Transition to hospital process orientation: The case of regional hospitals in Latvia
Bibliographic record
Abstract
Management of processes instead of functions has growing importance into the health care. Transition to hospital process orientation (HPO) changes the way physicians and other health professionals have used to practice before. Study was performed to explore factors affecting introduction of HPO in Latvian hospitals responding to significant external pressures during the years of economic crisis to detect the best practices used for process management implementation in clinical setting. To reach the research goal dissimilarities between current performance and management of hospitals were explored. As changes in hospital reimbursement system demand improved efficiency, hospital’s performance was measured by decrease in avoidable hospitalisations, and increase in usage of more cost effective alternatives to a full hospitalisation. A regression analysis was performed to evaluate correlations of hospitalisation rates in Latvian hospitals to various outpatient health services utilisation indicators. This was done to exclude influence of external factors on hospital performance and to prove the positive impact of HPO initiatives on hospitalisation rate. Afterward the performance of all regional hospitals was compared and the two most distinct hospitals were selected for further in depth analysis. Operational data of the selected hospitals and a set of structured interviews outlined the differences between both hospital’s managerial practices and factors affecting the introduction of process oriented initiatives. The theoretical research together with comparative analysis of approaches used in both hospitals served as a basis for elaboration of recommendations towards development of HPO and facilitation of the development of self-management competence of health professionals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".