in an even increased harm for health. The present study aims at evaluating these relationships in a sample of 1842 hospital workers in Northern Italy. Subjects were mainly women, 33.1% were aged > or = 45 yr, and they were almost evenly distributed between dayworkers and rotating shiftworkers (nights included). Shiftwork was associated with poor sleep, while it was protective against gastrointestinal disorders, poor work ability and job dissatisfaction. Work stress was the risk factor with the highest relevance for poor health. Ageing was associated with lower physical health. Few significant interactions were observed. Shiftwork with nights and high work stress significantly interacted in increasing the risk for poor sleep. The "healthy worker effect" may have played a strong role in study findings.     

The ethics of NHS computing: A terminal case

Value in the British National Health Service have shifted away from patient care towards financial control. However, in the quest for efficiency, huge amounts of NHS money have been wasted on computer system which failed. In this paper, I draw on a case study to explore some of the ethical issues which underlie this kind of waste of resources. Issues include the gap between public pronouncements and personal experience, the chaos of which lies behind the facade of rationality, and the systematic silencing of people, usually women, who question the viability of computer systems which are created for private gain rather than public service.     

Improving retention strategies for IT professionals working in the public sector

Despite much research interest, effective retention of IT professionals has proved difficult for many public sector organizations. By concentrating on intention to leave, researchers may not have provided a clear way to formulate effective retention strategies. Consequently, we used intention to stay as an alternative lens to identify factors that can reduce turnover of IT professionals. Our findings indicated that attitudes, perceived behavioral control (PBC), and identification with the organization all had a statistically significant relationship with intention to stay; attitude was the strongest. It was concluded that existing retention strategies needed to be refocused on the issues that make IT staff stay; a number of practical recommendations for IT managers are presented.     

Ergonomic evaluation of hospital bed design features during patient handling tasks

Patient handling tasks (e.g., transportation and repositioning) are important causes of musculoskeletal disorders among healthcare workers. The purpose of this study was to evaluate, during two patient handling tasks, the physical demands resulting from alternative hospital bed design features. Twenty-four novice participants were involved in two laboratory-based studies. The effects of a steering lock and adjustable push height were evaluated during a patient transportation task using perceptual responses and measures of performance and physical demands, and the effect of a bed contour feature was determined based on patient sliding distance during repeated bed raising/lowering. Use of the steering lock reduced the number of adjustments during bed maneuvering by 28% and decreased ratings of physical demands. Use of the adjustable push height reduced shoulder moments by 30%. With the contour feature, patient sliding distance was reduced by ∼40% over 12 raise/lower cycles. These results suggest that the steering lock and adjustable push height features can reduce physical demands placed on healthcare workers during patient transportation tasks. Although patient sliding distance was reduced using the contour feature, assessing direct effects of this feature on physical demands (e.g., reduced need for workers to reposition patients) will require further investigation.

Relevance to industry

Hospital bed design features have the potential to reduce physical demands required of healthcare workers, yet there have been only limited empirical studies of these. Findings of the two current studies suggest that proactive ergonomic considerations in hospital bed design can reduce these physical demands.     

Location allocation modeling for healthcare facility planning in Malaysia

Malaysia has seen tremendous growth in the standard of living and household per capita income. The demand for a more systematic and efficient planning has become increasingly more important, one of the keys to achieving a high standard in healthcare. In this paper, a Maximal Covering Location Problem (MCLP) is used to study the healthcare facilities of one of the districts in Malaysia. We address the limited capacity of the facilities and the problem is formulated as Capacitated MCLP (CMCLP). We propose a new solution approach based on genetic algorithm to examine the percentage of coverage of the existing facilities within the allowable distance specified/targeted by Malaysian government. The algorithm was shown to generate good results when compared to results obtained using CPLEX version 12.2 on a medium size problem consisting of 179 nodes network. The algorithm was extended to solve larger network consisting of 809 nodes where CPLEX failed to produce non-trivial solutions. We show that the proposed solution approach produces significant results in determining good locations for the facility such that the population coverage is maximized.