Head-to-head comparison of length of stay, patients' outcome and satisfaction in Switzerland before and after SwissDRG-Implementation in 2012 in 2012: an observational study in two tertiary university centers.

On 1 January 2012 Swiss Diagnosis Related Groups (DRG), a new uniform payment system for in-patients was introduced in Switzerland with the intention to replace a "cost-based" with a "case-based" reimbursement system to increase efficiency. With the introduction of the new payment system we aim to answer questions raised regarding length of stay as well as patients' outcome and satisfaction. This is a prospective, two-centre observational cohort study with data from University Hospital Basel and the Cantonal Hospital Aarau, Switzerland, from January to June 2011 and 2012, respectively. Consecutive in-patients with the main diagnosis of either community-acquired pneumonia, exacerbation of COPD, acute heart failure or hip fracture were included. A questionnaire survey was sent out after discharge investigating changes before and after SwissDRG implementation. Our primary endpoint was LOS. Of 1,983 eligible patients 841 returned the questionnaire and were included into the analysis (429 in 2011, 412 in 2012). The median age was 76.7 years (50.8% male). Patients in the two years were well balanced in regard to main diagnoses and co-morbidities. Mean LOS in the overall patient population was 10.0 days and comparable between the 2011 cohort and the 2012 cohort (9.7 vs 10.3; p = 0.43). Overall satisfaction with care changed only slightly after introduction of SwissDRG and remained high (89.0% vs 87.8%; p = 0.429). Investigating the influence of the implementation of SwissDRG in 2012 regarding LOS patients' outcome and satisfaction, we found no significant changes. However, we observed some noteworthy trends, which should be monitored closely.

Satisfaction des patients du CHUV en 1996-1997

[Table des matières] I. Matériel et méthode. 1. Mode d'administration de l'enquête. 2. Questionnaire. - II. Résultats. - III. Enseignements à tirer et recommandations. 1. Lettres d'accompagnement. 2. Questionnaire enfant. 3. Questionnaire adulte CTR. 4. Questionnaire adulte. 5. Résultats détaillés par question. 6. Représentation graphique des résultats.

Adhésion thérapeutique en oncologie : persistance, qualité d'exécution et satisfaction des patients sous traitement oral et MEMS®

Introduction: en oncologie apparaissent sur le marché depuis quelques années de nouveaux traitements en formulation orale facilitant l'administration et améliorant la qualité de vie du patient mais augmentant le risque de non adhésion et d'erreurs de posologie. L'observation par MEMS® (Medication Event Monitoring System) permet le suivi et l'encadrement du traitement oral et par le biais d'entretiens semi structurés menés par le pharmacien, ouvre la discussion sur les problèmes révélés par cette prise en charge. Méthode: étude non randomisée prospective uni centrique regroupant 50 patients inclus dans 3 groupes de traitements oncologiques oraux courants (capecitabine, letrozole/exemestane, imatinib/sunitinib) bénéficiant d'un suivi oncologique classique et équipés d'un MEMS® pour un an maximum. La persistance et la qualité d'exécution sont les deux paramètres mesurés grâce aux données récoltées électroniquement. Les entretiens sont dédiés à la prévention de la non adhésion et à la gestion des effets secondaires médicamenteux. La satisfaction est évaluée par un questionnaire à la fin du suivi. Résultats: à ce jour 38 patients ont été inclus dans l'étude. Les données complètes sont disponibles pour les 19 premiers patients dont 10 sous capecitabine et 9 sous letrozole/exemestane. Dans ce collectif l'âge médian est de 66 ans avec une majorité de femmes (11:8). La persistance à 10 jours est de 85% et la qualité d'exécution de 99%. Les toxicités observées supérieures à grade 1 sont 1 syndrome mains-pieds (G3) et 1 syndrome coronarien aigu (G3). Le questionnaire de fin de suivi relève une satisfaction de 85% des patients pour les entretiens proposés (57% utiles, 28% très utiles, 15% inutiles) et le succès quant à l'intégration du MEMS® dans leur quotidien (57% très facile, 43% facile). Conclusion: la persistance et la qualité d'exécution observées dans notre collectif sont excellentes. La satisfaction retrouvée auprès des patients reflète le besoin d'un soutien complémentaire face à la complexité de la maladie oncologique. La gestion pluridisciplinaire profite tant aux patients qu'au binôme médecin-pharmacien par l'amélioration de la communication globale entre les divers acteurs et par l'identification précoce des risques de non adhésion. La poursuite de cette étude et l'analyse des futures données permettra de mesurer le réel impact de notre intervention et de justifier le bénéfice pour des patients sous traitement similaire.

The effects of safety climate and trust on job satisfaction

Job satisfaction has been a frequently studied concept in organizational behavior. Past research has shown that trust in top management is an important factor influencing job satisfaction. To date, little attention has been paid to safety climate perceptions as a possible predictor of job satisfaction. In our study we investigated the direct and interactive effects of trust in top management and individual-level perceptions of safety climate in predicting job satisfaction. The findings of this study point to the importance of positive perceptions of safety climate on employees' job satisfaction when trust in top management is low.

Families of the traumatically brian-injured : a case study approach to perceptions of quality of service, degree of satisfaction, and family needs /

The purpose of this qualitative research study was to foster an understanding of the rehabilitation counselling practice offamilies of the brain-injured. Specifically, the study explores the perceptions of stakeholders in regards to the degree of satisfaction with the quality of service received. Questionnaires were administered, and semi-structured, openended interviews were conducted, with six participating families (n=8). Preliminary data were collected via two instruments: (i) the Family Participant Questionnaire, consisting of participants' sample characteristics, information pertaining to the history of the family, details of the injury, and information relating to the type, use, and need offamily services utilized; and (ii) the Community Integration Questionnaire, a measurement of the degree of social displacementllevel of community integration of the injured family member. Utilizing the procedural steps outlined by Colaizzi's (1978) method of protocol analysis, recommendations for a future program based on related and current family needs are discussed in detail. Substantiating and supporting information are offered to rehabilitation practitioners, educational planners, and policymakers alike, concerning the degree of satisfaction with rehabilitative service, and the means of improving upon the overall quality of health care to families of the brain-injured. Implications for clinical practice and research are also raised for discussion.

Linking of stress offset score (SOS), work satisfaction, and organizational commitment to intentions to quit

The purpose of this study was to identify the impact of stressors and offsetting satistiers, measured in this study with Stress Offset Score (SOS), on intentions to quit and examine the mediating and moderating effects of three facets of work satisfaction (job satisfaction, pay satisfaction, and satisfaction with supervisor) and two facets of organizational commitment (affective and nonnative commitment) on this relationship. The sample was composed of 2990 employees from 21 public and private organizations. The interaction of each type of work satisfaction and organizational commitment, with SOS, was tested using Ordinary Least Squares (OLS) procedures. Intentions to quit was the dependent variable. The research questions were determine: (1) Does SOS predict intentions to quit? (2) Does work satisfaction mediate the predictive relationship of SOS on intentions to quit? (3) Does organizational commitment mediate the predictive relationship of SOS on intent to quit? (4) Does work satisfaction moderate the predictive relationship of SOS on intentions to quit? and (5) Does organizational commitment moderate the predictive relationship of SOS on intentions to quit? The results indicated that SOS was negatively correlated with intentions to quit. Each of the types of work satisfaction and organizational commitment variables showed a partial mediated relationship with SOS and each relationship was highly significant, while normative commitment explained more of the relationship then other mediators. The study also tested for interactions but no statistical significant relationships where established between any of the interaction terms (e.g., SOSxJob Satisfaction and SOSxAffcctive Commitment) and intentions to quit.

Effect of combined care nursing on patient satisfaction, staff satisfaction, and quality of care /

This research evaluates the effect of combined care nursing on three outcomes: i) patient satisfaction; ii) staff satisfaction; and iii) quality of care. Oakville-Trafalgar Memorial Hospital was in the early planning stages of changing to combined care nursing from the traditional method of providing separate postpartum and nursery care to mothers and babies. The opportunity existed to evaluate formally the change to combined care. There were three hypotheses to be investigated. Data were collected from four sources: patient surveys, staff surveys, informal interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. The surveys were administered on three different occasions to patients and staff. Other sources of data included informal interviews with patients and staff who responded to the surveys, and chart audits.The study findings revealed that the majority of respondents had increased levels of satisfaction and perceptions of increased quality of care following implementation of combined care. These findings, related to combined care and the role of change in its implementation and evaluation, indicate that there are no right or easy answers about how to make new ideas become reality in a smooth, pleasant way.

A comparison of life satisfaction, job satisfaction, and happiness using demographic variables

This study examined the interrelationships among life satisfaction, job satisfaction, and happiness and the selected demographic variables of income, age, marital status, education, sex, job tenure, job title, type of school, and location of employment. Survey data were collected from 1,993 elementary, high school, and community college teachers in the southern Ontario area, representing ten public school boards, three Roman Catholic school boards and three community colleges. Several theories were utilized in developing thirteen hypotheses and eleven experimental hypotheses. A thorough review of the literature (to January, 1980) was undertaken and major conclusions noted. Hoppock's (1935) Job Satisfaction Measure, Gurin, Veroff, and Feld's (1960) Happiness Scale, and Converse and Robinson's (1965) Life Satisfaction Scale were used as the instrument. Chi-square analysis was employed as the statistical method. Indicative of the findings: the level of education taught was significantly related to all three organizational variables, sex was unrelated to life satisfaction though positively related to job satisfaction, and income was found not to be related to either happiness or life satisfaction. A minority of findings were contrary to hypothesized relationships. Specifically, age was found to be unrelated to any of the three organizational variables, and educational achievement was not significantly related to happiness. A model was developed to illustrate the interrelationships of the organizational and demographic variables. This model was designed specifically to reflect teacher attitudes, though it may have reasonable application for other relatively homogeneous groups of employees such as nurses, engineers, or social workers.

A contingency model of job satisfaction

The present research study was designed to test a contingency model of job satisfaction based on participation in decision making as the antecedent variable and job involvement as the intervening variable. The instruments used to measure the variables were the participation in decision making scale developed by Siegel and Ruh (1973), the job involvement scale by Lodahl and Kejner (1965) and the job satisfaction construct derived from Hoppock (1935). The findings indicate that statistically significant correlations do exist for the 1995 educators surveyed in this study. Educators who reported high levels of participation in decision making consistently reported high levels of job involvement (p!: 0.001). Also, teachers reporting high levels of job involvement consistently scored high on their levels of job satis faction (p!: 0.001). All major hypotheses were sUPFOrted by the data. Through exploratory hypotheses, the study attempted to develop statements of relationships between criteria of job satisfaction and sex and marital status of employees in the system. The hypotheses received only minimal support, but the results did highlight the impracticability of attempting to develop any such relationships without using definite personality and situational variables as moderators. Differences between male and female socialization, sex discrimination and multiplicity of roles are briefly discussed as possible explanations for the reported findings.

An examination of the effects of locus of control on perceptions of core job dimensions and job satisfaction

This study examined the moderating effects of locus of control on core job dimensions (skill variety, task identity, task significance, autonomy, feedback) and job satisfaction. Survey data were collected from 1995 educators in Southern Ontario. When core job dimensions were perceived to be high, job satisfaction scores were high. The converse relationship was also true; when core job dimensions were perceived to be low, job satisfaction scores were also low. As well, the investigation explored the effect of educators' locus of control of reinforcement on the relationship between core job dimensions and job satisfaction. Internals (N = 483-486) perceived more skill variety, more task identity, more task significance, more autonomy, more feedback and greater job satisfaction than externals (N = 626-629). However, contrary to expectation, the correlations between specific core job dimensions namely autonomy and feedback, were not systematically greater for internals compared to externals. In addition the findings reported here suggest some appropriate directions and strategies for measuring and increasing job satisfaction among teachers.

A Study of role conflict, role ambiguity, locus of control, job satisfaction and participation in decision making among front-line vocational service workers for mentally retarded adults

This study was an investigation of individual and organizational factors, as perceived by front-line vocational service workers from Adult Rehabilitation Centres (ARC Industries) for mentally retarded adults. The specific variables which were measured included role conflict/role ambiguity (role factors), internal/external locus of control (individual differences), job satisfaction with work and supervision (job attitudes) and participation in deci~ion making (organizational factor). The exploration of these constructs was conducted by means of self-report questionnaires which were completed by sixty-nine out of a total of ninety front-line employees. The surveys were distributed in booklet form to nine distinct rehabilitation facilities from St. Catharines, West Lincoln, Greater Niagara, Port Colborne, WeIland, Fort Erie, Hamilton, Guelph and Brantford. The survey data was evaluated by the statisti.cal Package for the Social Sciences (SPSS) which used the Pearson Product Moment Correlation procedure and a compar~son of means test. A comparison of correlation coefficients test was also conducted. This statistical procedure was calculated mathematically. The results obtained from the statistical evaluation confirmed the prediction that self-reported measures of participation in decision making and satisfaction (work and supervision) would be negatively correlated with role conflict and role ambiguity. As well, the speculation that perceived satisfaction (work and supervision) would be positively correlated with participation in decision making was empirically supported. Internal and external locus of control did not contribute to a significant difference in r~sponses to role perceptions (conflict and ambiguity) , satisfaction (work and supervision) or the correlational relationship between participation in decision making and satisfaction (work and supervision). Overall, the findings from this study substantiated the importance of examining employee perceptions in the workplace and the interrelationships among individual and organizational variables. This research was considered a contribution to the general area of occupational stress and to the study of individuals in work organizations.

Job satisfaction and dissatisfaction : comparison of behavioural and regular classroom teachers

Each of the forty Toronto Board of Education behavioural teachers was matched as closely as possible .with a regular cIassroom teacher from the same schooI, 0f the same sex, and teaching approxiately the same age group of chiIdren. A II of these teachers were sent a questionnaire (based on Herzberg's model) whose content reflected various aspects of job satisfaction or dissatisfaction. Demographic data was also gathered to be used in the study for examining correlations between satisfaction and various factors . T 10 additional questions were asked regarding factors that IOU Id influence the i r staying or Ieaving and one question was asked about lIerit pay . Chi Square tests and t-tests were conducted on the results. The majority of each group of teachers was very satisfied with their job while the behavioural teachers were significantly more satisfied than the regular teachers. Intrinsic factors played a more signi ficant role than did extrinsic ones. The demographic factors couId be found to be predictors of job satisfaction or dissatisfaction.

The impact of meaningfulness of and responsibility for work on the relationships among work values, organizational commitment, and job satisfaction for part- time faculty in a community college

One hundred and thirty four subjects participated in this survey. Quantitative data were obtained and correlational analyses were used to test a model to study the relationships among the achievement of work values and organizational commitment and job satisfaction and to identify the moderating effects of the meaningfulness of work and responsibility for work on these relationships. Part-time faculty in the Faculty of Continuing Education of a community college were mailed a questionnaire on all the variables of the model. Several reliable, valid instruments were used to test the variables. Data analysis through Pearson correlation and stepwise multiple regression analyses revealed that the achievement of the work values of recognition and satisfaction with promotions did predict organizational commitment and job satisfaction, although the moderating effects of the meaningfulness of work and responsibility for work was not supported in this study. This study suggests that the revised model may be used for determining the relationships between the achievement of work values and organizational commitment and job satisfaction in a community college setting.

Job satisfaction among nurses and its relationship to reflective practice /

This study was undertaken to explore job satisfaction among nurses and its relationship to reflective practice. It is a qualitative study that listens to the perspectives of 7 mental health nurses who work In a conmiunity hospital in southern Ontario. A pilot survey was conducted prior to the face-to -face interviews in order to develop meaningful questions to utilize in the interviews. Nurses participating in the study were ensured anonjnnlty and an opportunity to have their own personal perspectives heard. A convenient sample was obtained from the hospital in which the researcher worked as an educator and professional practice consultant. The concept of job satisfaction was found to be driven by the desire to do important work and to make a difference in patients' lives. The nurses articulated that it is directly related to other factors, such as the opportunity to work in one's area, of preference, involvement in decisionmaking processes, better patient/ staff ratios, and affordable, accessible continuing educational opportunities. Those nurses who have embraced reflective practice for many years seem to be able to sort out that which drives them to stay in nursing and that which will influence them to leave. The constraints of the study cO-e that it is a small qualitative study; therefore, the results are not generallzable. Reflection is integral to the practice of mental heallth nursing find a tool that is used extensively in therapy with patients. Future research could involve studing a different group of nurses who may be more task focused than mental health nurses.