According to W. Edwards Deming, American companies require nothing less than a transformation of management style and of governmental relations with industry. In Out of the Crisis, originally published in 1982, Deming offers a theory of management based on his famous 14 Points for Management. Management's failure to plan for the future, he claims, brings about loss of market, which brings about loss of jobs. Management must be judged not only by the quarterly dividend, but by innovative plans to stay in business, protect investment, ensure future dividends, and provide more jobs through improved product and service. In simple, direct language, he explains the principles of management transformation and how to apply them.

Out of the Crisis

Measuring Health: A Guide to Rating Scales and Questionnaires

Evaluating the quality of medical care.

: The document considers the effect of hospital insurance upon the consumption of those items in the consumer's utility function which relate to the 'quality' as well as the quantity of care consumed and suggests a means of minimizing the distorting influence of such insurance. It may also be of general relevance to the economics of insurance. (Author)

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The economics of moral hazard: further comment

PURPOSE
It is well established that recruitment to clinical trials (CTs) is difficult and time consuming. This article reports on factors related to CT participation among women who were invited to participate in a CT for breast cancer.


PATIENTS AND METHODS
Breast cancer patients who were eligible for a CT were identified by 16 different cancer centers. After their invitation to participate in a trial, patients who were undecided about participation in a CT were recruited into the present study at that time. After a patient made a decision about trial participation, a telephone interview was conducted to assess knowledge of CTs, perceived benefits and drawbacks of CTs, and personal factors affecting the women's decision regarding participation.


RESULTS
A total of 208 patients participated in the study. Fifty-eight percent of the patients decided to participate in a trial. Logistic regression analyses showed that the factors best explaining participation were trial phase, perceived drawbacks, time and travel considerations, therapeutic benefit of trial, and physician recommendation. Participation rates were similar for both phase I and phase III trials. However, a higher percentage of women recruited to phase II trials accepted.


CONCLUSION
This study suggests that reducing drawbacks of CT participation, particularly travel time, and improving physician communication of trials are needed to increase trial participation.

Factors associated with participation in breast cancer treatment

College is a critical time where students are more prone to engage in risky health behaviors known to negatively affect well-being, such as physical inactivity, stress, and poor dietary habits. A health promoting lifestyle is an important determinant of health status and is recognized as a major factor for the maintenance and improvement of health. This study was designed to assess the health-promoting lifestyle of students in health colleges and non-health colleges in Saudi Arabia. A total of 1656 students participated in this descriptive cross-sectional study. Data gathering was conducted from November 2016 to February 2017 at King Saud University. Participating students completed a self-reported questionnaire that included questions regarding their demographic characteristics and their health-promoting behaviors. The majority of participants were females (70.4%), 20% of the participants were overweight and 11.3%, were obese. The analysis showed that there was a significant difference between health colleges and non-health colleges with regards to the factor of health responsibility. Students at both schools were found to have an inadequate level of adherence to recommendations regarding physical activity and healthy eating habits. The analysis also found that majority of the students in both colleges do not attend educational programs on health care. The model shows that gender, type of college, year in school, and family structure were significant predictors of the health lifestyle of students in Saudi Arabia. The results of the current study indicate that university students are leading unhealthy lives, where the majority of them have unhealthy eating habits and poor physical activity level. Universities are ideal settings for implementing health promotion programs. Therefore, planning and implementing programs to motivate students to be more responsible for their own health, to engage more in physical activity, and to practice healthy eating habits and other forms of wellness are of paramount importance.

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Health promoting lifestyle of university students in Saudi Arabia: a cross-sectional assessment

Background: During a pandemic, healthcare professionals encounter various health hazards that affect their personal life and workplace Emotional intelligence (EI) has a substantial impact on nurses' success and performance in the healthcare industry However, previous research studies report inconsistent findings regarding how different levels of EI affect job performance (JP), particularly during pandemics The present study contributes to the literature on this contemporary topic by investigating the impact of EI on JP among nurses during COVID-19 crisis management in Saudi Arabia (SA) Methods: In a convenience sampling, 340 nurses from three tertiary hospitals completed an online survey assessing EI and JP during COVID-19 climax levels in March and April, 2020 Only nurses who had direct contact with patients diagnosed with COVID-19 were eligible The Wong & Law EI scale (WLEIS) was used in a cross-sectional design to determine participants' EI Empirically, JP was measured by the Individual Work Performance Questionnaire (IWPQ) Data analysis was performed using SPSS statistical software version 20 0 (IBM Corp) Results: Generally, nurses reported, out of a 5 -point Likert scale, moderate to high levels of EI (M = 3 99, SD = 0 434) Nurses in critical care units demonstrated the highest levels of EI, followed by nurses in intensive care, neonatal intensive care, then general nurses Nurses working in respiratory therapy demonstrated the lowest levels Across all groups during crisis, nurses reported a significant impact of EI on JP (beta = 0 389, p < 0 01) Conclusion: Nurses reported satisfactory levels of EI, and most of their practices were aligned with national standards during COVID-19, but slightly in inverse to EI However, more research is necessary to understand the greater impact of stressors influencing JP to the extent that levels of EI are no longer satisfactory

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The Impact of Emotional Intelligence on Job Performance During COVID-19 Crisis: A Cross-Sectional Analysis

The natural assimilation of the process through which health partners sustain long-term relationships is a key issue in maintaining social well-being, reducing health risk factors, and sustaining public health programs. One global initiative in building effective healthcare systems is public-private partnerships (PPPs). This study elucidates the proposed key performance indicators initiated by the Ministry of Health of Saudi Arabia based on the projections of the government, known as Vision 2030, from the perspective of health risk factors. Through an inductive content analysis, this study assessed primary and secondary data in relation to the Saudi National Transformation Program (NTP). To identify the institutions that played a role in formulating the new Saudi Healthcare System, health policies, regulations, and reports published between 1996 and 2016 were categorized. After ranking the risk factors, the investigator selected 13 healthcare professionals in four focus group interviews to insightfully explore the challenges that the NTP faces from a health risk perspective. Thus, the study employed qualitative data gathered through focus group interviews with key figures as well as data extracted from written sources to identify distinct but interrelated partnerships practiced within risk management. A methodological overview of NTP priority and implementation offered practical guidance in the healthcare context. The five critical factors in maintaining successful and sustainable PPPs were (1) trustworthiness, (2) technological capability, (3) patient-centeredness, (4) competence, and (5) flexibility. Concession on primary and secondary healthcare services might be a good option based on the literature review and considering its popularity in other countries. A high outcome-based risk of PPPs was found as the most commonly shared perspective in risk management. Although the impact of the NTP rise has yet to be explored, its potential for challenging health consequences requires consideration and substantial regulatory action. This study contributes to the emerging critical analysis on local health initiatives by highlighting how integration may only be possible with a more radical conceptualization of national health governance.

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Exploring shared risks through public-private partnerships in public health programs: a mixed method.

The aim of this study was to explore the impact of quality of care (QoC) on patients’ quality of life (QoL). In a cross-sectional study, two domains of QoC and the World Health Organization Quality of Life-Bref questionnaire were combined to collect data from 1,059 pre-­discharge patients in four accredited hospitals (ACCHs) and four non-accredited hospitals (NACCHs) in Saudi Arabia. Health and well-being are often restricted to the characterization of sensory qualities in certain settings such as unrestricted access to healthcare, effective treatment, and social welfare. The patients admitted to tertiary health care facilities are generally able to present themselves with a holistic approach as to how they experience the impact of health policy. The statistical results indicated that patients reported a very limited correlation between QoC and QoL in both settings. The model established a ­positive, but ultimately weak and insignificant, association between QoC (access and effective treatment) and QoL (r = 0.349, P = 0.000; r = 0.161, P = 0.000, respectively). Even though the two settings are theoretically different in terms of being able to conceptualize, adopt, and implement QoC, the outcomes from both settings demonstrated insignificant relationships with QoL as the results were quite similar. Though modern medicine has substantially improved QoL around the world, this paper proposes that health accreditation has a very limited impact on improving QoL. This paper raises awareness of this topic with multiple healthcare professionals who are interested in correlating QoC and QoL. Hopefully, it will stimulate further research from other professional groups that have new and different perspectives. Addressing a transitional health care system that is in the process of endorsing accreditation, investigating the experience of tertiary cases, and analyzing deviated data may limit the generalization of this study. Global interest in applying public health policy underlines the impact of such process on patients’ outcomes. As QoC accreditation does not automatically produce improved QoL outcomes, the proposed study encourages further investigation of the value of health accreditation on personal and social well-being.

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Quality of Care and Quality of Life: Convergence or Divergence?

A descriptive cross-sectional survey was conducted over 5 months in two tertiary hospitals in Riyadh, Saudi Arabia. The 5-month period was from November 2014 to March 2015. The survey instrument used was a Short-Form Health Survey SF-36 (the RAND 36-item) questionnaire that measure QOL of the caregivers. Our study subjects included 289 randomly selected Saudi caregivers. Almost all the mean scores were increased (higher than 50) with the exception of levels of energy/fatigue. Role functioning/physical scored the highest (81.02 ± 35.33) followed by physical functioning (76.34 ± 29.83). Other domains of QOL scored (71.02 ± 35.33) for the role functioning/emotional; pain (71.15 ± 28.48), emotional well-being (60.58 ± 18.44); social functioning (58.39 ± 25.83), and general health (54.32 ± 17.08). In multivariate regression analysis, the model predicts that the contributions of age, gender, and the cancer type of patients were a statistically significant predictor with the QOL domains of caregivers. Cancer caregivers in Saudi Arabia caring for patients more than 1 year after diagnosis reported favorable QOL. Factors associated with QOL domains included age, gender of the caregivers, and the types of cancer patients. These findings are encouraging as a baseline for providing more information to future studies in QOL of caregivers.

Wadi B. Alonazi

Papers

Health promoting lifestyle of university students in Saudi Arabia: a cross-sectional assessment

The Impact of Emotional Intelligence on Job Performance During COVID-19 Crisis: A Cross-Sectional Analysis

Exploring shared risks through public-private partnerships in public health programs: a mixed method.

Quality of Care and Quality of Life: Convergence or Divergence?

Assessment of Health-Related Quality of Life Among Caregivers of Patients with Cancer Diagnosis: A Cross-Sectional Study in Saudi Arabia