A Health System`s Analysis of the Interface between the Peripheral and the Tertiary Health Services

2.50
Hdl Handle:
http://hdl.handle.net/10755/162133
Category:
Abstract
Type:
Presentation
Title:
A Health System`s Analysis of the Interface between the Peripheral and the Tertiary Health Services
Author(s):
Bhengu, Busi
Author Details:
Busi Bhengu, School of Nursing, University of Kwa-Zulu Natal, email: Bhengub2@ukzn.ac.za
Abstract:
While the cost of high tech tertiary level intensive care units is escalating, the government has shifted its focus to the Primary Health Care. To cope, the tertiary system has introduced stricter admission criteria and early discharge. The appropriateness of referrals is also imperative. Therefore a need arose to establish the extent of trauma and emergencies dealt with in the peripheral health care system and its capacity of to cope with trauma and emergencies and post ICU discharges, including the output of the interface. A health system's analysis of the interface between the peripheral and tertiary systems was therefore conducted to determine the current situation and recommend less expensive strategies to cope in the peripheral system. A qualitative approach using a focused ethnographic method was conducted. Non- continuous participant observation, interviews and review of records were done using purposive, opportunistic and theoretical sampling. Uthukela District comprising of three hospitals was chosen for the peripheral system. Grey's and Edendale Hospitals in Pietermaritzburg and King Edward VIII, Wentworth and Addington Hospitals in Durban were chosen for the tertiary system with tertiary ICUs as referral bases for the district under study. Both the descriptive and theoretical data analyses were done based on the systems theory and related literature to the study. The Nvivo software was used to isolate free nodes from the data and these were subsequently clustered into categories according to the objectives of the study. The study revealed major deficiencies, which impede effective interface. The major findings were inappropriate provision of resources at the peripheral system of services. Boxed thinking was also found with each institution focusing on own intentions and not accommodating the need to interact with other services in their statement of intentions. Management of the interface seemed negated by the lack of well-defined referral policies, care management tools and supervision interface. Recommendations were made towards coordination of the exchanges between the peripheral and tertiary health care systems , for example, establishment of a coordinating office to facilitate the use of and access to ICU beds for the patients in the peripheral system. To ensure quality an audit tool was also recommended.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2004
Conference Name:
Fourth Conference of the Africa Honour Society
Conference Host:
Africa Honour Society of Nursing
Description:
The Africa Honour Society of Nursing was chartered in Gaborone, Botswana on 4 August 2004 and became the Tau Lambda-at-Large Chapter of the Honor Society of Nursing, Sigma Theta Tau International.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleA Health System`s Analysis of the Interface between the Peripheral and the Tertiary Health Servicesen_GB
dc.contributor.authorBhengu, Busien_US
dc.author.detailsBusi Bhengu, School of Nursing, University of Kwa-Zulu Natal, email: Bhengub2@ukzn.ac.zaen_US
dc.identifier.urihttp://hdl.handle.net/10755/162133-
dc.description.abstractWhile the cost of high tech tertiary level intensive care units is escalating, the government has shifted its focus to the Primary Health Care. To cope, the tertiary system has introduced stricter admission criteria and early discharge. The appropriateness of referrals is also imperative. Therefore a need arose to establish the extent of trauma and emergencies dealt with in the peripheral health care system and its capacity of to cope with trauma and emergencies and post ICU discharges, including the output of the interface. A health system's analysis of the interface between the peripheral and tertiary systems was therefore conducted to determine the current situation and recommend less expensive strategies to cope in the peripheral system. A qualitative approach using a focused ethnographic method was conducted. Non- continuous participant observation, interviews and review of records were done using purposive, opportunistic and theoretical sampling. Uthukela District comprising of three hospitals was chosen for the peripheral system. Grey's and Edendale Hospitals in Pietermaritzburg and King Edward VIII, Wentworth and Addington Hospitals in Durban were chosen for the tertiary system with tertiary ICUs as referral bases for the district under study. Both the descriptive and theoretical data analyses were done based on the systems theory and related literature to the study. The Nvivo software was used to isolate free nodes from the data and these were subsequently clustered into categories according to the objectives of the study. The study revealed major deficiencies, which impede effective interface. The major findings were inappropriate provision of resources at the peripheral system of services. Boxed thinking was also found with each institution focusing on own intentions and not accommodating the need to interact with other services in their statement of intentions. Management of the interface seemed negated by the lack of well-defined referral policies, care management tools and supervision interface. Recommendations were made towards coordination of the exchanges between the peripheral and tertiary health care systems , for example, establishment of a coordinating office to facilitate the use of and access to ICU beds for the patients in the peripheral system. To ensure quality an audit tool was also recommended.en_GB
dc.date.available2011-10-27T09:53:48Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T09:53:48Z-
dc.conference.date2004en_US
dc.conference.nameFourth Conference of the Africa Honour Societyen_US
dc.conference.hostAfrica Honour Society of Nursingen_US
dc.descriptionThe Africa Honour Society of Nursing was chartered in Gaborone, Botswana on 4 August 2004 and became the Tau Lambda-at-Large Chapter of the Honor Society of Nursing, Sigma Theta Tau International.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.