Objectives: This study aimed to examine the impact of work schedule and work position on fatigue levels among employees at a private geothermal firm in Indonesia during the COVID-19 pandemic. The company has modified its work schedule considering the COVID-19 epidemic to ensure a continuous supply of energy and meet the needs of the public. Methods: In this cross-sectional study, the dependent variable is fatigue, which is classified as a latent variable. Fatigue is assessed using the Indonesian version of the Swedish Occupational Fatigue Inventory (SOFI). Fatigue is a condition that has five dimensions: lack of energy, physical exertion, physical discomfort, sleepiness, and lack of motivation. The observed variables in this study include work schedule and work position, which serve as independent variables. Using structural equation modeling (SEM), we assessed the impact of the independent variables on each dimension of fatigue. This approach allowed for the analysis of both the measurement and structural models. Results: The investigation employed total sampling, involving 132 workers from the company who willingly participated in the study. According to the findings, workers' main fatigue dimension was lack of energy. However, the statistical analysis did not establish a significant influence of work schedule and work position on fatigue. Conclusion Based on the findings of the SEM analysis, it is evident that there is no statistically significant correlation between work schedules and job positions with various dimensions of fatigue assessed using the SOFI questionnaire. These dimensions include lack of energy, physical exertion, physical discomfort, sleepiness, and lack of motivation. While this outcome suggests that work schedules and job positions may not directly influence fatigue levels as measured in this study, it underscores the importance of implementing occupational health and safety management systems. Additionally, promoting good work practices such as offering flexible working hours may help address potential fatigue concerns among employees. However, further research is necessary to explore additional variables that could potentially impact fatigue levels in the context of the COVID-19 pandemic and beyond.
Work Schedule ; Personnel Staffing and Scheduling

OBJECTIVEImprove the electronic application appointment and scheduling methods in hospital to optimize patients appointment and improve utilization of hospital inspection equipment.

METHODAnalyze the workflow of existing electronic application and put forward the improvement scheme.

RESULTDeveloped a set of efficient appointment scheduling system, thus optimize the workflow of hospital exam.

CONCLUSIONThis system not only optimizes the patient's examination time, but also improves the utilization of hospital inspection equipment.

Appointments and Schedules ; Efficiency, Organizational ; Hospital Information Systems ; Personnel Staffing and Scheduling

OBJECTIVETo investigate the functional dyspepsia (FD) and functional gastrointestinal diseases (FGD) in shift nurses.

METHODS139 shift nurses were investigated while 104 nurses on daytime duty served as control at the same time. Two groups accepted investigation including digestive system questionnaire and the psychological mood table format.

RESULTS78 shift nurses (56.12%) had FD and FGD and the incidence rate was higher than the control group (41 nurses 39.42%; chi2 = 6.633, P < 0.01). In its sub-model, FD, IBS and FD + FGD symptom were present in shift nurses while FD, FD + FGD symptom and IBS predominated in the control group (P > 0.05). The SDS total score, SAS total score, work pressure total score and work tiredness in group A were higher than the control group (P < 0.05, P < 0.01).

CONCLUSIONShift nurses tend to have the functional dyspepsia and functional gastrointestinal diseases, which relates to passive mood work hard and nerve stress.

Adult ; Dyspepsia ; epidemiology ; Female ; Gastrointestinal Diseases ; epidemiology ; Humans ; Nurses ; Personnel Staffing and Scheduling ; Surveys and Questionnaires ; Young Adult

PURPOSE: This study was done to analyze variations in unit staffing and recommend policies to improve nursing staffing levels in intensive care units (ICUs). METHOD: A cross-sectional study design was used, employing survey data from the Health Insurance Review Agency conducted from June-July, 2003. Unitstaffing was measured using two indicators; bed-to-nurse (B/N) ratio (number of beds per nurse), and patient-to-nurse (P/N)ratio (number of average daily patients per nurse). Staffing levels were compared according to hospital and ICU characteristics. RESULT: A total of 414 institutions were operating 569 adult and 86 neonatal ICUs. Tertiary hospitals (n=42) had the lowest mean B/N (0.82) and P/N (0.76) ratios in adult ICUs, followed by general hospitals (B/N: 1.34, P/N: 0.97). Those ratios indicated that a nurse took care of 3 to 5 patients per shift. Neonatal ICUs had worse staffing and had greater variations in staffing ratios than adult ICUs. About 17% of adult and 26% of neonatal ICUs were staffed only by adjunct nurses who had responsibility for a general ward as well as the ICU. CONCLUSION: Stratification of nurse staffing levels and differentiation of ICU utilization fees based on staffing grades are recommended as a policy tool to improve nurse staffing in ICUs.
Analysis of Variance ; Female ; Humans ; Intensive Care Units/economics/*manpower/statistics & numerical data ; Intensive Care Units, Neonatal/economics/*manpower/statistics & numerical data ; Nursing Staff, Hospital/economics/*supply & distribution ; Personnel Staffing and Scheduling/*economics ; Workload

BACKGROUND: Critical care physician staffing is a crucial element of the intensive care unit (ICU) organization, and is associated with better outcomes in ICUs. Adult ICUs in Korea have been suffering from inadequate full-time intensivists and nurses because of insufficient reimbursement rates (<50% of the original critical care cost) from the National Health Insurance System. Recently, full-time intensivists have been introduced as a prerequisite for adult ICUs of tertiary hospitals in Korea. The purpose of this study was to examine the perception of intensivist staffing among critical care program directors regarding the barriers and solutions when implementing an intensivist model of critical care in Korea. METHODS: An email survey of critical care program directors in designated teaching hospitals for critical care subspecialty training by the Korean Society of Critical Care Medicine was performed. The survey domains included vision, culture, resources, barriers, and potential solutions to implementing intensivist physician staffing (IPS). RESULTS: Forty-two critical care program directors were surveyed. A total of 28 directors (66.7%) responded to email queries. Of these, 27 directors (96.4%) agreed that IPS would improve the quality of care in the ICU, although half of them reported a negative perception of relevant clinical colleagues for the role of full-time intensivists and poor resources for IPS in their hospitals. Increased financial burden due to hiring full-time intensivists and concerns regarding exclusion from the management of their critically ill patients in the ICU, together with loss of income for primary attending physicians were stated by the respondents to be major barriers to implementing IPS. Financial incentives for the required cost from the health insurance system and enhancement of medical law relevant to critical care were regarded as solutions to these issues. CONCLUSIONS: Critical care program directors believe that intensivist-led critical care can improve the outcome of ICUs. They indicated the financial burden due to IPS and underestimation of a full-time intensivist's role to be major barriers. The program directors agreed that a partnership between hospital leaders and the Ministry of Health and Welfare was needed to overcome these barriers.
Adult* ; Critical Care ; Critical Illness ; Electronic Mail ; Hospitals, Teaching ; Humans ; Insurance, Health ; Intensive Care Units ; Jurisprudence ; Korea ; Motivation ; National Health Programs ; Personnel Staffing and Scheduling ; Surveys and Questionnaires ; Tertiary Care Centers

BACKGROUND: Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. PURPOSE: To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. METHODS: A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. RESULTS: None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. CONCLUSIONS: The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.
Workload/economics ; Program Evaluation ; Personnel Staffing and Scheduling/*economics ; Nursing Staff, Hospital/economics/*supply & distribution ; Logistic Models ; Korea ; Humans ; *Hospital Charges ; *Health Policy ; Cross-Sectional Studies ; Bed Occupancy/economics ; Analysis of Variance

BACKGROUND: Critical care physician staffing is a crucial element of the intensive care unit (ICU) organization, and is associated with better outcomes in ICUs. Adult ICUs in Korea have been suffering from inadequate full-time intensivists and nurses because of insufficient reimbursement rates (<50% of the original critical care cost) from the National Health Insurance System. Recently, full-time intensivists have been introduced as a prerequisite for adult ICUs of tertiary hospitals in Korea. The purpose of this study was to examine the perception of intensivist staffing among critical care program directors regarding the barriers and solutions when implementing an intensivist model of critical care in Korea. METHODS: An email survey of critical care program directors in designated teaching hospitals for critical care subspecialty training by the Korean Society of Critical Care Medicine was performed. The survey domains included vision, culture, resources, barriers, and potential solutions to implementing intensivist physician staffing (IPS). RESULTS: Forty-two critical care program directors were surveyed. A total of 28 directors (66.7%) responded to email queries. Of these, 27 directors (96.4%) agreed that IPS would improve the quality of care in the ICU, although half of them reported a negative perception of relevant clinical colleagues for the role of full-time intensivists and poor resources for IPS in their hospitals. Increased financial burden due to hiring full-time intensivists and concerns regarding exclusion from the management of their critically ill patients in the ICU, together with loss of income for primary attending physicians were stated by the respondents to be major barriers to implementing IPS. Financial incentives for the required cost from the health insurance system and enhancement of medical law relevant to critical care were regarded as solutions to these issues. CONCLUSIONS: Critical care program directors believe that intensivist-led critical care can improve the outcome of ICUs. They indicated the financial burden due to IPS and underestimation of a full-time intensivist's role to be major barriers. The program directors agreed that a partnership between hospital leaders and the Ministry of Health and Welfare was needed to overcome these barriers.
Adult ; Critical Care ; Critical Illness ; Electronic Mail ; Hospitals, Teaching ; Humans ; Insurance, Health ; Intensive Care Units ; Jurisprudence ; Korea ; Motivation ; National Health Programs ; Personnel Staffing and Scheduling ; Surveys and Questionnaires ; Tertiary Care Centers

The COVID-19 pandemic has had a major impact in healthcare systems across the world, with many hospitals having to come up with protocols and measures to contain the spread of the virus. This affects various specialties' clinical practices in many ways. Since early 2020 in Singapore, the Department of Otorhinolaryngology at Tan Tock Seng Hospital had to rapidly adapt to this pandemic as we provided services to the main healthcare facility combating the virus in our country. We had to design new workflows and also remain flexible in view of the ever-changing situation. There are 6 important domains for an otolaryngology department or any clinical department in general to consider when making adjustments to their practices in an outbreak: (1) clinical work, (2) education, (3) research, (4) safety of patients and staff, (5) morale of medical staff and (6) pandemic frontline work. We hope that the sharing of our experiences and the lessons learnt will be useful for both our local and international colleagues.
Ambulatory Care ; Biomedical Research ; COVID-19/prevention & control* ; Delivery of Health Care/methods* ; Education, Medical ; Elective Surgical Procedures ; Health Workforce ; Humans ; Morale ; Otolaryngology/methods* ; Otorhinolaryngologic Surgical Procedures ; Personal Protective Equipment ; Personnel Staffing and Scheduling ; SARS-CoV-2 ; Singapore/epidemiology* ; Workflow

PURPOSE: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity in many countries, and it has high rate of hospital readmissions due to recurrent exacerbations of the disease. Many previous studies have suggested further examination of the factors that contribute to hospital readmissions of COPD patients. However, evidence on the effects of nurse staffing by registered nurses (RNs) on the readmission of COPD patients is lacking in Korea. The aim of our study was to evaluate the effects of nurse staffing on hospital readmissions of COPD patients. METHODS: We used National Health Insurance claim data from 2002 to 2012. A total of 1,070 hospitals and 339,379 hospitalization cases were included in the analysis. We divided the number of RNs per 100 beds and the proportion of RNs on staff to one of three groups (Q1: low; Q2: moderate; Q3: high). A generalized estimating equation model was used to evaluate the associations between readmission and nurse staffing. RESULTS: A higher number of RNs was associated with lower readmission rates of 8.9% (Q2) and 7.9% (Q3) respectively. A similar effect was observed as the proportion of RNs among the total nursing staff gradually increased, resulting in lower readmission rates of 7.7% (Q2) and 8.3% (Q3). CONCLUSIONS: Our results suggest notable positive effects of nurse staffing by RNs on patient outcomes. In addition, the magnitude of impact differed between different sizes of hospitals. Thus, human resource planning to solve staffing shortages should carefully consider the qualitative aspects of the nursing staff composition.
Aged ; Female ; Health Facility Size/statistics & numerical data ; Hospitals, General/statistics & numerical data ; Humans ; Male ; Nurses/*supply & distribution ; Nursing Staff, Hospital/*supply & distribution ; Patient Outcome Assessment ; Patient Readmission/*statistics & numerical data ; Personnel Staffing and Scheduling ; Pulmonary Disease, Chronic Obstructive/*nursing ; Quality of Health Care ; Recurrence ; Republic of Korea ; Retrospective Studies

Adult ; Age Factors ; Burnout, Professional ; epidemiology ; Female ; Health Status ; Humans ; Male ; Marital Status ; Mental Health ; Occupational Health ; Orthopedic Surgeons ; statistics & numerical data ; Pain ; epidemiology ; Personnel Staffing and Scheduling ; Sex Factors ; Singapore ; epidemiology ; Social Behavior ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires ; Work Schedule Tolerance