Showing papers in "International Journal of Health Care Quality Assurance in 2008"
TL;DR: Six factors regarding the service quality as perceived in both public and private Northern Cyprus hospitals are identified: empathy, giving priority to the inpatients needs, relationships between staff and patients, professionalism of staff, food and the physical environment.
Abstract: Purpose – The purpose of this research is to develop and compare some determinants of service quality in both the public and private hospitals of Northern Cyprus There is considerable lack of literature with respect to service quality in public and private hospitalsDesign/method/approach – Randomly, 454 respondents, who have recently benefited from hospital services in Famagusta, were selected to answer a modified version of the SERVQUAL Instrument The instrument contained both service expectations and perceptions questionsFindings – This study identifies six factors regarding the service quality as perceived in both public and private Northern Cyprus hospitals These are: empathy, giving priority to the inpatients needs, relationships between staff and patients, professionalism of staff, food and the physical environment Research results revealed that the various expectations of inpatients have not been met in either the public or the private hospitalsResearch implications/limitations – At the micro
182 citations
TL;DR: An augmented SERVQUAL instrument that was used to measure private patients' service expectations and perceptions emerged from the study, and the "reliability and fair and equitable treatment" factor was found to be the most important healthcare service quality dimension.
Abstract: Purpose – The paper aims to focus on an augmented SERVQUAL instrument that was used to measure private patients' service expectations and perceptions.Design/method/approach – A questionnaire was administered to 750 and 34 per cent responded.Findings – A new service quality instrument called PRIVHEALTHQUAL emerged from the study, based on factor and reliability analysis. The “reliability and fair and equitable treatment” factor was found to be the most important healthcare service quality dimension.Originality/value – Adds to the existing body of research on service quality and demonstrates that SERVQUAL is not a generic service quality measure for all industries.
177 citations
TL;DR: The research shows empirical evidence about the effect of both patient's emotions and service quality on satisfaction with healthcare services, and provides a model that includes valid and reliable measures.
Abstract: – The purpose of this research is to develop and empirically test a model to examine the major factors affecting patients' satisfaction that depict and estimate the relationships between service quality, patient's emotions, expectations and involvement., – The approach was tested using structural equation modeling, with a sample of 317 patients from six Portuguese public healthcare centres, using a revised SERVQUAL scale for service quality evaluation and an adapted DESII scale for assessing patient emotions., – The scales used to evaluate service quality and emotional experience appears valid. The results support process complexity that leads to health service satisfaction, which involves diverse phenomena within the cognitive and emotional domain, revealing that all the predictors have a significant effect on satisfaction., – The emotions inventory, although showing good internal consistency, might be enlarged to other typologies in further research – needed to confirm these findings., – Patient's satisfaction mechanisms are important for improving service quality., – The research shows empirical evidence about the effect of both patient's emotions and service quality on satisfaction with healthcare services. Findings also provide a model that includes valid and reliable measures.
148 citations
TL;DR: The results from this paper indicate the common six sigma projects implemented in healthcare organizations, typical implementation durations, cost benefits, and major barriers in implementation, and so on.
Abstract: Purpose – Medical and policy literature reports many six sigma applications at specific healthcare organizations. However, there is a lack of studies that investigate the broader status of six sigma in US healthcare systems. The purpose of this paper is to present the results from a national survey of six sigma programs in US healthcare organizations.Design/methodology/approach – Through the design, distribution, and analysis of a nationwide survey, this paper assesses the implementation of six sigma in healthcare facilities. Two sets of surveys were designed based on whether an organization has adopted six sigma or not.Findings – Findings from this paper indicate the common six sigma projects implemented in healthcare organizations, typical implementation durations, cost benefits, and major barriers in implementation, and so on.Research limitations/implications – This paper is limited by the low‐response rate owing to time and budget constraints. Through the dissemination of this paper, it is hoped that ...
105 citations
TL;DR: The value of health-related quality of life (HR-QOL) measurement is discussed and its development is described with a few examples, which adds those benefits to the literature already available.
Abstract: Purpose – The purpose of this article is to discuss the value of health‐related quality of life (HR‐QOL) measurement and describe its development with a few examples.Design/methodology/approach – The methodology is a literature review of various articles published in the last 25 years on health‐related quality of life.Findings – HR‐QOL tools are health status instruments, which are utilized to assess the changes in the health status of patients. These surveys are of increasingly importance as healthcare providers are challenged to justify treatment approaches and rationale for any intervention. Objective criteria can be used to determine whether there is clinical evidence of disease. However, the impact of disease on the individual's life is not included in such a clinical assessment. The use of validated and reliable health instruments is directed at measuring this impact in a reproducible and valid fashion. In patient‐centred research, “experimental” conditions are constantly changing because human bein...
97 citations
TL;DR: Japanese healthcare service quality is evaluated using its process characteristics (patient-provider interaction) and physical attributes (settings and appearance) and process quality attributes were found to be patient satisfaction antecedents.
Abstract: Purpose – To extend existing knowledge about health care quality and patient satisfaction by exploring Japanese context having a different health care system and a different culture from the USA and Europe.Design/methodology/approach – A structural equation model is used to explore links between quality perception and patient satisfaction as well as between patient satisfaction and intentional behavior relying on 159 Japanese outpatient replies.Findings – Japanese healthcare service quality is evaluated using its process characteristics (patient‐provider interaction) and physical attributes (settings and appearance). Process quality attributes were found to be patient satisfaction antecedents. Satisfaction in turn predicts patient intentional behavior (to return and to recommend). Japanese society cultural specificity seems to be an interesting background to understand Japanese evaluation when patients assess health service quality.Research limitations/implications – The sample investigated is relatively ...
90 citations
TL;DR: A preliminary assessment of patient attitudes regarding important aspects of service dimensions using SERVQUAL found that patient opinions are extremely important because they provide information that is not necessarily emphasized by managers or health care professionals, resulting in a more complete assessment of past performance and a clearer road map for future action.
Abstract: Purpose – This paper aims to conduct a preliminary assessment of patient attitudes regarding important aspects of service dimensions using SERVQUAL. Design/methodology/approach – The SERVQUAL scale is routinely used at the Baskent University Hospitals Network, Turkey. The study consisted of 550 randomly chosen patients who presented to any member of the hospital network during January and February 2006 and received treatment as inpatients or outpatients at those healthcare facilities.Findings – The patients' perceived scores were higher than expected for an ordinary hospital but lower than expected for a high‐quality hospital. Young patients had a high‐expected service score gap and a low adequate service score difference. Highly educated patients had a high‐expected service score difference. Uninsured patients had a low adequate service score difference. Originality/value – Baskent University multidisciplinary healthcare teams have performed periodic patient satisfaction surveys in order to identify stre...
74 citations
TL;DR: The paper demonstrates the use of the SERVQUAL scale in measuring the functional quality of the hospitals assessed, with the highest difference between the perceived service score and the expected service score found at the Alanya Application and Research Center in Alanya, Turkey.
Abstract: Purpose – The aim of this paper is to document a study, in which the SERVQUAL scale was used to evaluate hospital services, conducting a preliminary assessment of patient attitudes regarding the important aspects of service dimensions.Design/methodology/approach – The SERVQUAL scale was implemented into routine use at the Baskent University Hospitals Network in Baskent, Turkey. The study consisted of 550 randomly chosen patients who presented to any member hospital in that network during January and February 2006 and received treatment as inpatients or outpatients at those healthcare facilities. The SERVQUAL scale was utilised to evaluate hospital services.Findings – A questionnaire was completed by a total of 472 (86.0 per cent) patients. The perceived scores of the patients were higher than expected for an ordinary hospital but lower than expected for a high‐quality hospital. The highest difference between the perceived service score and the expected service score was found at the Alanya Application and...
68 citations
TL;DR: A theoretically driven model of the relationship between job demands, employees' motivation and resources, and supervisory support on employees' quality of work lives and their general health supports the assertion made by stress researchers regarding the extent to which both job demands and lack ofsupervisory support predict low QWL and negative health outcomes.
Abstract: Purpose – The purpose of this paper is to test a theoretically driven model of the relationship between job demands, employees' motivation and resources, and supervisory support on employees' quality of work lives and their general health.Deisgn/methodology/approach – The study uses large survey data that were collected in the years 1995, 2002, and 2003 respectively, drawn from the public health care employees sector in Catalonia (Spain). Albeit cross‐sectional methodology, the study embraces an additional retrospective and longitudinal design.Findings – The 2002 cross‐sectional study (n=2,926) supports the assertion made by stress researchers regarding the extent to which both job demands and lack of supervisory support predict low QWL and negative health outcomes: perceived motivation, resources and capabilities also appear as determinants but to a lesser extent. The stability of the results obtained was tested retrospectively by cross‐legging the model for the 1995 survey (n=2,901). In addition, a foll...
64 citations
TL;DR: The results revealed that the hospital does not quantify medical waste, and recommendations are given with the aim of improving medical waste management in hospitals.
Abstract: Purpose – The purpose of this paper is to examine the medical waste management practices of a hospital in Southern Africa.Design/methodology/approach – A case study methodology was utilised.Findings – The results revealed that the hospital does not quantify medical waste. Segregation of medical waste into infectious waste and non‐infectious waste is not conducted according to definite rules and standards. Separation of medical waste and municipal waste is however practiced to a satisfactory extent. Wheeled trolleys are used for on‐site transportation of waste. Off‐site transportation of waste is outsourced to a private firm. Incineration is used in the final disposal of infectious waste. Non‐infectious waste is disposed using land disposal method. There is no policy and plan in place for managing medical waste. A number of problems were identified with respect to medical waste management.Originality/value – The paper gives recommendations with the aim of improving medical waste management in hospitals.
64 citations
TL;DR: The effects of the accreditation process on organizational control and quality management practices in two Quebec primary-care health organizations are described and a theoretical model for understanding organizational changes brought about by accreditation of primary services is provided.
Abstract: Purpose – The purpose of this paper is to describe and understand the effects of the accreditation process on organizational control and quality management practices in two Quebec primary‐care health organizations.Design/methodology/approach – A multiple‐case longitudinal study was conducted taking a mixed qualitative/quantitative approach. An analytical model was developed of the effects of the accreditation process on the type of organizational control exercised and the quality management practices implemented. The data were collected through group interviews, semi‐directed interviews of key informers, non‐participant observations, a review of the literature, and structured questionnaires distributed to all the employees working in both institutions.Findings – The accreditation process has fostered the implementation of consultation mechanisms in self‐assessment teams. Improving assessments of client satisfaction was identified as a prime objective but, in terms of the values promoted in organizations, ...
TL;DR: Additional attention is focused on making a sound technical and business case for implementing six sigma tools to eliminate medical errors that will enable hospital managers to increase their hospital's profitability in the long run and also ensure patient safety.
Abstract: Purpose – Healthcare costs in the USA have continued to rise steadily since the 1980s. Medical errors are one of the major causes of deaths and injuries of thousands of patients every year, contributing to soaring healthcare costs. The purpose of this study is to examine what has been done to deal with the medical‐error problem in the last two decades and present a closed‐loop mistake‐proof operation system for surgery processes that would likely eliminate preventable medical errors.Design/methodology/approach – The design method used is a combination of creating a service blueprint, implementing the six sigma DMAIC cycle, developing cause‐and‐effect diagrams as well as devising poka‐yokes in order to develop a robust surgery operation process for a typical US hospital.Findings – In the improve phase of the six sigma DMAIC cycle, a number of poka‐yoke techniques are introduced to prevent typical medical errors (identified through cause‐and‐effect diagrams) that may occur in surgery operation processes in ...
TL;DR: Evaluating the status of US hospital Laboratory Information Systems shows that the need for these systems is growing to meet accompanying technological and workload demands, and increasing investment in laboratory information systems is providing state-of-the-art clinical laboratory support, which enhances clinical care processes and improves quality.
Abstract: Purpose – The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare service provision. Data show that the need for these systems is growing to meet accompanying technological and workload demands. Additionally, laboratory tests provide the majority of information for clinical decision‐making. Laboratory processes automation, including patient result verification, has greatly improved laboratory test throughput while decreasing turn‐around‐times, enabling critical results to reach physicians rapidly for improved clinical outcomes.Design/methodology/approach – Data were drawn from the 2007 Healthcare Information and Management Systems Society (HIMSS) Analytics Database, which includes over 5,000 US healthcare organizations and provides extensive data on the hardware, software, and information technology infrastructure within healthcare organizations.Findings – US hospitals are actively involved i...
TL;DR: It is shown that performance data use could be promoted with a better understanding of the type of indicators that are important to different stakeholders, and factors were identified that influence stakeholder views of performance data.
Abstract: Purpose – The purpose of this paper is to show that performance data use could be promoted with a better understanding of the type of indicators that are important to different stakeholders. This study explored patient, nurse, physician and manager preferences for cancer care quality indicators.Design/methodology/approach – Interviews were held with 30 stakeholders between March and June 2004. They were asked to describe how they would use a cancer “report card”, and which indicators they would want reported. Transcripts were reviewed using qualitative analysis.Findings – Role (patient, nurse, physician, manager) influenced preferences and perceived use of performance data. Patients and physicians were more skeptical than nurses and managers; patients and managers expressed some preferences distinct from nurses and physicians; and patients and nurses interpreted indicators more broadly than physicians and managers. All groups preferred technical process over outcome or interpersonal process indicators.Res...
TL;DR: The proposed model can be used to prioritize change projects, manage stakeholder resistance and establish a better organizational and professional competence for managing healthcare organization change projects.
Abstract: Purpose – This paper aims to create a model for evaluating organizational change initiatives from a stakeholder resistance viewpoint.Design/methodology/approach – The paper presents a model to evaluate change projects and their expected benefits. Factors affecting the challenge to implement change were defined based on stakeholder theory literature. The authors test the model's practical validity for screening change initiatives to improve operating room productivity.Findings – Change initiatives can be evaluated using six factors: the effect of the planned intervention on stakeholders' actions and position; stakeholders' capability to influence the project's implementation; motivation to participate; capability to change; change complexity; and management capability.Research limitations/implications – The presented model's generalizability should be explored by filtering presented factors through a larger number of historical cases operating in different healthcare contexts. The link between stakeholders...
TL;DR: It is found that applying business process re-engineering in the right circumstances and selected settings for quality improvement is critical for its success, and that it is certainly "not for everybody".
Abstract: Purpose – Pressure to change is politically driven owing to escalating healthcare costs and an emphasis on efficiency gains, value for money and improved performance proof in terms of productivity and recently to some extent by demands from less satisfied patients and stakeholders. In a background of newly immerging expensive techniques and drugs, there is an increasing consumer expectation, i.e. quality services. At the same time, health system managers and practitioners are finding it difficult to cope with demand and quality expectations. Clinicians are frustrated because they are not recognised for their contribution. Managers are frustrated because meaningful dialogue with clinicians is lacking, which has intensified the need for change to a more efficient system that satisfies all arguments about cost effectiveness and sustainable quality services. Various strategies, originally developed by management quality “gurus” for engineering industries, have been applied to health industries with variable s...
TL;DR: The model has been found to capture attributes that characterize healthcare quality in a developing country such as the UAE and could represent other modern healthcare systems and can be used as a basis for evaluation in healthcare practices from discharges (in-patients) point of view.
Abstract: Purpose – The purpose of this paper is to show that, although there has been some research to identify the dimensions on which healthcare quality and in‐patient satisfaction should be measured, the confirmation of constructs and indicators that constitute an overall care quality and satisfaction remains unclear. The objective is to present several models of service quality and satisfaction in healthcare for discharged patients; and to test those models in a sample of discharged patients in public hospitals in the United Arab Emirates.Design/methodology/approach – A detailed in‐patient survey (using interviews) was used. Data were collected with questionnaires from adult discharges (n=244) in public hospitals in the UAE. Several structures are proposed and tested. Confirmatory Factor Analysis (CFA) and LISREL SIMPLIS using maximum likelihood estimation were used to estimate and test the parameters of the hypothesized models derived deductively from the previous literature.Findings – Several models (with on...
TL;DR: The level of patient satisfaction or dissatisfaction in one Riyadh tertiary centre is spotlighted and it is recommended that service standards in the areas in which patients were significantly dissatisfied should be raised by involving senior leaders.
Abstract: Purpose – As one of the healthcare organizations striving to reach optimum quality level, King Abdulaziz Medical City staff believed that knowing the patients' service perspective is one core service quality indicator. This article aims to spotlight the level of patient satisfaction or dissatisfaction in one Riyadh tertiary centre.Design/methodology/approach – Cross‐sectional survey involving 1983 inpatient, outpatient and emergency care patients at King Abdulaziz Medical City, Riyadh using a self‐developed patient satisfaction questionnaire.Findings – There was a significant satisfaction with room comfort (88.5 percent), room temperature (78.1 percent), room call button system (87.9 percent), room cleanliness (79.6 percent) and respectful staff (87.4 percent). Patients were significantly dissatisfied with phlebotomists not introducing themselves (74 percent), not explaining procedures (57.2 percent) and physicians not introducing themselves (59.1 percent).Research limitations/implications – Only the over...
TL;DR: A typology comprising three unique surveyor styles is identified--interrogator; explorer; and discusser, which has application for development by accreditation agencies to be used with surveyors as a self-reflection tool to improve learning and development.
Abstract: Purpose – This paper aims to investigate how health care accreditation surveyors enact their role with a view to identifying a surveyor styles typology.Design/methodology/approach – This study was conducted in two phases. First, observational research was used to examine the conduct of a small survey team during the 2005 accreditation survey of a rural health service in Australia. The survey team was from the Australian Council on Healthcare Standards (ACHS), the major health care accreditation agency in Australia. Second, the emerging typology was reviewed by an expert panel of ACHS surveyors.Findings – A typology comprising three unique surveyor styles is identified – interrogator; explorer; and discusser. Additionally, a further style, the questioner, is hypothesised.Research limitation/implications – The typology has application for development by accreditation agencies to be used with surveyors as a self‐reflection tool to improve learning and development. The knowledge gained about surveyors' styles...
TL;DR: Recurring themes for effective improvement of healthcare delivery organisations emerge in the paper, as do identification of the inevitable barriers to change.
Abstract: Purpose – Taking the physician sourced observation that “wasting time is always more expensive than saving it” leads naturally to the conclusion that effective and efficient patient-centred healthcare delivery systems are highly desirable targets for the National Health Service (NHS) and similar providers. But has “joined up healthcare” even been achieved, and if so, how? What procedures must be in place to maximise the chances of its occurrence? This paper aims to investigate these issues.
Design/methodology/approach – This paper answers these questions experientially via “Insider Action Research” projects plus careful critique of published case studies.
Findings – Recurring themes for effective improvement of healthcare delivery organisations emerge in the paper, as do identification of the inevitable barriers to change.
Originality/value – The paper takes stock of NHS service developments in a broader theoretical light.
TL;DR: This study is the first to evaluate patient satisfaction with all three process segments and indicates that each process stage mediates subsequent stages, that the process segment is the most important to the patient and that the antecedents have differing impacts on patient satisfaction depending where in the process the antecesent is evaluated.
Abstract: Purpose – The purpose of this research is to develop an alternative method of measuring out‐patient satisfaction where satisfaction is the central construct. The Gap Model operationalized by SERVQUAL is widely used to measure service quality. However, the SERVQUAL instrument only measures expectations (resulting from the pre‐process segment of the service experience) and perceptions (resulting from the post‐process segment). All three segments should be measured. The lack of proper segmentation and methodological criticisms in the literature motivated this study.Design/methodology/approach – A partial least squares (PLS) approach, a form of structural equation modeling, is used to develop a framework to evaluate patient satisfaction in three service process segments: pre‐process, process, and post‐process service experiences.Findings – Results indicate that each process stage mediates subsequent stages, that the process segment is the most important to the patient and that the antecedents have differing i...
TL;DR: This is the first thorough review of the possibilities and limitations associated with the use of claims and complaints data in health care research and improvement in Sweden.
Abstract: Purpose – The purpose of this paper is to describe patient complaints and claims data from Swedish databases and assess their value for scientific research and practical health care improvement.Design/methodology/approach – The article first describes previous research into patient claims and similar schemes. It then presents three types of data on patient claims and complaints in Sweden: data generated by the Patient Insurance Fund, the Medical Responsibility Board and the Patients' Advisory Committees and considers methodological issues in using the data.Findings – The databases' value is problems related to spontaneous reporting, which makes it difficult to know how much the data correspond to general injury rates and health care patterns. Another issue is the balance between the size of study materials and the timeliness, e.g. when diagnosis‐specific analysis requires data pooling over several years in order to reach adequate case numbers. Adjustment for confounders not present in the databases, e.g. ...
TL;DR: It is argued that understanding and exceeding customer expectations in the aged care services is more complex than other health services and general services because of the multiple stakeholders and additional intimacies that exist.
Abstract: – The purpose of this paper is to argue that understanding and exceeding customer expectations in the aged care services is more complex than other health services and general services because of the multiple stakeholders and additional intimacies that exist., – The author first explores expectation theory and how it links to customer behaviour and then discusses confirmation/disconfirmation theory., – The author builds an argument that aged care service providers must understand consumer needs and expectations so that customer satisfaction is generated., – Exploring patient and relative expectation and satisfaction in different theoretical contexts.
TL;DR: Assessment of patient satisfaction in Greek public hospitals raises concerns about how patients evaluate as the aspects of care which patients take for granted when they evaluate their experience with health care providers needs to be illustrated further.
Abstract: Purpose – The purpose of this paper is to assess patient satisfaction in Greek public hospitals.Design/methodology/approach – In total, 367 patients participated in the study with a minimum of three days stay at the hospital. Measures included overall satisfaction, satisfaction with medical and nursing staff, satisfaction with room facilities, waiting times, extra costs. Information was also collected concerning sex, age, education, salary and length of stay in the hospital. Participants were also asked to indicate, in an open‐ended question, the most positive and the most negative aspects of their care.Findings – Patients' bad experience with aspects of their care was not directly reflected in low levels of satisfaction. Patients had to wait long hours to get an appointment with a doctor or after their examination to be admitted to the hospital. Many patients had to rely on a personal nurse and to pay extra money to the medical and nursing staff. They considered lack of staff as the main drawback of the ...
TL;DR: The programme's impact was evident in acknowledged change to participants' attitude, behaviour and performance with examples conveyed to demonstrate both the effect on clinical practice and perceived organisational benefits gained.
Abstract: – The purpose of this paper is to explore the effect of a clinical leadership programme on senior clinicians within National Health Service Lanarkshire, in terms of key constituents for fostering leadership development, specific skills developed and impact this has had on clinical practice., – A qualitative research design was employed over several stages, involving 44 senior clinical managers, with member validation substantiating findings and thematic analysis used to analyse data collected., – The programme's impact was evident in acknowledged change to participants' attitude, behaviour and performance with examples conveyed to demonstrate both the effect on clinical practice and perceived organisational benefits gained. The use of role play, scenario planning and enquiry‐based learning approaches were deemed critical in achieving such change., – Time constraints merited two different cohorts being examined simultaneously during the various stages of the programme. A longitudinal study is underway encompassing the evaluations of several cohorts through various stages of the programme to enable time‐based comparisons to be made and enhance the rigour and scrutiny of the programme's impact on clinical practice., – The paper is foremost in determining structure and processes employed on the programme, specific leadership skills developed, subsequent effect on clinical practice and perceived organisational benefits gained but not necessarily contemplated by staff prior to embarking on the programme, such as the emergence of communities of practice.
TL;DR: Fuzzy QFD may help LIFENET promoters to consider customers' favored health services thereby helping strategically in their attempt for major expansion, in order to get the most benefits of becoming first-movers in the sector.
Abstract: Purpose – The purpose of this paper is to suggest the fuzzy quality function deployment (QFD) method to assess LIFENET customers' spoken and unspoken needs in order to achieve the various objectives like: how to decide optimum portfolio for health services strategically; how to assess competitors' market position in order to reckon the market position of LIFENET; and how to set the revised target in order to satisfy the customers' demand and to fetch profit in order to satisfy managers' mission and vision in a competitive market.Design/methodology/approach – A fuzzy QFD method has been devised to take care of the various LIFENET objectives. Fuzzy logic's use has been recommended to remove the uncertainty, vagueness, and impreciseness from data obtained to assess customers' spoken and unspoken needs. Symmetric triangular fuzzy numbers (STFNs) may be used to assess various needs to enhance data accuracy. House of quality (HOQ), an in‐built QFD matrix, may be constructed to take care of LIFENET's various req...
TL;DR: In this paper, the authors test multiple possible linkages (or profiles) between certain personal, organizational, and cultural variables that affect both burnout and vigor in Swedish physicians working in Swedish public hospitals.
Abstract: Purpose – The traditional perspective in the occupational and organizational psychology literature aimed at understanding well‐being, has focused almost exclusively on the “disease” pole Recently, however, new concepts focusing on health are emerging in the so‐called “positive psychology” literature The purpose of this paper is to test multiple possible linkages (or profiles) between certain personal, organizational, and cultural variables that affect both burnout and vigor Burnout (disease) and vigor (health) are assumed to represent two extreme poles of the well‐being phenomenonDesign/methodology/approach – An innovative statistical treatment borrowed from data mining methodology was used to explore the conceptual model that was utilized A self‐administered questionnaire from a sample of 1,022 physicians working in Swedish public hospitals was used Standardized job/work demands with multiple items were employed in conjunction with the Uppsala Burnout scale, which was dichotomized into high (burnou
TL;DR: It is suggested that the reliability of health care processes would need to substantially improve before an incident reporting system can have a meaningful impact on patient safety.
Abstract: Purpose – The aim of this paper is to generate a debate regarding the value of incident reporting in the UK.Design/methodology/approach – This paper critiques the dominant approach to patients in the UK.Findings – It is suggested that the reliability of health care processes would need to substantially improve before an incident reporting system can have a meaningful impact on patient safety.Practical implications – Greater benefits in patient safety will be accrued by focusing resources on designing reliable processes rather than the extension of incident reporting.Originality/value – This paper offers a local perspective on a potentially flawed national strategy.
TL;DR: It appears that surveying physicians' perspectives is an essential tool for gathering information about how provided health care services are perceived, and results should be useful for continuous quality improvement by regular measuring and reporting to executive boards.
Abstract: Purpose – The purpose of this research is to show that referring physicians play a strategic role in health care management. This study aims to evaluate the perception of hospital services by referring physicians and clinicians for quality improvement.Design/method/approach – Referring physicians in private practice and hospital clinicians at a large dermatology academic department providing inpatient and outpatient services at secondary and tertiary care levels were surveyed to determine their perceptions of service quality. A comparative questionnaire survey was established to identify improvement areas and factors that drive referral rates using descriptive and inferential statistics.Findings – Referring physicians' (n=53) and clinicians' (n=22) survey results concordantly revealed that timely and significant information about hospital stay as well as accessibility to hospital staff are major points for improvement. Significant differences between both samples were found with respect to inpatient servi...
TL;DR: The health center's performance as a system, improved significantly as a way of intensifying diabetic regimens thereby achieving improved glycemic control and the protocol was well received by both nurses and physicians.
Abstract: Purpose – The purpose of this paper is to pilot‐test the feasibility and impact of protocol‐driven point‐of‐care HbA1c testing on levels of glycemic control and on rates of diabetic regimen intensification in an urban community health center serving low‐income patients.Design/methodology/approach – The paper suggests a primary care process re‐design, using point of care finger‐stick HbA1c testing under a standing order protocol that provided test results to the provider at patient visit.Findings – The paper finds that the protocol was well received by both nurses and physicians. HbA1c testing rates increased from 73.6 percent to 86.8 percent (p=0.40, n=106). For the 69 patients who had both pre‐ and post‐intervention results, HbA1c levels decreased significantly from 8.55 to 7.84 (p=0.004, n=69). At baseline, the health center as a system was relatively ineffective in responding to elevated HbA1c levels. An opportunity to intensify, i.e. a face‐to‐face visit with lab results available, occurred for only 6...