急診室人滿為患已成為世界各地強(qiáng)烈關(guān)注的話題,與護(hù)理質(zhì)量、患者結(jié)局的降低、死亡率、醫(yī)生以及病人的不滿等密切相關(guān)。緊急部門(mén)人滿為患可能基于各種外部和內(nèi)部因素。外部因素可能包括�？撇》俊⒋参还芾韱卧�(BMUs)、實(shí)驗(yàn)室等的低效操作。住院手術(shù)管理是一個(gè)非常復(fù)雜的現(xiàn)象,基于各種醫(yī)療條件。因此,由于操作效率低下導(dǎo)致的病人流量不足,造成瓶頸,最終緊急部門(mén)人滿為患(Zhao et al.,2015)。因此,選擇了住院手術(shù)管理,以減輕在新加坡一家主要公立醫(yī)院(努哈)國(guó)立大學(xué)醫(yī)院急診室人滿為患的情況。內(nèi)部因素可能包括門(mén)診就診的急診科,有輕微的醫(yī)療狀況。據(jù)觀察,在國(guó)立大學(xué)醫(yī)院急診科就診的病人中,約有68.6%是根據(jù)穩(wěn)定的醫(yī)療狀況、人員傷亡或轉(zhuǎn)診到其他醫(yī)院出院的。這68.6%的病人引起了我們的注意。根據(jù)Uscher-Pinesetal.(2013),在美國(guó)就診的病人中,至少有30%的人患有輕微的醫(yī)療狀況。中國(guó)區(qū)級(jí)醫(yī)院面臨挑戰(zhàn)的相似性(Tuetal.,2015b)。即使在豐富了足夠的急救部門(mén)的能力后,中國(guó)的地區(qū)級(jí)醫(yī)院急診部門(mén)也變得人滿為患(Li etal.,2016)。與此同時(shí),中國(guó)的初級(jí)保健資源約有41%的未...

【文章頁(yè)數(shù)】：150 頁(yè)

【學(xué)位級(jí)別】：博士

【文章目錄】：
Abstract
Abstract (In Chinese)
CHAPTER 1 Introduction
    1.1 BACKGROUND
    1.2 SIGNIFICANCE OF STUDY
    1.3 RESEARCH PROBLEMS
        1.3.1 First Research Problem
        1.3.2 Second Research Problem
    1.4 SCOPE OF THE STUDY
    1.5 RESEARCH OBJECTIVES
        1.5.1 Associated with First Research Problem
        1.5.2 Associated with Second Research Problem
    1.6 STRUCTURE OF THE THESIS
CHAPTER 2 Literature Review
    2.1 INPATIENT OPERATIONS MANAGEMENT
    2.2 OUTPATIENT FLOW MANAGEMENT
        2.2.1 Healthcare Delivery System in China
        2.2.2 Healthcare Challenges in Rural China
        2.2.3 Healthcare Challenges in Urban China
        2.2.4 Offline Healthcare Service Satisfaction
        2.2.5 e-Hospitals and ED Overcrowding
        2.2.6 m-Health
        2.2.7 m-Health Innovation in China
        2.2.8 Government Support
        2.2.9 Technology Acceptance Model and Trust
Part Ⅰ First Research Problem Inpatient Operations Management
    CHAPTER 3 Inpatient Operations Management to Mitigate EDOvercrowding in a Singaporean Hospital
        3.1 INTRODUCTION
            3.1.1 Healthcare: USA and Singapore
        3.2 NATIONAL UNIVERSITY HOSPITAL,SINGAPORE
            3.2.1 History
            3.2.2 Quality of Healthcare
            3.2.3 Resources
            3.2.4 Dilemma
            3.2.5 Dealing with ED Overcrowding
        3.3 INPATIENT WARDS
            3.3.1 Critical Care Wards
            3.3.2 General/ Specialty Wards
            3.3.3 Gynecology Wards
            3.3.4 Pediatric Wards
        3.4 RESEARCH METHODOLOGY
        3.5 INPATIENT ADMISSION SOURCES
            3.5.1 Emergency Department (ED)
            3.5.2 Intensive Care Unit (ICU)
            3.5.3 High Dependence Wards (HDWs)
            3.5.4 Elective Patients (EL)
            3.5.5 Same-Day-Admission (SDA) Patients
        3.6 HOSPITAL OPERATIONS
            3.6.1 Emergency Department Operations
            3.6.2 BMU Operations
            3.6.3 Transfer from ED to Inpatient Wards
            3.6.4 Inpatient Ward Operations
        3.7 ANALYSIS
            3.7.1 Possible causes of ED overcrowding and expected bottlenecks
            3.7.2 Ishikawa Fish Bone Analysis
                3.7.2.1 Human resources
                3.7.2.2 Resources (Machinery and Capacity)
                3.7.2.3 Processes
                3.7.2.4 Stakeholders
        3.8 DISCUSSION
            3.8.1 Alternative solutions to reduce ED overcrowding
            3.8.2 Optimal policy and its execution
                3.8.2.1 Existing discharge process
                3.8.2.2 Optimal solution
                    3.8.2.2.1 Discharge forecast
                    3.8.2.2.2 Early discharge policy
                    3.8.2.2.3 First discharge round
                    3.8.2.2.4 Second discharge round
                    3.8.2.2.5 Discharge lounge
        3.9 CONCLUSION
Part Ⅱ Second Research Problem Outpatient Flow Management
    CHAPTER 4 Outpatient Healthcare Service Delivery Model of Chunyu Yisheng
        4.1 INTRODUCTION
        4.2 RESEARCH METHODOLOGY
        4.3 THE CASE OF CHUNYU YISHENG
            4.3.1 Start-up
            4.3.2 Financing
            4.3.3 Product Development
            4.3.4 Establishment of the Business Model
            4.3.5 Mode of Consultation and Charges
        4.4 Discussion, Implication, and Conclusion
        4.5 Limitations and Future Research
    CHAPTER 5 Mobile-based Outpatient Healthcare Service Delivery Model: DivertingOutpatient Flow Prior Visiting Territory-Tier Hospitals to Mitigate ED Overcrowding
        5.1 INTRODUCTION
        5.2 MOBILE-BASED OUTPATIENT HEALTHCARE SERVICE DELIVERY MODEL
        5.3 THEORETICAL MODEL AND HYPOTHESIS
            5.3.1 Technology Acceptance Model
            5.3.2 Perceived Ease of Use
            5.3.3 Perceived Government Support
            5.3.4 Trust
            5.3.5 Perceived Usefulness
        5.4 METHOD
            5.4.1 Research Setting
            5.4.2 Measurement
            5.4.3 Questionnaire Design and Data Collection
            5.4.4 Data Analysis
        5.5 RESULTS
            5.5.1 Common Method Bias
            5.5.2 Demographic Information
            5.5.3 Measurement Model
            5.5.4 Structural Model
        5.6 DISCUSSION
            5.6.1 Implications
            5.6.2 Limitation and Future Research
    CHAPTER 6 Discussion, Conclusion, Implications, and Future Research
        6.1 DISCUSSION AND CONCLUSION
        6.2 IMPLICATIONS
            6.2.1 Practical Implications
            6.2.2 Theoretical Implications
        6.3 FUTURE RESEARCH
References
Acknowledgement
List of Publications
Appendix for Chapter 5
    Cover Letter for Survey Instrument
    Part "A" of Survey Instrument
    Part "B" of Survey Instrument



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