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During the nineteenth century, children's physical health became a dominant theme in France and Great Britain, two of Europe's pediatric pioneers. This dissertation examines how British and French doctors, legislators, hospital administrators, and social reformers came to see the preservation of children's physical health as an object of national and international concern. Medical knowledge and practice shaped, and was shaped by, nineteenth-century child preservation activities in France and Great Britain, linking medicine, public health, and national public and private efforts to improve the health of nations, especially that of their future members. Children's hospitals played a significant role in this process by promoting child health; preventing and combating childhood diseases; fostering pediatric professionalization and specialization; and diffusing medical-based justifications for child welfare reforms in the second half of the century. This deeply contextualized tale of two hospitals, Great Ormond Street Hospital for Children in London (1852) and Sainte-Eugénie in Paris (1855), traces a crescendo in the interest, provision, and advocacy for children's medical care over time: from foundling homes and dispensaries to specialized hospitals with convalescent branches and large outpatient clinics. As a comparative study of the medicalization of children's bodies between 1820 and 1890, this dissertation also investigates the transnational exchange of medical ideas, institutions, and practices pertaining to child health between France and Great Britain during a period of nation-building. Specialized pediatric institutions in Paris and London built upon and solidified local, national, and international interests in improving and preserving child health. Despite great differences in their hospital systems, French and British children's hospital administrators and doctors looked to one another as partners, models, and competitors. Nineteenth-century French and British concerns for national public health, and child health in particular, had important distinctions and parallels, but medical, institutional, and legislative developments related to these concerns were not isolated activities, but rather, tied to transnational communication, cooperation, and competition.
ContributorsSchreiner, Stephanie (Author) / Fuchs, Rachel G. (Thesis advisor) / Green, Monica (Committee member) / Szuter, Christine (Committee member) / Thompson, Victoria (Committee member) / Arizona State University (Publisher)
Created2014
Description
For more than twenty years, clinical researchers have been publishing data regarding incidence and risk of adverse events (AEs) incurred during hospitalizations. Hospitals have standard operating policies and procedures (SOPP) to protect patients from AE. The AE specifics (rates, SOPP failures, timing and risk factors) during heart failure (HF) hospitalizations are unknown. There were 1,722 patients discharged with a primary diagnosis of HF from an academic hospital between January 2005 and December 2007. Three hundred eighty-one patients experienced 566 AEs, classified into four categories: medication (43.9%), infection (18.9%), patient care (26.3%), or procedural (10.9%). Three distinct analyses were performed: 1) patient's perspective of SOPP reliability including cumulative distribution and hazard functions of time to AEs; 2) Cox proportional hazards model to determine independent patient-specific risk factors for AEs; and 3) hospital administration's perspective of SOPP reliability through three years of the study including cumulative distribution and hazard functions of time between AEs and moving range statistical process control (SPC) charts for days between failures of each type. This is the first study, to our knowledge, to consider reliability of SOPP from both the patient's and hospital administration's perspective. AE rates in hospitalized patients are similar to other recently published reports and did not improve during the study period. Operations research methodologies will be necessary to improve reliability of care delivered to hospitalized patients.
ContributorsHuddleston, Jeanne (Author) / Fowler, John (Thesis advisor) / Montgomery, Douglas C. (Thesis advisor) / Gel, Esma (Committee member) / Shunk, Dan (Committee member) / Arizona State University (Publisher)
Created2012
Description
Diabetes is becoming a serious problem in China. At the same time, China’s medical
system has faced a difficult situation because of the lack of medical resources and the unequal medical resource distribution between the BHs and BLHs. BH doctors are tremendously busy with both serious and minor illnesses while BLH medical providers are worried about a sufficient source of patients. This study aims to find the potential feasibility of a new service model in managing diabetes which will solve these medical problems. The study was conducted using an extensive literature review in addition to employing an interview and survey method to explore the perception and current situation in workload and income of medical providers from one BH and one BLH in China. Furthermore, this study tried to understand the acceptance of online medical technology in these medical provider groups. The results showed that doctors in the BH do not have the time needed to engage in extra work. This population is not satisfied with their work responsibilities and income structure. They want to engage in diagnosing and prescribing tasks, with respect to diabetes management. They would like to distribute the management work to BLH. On the other hand, medical providers in BLH have extra time and enthusiasm in doing extra work to improve their income. They are not satisfied with their workload and income, and want to change it. BLHs are willing to do the management work assisting the BH doctors. Additionally, the study showed that online medical technology requires a broader user education for medical providers from both big and BLHs. The conclusion can be summarized as design research advice for future service design in healthcare management. The proposed online medical service should meet different level medical providers' position and requirements regarding time, payment, and value. BH doctors are more suitable for diagnosing and prescribing and BLH medical providers are more suitable for follow-up service. This service should reflect the value of the BH doctors' professional service and the value of BLH medical providers' health management service. (discuss how design can improve this situation through app development)
system has faced a difficult situation because of the lack of medical resources and the unequal medical resource distribution between the BHs and BLHs. BH doctors are tremendously busy with both serious and minor illnesses while BLH medical providers are worried about a sufficient source of patients. This study aims to find the potential feasibility of a new service model in managing diabetes which will solve these medical problems. The study was conducted using an extensive literature review in addition to employing an interview and survey method to explore the perception and current situation in workload and income of medical providers from one BH and one BLH in China. Furthermore, this study tried to understand the acceptance of online medical technology in these medical provider groups. The results showed that doctors in the BH do not have the time needed to engage in extra work. This population is not satisfied with their work responsibilities and income structure. They want to engage in diagnosing and prescribing tasks, with respect to diabetes management. They would like to distribute the management work to BLH. On the other hand, medical providers in BLH have extra time and enthusiasm in doing extra work to improve their income. They are not satisfied with their workload and income, and want to change it. BLHs are willing to do the management work assisting the BH doctors. Additionally, the study showed that online medical technology requires a broader user education for medical providers from both big and BLHs. The conclusion can be summarized as design research advice for future service design in healthcare management. The proposed online medical service should meet different level medical providers' position and requirements regarding time, payment, and value. BH doctors are more suitable for diagnosing and prescribing and BLH medical providers are more suitable for follow-up service. This service should reflect the value of the BH doctors' professional service and the value of BLH medical providers' health management service. (discuss how design can improve this situation through app development)
ContributorsLiu, Maozhen (Author) / Takamura, John (Thesis advisor) / Doebbeling, Bradley (Committee member) / Herring, Donald (Committee member) / Arizona State University (Publisher)
Created2018
Description
Electroencephalogram (EEG) used simultaneously with video monitoring can record detailed patient physiology during a seizure to aid diagnosis. However, current patient monitoring systems typically require a patient to stay in view of a fixed camera limiting their freedom of movement. The goal of this project is to design an automatic patient monitoring system with software to track patient movement in order to increase a patient's mobility. This report discusses the impact of an automatic patient monitoring system and the design steps used to create and test a functional prototype.
ContributorsBui, Robert Truong (Author) / Frakes, David (Thesis director) / Helms Tillery, Stephen (Committee member) / Barrett, The Honors College (Contributor) / Electrical Engineering Program (Contributor)
Created2014-05
Description
This long form creative nonfiction essay gives insider details on working in an emergency room as a medical scribe. The most pertinent topic is death and how the author copes with seeing patients die on a regular basis. Other topics are emergency room procedures, specific diagnoses and treatments, as well information on the other personnel in an emergency room.
ContributorsFeller, Aaron Lee (Author) / Gutkind, Lee (Thesis director) / Robert, Jason (Committee member) / Rowe, Todd (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / Department of English (Contributor)
Created2013-05
Description
The healthcare industry is currently facing significant changes. One of the changes in the industry is a movement towards patient-focused care, which considers the patient as a person and the impact of care on the person. Patient experience is part of patient-focused care, and has similarities to the marketing term customer experience, which contributes to happier customers and long-term financial growth and success for businesses. This thesis defines current issues in patient experience as it relates to hospital manager decision making. Through secondary research, this thesis demonstrates what patient experience is, the role it plays in healthcare and hospital settings, the pressures on hospitals to increase patient experience performance, how patient experience performance is measured, and what strategies or action drive improvements under current performance measurements. Many studies and articles exist examining each of these issues individually. However, these sources do not comprehensively define patient experience in hospitals with perspective on how this influences hospital strategy and decision-making. Previous works on patient experience from the perspective of hospital strategy do not include considerations for recent industry shifts, most notably the Patient Protection and Affordable Care Act. The collected definitions in this thesis provide guidance of relevant concerns hospital managers consider when formulating organization-wide strategy related to patient experience. This thesis explains how patient experience contributes to the success of hospitals in the short-term, medium-term, and long-term and how patient experience may shift its focus over time. Short-term concerns include specific regulations and definitions from the Centers for Medicare and Medicaid services, responsible for over half of all payments to hospitals. Conforming to CMS standards is a matter of survival for most hospitals in the short-term. Hospitals are adjusting to rules and payment models not in existence just two years ago. First, hospitals will adapt, and then hospitals will strive to optimize under new standards as well as respond to adjustments in the rules over the next several years. After patient experience standards are well established, certain aspects of patient experience will be part of long-term differentiation and success for hospitals. Responding comprehensively to the shift towards improving patient experience is a critical aspect for hospitals to weather the many changes in the healthcare industry. Patient experience will provide better care to patients and better financial health to the hospitals that perform above patient experience standards.
ContributorsWilton, Kara Alexandra (Author) / Ketcham, Jonathan (Thesis director) / Ostrom, Amy (Committee member) / Barrett, The Honors College (Contributor) / W. P. Carey School of Business (Contributor) / Department of Supply Chain Management (Contributor) / Department of Marketing (Contributor)
Created2014-05
Description
Hospitals constitute 9 percent of commercial energy consumption in the U.S. annually, though they only make up 2 percent of the U.S. commercial floor space. Consuming an average of 259,000 Btu per square foot, U.S. hospitals spend about 8.3 billion dollars on energy every year. Utilizing collaborative delivery method for hospital construction can effectively save healthcare business owners thousands of dollars while reducing construction time and resulting in a better product: a building that has fewer operational deficiencies and requires less maintenance. Healthcare systems are integrated by nature, and are rich in technical complexity to meet the needs of their various patients. In addition to being technologically and energy intensive, hospitals must meet health regulations while maintaining human comfort. The interdisciplinary nature of hospitals suggests that multiple perspectives would be valuable in optimizing the building design. Integrated project delivery provides a means to reaching the optimal design by emphasizing group collaboration and expertise of the architect, engineer, owner, builder, and hospital staff. In previous studies, IPD has proven to be particularly beneficial when it comes to highly complex projects, such as hospitals. To assess the effects of a high level of team collaboration in the delivery of a hospital, case studies were prepared on several hospitals that have been built in the past decade. The case studies each utilized some form of a collaborative delivery method, and each were successful in saving and/or redirecting time and money to other building components, achieving various certifications, recognitions, and awards, and satisfying the client. The purpose of this research is to determine key strategies in the construction of healthcare facilities that allow for quicker construction, greater monetary savings, and improved operational efficiency. This research aims to communicate the value of both "green building" and a high level of team collaboration in the hospital-building process.
ContributorsHansen, Hannah Elizabeth (Author) / Parrish, Kristen (Thesis director) / Bryan, Harvey (Committee member) / Civil, Environmental and Sustainable Engineering Programs (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
This thesis project discusses the transitions of the physician profession and their struggle to maintain autonomy throughout American History until approximately the 1980's. Included in the historical account of the physician profession, is the development of the American Hospital System and its origins working under the physician profession. As history progresses from 1760 on, what comes to light is a cyclical struggle for physicians to remain independent from the corporations, while using them to gain social and economic prestige. This work focuses on how the establishment of private practice in the United States has lead to the current system in place today, illustrating a long fight for control of the medical field that still rages on today. As physicians gained power and autonomy in the medical field during the 20th century, constant attempts of government intervention can be seen within the convoluted history of this professional field. The rise of corporate healthcare, that works in tandem with private physicians, was a critical period in forgotten American History that subsequently allowed physicians to increase their stranglehold on the medical service industry. The goal of this research was to establish a better understanding of American Medicine's history to better tackle the new problems we face today. As America transitions to a period of public health outcry, it is important to establish a somewhat linear rendition of a mostly untold history that directly impacts the lives of every citizen in this country. This work attempts to mend the broken pieces of that history to give light to how healthcare evolved into what it is today.
ContributorsParkhurst, Erik Lewis (Author) / Tyler, William (Thesis director) / Coursen, Jerry (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
This document introduces the need for the Rest Egg system and defines an accessible method of smartphone integration. Excessive noise can prevent recovering patients and special needs persons from resting correctly. The Rest Egg was designed for these people- people who are in critical need of quality rest but are often unable to eliminate stressors themselves. This system ensures their environment is calm by alerting caretakers' smartphones if noise reaches abrasive levels. Smartphones were the preferred device due to the wide spread of such devices in today's market. After making open sourcing a goal, something ubiquitous and affordable \u2014 yet usable and dependable \u2014 was necessary for the alert system. These requirements lead to the election an online alert service: Pushover, a trademark and product of Superblock, LLC.
ContributorsJennings, Tyler Blake (Author) / Goryll, Michael (Thesis director) / Kozicki, Michael (Committee member) / Barrett, The Honors College (Contributor) / Electrical Engineering Program (Contributor)
Created2016-05
Description
The objective of this research is to understand how a set of systems, as defined by the business process, creates value. The three studies contained in this work develop the model of process-based automation. The model states that complementarities among systems are specified by handoffs in the business process. The model also provides theory to explain why entry systems, boundary spanning systems, and back-end control systems provide different impacts on process quality and cost. The first study includes 135 U. S. acute care hospitals. The study finds that hospitals which followed an organizational pattern of process automation have better financial outcomes. The second study looks in more depth at where synergies might be found. It includes 341 California acute care hospitals over 11 years. It finds that increased costs and increase adverse drug events are associated with increased automation discontinuity. Further, the study shows that automation in the front end of the process has a more desirable outcome on cost than automation in the back end of the process. The third study examines the assumption that the systems are actually used. It is a cross-sectional analysis of over 2000 U. S. hospitals. This study finds that system usage is a critical factor in realizing benefits from automating the business process. The model of process-based automation has implications for information technology decision makers, long-term automation planning, and for information systems research. The analyses have additional implications for the healthcare industry.
ContributorsSpaulding, Trent Joseph (Author) / Santanam, Raghu T (Thesis advisor) / Vinze, Ajay (Committee member) / Furukawa, Michael F. (Committee member) / Arizona State University (Publisher)
Created2011