International Journal Of Health Care Quality Assurance[JOURNAL]
Sun
200 papers
Spiritual leadership and adaptive performance among health workers: the roles of optimism and trust.
Boateng EA, Ahomka Yeboah M, Ansong A … +1 more , Kwao IT
Int J Health Care Qual Assur · 2026 Jun · PMID 41293915 · Publisher ↗
PURPOSE: This study examines how leaders could use spiritual values to influence the adaptive performance of health workers to deliver quality care to patients through the mediation and moderation effects of optimism and...
PURPOSE: This study examines how leaders could use spiritual values to influence the adaptive performance of health workers to deliver quality care to patients through the mediation and moderation effects of optimism and trust, respectively. DESIGN/METHODOLOGY/APPROACH: We employed a quantitative approach to collect data from 356 health workers and used the partial least squares structural equation modeling (PLS -SEM) technique to test the hypotheses in the study. FINDINGS: The study found that health leaders' application of spiritual values positively influenced the adaptive performance of health workers in delivering quality patient care. Moreover, health workers' optimism was identified as a mediating variable in the relationship between spiritual leadership and adaptive performance, indicating that optimistic attitudes partially explain how spiritual leadership translates into improved adaptability. While trust among health workers was positively associated with their adaptive performance, it did not moderate the relationship between spiritual leadership and adaptive performance. This suggests that although trust is important for performance, it does not strengthen the influence of spiritual leadership on adaptability. ORIGINALITY/VALUE: This study offers new insights into the mechanisms and boundary conditions through which health leaders can leverage spirituality to enhance health workers' performance in delivering quality healthcare. By examining the sequential roles of optimism (as a mediator) and trust (as a moderator), the study integrates elements of positive psychology into the framework of spiritual leadership theory. This approach deepens our understanding of how intervening personality traits can shape the relationship between leadership styles and employee performance, thereby highlighting the psychological pathways that support improved outcomes in healthcare settings.
The balanced scorecard as a strategic management tool in urban medical groups in China: an experimental study.
Huang LL, Wang B, Hu W … +2 more , Zhou A, Chen X
Int J Health Care Qual Assur · 2026 Jun · PMID 41283638 · Publisher ↗
PURPOSE: This paper aims to integrate the balanced scorecard (BSC) into the medical service quality management of urban medical groups (UMGs), verify its feasibility and enhance resource allocation and system efficiency...
PURPOSE: This paper aims to integrate the balanced scorecard (BSC) into the medical service quality management of urban medical groups (UMGs), verify its feasibility and enhance resource allocation and system efficiency in addressing challenges like fragmented resources and poor coordination in China's urban medical service systems. DESIGN/METHODOLOGY/APPROACH: A retrospective study was conducted, in which a BSC-based strategic management model (using BSC as an improvement tool strategy) was constructed in a Zhejiang UMG from 2021 to 2024. The following four core dimensions were selected based on BSC theory and UMGs' operational needs. Financial: focused on resource allocation efficiency including medical revenue and outpatient as well as inpatient costs to ensure sustainable operations. Customer: targeted patient accessibility and satisfaction including county visit rate and chronic disease management to align with hierarchical care policies. Internal processes: measured service capacity including number of cases handled by branches to reflect grassroots capability upgrades. Learning and growth: tracked technical diffusion including new technologies introduced to branches and workforce development to strengthen long-term competitiveness. FINDINGS: Significant improvements were observed in key indicators: county visit rate rose by 36.35% (p < 0.001), diabetes management rate increased by 13.79% (p < 0.001), new technologies in branches grew by 66.67% and branch hospitals reduced outpatient (-20.68%) and inpatient costs (-23.96%). However, head hospital outpatient costs rose by 14.36% and hypertension management showed no significant change (p = 0.145). RESEARCH LIMITATIONS/IMPLICATIONS: This study's rigor is anchored in its BSC-driven key performance indicators and longitudinal design, but several limitations. First, the exclusive focus on quantitative metrics neglects qualitative dimensions, such as patient experience or staff morale, which are critical for holistic evaluation. Second, the absence of cost-effectiveness analysis limits understanding of resource utility. Third, the short observation period (three years) may not capture long-term impacts of BSC implementation, such as generational shifts in healthcare-seeking behavior. Fourth, the study's focus on UMGs may limit its generalizability to rural or underserved areas with distinct healthcare infrastructure and population needs. PRACTICAL IMPLICATIONS: It is the first integration of BSC into UMGs' medical service quality management, demonstrating BSC's effectiveness in driving balanced growth via enhanced grassroots accessibility and technical integration. It offers a data-driven strategic model for UMGs to improve resource allocation and achieve equitable healthcare. ORIGINALITY/VALUE: This study fills the research gap in applying multi-dimensional performance management tools to China's context-specific UMGs. It extends BSC's application scope from individual hospitals or general healthcare institutions to integrated healthcare systems. By validating BSC's effectiveness in driving balanced growth through grassroots accessibility enhancement and technical integration via longitudinal empirical data, the research enriches the academic literature on BSC in healthcare management and provides a novel theoretical-practical framework for similar integrated healthcare reform in middle-income countries.
Healthcare service quality, satisfaction and loyalty in university hospitals: the moderating effects of age and visit frequency.
Chocknakawaro A, Pusaksrikit T
Int J Health Care Qual Assur · 2025 Nov · PMID 41273264 · Publisher ↗
PURPOSE: This research examines the relationship across the five dimensions of SERVQUAL (tangibles, reliability, responsiveness, assurance and empathy) with satisfaction and loyalty of patients at public university hospi...
PURPOSE: This research examines the relationship across the five dimensions of SERVQUAL (tangibles, reliability, responsiveness, assurance and empathy) with satisfaction and loyalty of patients at public university hospitals in Thailand and the moderating effects of age and visit frequency in these relationships. DESIGN/METHODOLOGY/APPROACH: A survey method was used to gather data from three major public university hospitals in Thailand. A total of 390 questionnaires were analyzed using the structural equation model. FINDINGS: The results demonstrate that patient satisfaction is positively impacted by each of the five service quality dimensions. Patient loyalty and service quality are mediated by patient satisfaction. The impact of each dimension of service quality on patient satisfaction and loyalty varies depending on patients' age group and their frequent visits. ORIGINALITY/VALUE: This study demonstrates that visit frequency is a better predictor for moderating effect as it can explain how frequent-and infrequent-visit patients differ in their service quality preferences, which affects patient satisfaction and patient loyalty.
Prepare for the worst, hope for the best: a qualitative study on workplace violence in healthcare.
Haymore J, Sun J, Barber D
Int J Health Care Qual Assur · 2026 Jun · PMID 41267632 · Publisher ↗
PURPOSE: The purpose of the study is to explore how healthcare employees process and cope with workplace violence (WPV) in an effort to improve employee and organizational performance. DESIGN/METHODOLOGY/APPROACH: This q...
PURPOSE: The purpose of the study is to explore how healthcare employees process and cope with workplace violence (WPV) in an effort to improve employee and organizational performance. DESIGN/METHODOLOGY/APPROACH: This qualitative study is based on the theories of cognitive adaptation and social exchange. Research and interview questions were developed from these theories to uncover how healthcare workers process and cope with the trauma of violence. Participants gave accounts of verbal, physical and psychological acts of violence perpetrated by patients, patient family members, and colleagues. FINDINGS: Findings are discussed including WPV experiences, coping with WPV and organizational support to WPV, among others. Detailed preventive and reactive organizational strategies to help employees cope with WPV are recommended. The study offers significant theoretical implications and provides a comprehensive framework for interpreting how employees process, cope with and perceive organizational responses to WPV. RESEARCH LIMITATIONS/IMPLICATIONS: The study advances our understanding of how healthcare workers cope with WPV at different times and informs future research on the resources and support that are needed from employers at different stages of the coping process. The study has several limitations. First, the study relies on interview data that are the perceptions and self-reported data of healthcare workers. Another limitation is that while data saturation was achieved after 11 interviews, this number is modest considering the number of healthcare workers that experience WPV. PRACTICAL IMPLICATIONS: Healthcare organizations should adopt a Workplace Violence Prevention Plan (WVPP) that addresses all types, forms and levels of violence, including the threat of terrorism. Selection techniques should be designed to assess candidates' responses to high-stress situations, helping to identify individuals who may struggle with workplace conflict or criticism. Organizations should implement a confidential reporting system and establish a dedicated threat management team (TMT). Healthcare organizations should routinely update their training programs and provide ongoing support to those who have experienced WPV. SOCIAL IMPLICATIONS: Organizations have a responsibility to keep their employees safe and secure. Trauma resulting from violence and unsafe conditions not only harms performance but has significant implications for employee mental health and physical well-being. Organizations can and must do more to keep workers safe from deviant, violent and counterproductive work behaviors. ORIGINALITY/VALUE: To our knowledge, this is among the few research studies to examine how healthcare workers from both administrative and clinical positions cope with WPV through the frameworks of cognitive adaptation and social exchange.
Development of a framework for evaluation of quality of emergency care services of Indian hospitals.
Amit K, James AT, Kumar G
Int J Health Care Qual Assur · 2026 Jun · PMID 41237089 · Publisher ↗
PURPOSE: The purpose of this paper is to develop a comprehensive Emergency Care Service Quality Index (ECSQI) using a digraph-matrix approach. DESIGN/METHODOLOGY/APPROACH: About eight emergency healthcare service quality...
PURPOSE: The purpose of this paper is to develop a comprehensive Emergency Care Service Quality Index (ECSQI) using a digraph-matrix approach. DESIGN/METHODOLOGY/APPROACH: About eight emergency healthcare service quality factors have been identified in the literature and field investigations. The service quality factor relationships were analysed using graph theory and matrices. The equivalent matrix from the digraph establishes an emergency healthcare service quality function, which helps in evaluating the ECSQI. FINDINGS: The findings indicate that the quality of the treatment procedure and patient safety have the most significant impact on the ECSQI, whereas elements like hospital ambience have a comparatively minor effect. The framework emphasizes key areas for enhancement and offers a measurable system to monitor service quality in emergency care. RESEARCH LIMITATIONS/IMPLICATIONS: The adapted methodology can be practically applied to evaluate and compare the service quality of different hospital emergency departments. The insights gained from such assessments can assist emergency department managers in devising effective strategies to enhance service quality and overall patient satisfaction. PRACTICAL IMPLICATIONS: The ECSQI offers hospital administrators and policymakers a decision-support instrument to identify deficiencies, prioritize solutions and enhance patient safety. The model can be included in digital dashboards for real-time surveillance and accrediting procedures. ORIGINALITY/VALUE: This work has the novelty of identifying the factors of emergency healthcare service quality of Indian hospitals and employing the structural methodology in modelling the factors for assessing the service quality.
The second victim's satisfaction index model.
Al-Nasser M, Al-Nasser A
Int J Health Care Qual Assur · 2026 May · PMID 41231717 · Publisher ↗
PURPOSE: This article proposes a new customer satisfaction model. The purpose of the proposed model is to identify the key factors that influence the second victim's (SV's) satisfaction level. In a medical context, the S...
PURPOSE: This article proposes a new customer satisfaction model. The purpose of the proposed model is to identify the key factors that influence the second victim's (SV's) satisfaction level. In a medical context, the SV refers to caregivers who provide all kinds of daily support to a close relative who is living with chronic and irreversible conditions, such as Alzheimer's patients. DESIGN/METHODOLOGY/APPROACH: The model is simulated from the American customer satisfaction model, but with different latent variables. Based on literature and theoretical considerations, four predictors of caregiver satisfaction were identified: knowledge, empathy, memory and lifestyle. To evaluate the research model, this study employed the partial least squares structural equation modeling technique. FINDINGS: Data were collected from a sample of 154 Alzheimer's caregivers over a period of three months using convenience and network sampling techniques. The analysis revealed several key findings. Both knowledge and memory had a significant and positive influence on caregivers' satisfaction, indicating the importance of cognitive resources and caregiving competence. In addition, memory and lifestyle influence empathy, suggesting that both personal reflection and healthy routines may enhance emotional attunement toward care recipients. RESEARCH LIMITATIONS/IMPLICATIONS: The main limitation we faced in this study is the difficulty in collecting a large sample size; the study relies on a sample of 154 caregivers. PRACTICAL IMPLICATIONS: This study offers valuable models that shape SV's satisfaction. By identifying and validating the roles of knowledge, memory, empathy and lifestyle, the model offers a robust framework for developing targeted interventions to support and empower caregivers. SOCIAL IMPLICATIONS: The insights gained from this research can contribute to greater family caregivers' awareness, especially on caregiver knowledge and memory to improve the lifestyle and increase their satisfaction level when they are dealing with Alzheimer's patients. ORIGINALITY/VALUE: The originality of this study lies in its optimal model results, which show the main significant factors of the SVs, which advances understanding and opens new avenues for future research.
Examining citizen loyalty in primary healthcare in Bangladesh: the role of service quality, trust and satisfaction.
Nur Ullah M, Shaulin N
Int J Health Care Qual Assur · 2026 May · PMID 41231711 · Publisher ↗
PURPOSE: The factors that influence citizen loyalty toward Union Health and Family Welfare Centers are examined in this study, with particular attention paid to the connections among service quality, public trust, satisf...
PURPOSE: The factors that influence citizen loyalty toward Union Health and Family Welfare Centers are examined in this study, with particular attention paid to the connections among service quality, public trust, satisfaction and loyalty in the provision of primary healthcare. DESIGN/METHODOLOGY/APPROACH: Using a structured survey and a quantitative approach, this study collected data from 439 respondents. The study uses structural equation modeling to identify both direct and indirect effects among the constructs, providing important new information on the factors determining citizen loyalty. FINDINGS: The results show that in public healthcare, service quality affects citizen loyalty indirectly through public trust (PT) and satisfaction (SA), rather than directly. Public trust emerged as the strongest driver of long-term engagement, while satisfaction served as a key mediator. These findings challenge traditional SQ-loyalty models and highlight the need to include mediating constructs in public health research to better capture loyalty dynamics. RESEARCH LIMITATIONS/IMPLICATIONS: The theoretical ramifications call for a rethinking of loyalty models to take nonlinear and contextual linkages into consideration. PRACTICAL IMPLICATIONS: The practical implication offers strategic recommendations for healthcare policymakers and administrators, advocating for a focus on enhancing public trust and satisfaction as core elements in citizen loyalty initiatives. ORIGINALITY/VALUE: This study is original and new, having a substantial contribution to the primary healthcare scholarship by providing a model that can inform policy interventions aimed at fostering sustainable, citizen-centered healthcare services.
Privacy awareness, attitudes and affecting factors of patients hospitalized in general surgery clinic.
Can Özdemi̇r R, Işik MT, Kaynarpınar D
Int J Health Care Qual Assur · 2026 May · PMID 41191434 · Publisher ↗
PURPOSE: The right to privacy is an important value in medical ethics. This study was aimed at determining privacy-related attitudes and awareness of inpatients receiving health services in health institutions and reveal...
PURPOSE: The right to privacy is an important value in medical ethics. This study was aimed at determining privacy-related attitudes and awareness of inpatients receiving health services in health institutions and revealing the affecting factors. DESIGN/METHODOLOGY/APPROACH: In this descriptive, cross-sectional study, 194 patients hospitalized in the general surgery department of a university hospital were included. Data were collected using a two-part questionnaire. In the first part of the questionnaire, questions on the participant's descriptive characteristics and their knowledge about the subject were included. The second part included the "Patient Privacy Awareness and Attitude Scale." FINDINGS: The mean age of the participants was 47.60 ± 16.47 years. Of them, 60.8% were women, 83.0% were knowledgeable about patient privacy and 90.2% had heard of the concept of patient rights. A significant relationship was determined between the participants' awareness of patient privacy, and variables such as age, education level, financial status and knowledge about privacy. RESEARCH LIMITATIONS/IMPLICATIONS: In this study, the majority of the participants were knowledgeable of patient privacy. Almost all of them thought that healthcare personnel were careful about patient privacy. While medical interventions were implemented, it was observed that the participants' body privacy-related awareness levels were high. PRACTICAL IMPLICATIONS: Patients' awareness of privacy is extremely important. Informational privacy is as important as physical privacy. Patients' awareness of privacy is extremely important. Informational privacy is as crucial as physical privacy. Patients' awareness of patient rights and privacy is crucial during the healthcare process. SOCIAL IMPLICATIONS: Patient rights are the embodiment of fundamental human rights within the context of the right to health. A heightened patient awareness of their rights is effective in increasing satisfaction with healthcare services. This study is believed to be effective in raising patient awareness of privacy. ORIGINALITY/VALUE: This study aimed to determine the privacy attitudes and influencing factors of patients in a surgical clinic. Privacy is an important value in medical practice.
Understanding trust in mandatory telemedicine use during COVID-19: a modified health belief model approach.
Shin S, Lee WJ
Int J Health Care Qual Assur · 2026 May · PMID 41144288 · Publisher ↗
PURPOSE: This study explores the determinants of trust in telemedicine when its use was mandated during the COVID-19 pandemic in South Korea. It extends the health belief model by incorporating two service related constr...
PURPOSE: This study explores the determinants of trust in telemedicine when its use was mandated during the COVID-19 pandemic in South Korea. It extends the health belief model by incorporating two service related constructs: service quality and perceived cost. DESIGN/METHODOLOGY/APPROACH: An online survey was conducted with 288 individuals who were confirmed COVID-19 patients and required to use telemedicine services during isolation. Partial least squares structural equation modeling was applied to examine the relationships between health beliefs including perceived severity, perceived susceptibility and self-efficacy, service perceptions such as service quality and perceived cost, trust in telemedicine and behavioral intention to use telemedicine services. FINDINGS: The results showed that self-efficacy, service quality and perceived cost positively influenced trust in telemedicine. In contrast, perceived severity and perceived susceptibility did not have a meaningful impact. Trust was found to be a key factor in shaping patients' intention to continue using telemedicine services. Overall, the proposed model was supported, highlighting the importance of confidence and service related perceptions in building trust under mandatory usage conditions. ORIGINALITY/VALUE: This study provides empirical evidence on trust formation under mandatory telemedicine use, a scenario rarely explored in the literature. It demonstrates that trust is primarily driven by users' self-efficacy and service perceptions rather than by health risk perceptions, offering practical guidance for enhancing remote care engagement during policy enforced use conditions.
An assessment of dental care quality and patient experience in Yerevan, Armenia.
Mkrtchyan M, Hites L, Papieva I … +1 more , Thompson ME
Int J Health Care Qual Assur · 2026 Feb · PMID 41125433 · Publisher ↗
PURPOSE: Patient experience is a key component of quality of care. This study assessed patient experiences of dental care in Armenia, identifying associated factors and gaps between patients' expectations and care provid...
PURPOSE: Patient experience is a key component of quality of care. This study assessed patient experiences of dental care in Armenia, identifying associated factors and gaps between patients' expectations and care provided. DESIGN/METHODOLOGY/APPROACH: We conducted a cross-sectional survey of 164 dental patients from seven randomly selected dental clinics in Yerevan's seven largest districts. A self-administered questionnaire assessed patient experience and Patient Experience Scores (PES, range 1-5) were calculated. FINDINGS: A total of 164 respondents (response rate 83%) with mean age of 42 years completed the questionnaire. Overall satisfaction with the last visit was rated "excellent" by 52% (n = 86) patients, "good" by 34% (n = 56) and "poor-fair" by 13% (n = 21). The overall mean PES was 3.92. "Respect," "Pain management" and "Safety" were scored highest, indicating that they are the most valued aspects of care. The lowest scores were observed in "General satisfaction," "Privacy" and "Quality of care." Most domains (9 of 11) were positively correlated with PES. Increasing age was associated with lower PES (OR 0.98 per year), and higher standard of living with higher PES (3.17 average, 5.64 above average as compared to below average). The single "General Satisfaction" item averaged less than 3.0 and did not track with the other PES domains, a concern since the single item is often used in place of the full scale. ORIGINALITY/VALUE: The concept of patient experience is complex. This first study of dental patient experience in Armenia provides a foundation for further research, including benchmarking and other efforts that will drive quality improvement.
Professional stereotypes in interprofessional health care teams collaborating in long-term care facilities.
Sheffer-Hilel G, Barkan N, Drach-Zahavy A
Int J Health Care Qual Assur · 2026 Feb · PMID 41098030 · Publisher ↗
PURPOSE: The purpose of this study is to investigate the combined effects of healthcare professionals' hetero-stereotypes, auto-stereotypes and the content of stereotypes, as well as their interactions, on the perception...
PURPOSE: The purpose of this study is to investigate the combined effects of healthcare professionals' hetero-stereotypes, auto-stereotypes and the content of stereotypes, as well as their interactions, on the perception of stereotypes about a profession, above and beyond sociodemographic characteristics. DESIGN/METHODOLOGY/APPROACH: A cross-sectional design was employed with a sample of physicians, nurses, dieticians and social workers working in 59 geriatric facilities. Data were collected using a validated questionnaire. FINDINGS: Competence had the most significant role in contributing to professional stereotypes, followed by warmth, while being a team player had the least impact (estimate = 0.01, p = 0.01; estimate = 0.29, p < 0.001; estimate = 0.19, p < 0.001). Hetero-stereotypes notably influenced perceived stereotypes (F[3, 2166] = 35.67, p < 0.0001). Auto-stereotypes also impacted perceived stereotypes, but this effect became non-significant when controlling for ethnicity and tenure. Hetero- and auto-stereotypes interacted significantly to affect perceived stereotypes (estimate = 0.38, p < 0.001). PRACTICAL IMPLICATIONS: Healthcare educators must already nurture dual identities in the early stages of students' professional identity formation by providing both nonprofessional and interprofessional education throughout their programs. ORIGINALITY/VALUE: Existing models, typically encompass only competence/agency and warmth/communicative ability dimensions, neglecting a crucial aspect - being a team player. This additional dimension gauges a professional's ability to coordinate and lead teamwork within a specific profession. There is evidence of professional stereotypes among employed professional in health care. There is a combined impact of hetero-stereotypes (perceptions of other professions) and auto-stereotypes (internalized perceptions of one's own profession) on interprofessional interactions.
Distributive justice in performance appraisal and healthcare workforce retention: the interplay of trust and value congruence.
Dechawatanapaisal D
Int J Health Care Qual Assur · 2026 Feb · PMID 41090517 · Publisher ↗
PURPOSE: Drawing on the norm of reciprocity and social exchange theory, this study examines a sequential mediation model in which distributive justice in performance appraisal enhances job embeddedness through two key in...
PURPOSE: Drawing on the norm of reciprocity and social exchange theory, this study examines a sequential mediation model in which distributive justice in performance appraisal enhances job embeddedness through two key intervening mechanisms: trust in management and value congruence. DESIGN/METHODOLOGY/APPROACH: Data were collected via an online survey from 301 healthcare professionals in Thailand. The proposed hypotheses were tested using confirmatory factor analysis, the PROCESS macro and bootstrapping techniques. FINDINGS: The results indicate that trust in management and value congruence sequentially mediate the positive relationship between distributive justice in performance appraisal and employee retention, as manifested in greater job embeddedness. PRACTICAL IMPLICATIONS: The findings suggest that managers at all levels should be trained to conduct performance appraisals that uphold fairness, respect and dignity. Organizations should standardize appraisal systems by employing objective and measurable indicators to ensure fair assessments, foster a culture of trust and promote shared values. ORIGINALITY/VALUE: Prior research highlights the importance of justice in performance appraisals, but the mechanisms linking these perceptions to employee outcomes remain underexplored. This study addresses this gap by examining its impact on job embeddedness through the serial mediating roles of trust in management and value congruence. The findings advance organizational justice theory and shed light on key drivers of employee retention.
Blood donation/intention among healthcare workers in a teaching hospital in Central Ghana.
Makafui Kwashie S, Adomah-Afari A
Int J Health Care Qual Assur · 2026 Feb · PMID 41090463 · Publisher ↗
PURPOSE: The study aimed to assess factors associated with blood donation/intention among healthcare workers at the Cape Coast Teaching Hospital, Central Region, Ghana. DESIGN/METHODOLOGY/APPROACH: A hospital-based cross...
PURPOSE: The study aimed to assess factors associated with blood donation/intention among healthcare workers at the Cape Coast Teaching Hospital, Central Region, Ghana. DESIGN/METHODOLOGY/APPROACH: A hospital-based cross-sectional study was conducted among 458 healthcare workers, selected via stratified and systematic random sampling. They responded to a structured questionnaire that had been validated by earlier researchers. Data was collected using a validated structured questionnaire and analysed using descriptive statistics, chi-square tests, and logistic regression. STATA v17 was used, and a level of significance of p < 0.05 at 95% Confidence Interval (CI) was accepted. FINDINGS: Only 36.3% of respondents (455/458; response rate: 99.3%) had ever donated blood. Males were significantly more likely to donate than females (AOR = 0.63; 95% CI = [0.41; 0.98]). Past donors exhibited stronger future donation intentions (AOR = 8.68; 95% CI = [3.82; 19.73]). Community factors such as cultural/religious acceptance and peer/family influence were key predictors of donation behaviour (p < 0.05). RESEARCH LIMITATIONS/IMPLICATIONS: As a single-institution quantitative study, findings may not be generalisable. Future research should incorporate qualitative methods to explore contextual barriers. PRACTICAL IMPLICATIONS: The low donation rate (36.3%) underscores the need for gender-sensitive and community-driven campaigns to address cultural and social deterrents among healthcare workers. SOCIAL IMPLICATIONS: Community factors most likely influence the practice of blood donation. Hence, more attention should be paid to these factors when designing interventions to bring about blood donation behavioural change. ORIGINALITY/VALUE: This study highlights the understudied role of sex, intention, and socio-cultural norms in blood donation behaviour within Ghana's healthcare workforce, offering evidence for localised intervention strategies.
A five-decade review of academic research on healthcare supply chain: a bibliometric approach using co-word analysis and bibliographic coupling.
Acuña-Muñoz MJ, Carvajal-Trujillo E, Orts-Cardador JJ … +1 more , Liébana-Cabanillas F
Int J Health Care Qual Assur · 2026 Feb · PMID 41077932 · Publisher ↗
PURPOSE: This paper analysed the impact and evolution of scientific research on the healthcare supply chain (HCS) from a longitudinal perspective, covering the period 1971-2024. The study used data from the Web of Scienc...
PURPOSE: This paper analysed the impact and evolution of scientific research on the healthcare supply chain (HCS) from a longitudinal perspective, covering the period 1971-2024. The study used data from the Web of Science and Scopus databases to identify emerging and established areas of study in the field of HCS. DESIGN/METHODOLOGY/APPROACH: A bibliometric study was conducted using a dataset of 3,602 publications. The analysis focused on keyword co-occurrences to examine the evolution of HCS research. The representation of keywords is presented in tables, diagrams and longitudinal maps to highlight research topics in the field. FINDINGS: This study provides insights into the evolution of HCS research in terms of emerging and established areas of study. The analysis of 3,602 publications allowed the identification of key themes and trends in the field and offers a comprehensive view of the state of the art. The results are presented through tables, diagrams and longitudinal maps, thus facilitating a clearer understanding of the research landscape. PRACTICAL IMPLICATIONS: The findings have practical implications for researchers and scholars in the HSC domain. The identified research areas and trends provide valuable guidance for future research in the field. Researchers can use this information to navigate the current state of the field and make informed decisions about the direction of their research. ORIGINALITY/VALUE: This study contributes to the understanding of the evolution of scientific research on healthcare supply chain from 1971 to 2024. By employing bibliometric analysis and visual representations, a unique perspective on the HCS landscape is presented. The results provide valuable insights for researchers and scholars, offering a foundation for further investigations in the field of HSC research.
The application of generative AI to healthcare regulation.
Farrelly J, Lucey JV, Kiernan G … +10 more , McQuaid L, Stepala P, Conroy S, O' Rourke S, White CJ, Leahy C, Clarke N, Hernandez HC, Keyes L, Neville S
Int J Health Care Qual Assur · 2025 Oct · PMID 41069218 · Publisher ↗
PURPOSE: The article investigates the application of generative artificial intelligence (GenAI), specifically Microsoft Copilot 365, in automating the drafting of regulatory reports for a national healthcare regulator. T...
PURPOSE: The article investigates the application of generative artificial intelligence (GenAI), specifically Microsoft Copilot 365, in automating the drafting of regulatory reports for a national healthcare regulator. The initiative aimed to assess the feasibility and effectiveness of AI technologies in reducing manual effort, maintaining quality and accuracy of report and enhancing operational efficiency in the regulatory reporting processes. DESIGN/METHODOLOGY/APPROACH: A proof of concept (PoC) was conducted to evaluate Microsoft Copilot 365's capabilities in generating high-quality draft reports. Sample data were extracted and structured from a data repository to train AI prompts. Test cases were selected to simulate real-world scenarios. AI-generated documents were compared with human-authored reports. Accuracy, completeness and overall quality was compared using standardised BERTScore and ROUGE-L metrics. FINDINGS: AI-generated reports closely matched human-authored documents in terms of accuracy, completeness and quality. BERTScore and ROUGE-L metrics indicated high alignment, with Copilot outputs showing strong consistency across various regulations. Feedback from stakeholders highlighted the AI's performance and its potential impact on time reduction. PRACTICAL IMPLICATIONS: The successful implementation of this PoC underscores the transformative potential of AI technologies in regulatory environments. Automating routine tasks may allow regulators to reallocate human resources to onsite inspection activities, enhancing overall operational effectiveness. The findings support the integration of AI in regulatory reporting, paving the way for future advancements in this domain. ORIGINALITY/VALUE: This is the first paper to our knowledge that investigates the application of GenAI, specifically Microsoft Copilot 365, in automating the drafting of regulatory reports for a healthcare regulator.
Analyzing the impact of service quality on companion's satisfaction with the Malaysian public hospitals amidst the COVID-19 pandemic.
Mohamad WN, Kassim NM, Fei Z
Int J Health Care Qual Assur · 2025 Oct · PMID 41047851 · Publisher ↗
PURPOSE: This study investigates the relationship between five service quality dimensions: communication, courtesy, emotional support, hospital amenities and understanding of needs and the satisfaction of patient compani...
PURPOSE: This study investigates the relationship between five service quality dimensions: communication, courtesy, emotional support, hospital amenities and understanding of needs and the satisfaction of patient companions in Malaysian public hospitals during the COVID-19 pandemic. DESIGN/METHODOLOGY/APPROACH: This study employed a quantitative research approach, utilizing a structured questionnaire to survey 260 respondents in Malaysian public hospitals. The questionnaire was designed to assess respondents' perceptions of service quality dimensions, measure their satisfaction with public hospital services and gather demographic and background information. The data underwent validation factor analysis to ensure the reliability and validity of the measurement model. Additionally, structural equation modeling (SEM) was conducted to evaluate the strength and significance of the relationships between the variables. FINDINGS: The study findings revealed that emotional support, courteous behavior, hospital amenities and responsiveness to companions' needs in Malaysian public hospitals were positively associated with companion satisfaction. Additionally, communication was found to have a significant and negative impact on companion satisfaction. ORIGINALITY/VALUE: By integrating emotional, behavioral and infrastructural elements into the SERVQUAL model, this study addresses the often-overlooked perspective of patient companions. It offers actionable insights for improving public hospital service quality in pandemic and post-pandemic contexts.
Quality management control by Six Sigma metrics operating curves for a medical services organization.
Fontalvo Herrera TJ, Arnedo Barrios KA
Int J Health Care Qual Assur · 2025 Oct · PMID 40952007 · Publisher ↗
PURPOSE: To evaluate a medical service provider organization, operating under variable conditions, using operating curves based on Six Sigma metrics. DESIGN/METHODOLOGY/APPROACH: Basic research that developed a rational...
PURPOSE: To evaluate a medical service provider organization, operating under variable conditions, using operating curves based on Six Sigma metrics. DESIGN/METHODOLOGY/APPROACH: Basic research that developed a rational quantitative approach supported by mathematics and statistical quality control, where the performance of the system's quality was evaluated, supported by a sensitivity analysis with the creation of dynamic tables and operation curves of the six sigma metrics. FINDINGS: A method for evaluating the quality of a medical service and its processes is proposed, which allows determining the performance of quality Z under variable conditions using the proposed operation curves. ORIGINALITY/VALUE: As a contribution and originality of this research, a comprehensive control system is proposed. A statistical study was evaluated using six sigma metric operating curves for a medical service.
Dynamic systems modeling for quality improvement in reducing neonatal mortality: evidence from Kerman and Bam, Iran.
Amini E, Amiresmaili M, Torabinejad Z … +1 more , Bagherzadeh MA
Int J Health Care Qual Assur · 2025 Oct · PMID 40923870 · Publisher ↗
PURPOSE: Neonatal mortality is a significant global health issue, particularly in low- and middle-income countries. This study aims to identify and understand the factors contributing to high neonatal mortality rates in...
PURPOSE: Neonatal mortality is a significant global health issue, particularly in low- and middle-income countries. This study aims to identify and understand the factors contributing to high neonatal mortality rates in the cities of Kerman and Bam, Iran, to develop effective strategies for improvement. DESIGN/METHODOLOGY/APPROACH: We employed systems dynamics to develop Causal Loop Diagrams that capture qualitative interactions among determinants of neonatal mortality. These CLDs were transformed into stock and flow diagrams for quantitative analysis. Using least squares regression techniques in MATLAB, we analyzed 60 months (2017-2021) of historical data from the Iranian Maternal and Neonatal database, the Integrated Health System (SIB), and Iran's Statistical Yearbooks. Expert interviews and hospital informatics were also utilized to enhance the model's robustness. FINDINGS: The developed model demonstrated a validation accuracy of approximately 94% based on Mean Absolute Percentage Error (MAPE). Key determinants were categorized into health factors (e.g. preterm birth, eclampsia), socio-demographic factors (e.g. maternal education, substance abuse), and healthcare system factors (e.g. NICU capacity, specialist staff). Simulation scenarios revealed that a 20% increase in NICU capacity could reduce neonatal mortality by 35% in Bam and 7% in Kerman. Additionally, hiring 15% more specialist staff reduced mortality by 10% in Bam and 7% in Kerman. RESEARCH LIMITATIONS/IMPLICATIONS: While this study is based on data from two specific cities, which may limit its applicability to other regions with different healthcare infrastructures and socio-economic conditions, the integrated qualitative and quantitative methodology employed can be effectively applied to other areas and societies. Future research should expand to additional regions and incorporate more factors, such as genetic predispositions and environmental influences, to enhance the model's generalizability and accuracy. The findings provide clear guidance for healthcare policymakers on effective resource allocation, such as expanding NICU capacity and training more healthcare professionals, to reduce neonatal mortality rates. PRACTICAL IMPLICATIONS: The model offers a robust framework for simulating intervention scenarios, enabling data-driven decision-making for optimizing healthcare strategies. By reducing neonatal mortality, this research contributes to the overall health and well-being of communities, fostering healthier families and populations, and leading to long-term societal benefits, including enhanced quality of life and economic productivity. ORIGINALITY/VALUE: This study is among the first in Iran to utilize a comprehensive systems dynamics approach to analyze factors affecting neonatal mortality. It presents a highly accurate dynamic model that integrates qualitative and quantitative data, offering a replicable methodology adaptable to other regions facing similar health challenges. The innovative application of dynamic systems modeling in neonatal health provides significant contributions to healthcare management and public health, supporting global efforts to reduce neonatal mortality.
Advancing healthcare innovation with Quality 5.0: a hybrid fuzzy AHP-TOPSIS model for strategic prioritization.
Bagherian A, Mukherjee S
Int J Health Care Qual Assur · 2025 Oct · PMID 40905593 · Publisher ↗
PURPOSE: The present study will outline the systematic approach toward implementing Quality 5.0 in the healthcare industry by focusing on patient-centered innovations. It is concerned with assisting healthcare organizati...
PURPOSE: The present study will outline the systematic approach toward implementing Quality 5.0 in the healthcare industry by focusing on patient-centered innovations. It is concerned with assisting healthcare organizations with digital transformation with a powerful decision-making model that balances the technological, human-centered and ethical objectives. DESIGN/METHODOLOGY/APPROACH: A hybrid multi-criteria decision-making model of Fuzzy Analytic Hierarchy Process (AHP) and Fuzzy Technique for Order Preference by Similarity to Ideal Solution has been applied. The evaluation was performed on five dimensions, including Human-Centered Artificial Intelligence and Automation (HAA), Patient-Centric Digital Healthcare, Sustainable Healthcare Practices, Workforce Adaptation and Ethical and Regulatory Compliance. FINDINGS: HAA revealed to be the most effective enabler of Quality 5.0 since it guarantees the enhancement of clinical decision-making by means of AI-controlled diagnostics and robot-assisted surgery coupled with the essential level of human surveillance. Green hospital initiatives and other approaches in the sustainable healthcare area were identified as paths that reduce the number of environmental costs as well as operational costs. The readiness of the workforce and integrity became vital supplementary elements. PRACTICAL IMPLICATIONS: The suggested model will offer healthcare institutions an advanced framework to prioritize innovations through ethical demand, technology readiness, and patient-centered care. It enables organized decision-making within the complicated innovation settings. ORIGINALITY/VALUE: This study is among the first to apply a hybrid Fuzzy AHP-TOPSIS approach to operationalize Quality 5.0 in healthcare. It offers a novel, patient-centered prioritization framework grounded in both technological and ethical dimensions of healthcare innovation.
Perceived service quality and its improvement with QFD for state social enterprises (SSEs).
Contreras Castañeda ED, Alvarez C, Suárez A
Int J Health Care Qual Assur · 2025 Oct · PMID 40847585 · Publisher ↗
PURPOSE: In health services, the perceived service quality plays a preponderant role in its continuous improvement. This study sought to integrate the perceived service quality as the customer's voice in the quality func...
PURPOSE: In health services, the perceived service quality plays a preponderant role in its continuous improvement. This study sought to integrate the perceived service quality as the customer's voice in the quality function deployment (QFD) for the improvement of healthcare services in the city of Tunja, Colombia. DESIGN/METHODOLOGY/APPROACH: A study was carried out with the adaptation of the SERVQUAL and SERVPERF scales applied to a sample of 378 users of a State Social Company (SSE). An exploratory factor analysis (EFA) was developed to find the factors that influence the quality of the health service under study and integrate them into a QFD matrix, whose output is the criteria for service improvement. FINDINGS: The QFD analysis allowed the formulation of twelve improvement actions for the quality of the service provided by the SSE. Consequently, the improvement in health services can be achieved through the voice of the customer and the identification of priority technical conditions to intervene in the service. ORIGINALITY/VALUE: In the case of the context under study and for outpatient ambulatory care services, it is the first study on the dimensions of perceived quality that influence the outpatient service and from these results to use QFD to generate improvement alternatives to the service.
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