International Journal Of Health Care Quality Assurance[JOURNAL]
Sun
200 papers
Service quality in healthcare: understanding the relationship between patient experience and healthcare outcomes.
Zehra S, Ranjan J, Shukla M
Int J Health Care Qual Assur · 2025 Oct · PMID 40772302 · Publisher ↗
PURPOSE: This study investigates the pivotal role of service quality in shaping patient experiences and influencing healthcare outcomes. It examines multiple dimensions of hospital service quality and how they collective...
PURPOSE: This study investigates the pivotal role of service quality in shaping patient experiences and influencing healthcare outcomes. It examines multiple dimensions of hospital service quality and how they collectively contribute to enhancing the overall patient experience. Utilizing a quantitative survey-based approach, the research offers a comprehensive analysis of the key factors that drive patient perceptions within the healthcare perspective. DESIGN/METHODOLOGY/APPROACH: A purposive non-probability sampling technique was employed to select respondents from the outpatient department of a private multi-specialty hospital in the Delhi-NCR region of India. Data were collected using a structured questionnaire, and structural equation modeling (SEM) was applied to test the proposed conceptual model and research hypotheses. FINDINGS: Results indicate a strong positive correlation between multifaceted dimensions of hospital service quality and patient experiences. Patients who report positive experiences are more likely to intend to revisit the same healthcare facility for future medical needs. RESEARCH LIMITATIONS/IMPLICATIONS: Overall, this study underscores the importance of prioritizing and optimizing various dimensions of hospital service quality to cultivate positive patient experiences and nurture enduring patient-provider relationships in the healthcare sector. Policymakers may find this study helpful in developing, constructing and modifying quality management systems for healthcare organizations. ORIGINALITY/VALUE: Very few studies have been performed on healthcare service quality dimensions and measured their impact on healthcare outcomes. This study examined the effects of three new quality indicators on patient experience and healthcare outcomes: environmental quality, process quality and interaction quality.
Patients' perceptions of service quality in mobile health apps: the role of Need-for-Touch and physician characteristics in the post-COVID-19 era.
Lee WJ, Shin S
Int J Health Care Qual Assur · 2025 Oct · PMID 40720512 · Publisher ↗
PURPOSE: This study explores how doctors' characteristics, including effort, listening, expertise, and credibility, influence patients' perceptions of service quality in mobile health (mHealth) applications in the post-C...
PURPOSE: This study explores how doctors' characteristics, including effort, listening, expertise, and credibility, influence patients' perceptions of service quality in mobile health (mHealth) applications in the post-COVID-19 era. It also investigates whether the Need-for-Touch moderates the relationship between doctor-patient rapport and perceived service quality in non-face-to-face consultations. DESIGN/METHODOLOGY/APPROACH: A survey was conducted among Korean college students who used mHealth applications after the COVID-19 pandemic. A total of 152 valid responses were collected and structural equation modeling was used to evaluate the relationships between doctors' characteristics, rapport, service quality, and the moderating effect of Need-for-Touch. FINDINGS: The results show that doctors' effort, listening, expertise, and credibility significantly enhance patients' perceptions of service quality through rapport-building in mHealth contexts. However, the Need-for-Touch did not moderate the rapport-service quality relationship, indicating that physical presence is less critical in remote healthcare consultations. ORIGINALITY/VALUE: Previous studies emphasized the importance of Need-for-Touch in face-to-face healthcare environments, highlighting how physical interaction fosters patient trust, satisfaction, and rapport. However, this study shifts the focus to digital healthcare, examining how physician characteristics can compensate for the absence of physical touch in mHealth services. The findings extend current knowledge by demonstrating that service quality can be achieved through non-physical interactions. This perspective offers valuable implications for enhancing mHealth service delivery in the post-COVID-19 era.
Does healthcare access affect trust in institutions? Empirical evidence in Canada during the COVID-19 pandemic.
Berrich O, Lamari M, Lakhal F
Int J Health Care Qual Assur · 2025 Oct · PMID 40454617 · Publisher ↗
PURPOSE: The paper investigates the determinants of citizens' trust in institutions, including banks and companies, during the COVID-19 pandemic in Canada. DESIGN/METHODOLOGY/APPROACH: We used a survey, conducted in 2020...
PURPOSE: The paper investigates the determinants of citizens' trust in institutions, including banks and companies, during the COVID-19 pandemic in Canada. DESIGN/METHODOLOGY/APPROACH: We used a survey, conducted in 2020, with 36,851 respondents to identify what made some trust and others distrust institutions during the COVID-19 pandemic. Our methodology incorporated ordinary least squares and logit estimations. FINDINGS: Lack of healthcare access had a significant negative impact on people's trust in institutions. Consistent with life experience theory, we found that individuals facing healthcare barriers may distrust firms and banks. Sociodemographic variables, including gender, education and marital status, were likely to shape the effect of healthcare access problems on trust in institutions. Moreover, mental health issues stemming from healthcare access problems adversely affected trust in banks and firms, suggesting that people who had mental health problems during COVID-19 were more likely to lose trust in these institutions. The relationship between healthcare access and trust in banks and firms was more pronounced among men and highly educated people. The results were robust to the instrumental variable approach. PRACTICAL IMPLICATIONS: We showed that a link between trust in institutions and problems with healthcare access can inspire partnerships between Canadian institutional entities, typically banks and firms, and healthcare organizations. This would help strengthen long-term trust in these institutions. ORIGINALITY/VALUE: The potential long-term economic consequences of COVID-19 created a crisis in the public's trust in institutions, typically firms and banks. This paper examined the relationship between healthcare access and trust in institutions, addressing the limited evidence on this topic.
Determinants of life expectancy: evidence from World Bank income groups using a panel dummy interaction approach.
Sofi SA, Yasmin E
Int J Health Care Qual Assur · 2025 Jul · PMID 40396777 · Publisher ↗
PURPOSE: Achieving optimal health outcomes is central to global health policies. This study examines the impact of out-of-pocket (OOP) health expenditures and other determinants on life expectancy across income groups cl...
PURPOSE: Achieving optimal health outcomes is central to global health policies. This study examines the impact of out-of-pocket (OOP) health expenditures and other determinants on life expectancy across income groups classified by the World Bank. DESIGN/METHODOLOGY/APPROACH: Using panel data and a fixed-effects model with dummy interactions, the findings reveal that OOP expenditures reduce life expectancy more in low-income economies, underscoring the need to lower financial barriers to healthcare. FINDINGS: Gross domestic product (GDP) per capita is significant for improving life expectancy more in low-income economies, but diminishing returns suggest aligning growth with health policies. Immunization consistently improves life expectancy, highlighting preventive care's importance. Unemployment limits healthcare access, particularly in low-middle-income economies, requiring policies to address economic instability. Alcohol consumption adversely affects life expectancy in high-income economies, highlighting the impact of lifestyle changes and the need for regulatory interventions. PRACTICAL IMPLICATIONS: By exploring the interplay of health expenditures, socioeconomic factors and lifestyle risks, the study offers insights for equitable global health policies aimed at improving health outcomes across income groups. ORIGINALITY/VALUE: (1) While previous studies have analysed the impact of various socio-economic factors on life expectancy in developed economies, little is known about the impact of these factors in Low and Middle Income Economies. (2) Moreover, the impact of out-of-pocket health expenditure on life expectancy has not been comprehensively analysed across different income groups. (3) Findings reveal that out-of-pocket expenditures negatively affect life expectancy more in low-income economies than in high-income economies, emphasizing the need for reducing the financial burden to improve healthcare access. (4) Alcohol consumption adversely impacts life expectancy in high-income economies, highlighting the need for regulatory interventions targeting lifestyle-related risks. (5) This study enhances understanding of how health expenditures, socio-economic factors, and lifestyle choices influence life expectancy across income groups, offering insights to guide equitable global health policies.
A process improvement study on patient flow from emergency department to intensive care unit.
Nikita N, Singh A
Int J Health Care Qual Assur · 2025 Jul · PMID 40377340 · Publisher ↗
PURPOSE: This study aimed to improve the efficiency and effectiveness of patient flow from the emergency department (ED) to the intensive care unit (ICU) in a super specialty hospital. DESIGN/METHODOLOGY/APPROACH: The st...
PURPOSE: This study aimed to improve the efficiency and effectiveness of patient flow from the emergency department (ED) to the intensive care unit (ICU) in a super specialty hospital. DESIGN/METHODOLOGY/APPROACH: The study was conducted in the emergency department of a super-specialized hospital, focusing on inpatients requiring subsequent admission to the intensive care unit (ICU). It employed a cross-sectional observational design, utilizing primary data collected through first-hand observations via a data tracking sheet. Data analysis encompassed pre- and post-intervention phases, with 232 patients, including 108 patients in the pre-intervention phase and 124 patients in the post-intervention phase, to ensure statistically meaningful results. The study has also utilized tools such as Project Charter, Microsoft Excel, SIPOC, CTC and CTQ, DPMO, Six Sigma, Value Stream Mapping and Root Cause Analysis. FINDINGS: Reduced turnaround time (TAT) by 81%, increased value-added activity percentage from 24.4 to 37.2%, improved sigma level from 2.25 to 2.82 and decreased DPMO (defects per million opportunities) from 226,852 to 92,742. ORIGINALITY/VALUE: This study focuses on a specific aspect of healthcare process improvement within a super-specialty hospital, employs a comprehensive Six Sigma methodology and statistical analysis to identify bottlenecks and improve efficiency, and focuses on TAT reduction and defect elimination.
Optimizing tracheostomy weaning with PDCA cycles: a four-year multidisciplinary quality improvement initiative in Northeast Brazil.
Catunda R, Bilo BB, Farias JL … +1 more , Formiga MF
Int J Health Care Qual Assur · 2025 Jul · PMID 40367234 · Publisher ↗
PURPOSE: We aimed to assess the impact of plan-do-check-act (PDCA) cycles on tracheostomy weaning in ICU patients from 2019 through 2023. DESIGN/METHODOLOGY/APPROACH: A retrospective study was conducted at a private hosp...
PURPOSE: We aimed to assess the impact of plan-do-check-act (PDCA) cycles on tracheostomy weaning in ICU patients from 2019 through 2023. DESIGN/METHODOLOGY/APPROACH: A retrospective study was conducted at a private hospital, analyzing recorded data from two PDCA cycles that were implemented to reduce mean tracheostomy weaning times between 2019 and 2023. We further classified distinct timeframes for a separate analysis, including the baseline (April 2019-August 2020), the period post-PDCA cycle I (January 2021-April 2022) and the period post-PDCA cycle II (August 2022-December 2023). FINDINGS: A total of 70 individuals completed the protocol (mean age ± SD, 60.51 ± 17.19 years; 31.4% female). One-way ANOVA revealed mean differences in weaning time compared to 2019 were significant: 2020-3.86 days ( = 0.02), 2021-6.56 days ( = 0.00), 2022-7.80 days ( = 0.00) and 2023-8.74 days ( = 0.00). Subgroup analysis also revealed significant differences in weaning time among baseline, post-first PDCA cycle and post-second PDCA cycle ( (2) = 20.15, = 0.00, η2 = 0.51). ORIGINALITY/VALUE: This management model underscores the benefits of consistently improving the quality management of physiotherapy, delivering value-based healthcare through the collaboration of a multidisciplinary team.
Patient queue analysis as a component of Lean Six Sigma improvement in healthcare processes: a case study from a chemotherapy day unit.
Abuyadek R, Shehata A, Guirguis W
Int J Health Care Qual Assur · 2025 Jul · PMID 40341115 · Publisher ↗
PURPOSE: Oncology patients are a vulnerable group that faces multiple challenges, aggravated by long waiting times and service queues. This article aims to use Lean Six Sigma (LSS) to improve the chemotherapy preparation...
PURPOSE: Oncology patients are a vulnerable group that faces multiple challenges, aggravated by long waiting times and service queues. This article aims to use Lean Six Sigma (LSS) to improve the chemotherapy preparation process and prospectively study the patient files' queue dynamics to prioritise process improvement remedies against adding resources strategy. DESIGN/METHODOLOGY/APPROACH: Six Sigma methodology has been employed together with Lean tools and queue dynamics in a case study research in a chemotherapy day unit to define, measure, analyse, improve and control the problematic process. The study population involved all internal customers and a sample of external customers ( = 450). The study processes were measured by 25 data points. FINDINGS: The most frequent problem was the "Long waiting time from oncologist assessment till receiving chemotherapy". Mean value-added time for chemotherapy preparation was 42 min, the defect was any patient's waiting time exceeding it. The average pre-intervention waiting time was 65.5 ± 27.20 min. The defect baseline sigma level was 0.78 sigma. Remedies involved assigning two pharmacists, arranging the pharmacy setting to satisfy chemotherapy preparation steps, adjusting the number of patients/hours, standardising patients' files interarrival time, delivering files to the pharmacy by piece, not by batch, and fixing the printers and landlines. Post-intervention mean patient waiting time was reduced significantly to 58.7 ± 23.44 min (-value = 0.05), and the defect sigma level was raised to 0.91 sigma. RESEARCH LIMITATIONS/IMPLICATIONS: This study draws attention to prioritising process improvement remedies in complex care settings with long queues. SOCIAL IMPLICATIONS: This study enhances service delivery and customer satisfaction. ORIGINALITY/VALUE: This study serves as one of the few publications to study patient queue behaviour as a part of LSS improvements in healthcare projects.
Health professionals' experiences with participating in quality improvement in elderly care.
Wieslander L, Haggström M, Bäckström I
Int J Health Care Qual Assur · 2025 Jul · PMID 40334014 · Full text
PURPOSE: Employee participation in quality improvement is essential for fostering engagement and job satisfaction and delivering high-quality care, as highlighted in the total quality management literature. However, how...
PURPOSE: Employee participation in quality improvement is essential for fostering engagement and job satisfaction and delivering high-quality care, as highlighted in the total quality management literature. However, how employee participation is facilitated during quality improvement processes within healthcare organizations remains largely unexplored. Previous studies have identified a research gap, highlighting the importance of examining this phenomenon from the perspective of health professionals. The purpose of this study was to gain a deeper understanding of how health professionals in nursing homes experience their participation in quality improvement. The underlying aim was to describe their involvement and how it can be strengthened, ultimately improving the quality of care. DESIGN/METHODOLOGY/APPROACH: This study is based on interviews with 17 health professionals from 2 nursing homes in a medium-sized Swedish municipality. Data were analysed with Reflexive Thematic Analysis. FINDINGS: The themes identified through the analysis are "experiences of barriers at the organizational level that limit participation in quality improvement" and "experiences of barriers in daily care that limit participation in quality improvement". ORIGINALITY/VALUE: The themes address barriers to participation in quality improvement, reflecting an organizational structure that hinders participation and quality improvement. A quality culture, along with structured approaches to improve quality and foster employee participation is lacking. Implementing total quality management could help address the challenges faced by health professionals in these settings.
Public health insurance for the elderly: an insight from bibliometric analysis.
Agrawal G, Kumar A
Int J Health Care Qual Assur · 2025 Apr · PMID 40214206 · Publisher ↗
PURPOSE: The study examines worldwide public health insurance and ageing studies. This was accomplished by doing a thorough bibliometric analysis of publications published between 2002 and 2022 (till 31st May), which inc...
PURPOSE: The study examines worldwide public health insurance and ageing studies. This was accomplished by doing a thorough bibliometric analysis of publications published between 2002 and 2022 (till 31st May), which includes 479 articles for the analysis. DESIGN/METHODOLOGY/APPROACH: This study used the Web of Science database to analyse the vast quantity of data from the journals referenced above. VOSviewer creates network maps, keyword concurrences and cross-country co-authorship. The research analyses parameters like article distribution by year and citation frequency to determine top publications. After that, co-authorship, country co-authorship and keyword co-occurrence bibliometric network maps are shown. FINDINGS: The finding of the study reveals that the year 2020 is the most productive year for publication; BMJ Open is referred to as the most productive journal in this area, and "Depression in the Elderly" is the most referenced paper. The US has published the highest number of articles. We've seen 21 authors work with "Akishita and Ishizaki". The USA is the most collaborative author with other countries and conducted a keywords-based cluster analysis in which "Public health insurance, older adults and long-term care" are the most frequent keywords in this domain. ORIGINALITY/VALUE: This article aligns with the current literature on elderly public health insurance. The authors utilize bibliometric analysis to provide a more comprehensive and robust understanding of this area. Those interested in conducting further research in this field can use the findings of this study as a guide.
Access barriers for severe mental disorders in Colombia.
Rodriguez Fandino JC
Int J Health Care Qual Assur · 2025 Apr · PMID 40145312 · Publisher ↗
PURPOSE: This study aims to identify the barriers to accessing mental health services in Colombia, analyze the causes that generate them and how they perpetuate over time and critically call for the strengthening of the...
PURPOSE: This study aims to identify the barriers to accessing mental health services in Colombia, analyze the causes that generate them and how they perpetuate over time and critically call for the strengthening of the provision and guarantee of access to these services in the country. DESIGN/METHODOLOGY/APPROACH: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. The databases Science Direct, Proquest and Google Scholar were consulted, and the following search terms were used: Accessibility to health services, health disparities, bipolar disorder, schizophrenia and Colombia. A total of 35 articles meeting the inclusion criteria were analyzed, which allowed the classification of access barriers into five categories: governmental, personal, familial, social and institutional, all of which directly or indirectly affect access to mental health services. FINDINGS: Colombia regularly faces various social issues; thus, progress in the field of mental health in terms of treatment, research and prevention is imperative. For such a change to be possible, contributions from legislation and health authorities are required, taking into account the individuality of the patient, their context and their limitations. ORIGINALITY/VALUE: This study offers a critical view of the barriers that hinder access to mental health services in Colombia, highlighting the need to strengthen the provision and guarantee access to these services.
Quality of patient-physician intercultural communication in healthcare tourism and medical interview experiences at an Indian hospital.
Mehra P, Tyagi H
Int J Health Care Qual Assur · 2025 Apr · PMID 40134048 · Publisher ↗
PURPOSE: While many studies have addressed health communication and physician-patient interactions, knowledge about intercultural communication in medical tourism is limited. Our empirical study, therefore, investigates...
PURPOSE: While many studies have addressed health communication and physician-patient interactions, knowledge about intercultural communication in medical tourism is limited. Our empirical study, therefore, investigates aspects related to patients' cultural beliefs regarding the quality of healthcare and the way this shapes their expectations and experiences in an intercultural medical interview setting at a Joint Commission International (JCI) accredited host country hospital in India. The theoretical foundation is the Communication Accommodation Theory. DESIGN/METHODOLOGY/APPROACH: A quantitative design was used in this study using the convenience sampling method. Data were collected from 300 medical tourism (MT) patients immediately after their face-to-face medical interview at the hospital. FINDINGS: The non-Western cultures displayed higher intercultural communication (ICC) expectations from the host country doctors than the Western patients, possibly on account of cultural similarity with and proximity to the host country. ICC beliefs of MT patients supported by convergent communication accommodation by the doctors led to the perception of better ICC experience in clinical consultations with the potential to improve word-of-mouth promotion, patient satisfaction and revisit intentions; patients' expectations mediated the relationship. Consultation time in minutes controlled the relationship between patient ICC beliefs, expectations and experience in the medical consultations. The proposed model was undifferentiated for age, gender and geography of the MT patient as well as wait time (in minutes). ORIGINALITY/VALUE: While culture has been recognised as a significant factor in shaping the growth in medical tourism, research is scant on cultural and religious communication accommodation practices of host country doctors and medical staff and its effects on patient experience. Most studies on culture and MT have either evaluated the role of culture on the destination choice of international patients (cultural affinity or cultural familiarity) or have analysed the effect of distance between the host and the guest country as critical determinants of the choice of MT country. This study is probably the first to assess the quality of ICC beliefs, expectations and effects on MT patients' experiences. It is also the pioneering study to relate the context of MT with the well-regarded Communication Accommodation Theory, especially the manner in which convergent and divergent accommodation occurred between MT patients and MT service providers in the host country.
The response of the benchmark healthcare index of India to COVID-19 pandemic: a return volatility approach.
Bangur P
Int J Health Care Qual Assur · 2025 Feb · PMID 39704011 · Publisher ↗
PURPOSE: From poor healthcare infrastructure to vaccine donors, India has traveled a long way. In this study, the author tried to find the investment certainty and persistence of volatility in the Indian healthcare syste...
PURPOSE: From poor healthcare infrastructure to vaccine donors, India has traveled a long way. In this study, the author tried to find the investment certainty and persistence of volatility in the Indian healthcare system due to COVID-19. DESIGN/METHODOLOGY/APPROACH: Using the Generalized Autoregressive Conditional Heteroskedasticity (GARCH 1,1) model, this study quantifies the change in the conditional variance after the first case report of COVID-19. The author has used the S&P BSE HEALTHCARE index time series to analyze India's healthcare infrastructure and practices. FINDINGS: The author found evidence of a decrease in investment certainty in investments related to India's healthcare infrastructure and practices after the first case report of COVID-19. Furthermore, the estimation of the econometric model suggests the presence of a large degree of volatility persistence in the S&P BSE HEALTHCARE index. ORIGINALITY/VALUE: This research would be the first of its kind where the return volatility of the Indian healthcare sector has been discussed. Also, this research quantifies the return volatility of the healthcare sector during the pre- and post-COVID-19 period.
Risk management in Moroccan public hospitals: a literature review.
Oumghar A, Izza I
Int J Health Care Qual Assur · 2025 Feb · PMID 39692520 · Publisher ↗
PURPOSE: The objective of this review is to provide a comprehensive analysis of risk management practices in the healthcare sector, with a particular focus on identifying challenges and strategies in Moroccan hospitals....
PURPOSE: The objective of this review is to provide a comprehensive analysis of risk management practices in the healthcare sector, with a particular focus on identifying challenges and strategies in Moroccan hospitals. DESIGN/METHODOLOGY/APPROACH: A literature search was carried out on several academic search engines using search terms reflecting the relationship between risk management and public hospitals in Morocco. FINDINGS: The Moroccan public hospital is confronted with several disjunctions, which can be sources of multiple risks. This influences the quality of care provided to patients and can sometimes threaten their vital prognosis. The risk management process can help health professionals, researchers and risk managers to be agile and identify and anticipate risks in order to avoid serious accidents that can affect the whole organization, especially after the pandemic lived experiences (COVID-19). ORIGINALITY/VALUE: Protecting human life in an environment where risks are omnipresent is a dilemma that every hospital organization must confront. So, risk management in the hospital is not a simple process, given the interaction of several components and the sensitivity of the field. Risk management in this establishment must be rigorous because every error can cost human life. In this sense, the analysis of risk management processes in Moroccan hospitals, based on what really exists, enables the identification of shortcomings in order to master the risk management system and thus protect goods and services as well as human life, which is the ultimate goal of the hospital organization's existence.
The effect of family members' communication mode choice on the family's perceptions of care.
Gerblich A, Rubin E, Kennedy K
Int J Health Care Qual Assur · 2025 Feb · PMID 39630587 · Publisher ↗
PURPOSE: Family-centered rounds (FCR) are a multidisciplinary process in which patients and/or family members are present and actively participate in medical rounds. While research has shown that FCR may enhance collabor...
PURPOSE: Family-centered rounds (FCR) are a multidisciplinary process in which patients and/or family members are present and actively participate in medical rounds. While research has shown that FCR may enhance collaborative information exchange and reduce family anxiety, the impact of the information exchange modality on the experience has been largely unexplored. Medical rounds are typically assumed to be carried out in person at the bedside. In this research, we challenge this perception. We ask whether FCR communication is best conducted at the bedside or if similar communication outcomes are obtained when family members choose the communication mode according to their preferences. DESIGN/METHODOLOGY/APPROACH: Using a field experiment in which participants choose the communication mode, we empirically analyze perceptions of the resulting communication in terms of information exchange. Three communication modes are available for participants to choose from (i.e. patients' families): face-to-face (FtF), phone and video conferencing. A questionnaire is distributed, and the responses of the patients' family members are analyzed. ANOVA tests are carried out to analyze the effect of communication mode on family perceptions. FINDINGS: Perceptions following video conferencing or FtF interaction were significantly higher than perceptions following the use of a phone. Thus, our results show clear superiority of video and FtF communication modes as facilitators of effective communication perceptions. There is also marginal evidence that FtF communication is perceived as superior than video conferencing in supporting the receipt of information and understanding but not in the ability to convey information and input to the care team. These results suggest that allowing family members to choose their communication preferences does not always support effective communication. A case can be made for motivating patient family members to use face-to-face or video communication rather than phone if possible. ORIGINALITY/VALUE: The possible ramifications of allowing family members to choose communication mode with the care team have been largely unexplored. Medical rounds are typically assumed to be carried out in person at the bedside. In this research, we challenge this perception. We ask whether communication is best conducted at the bedside or whether similar communication outcomes are obtained when family members choose the communication mode according to their preferences.
Geographical health inequalities in India: the impact of the COVID-19 pandemic on healthcare access and healthcare inequality.
Jayaprakash P, Majumdar R, Ingole S
Int J Health Care Qual Assur · 2024 Nov · PMID 39548662 · Publisher ↗
PURPOSE: With an emphasis on spatial health disparities, this study examines how COVID-19 has affected healthcare access and inequality in India. The study developed the Healthcare Access Index (HAI) and Healthcare Inequ...
PURPOSE: With an emphasis on spatial health disparities, this study examines how COVID-19 has affected healthcare access and inequality in India. The study developed the Healthcare Access Index (HAI) and Healthcare Inequality Index (HII) to assess the pandemic's effects on healthcare. The study addresses spatial health disparities in healthcare access and inequality, filling gaps in the literature. The final aim of the study is to offer policy suggestions to lessen healthcare inequities in India, particularly in the context of COVID-19. DESIGN/METHODOLOGY/APPROACH: The study incorporates secondary data from publicly accessible databases such as the National Family Health Survey, Niti-Ayog and Indian Census databases and employs a quantitative research design. The impact of the COVID-19 pandemic on healthcare access and healthcare inequality in India is examined using the HAI and the HII. The five dimensions of healthcare access - availability, accessibility, accommodation, cost and acceptability - were used in developing the HAI. The study uses a panel data analysis methodology to examine the HAI and HII scores for 19 states over the pre-COVID-19 (2015) and post-COVID-19 (2020) periods. In order to investigate the connection between healthcare access, healthcare inequality and the COVID-19 pandemic, the analysis employs statistical tests such as descriptive statistics, correlation analysis, factor analysis and visualization analysis. FINDINGS: According to the study, COVID-19 impacted healthcare access and inequality in India, with notable regional inequalities between states. The pandemic has increased healthcare disparities by widening the gap between states with high and low HII ratings. Healthcare access is closely tied to healthcare inequality, with lower levels of access being associated with more significant levels of inequality. The report advises governmental initiatives to lessen healthcare disparities in India, such as raising healthcare spending, strengthening healthcare services in underperforming states and enhancing healthcare infrastructure. PRACTICAL IMPLICATIONS: For Indian healthcare authorities and practitioners, the study has significant ramifications. In light of the COVID-19 pandemic, there has been a main focus on addressing geographic gaps in healthcare access and inequality. The report suggests upgrading transportation infrastructure, lowering out-of-pocket costs, increasing health insurance coverage and enhancing healthcare infrastructure and services in underperforming states. The HAI and the HII are tools that policymakers can use to identify states needing immediate attention and appropriately spend resources. These doable recommendations provide a framework for lowering healthcare disparities in India and enhancing healthcare outcomes for all communities. ORIGINALITY/VALUE: The study's originality resides in establishing the HAI and HII indices, using panel data analysis and assessing healthcare inequality regarding geographic disparities. Policy choices targeted at lowering healthcare disparities and enhancing healthcare outcomes for all people in India can be informed by the study's practical consequences.
Participation in the digital transformation of healthcare: a review of qualitative studies.
Wieslander L, Bäckström I, Häggström M
Int J Health Care Qual Assur · 2024 Nov · PMID 39541252 · Full text
PURPOSE: The purpose of this review is to identify how health professionals perceive participation in implementation of new technology in healthcare organizations. DESIGN/METHODOLOGY/APPROACH: A qualitative systematic re...
PURPOSE: The purpose of this review is to identify how health professionals perceive participation in implementation of new technology in healthcare organizations. DESIGN/METHODOLOGY/APPROACH: A qualitative systematic review based on the PRISMA diagram, was conducted using qualitative synthesis. NVivo software was used for thematic analysis. The searches were performed in PubMed, CINAHL and Scopus. FINDINGS: A total of 15 articles were included in the review, four themes describing how participation of health professionals in digital transformation affects the outcomes were identified, and three themes describing the factors that are necessary to promote participation. The underlying latent theme of an unmet desire to participate in the digital transformation was also identified in the analysis. ORIGINALITY/VALUE: The digital transformation of healthcare is complex and faces many obstacles if not managed correctly. Professional participation in the implementation seems to be essential for success. Focus on increased resources and planning during early stages, as well as teamwork and ethical reflection is important addressing the challenges that professionals face in digital transformation of healthcare.
Governance of healthcare quality: exploring the relationships between hospital board performance and healthcare quality outcomes.
Mourajid Y, Chahboune M, Ifleh A … +6 more , Al Wachami N, Arraji M, Boumendil K, Iderdar Y, Bouchachi FZ, Hilali A
Int J Health Care Qual Assur · 2024 Nov · PMID 39530195 · Publisher ↗
PURPOSE: This paper aims to contribute to the existing literature in the field of hospital governance by exploring the relationship between the attributes and performance of hospital boards and hospital performance in te...
PURPOSE: This paper aims to contribute to the existing literature in the field of hospital governance by exploring the relationship between the attributes and performance of hospital boards and hospital performance in terms of quality of healthcare. DESIGN/METHODOLOGY/APPROACH: A survey of board performance in public hospitals in Morocco was carried out, in which we surveyed all board members of the 13 hospitals in the Casablanca-Settat region. A total of 82 members responded (82% response rate) to the previously adapted and validated self-evaluation questionnaire on board self-assessment questionnaire (BSAQ) board member performance. FINDINGS: On average, the hospital boards studied had eight members. In terms of clinical expertise, half the members were physicians and 17% were nurses. In addition, positive correlations were found between certain board characteristics, notably age, seniority, members' perceptions of their impact on the quality of healthcare and several dimensions of board performance. In parallel, the results showed strong and significant associations between turnover rate and BSAQ score. Negative correlations were also found between average length of stay and BSAQ score. With regard to mortality parameters, it should be noted that we were unable to establish a strong empirical correlation between hospital boards' self-assessed performance and other hospital mortality indicators. RESEARCH LIMITATIONS/IMPLICATIONS: The present study offers a rigorous rationale for the use of the French-translated BSAQ in the hospital context, and we hope that others will use this tool in future work within the framework of evidence-based research. In addition, the BSAQ tool's focus on board competencies (and not just structure, composition or processes) provides valuable insights into what boards need to learn in order to function effectively. However, despite the insistence of the authors of this study on the need for a comprehensive census of public hospital board members in the region, several obstacles were encountered. Firstly, there were difficulties related to vacancies within the hospitals, which had the effect of restricting the representativeness of the sample. Secondly, access to hospital board members proved complex due to their busy schedules and the confidential nature of their meetings. Finally, it is important to note that national performance indicators in Morocco may not be as reliable as in other countries, which could complicate the identification of high-performing hospital systems and, consequently, make inference difficult. ORIGINALITY/VALUE: This study provides large-scale empirical evidence of processes related to the governance of quality of healthcare and elucidates the existence of an association between hospital board performance and clinical performance. The use of validated tools such as the BSAQ should therefore help improve the performance of boards and governance in public hospitals.
Linking organizational cronyism, time theft and nurse's proactive behavior: an evidence from public sector hospitals of Pakistan.
Khan MA
Int J Health Care Qual Assur · 2024 Oct · PMID 39404099 · Publisher ↗
PURPOSE: The main objective of this study was to understand employees engage in time theft behavior and is the behavioral consequence of this deviant behavior. To do this, the conservation of resources theory helps to...
PURPOSE: The main objective of this study was to understand employees engage in time theft behavior and is the behavioral consequence of this deviant behavior. To do this, the conservation of resources theory helps to examine the role of organizational cronyism behind employee time theft behavior and decreased proactive behavior. DESIGN/METHODOLOGY/APPROACH: A three-wave self-administered employee survey was used for data collection. The data were collected through an adopted questionnaire from nurses working in the public sector hospitals of Pakistan. Structural equation modeling (SEM) was used to analyze data collected from 256 respondents. FINDINGS: The results of this three-wave study supported the hypotheses which are: (1) Organizational cronyism positively predicts employee involvement in time theft behavior. (2) Employee time theft behavior negatively impacts their proactive behavior. (3) Organizational cronyism is detrimental to employee proactive behavior. (4) The relationship between organizational cronyism and proactive behavior is mediated by time theft. PRACTICAL IMPLICATIONS: In the presence of organizational cronyism, employees use time theft as a dysfunctional coping strategy to conserve their valued resources rather than allowing the organization to consume them. Organizational leaders of public sector hospitals must promote merit-based HRM practices to discourage time theft behavior as well as to improve the proactive performances of the nurses. ORIGINALITY/VALUE: This study is one of the initial attempts to extend the scant literature on the antecedents and consequences of time theft behavior and its dimensions in the South Asian context.
A cross-organizational Lean deployment in an Italian regional healthcare system.
Rosa A, Marolla G, McDermott O
Int J Health Care Qual Assur · 2023 Nov · PMID 37957840 · Full text
PURPOSE: This study explores how Lean was deployed in several hospitals in the Apulia region in Italy over 3.5 years. DESIGN/METHODOLOGY/APPROACH: An exploratory qualitative design was drawn up based on semi-structured i...
PURPOSE: This study explores how Lean was deployed in several hospitals in the Apulia region in Italy over 3.5 years. DESIGN/METHODOLOGY/APPROACH: An exploratory qualitative design was drawn up based on semi-structured interviews. FINDINGS: The drivers of Lean in hospitals were to increase patient satisfaction and improve workplace well-being by eliminating non-value-add waste. The participants highlighted three key elements of the pivotal implementation stages of Lean: introduction, spontaneous and informal dissemination and strategic level implementation and highlighted critical success and failure factors that emerged for each of these stages. During the introduction, training and coaching from an external consultant were among the most impactful factors in the success of pilot projects, while time constraints and the adoption of process analysis tools were the main barriers to implementation. The experiences of the Lean teams strongly influence the process of spontaneous dissemination aided by the celebration of project results and the commitment of the departmental hospital heads. PRACTICAL IMPLICATIONS: Lean culture can spread to allow many projects be conducted spontaneously, but the Lean paradigm can struggle to be adopted strategically. Lean in healthcare can fail because of the lack of alignment of Lean with leadership in healthcare and with their strategic vision, a lack of employees' project management skills and crucially the absence of a Lean steering committee. ORIGINALITY/VALUE: The absence of managerial expertise and a will to support Lean implementation do not allow for systemic adoption of Lean. This is one of the first and largest long-term case studies on a Lean cross-regional multi-hospital application in healthcare.
The mediating effect of patient trust on the relationship between service quality and patient satisfaction.
Al-Hilou M, Suifan T
Int J Health Care Qual Assur · 2023 Nov · PMID 37938922 · Publisher ↗
PURPOSE: The prime aim of this research is to examine the mediating effect of patient trust on the relationship between service quality and patient satisfaction in Amman, Jordan. DESIGN/METHODOLOGY/APPROACH: A convenienc...
PURPOSE: The prime aim of this research is to examine the mediating effect of patient trust on the relationship between service quality and patient satisfaction in Amman, Jordan. DESIGN/METHODOLOGY/APPROACH: A convenience sample of patients visiting seven out of the 44 private hospitals in Amman was selected. In total, 385 questionnaires were distributed among patients, with a response rate of 91%. Of these, 35 were disregarded, and the data from the remaining 350 questionnaires were analyzed using SPSS. FINDINGS: The results showed that service quality has a statistically significant effect on patient satisfaction. Furthermore, service quality has a statistically significant effect on patient trust, while there is also a statistically significant effect of patient trust on patient satisfaction. The findings also revealed that patient satisfaction partially mediates the relationship between service quality and patient satisfaction. ORIGINALITY/VALUE: Generating more insights in the areas of service quality, patient trust and patient satisfaction while also extending the findings of earlier studies. The prior studies in the literature that focus on customers are given a more advantageous perspective by using Jordanian hospitals as a population to test the model of this research. The majority of past research on service quality, patient satisfaction and patient trust in the healthcare sector has been conducted in western nations.
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