International Journal Of Health Care Quality Assurance[JOURNAL]
Sun
200 papers
Evaluating patient and medical staff satisfaction from doctor-patient communication.
Katsaliaki K
Int J Health Care Qual Assur · 2022 Aug · PMID 35915934 · Publisher ↗
PURPOSE: The purpose of this study is to investigate and compare the views of doctors, nursing staff and hospitalized patients on the level of information they provide and receive respectively in public hospitals, focusi...
PURPOSE: The purpose of this study is to investigate and compare the views of doctors, nursing staff and hospitalized patients on the level of information they provide and receive respectively in public hospitals, focusing on the factors that affect their communication. DESIGN/METHODOLOGY/APPROACH: The study used a cross-sectional survey with a sample of 426 participants from two general hospitals in Greece-Pella and KAT Attica. Data were collected through a questionnaire in March-May 2020 and was analyzed with mean comparisons and correlations. FINDINGS: The results showed discrepancy in the satisfaction rate, with 67.3% satisfied patients from doctors' communication vs. 83.7% satisfied doctors. Improvements in hospital staff - patient communication are required especially on alternative therapies' discussion and time spent on communication. All respondents agreed that staff shortage is a deterrent factor for effective communication. Seamless for all respondents' groups, the factors that affect the communication satisfaction level are the duration of communication, time allowed for expressing questions and interest in patients' personal situation. PRACTICAL IMPLICATIONS: Strengthening the communication skills of medical staff and providing clear guidelines on when and how to inform patients are essential. ORIGINALITY/VALUE: This study contributes to the growing body of research on doctor-patient communication. Its originality lies on the fact that communication satisfaction level was examined simultaneously for doctors, nurses and patients. The study provides additional evidence supporting the link among satisfaction and duration of communication and personalized relationship. The study's findings are important in the training of medical staff and the management of patients' expectations.
Lean six sigma and stroke in rural hospital - The case of Baruch Padeh Medical Center.
Tzadok B, Ben Tov O, Vaispapir V … +4 more , Shornikov L, Marik O, Martens L, Tal Or E
Int J Health Care Qual Assur · 2022 Jan · PMID 35075887 · Publisher ↗
PURPOSE: This case study aims to demonstrate the strengths of the Lean Six Sigma (LSS) methodology to improve the acute ischemic stroke (AIS) treatment rates and reduce process lead time at Baruch Padeh Medical Center (B...
PURPOSE: This case study aims to demonstrate the strengths of the Lean Six Sigma (LSS) methodology to improve the acute ischemic stroke (AIS) treatment rates and reduce process lead time at Baruch Padeh Medical Center (BPMC), a rural hospital in the Galilee region of Northern Israel. The LSS project redefined the BPMC stroke care pathway and increased its efficacy. DESIGN/METHODOLOGY/APPROACH: The LSS methodology was implemented in September 2017 by integrating lean principles and the Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control). Existing procedures, field observation, ad hoc measurement and in-depth interviews were utilized, and the GEMBA method was implemented to identify root cause and improve actions optimizing the stroke pathway. FINDINGS: The presented case shows the usefulness of the LSS methodology in improving quality performance in a rural hospital. The intervention allowed the BPMC to improve the intravenous tissue plasminogen activator (IV-tPA) administration rate (+15.2%), reducing the process lead time. The lead time of door-to-computer tomography decreased from 52 to 26 min, and the door-to-needle time decreased from 94 to 75 min. ORIGINALITY/VALUE: The present case study shows the implementation of the LSS methodology aimed to improve the IV-tPA administration rate and reduce the stroke pathway lead time in a rural hospital. The case demonstrates the potential for the LSS methodology to support the AIS pathway optimization and represents a guide for healthcare organizations located in rural areas.
Examining the behavioural intention of inpatients in Indian government hospitals.
Singh D, Dixit K
Int J Health Care Qual Assur · 2022 Jan · PMID 35048622 · Publisher ↗
PURPOSE: The purpose of this research is to examine the impact of perceived service quality (PSQ) on the behavioural intention (BI) of patients in Indian government hospitals. The underlying mechanism of trust and patien...
PURPOSE: The purpose of this research is to examine the impact of perceived service quality (PSQ) on the behavioural intention (BI) of patients in Indian government hospitals. The underlying mechanism of trust and patient satisfaction (SAT) is examined as multiple mediating effect. DESIGN/METHODOLOGY/APPROACH: Data from 510 respondents were collected using structured questionnaires. Six government hospitals, namely, S.M.S. Hospital, J.L.N. Hospital, New Medical College Hospital, Maharana Bhupal Medical Hospital, Mathuradas Hospital and P.B.N. Hospital, were selected from the cities of Jaipur, Ajmer, Kota, Udaipur, Jodhpur and Bikaner, respectively. The data were collected from adult patients (>18 years old) who spent at least two nights in a government hospital between 1 October, 2020 and 30 December, 2020. PSQ formed as a reflective-formative model was analysed using the repeated indicator approach. Structural equation modelling (SEM) using SMART-PLS software was used to test the hypothesised model(s) derived deductively from literature. FINDINGS: The findings support the following conclusions: (1) the positive relationship between PSQ and BI is significant; (2) SAT mediates the PSQ and BI relationship; (3) trust mediates the PSQ and BI relationship; (4) the mediation effect of SAT is stronger than that of trust. PRACTICAL IMPLICATIONS: The results indicate that, in order to enhance the positive BI of patients towards government hospitals, it is necessary for the hospitals to work on strategies to enhance the service quality provided to patients. The outcome of this study will enable state government hospitals to get a better understanding of the different dimensions of service quality and will help in observing the factors that contribute to patients' satisfaction and trust in building long-term relationships by encouraging a positive BI. ORIGINALITY/VALUE: There is a dearth of research in India that evaluates the relationships between the constructs PSQ, trust, BI and SAT in the context of healthcare service. This empirical study is an attempt to fill this gap by focussing on the government hospitals in India.
Persons with disability perception of facilities management service quality: hospital buildings in Malaysia.
Awang NA, Chua SJL, Ali AS … +3 more , Au-Yong CP, Naicker AS, Yuliawiratman BS
Int J Health Care Qual Assur · 2021 Oct · PMID 34595895 · Publisher ↗
PURPOSE: This study aims to discover the perception of persons with disabilities (PWDs) towards facilities management (FM) service quality at hospital buildings in Malaysia. DESIGN/METHODOLOGY/APPROACH: A questionnaire s...
PURPOSE: This study aims to discover the perception of persons with disabilities (PWDs) towards facilities management (FM) service quality at hospital buildings in Malaysia. DESIGN/METHODOLOGY/APPROACH: A questionnaire survey was conducted with 99 respondents in selected hospitals in Selangor, Malaysia. FINDINGS: This study aims to discover the perception of PWDs towards FM service quality, and it has found a gap for improvement. The area that requires the highest attention includes the importance of (1) assurance on accessibility despite maintenance activity being conducted (2) criticality of facilities maintenance itself, (3) assurance on comfort and safety, (4) reliable medium to ask for assistance or giving feedback, (5) signage that is clearly seen and easily understood and (6) staff responsiveness. RESEARCH LIMITATIONS/IMPLICATIONS: This instrument is validated by PWDs under the physical disability category only, specifically in the hospital context. Future research is recommended to identify the FM service quality aspect for different categories of disability (sensory, mental or intellectual impairment). PRACTICAL IMPLICATIONS: The findings provide evidence for FM to consider PWDs' perceptions in FM strategy development. Even FM provides a healthcare support system. FM service quality partly reflects healthcare service quality. SOCIAL IMPLICATIONS: Accommodating the need of PWDs through the improvement of FM service quality aspect will partly fulfil the right of PWDs for equality of access to healthcare. ORIGINALITY/VALUE: This SERVQUAL tools can be improvised and used to measure the perception of PWDs on FM service quality systematically and holistically. Understanding the service quality aspect is important for a facility manager to precisely measure and prioritise what is truly important to the building users with special needs and try to accommodate this need in the management activity.
Evaluation of patient safety culture in a private general hospital: a case study in Brazil.
Prates CG, Caregnato RCA, Magalhães AMM … +3 more , Dal Pai D, Urbanetto JS, Moura GMSS
Int J Health Care Qual Assur · 2021 Jun · PMID 34100568 · Publisher ↗
PURPOSE: The purpose is to assess the patient safety culture perceived by healthcare and administrative staff in a Brazilian hospital and examine whether education and experience are related to positive perceptions. DESI...
PURPOSE: The purpose is to assess the patient safety culture perceived by healthcare and administrative staff in a Brazilian hospital and examine whether education and experience are related to positive perceptions. DESIGN/METHODOLOGY/APPROACH: A descriptive-analytical case study was carried out at Ernesto Dornelles Hospital, a private Brazilian institution. The Brazilian version of the Hospital Survey on Patient Safety Culture was used to assess the perceptions of 618 participants, of whom 315 worked in healthcare assistance and 303 in administrative services. The main outcome was the percentage of positive responses, and the independent variables included the type of work, schooling and length of experience. FINDINGS: None of the twelve dimensions was strengthened. The percentage of positive responses was the highest for "Hospital management support for patient safety" (67.5%), and the lowest was for "Nonpunitive response to error" (29%). The healthcare staff had a slightly higher average than the administrative staff. The percentage of positive responses from professionals with undergraduate or graduate degrees was higher for the eight dimensions of safety culture. The length of hospital experience was not associated with any dimensions. ORIGINALITY/VALUE: This study explored the influence of education and professional experience on the perception of patient safety in healthcare and administrative staff from a private institution. These approaches allow to know with greater depth and clarity factors that are related to the patient safety culture and, thus, have more consistent evidence to support interventions in specific needs.
The voice of patients in Israel's general hospitals.
Semyonov-Tal K
Int J Health Care Qual Assur · 2021 May · PMID 33942593 · Publisher ↗
PURPOSE: The purpose of this study is to capture the variety of issues that concern patients and to examine the extent to which personal characteristics of patients, such as education, ethnicity, age, gender and conditio...
PURPOSE: The purpose of this study is to capture the variety of issues that concern patients and to examine the extent to which personal characteristics of patients, such as education, ethnicity, age, gender and conditions of hospitalisation, influence the tendency to "express (negative) voice" and raise "critical views". DESIGN/METHODOLOGY/APPROACH: Using data obtained from the 2014 Survey of Health Satisfaction in Israel, the study focuses on patients' responses to an open-ended question regarding the medical care experience in hospitals. FINDINGS: The analysis reveals that "the voice of patients" spreads across a wide variety of issues, including the physical condition of the hospital and caregiver behaviour. Multivariate regression models show that subgroups with greater access to social and economic resources (i.e. in Israel, individuals who are Jewish), academics, women and younger patients are more likely to express critical voice regarding the hospitalisation experience. Likewise, inferior hospitalisation conditions are likely to increase expression of negative "voice" and criticism. ORIGINALITY/VALUE: The findings underscore the importance and value of open-ended questions in evaluating healthcare satisfaction, suggesting that the likelihood of expressing critical voice is higher among patients of high socio-economic status - perhaps because they are more likely to expect, demand and feel entitled to high-quality care. Likewise, inferior hospitalisation conditions increase the critical voice.
Overuse of small chest drains for pleural effusions: a retrospective practice review.
Tajarernmuang P, Gonzalez AV, Valenti D … +1 more , Beaudoin S
Int J Health Care Qual Assur · 2021 Apr · PMID 33909374 · Publisher ↗
PURPOSE: Small-bore drains (≤ 16 Fr) are used in many centers to manage all pleural effusions. The goal of this study was to determine the proportion of avoidable chest drains and associated complications when a strategy...
PURPOSE: Small-bore drains (≤ 16 Fr) are used in many centers to manage all pleural effusions. The goal of this study was to determine the proportion of avoidable chest drains and associated complications when a strategy of routine chest drain insertion is in place. DESIGN/METHODOLOGY/APPROACH: We retrospectively reviewed consecutive pleural procedures performed in the Radiology Department of the McGill University Health Centre over one year (August 2015-July 2016). Drain insertion was the default drainage strategy. An interdisciplinary workgroup established criteria for drain insertion, namely: pneumothorax, pleural infection (confirmed/highly suspected), massive effusion (more than 2/3 of hemithorax with severe dyspnea /hypoxemia), effusions in ventilated patients and hemothorax. Drains inserted without any of these criteria were deemed potentially avoidable. FINDINGS: A total of 288 procedures performed in 205 patients were reviewed: 249 (86.5%) drain insertions and 39 (13.5%) thoracenteses. Out of 249 chest drains, 113 (45.4%) were placed in the absence of drain insertion criteria and were deemed potentially avoidable. Of those, 33.6% were inserted for malignant effusions (without subsequent pleurodesis) and 34.5% for transudative effusions (median drainage duration of 2 and 4 days, respectively). Major complications were seen in 21.5% of all procedures. Pneumothorax requiring intervention (2.1%), bleeding (0.7%) and organ puncture or drain misplacement (2%) only occurred with drain insertion. Narcotics were prescribed more frequently following drain insertion vs. thoracentesis (27.1% vs. 9.1%, = 0.03). ORIGINALITY/VALUE: Routine use of chest drains for pleural effusions leads to avoidable drain insertions in a large proportion of cases and causes unnecessary harms.
Editorial.
Chandra C
Int J Health Care Qual Assur · 2021 Feb · PMID 33590733 · Publisher ↗
Abstract loading — click title to view on PubMed.
Guidelines for student accoucheurs' acceptance in maternal healthcare.
Madlala ST, Sibiya MN, Ngxongo TSP
Int J Health Care Qual Assur · 2021 Feb · PMID 33543607 · Full text
PURPOSE: The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student accoucheurs studying at the Free S...
PURPOSE: The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student accoucheurs studying at the Free State School of Nursing are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal healthcare institutions. This results in poor quality of training of student accoucheurs in maternal healthcare. Considerable studies have been conducted on males in midwifery nursing, but no guidelines have been developed to facilitate student accoucheurs' acceptance and improvement of the quality of training in maternal healthcare, hence the purpose of this study. DESIGN/METHODOLOGY/APPROACH: A descriptive, explorative qualitative design was used in this study. Qualitative focused group discussions ( = 32) were conducted through purposeful sampling method. Data was analysed thematically. FINDINGS: Three main categories emerged: student accoucheurs' related factors with social interactions and relations as a theme; maternal healthcare users' related factors with transcultural diversity and socio-economic status as themes; nurse training institutions and maternal healthcare institutions service providers-related factors with gender inequality in the work place as a theme. Ultimately, the guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in maternal healthcare institutions were developed and recommended for implementation. ORIGINALITY/VALUE: The paper developed guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in Free State maternal healthcare institutions.
Adverse obstetric outcomes in two Brazilian maternity hospitals.
Andrade AL, Gama ZADS, Freitas MR … +4 more , Medeiros WR, Sousa KM, Silva EMMD, Rosendo TS
Int J Health Care Qual Assur · 2021 Jan · PMID 33393747 · Publisher ↗
PURPOSE: Obstetric adverse outcomes (AOs) are an important topic and the use of composite measures may favor the understanding of their impact on patient safety. The aim of the present study was to estimate AO frequency...
PURPOSE: Obstetric adverse outcomes (AOs) are an important topic and the use of composite measures may favor the understanding of their impact on patient safety. The aim of the present study was to estimate AO frequency and obstetric care quality in low and high-risk maternity hospitals. DESIGN/METHODOLOGY/APPROACH: A one-year longitudinal follow-up study in two public Brazilian maternity hospitals. The frequency of AOs was measured in 2,880 randomly selected subjects, 1,440 in each institution, consisting of women and their newborn babies. The frequency of 14 AOs was estimated every two weeks for one year, as well as three obstetric care quality indices based on their frequency and severity as follows: the Adverse Outcome Index (AOI), the Weighted Adverse Outcome Score and the Severity Index. FINDINGS: A significant number of mothers and newborns exhibited AOs. The most prevalent maternal AOs were admission to the ICU and postpartum hysterectomy. Regarding newborns, hospitalization for > seven days and neonatal infection were the most common complications. Adverse outcomes were more frequent at the high-risk maternity, however, they were more severe at the low-risk facility. The AOI was stable at the high-risk center but declined after interventions during the follow-up year. ORIGINALITY/VALUE: High AO frequency was identified in both mothers and newborns. The results demonstrate the need for public patient safety policies for low-risk maternity hospitals, where AOs were less frequent but more severe.
The quality of patient care in oncology departments in Karachi, Pakistan: patients' perceptions.
Fayyaz R, Ahmed FA, Abid A … +8 more , Akhtar A, Jarwar R, Jasmine A, Khan SA, Shahid S, Khan I, Yousuf AM, Jehan I
Int J Health Care Qual Assur · 2020 Dec · PMID 33381957 · Publisher ↗
PURPOSE: This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to identify domains where improvement i...
PURPOSE: This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to identify domains where improvement is needed. DESIGN/METHODOLOGY/APPROACH: This is a cross-sectional study carried out at two tertiary care hospitals of Karachi, Pakistan, belonging to private and public sector, respectively, between February and April 2018. Face-to-face interviews were conducted using a modified questionnaire having five-point Likert scale questions regarding satisfaction of patients with doctors, nursing staff, information provided and the hospital standards. SPSS 20 was used for statistical analysis, and the results were expressed using mean, frequencies, percentages and -values. FINDINGS: The authors approached 415 patients, out of which 389 patients agreed to participate in the study. For both hospitals, the lowest mean scores were for sections pertaining to satisfaction with psychosocial support and information provided. The mean satisfaction score of patients from the private hospital were found to be significantly higher as compared to patients from the public hospital for all domains of patient care (-value < 0.01 using -test for two independent samples). The data showed an increasing trend of "satisfied" responses as the household income increased. RESEARCH LIMITATIONS/IMPLICATIONS: A comparative study should be conducted with the aim of pinpointing the differences in areas in which there is a significant difference in positive satisfaction levels between private and public sectors. Similar research could also be expanded adding other variables that affect quality of care such as doctor's approach to their patients, time given during each consultation and patient's understanding of doctor's knowledge. Further studies can be done to bridge the gaps between what a doctor views as standard care and what the patient knows will help them receive a more holistic approach to care. PRACTICAL IMPLICATIONS: Assessing the quality of care helps determine gaps in care and allocating health resources accordingly. In clinical practice, emphasis needs to be given on increased duration and improved quality of patient counselling to improve the low satisfaction levels of patients regarding the psychosocial support. Addressing patients' concerns should be made part of clinical teaching from an undergraduate level. As far as patient access to doctors of the specific speciality is concerned, hospital managements should adopt systems to ensure continuum of care and come up with mechanisms to bridge the discrepancy between a patient's needs and doctor availability. SOCIAL IMPLICATIONS: After being identified as a major deficiency, training doctors in the sensitivities of the population and demographics, especially with respect to socio-economic statuses, can aid in enhancing patient satisfaction to the treatment. Implementation of patient-centred care leads to greater satisfaction with care, which, in turn, increases a patient's self efficacy in managing important aspects of their care and improves health care-related quality of life. ORIGINALITY/VALUE: Cancer patients have long-term exposure to the hospital environment. A patient's satisfaction with the quality of care is an important determinant in patient compliance to the treatment protocol and required hospital visits. There is a dearth of research on the outpatient quality of care in the oncology departments in Karachi. This study provides an overview of the quality of care available to cancer patients in Karachi both in public and private sectors. The results of our study identify the gaps in the quality of care being provided to the patients in a developing country like Pakistan, which can be used to improve the quality of care, leading to better patient outcomes.
Assessing the telemedicine acceptance for adults in Brazil.
Serrano KM, Mendes GHS, Lizarelli FL … +1 more , Ganga GMD
Int J Health Care Qual Assur · 2020 Dec · PMID 33369378 · Publisher ↗
PURPOSE: This study aimed to find factors influencing the acceptance of telemedicine for adults in Brazil. Moreover, it investigates the moderating role of disease complexity and the generational digital divide phenomeno...
PURPOSE: This study aimed to find factors influencing the acceptance of telemedicine for adults in Brazil. Moreover, it investigates the moderating role of disease complexity and the generational digital divide phenomenon on the intention to use the telemedicine service. DESIGN/METHODOLOGY/APPROACH: A quasi-experiment was employed. Primary data were collected using a survey research method considering two different scenarios based on disease complexity and symptom severity. A total of 248 responses were collected using a structured questionnaire. The authors also tested these two scenarios in three generations (X, Y and Z) of adults. Partial least squares structural equation modeling (PLS-SEM) was used to analyze the collected data and test the research hypotheses. FINDINGS: The results indicated that performance expectancy and perceived security and reliability are two predictors of the behavioral intention to use telemedicine, whereas effort expectancy and social influence showed no statistical significance. Furthermore, the results demonstrated that adults tend to adopt telemedicine regardless of the level of disease complexity. Finally, this study does not support the existence of a digital divide in the three generations. ORIGINALITY/VALUE: The study applies the UTAUT model to assess the telemedicine acceptance for younger generations. It examines patient risk perception (security and reliability) as one antecedent of telemedicine acceptance.
Determinants of inpatient satisfaction: evidence from Switzerland.
Tobler S, Stummer H
Int J Health Care Qual Assur · 2020 Dec · PMID 33350289 · Publisher ↗
PURPOSE: A common way to handle quality problems and increasing costs of modern health care systems is more transparency through public reporting. Thereby, patient satisfaction is seen as one main reported outcome. Previ...
PURPOSE: A common way to handle quality problems and increasing costs of modern health care systems is more transparency through public reporting. Thereby, patient satisfaction is seen as one main reported outcome. Previous studies proposed several associated factors. Only a few of them included organizational determinants with potential to inform the health care provider's management. Therefore, the aim of this study was to investigate the influence of organizational contingency factors on patient satisfaction. DESIGN/METHODOLOGY/APPROACH: As a case, Switzerland's inpatient rehabilitation sector was used. Therein, a cross-sectional study of public released secondary data with an exploratory multiple linear regression (MLR) modeling approach was conducted. FINDINGS: Five significant influencing factors on patient satisfaction were found. They declared 42.2% of the variance in satisfaction on provider level. The organizations' supplementary insured patients, staff payment, outpatients, extracantonal patients and permanent resident population revealed significant correlations with patient satisfaction. RESEARCH LIMITATIONS/IMPLICATIONS: Drawing on publicly available cross-sectional data, statistically no causality can be proved. However, integration of routine data and organization theory can be useful for further studies. PRACTICAL IMPLICATIONS: Regarding inpatient satisfaction, improvement levers for providers' managers are as follow: first, service provision should be customized to patients' needs, expectations and context; second, employees' salary should be adequate to prevent dissatisfaction; third, the main business should be prioritized to avoid frittering. ORIGINALITY/VALUE: Former studies regarding public reporting are often atheoretical and rarely used organizational variables as determinants for relevant outcomes. Therefore, uniformed data are useful.
An optimized queue management system to improve patient flow in the absence of appointment system.
Safdar KA, Emrouznejad A, Dey PK
Int J Health Care Qual Assur · 2020 Nov · PMID 33179461 · Publisher ↗
PURPOSE: The aim of this research study is to develop a queue assessment model to evaluate the inflow of walk-in outpatients in a busy public hospital of an emerging economy, in the absence of appointment systems, and co...
PURPOSE: The aim of this research study is to develop a queue assessment model to evaluate the inflow of walk-in outpatients in a busy public hospital of an emerging economy, in the absence of appointment systems, and construct a dynamic framework dedicated towards the practical implementation of the proposed model, for continuous monitoring of the queue system. DESIGN/METHODOLOGY/APPROACH: The current study utilizes data envelopment analysis (DEA) to develop a combined queuing-DEA model as applied to evaluate the wait times of patients, within different stages of the outpatients' department at the Combined Military Hospital (CMH) in Lahore, Pakistan, over a period of seven weeks (23rd April to 28th May 2014). The number of doctors/personnel and consultation time were considered as outputs, where consultation time was the non-discretionary output. The two inputs were wait time and length of queue. Additionally, VBA programming in Excel has been utilized to develop the dynamic framework for continuous queue monitoring. FINDINGS: The inadequate availability of personnel was observed as the critical issue for long wait times, along with overcrowding and variable arrival pattern of walk-in patients. The DEA model displayed the "required" number of personnel, corresponding to different wait times, indicating queue build-up. ORIGINALITY/VALUE: The current study develops a queue evaluation model for a busy outpatients' department in a public hospital, where "all" patients are walk-in and no appointment systems. This model provides vital information in the form of "required" number of personnel which allows the administrators to control the queue pre-emptively minimizing wait times, with optimal yet dynamic staff allocation. Additionally, the dynamic framework specifically targets practical implementation in resource-poor public hospitals of emerging economies for continuous queue monitoring.
Determinants of screening methods utilization among Iraq/Sulaimani women.
Shakor JK, Mohammed AK, Hama-Karim YH
Int J Health Care Qual Assur · 2020 Oct · PMID 33108114 · Publisher ↗
PURPOSE: This study aims to find out the participation rate of women in the utilization of screening methods to determine the relationship of sociodemographic health characteristics and breast cancer (BC) awareness with...
PURPOSE: This study aims to find out the participation rate of women in the utilization of screening methods to determine the relationship of sociodemographic health characteristics and breast cancer (BC) awareness with the utilization of screening methods. The authors' study aims to examine the relationship between women's belief and the utilization of screening methods. DESIGN/METHODOLOGY/APPROACH: A cross-sectional study was conducted in three health centers from December 13, 2016 to June 12, 2017. A questionnaire was constructed for data collection about sociodemographic characteristics, screening awareness and medical and health background variables. Additionally, BC awareness measure and champion health belief model scales were used to measure women's perceptiveness about BC. FINDINGS: Despite the awareness among 78.9% of women regarding clinical breast examination (CBE) as a screening method, only 9.5% women utilized it for screening. Due to prescription by physicians for diagnosis of BC, 23.6% women had done mammography at least once in their life. Having jobs and a good education significantly influenced the utilization of CBE as a screening method. The logistic regression analysis found that old age, family history of BC, good knowledge about BC, perceived susceptibility, low rate of perceived barriers to mammography and CBE predicted participation in screening. ORIGINALITY/VALUE: Enhancing knowledge about BC and screening, emphasizing the susceptibility to BC and the benefits of screening will help in better participation. Importance should be given to illiterate and unemployed women.
Association of patient safety indicator 03 and clinical outcome in a surgery hospital.
Al-Tehewy MM, Abd Al-Razak SE, Hikal TS … +1 more , Wahdan MM
Int J Health Care Qual Assur · 2020 Oct · PMID 33098399 · Publisher ↗
PURPOSE: Patient safety indicators (PSIs) were developed as a tool for hospitals to identify potentially preventable complications and improve patient safety performance. The study aimed at measuring the incidence of the...
PURPOSE: Patient safety indicators (PSIs) were developed as a tool for hospitals to identify potentially preventable complications and improve patient safety performance. The study aimed at measuring the incidence of the Agency for Healthcare Research and Quality (AHRQ) PSI03 (pressure ulcer [PU] rate) and to identify the association between PSI03 and clinical outcomes including death, readmission within 30 days and length of stay (LOS) at the cardiothoracic surgery hospital at Ain Shams University, Cairo, Egypt. DESIGN/METHODOLOGY/APPROACH: An exploratory prospective cohort study was conducted to follow up patients, who fulfilled the inclusion criteria, from admission until one month after discharge at the cardiothoracic surgery hospital. Data were collected through basic information and follow-up sheets. The total number of included participants in the study was 330. FINDINGS: PSI03 incidence rate was 67.7 per 1,000 discharges. Patients aged 60 years and above had the highest risk among all age groups. In patients who developed PSI03, the risk ratio (RR) of death was 8.8 [95% CI (3.79-20.24)], RR of staying more than 30 days at the hospital was 1.5 [95% CI (1.249-1.872)] and of readmission within 30 days in patients who developed PSI03 was 1.5 [95% CI (0.38-6.15)]. In the study's hospital, the patients who developed PSI03 were at higher risk of death and stayed longer at the hospital than patients without PSI03. This study demonstrated a clear association between PSI03 and patient outcomes such as LOS and mortality. Early detection, prevention and proper management of PSI03 are recommended to decrease unfavorable clinical outcomes. ORIGINALITY/VALUE: The importance of PSIs lies in the fact that they facilitate the recognition of the adverse events and complications which occurred during hospitalization and give the hospitals a chance to improve the possible clinical outcomes. Therefore, the current study aimed at measuring the association between AHRQ PSI03 ( PU rate) and the clinical outcomes including death, readmission within 30 days and the LOS at the cardiothoracic surgery hospital at Ain Shams University. This study will provide the hospital management with baseline data for this type of adverse event and guide them to develop a system for identifying the high-risk group of patients and to upgrade relevant hospital policies and guidelines that lead to improved patient outcomes.
Interprofessional, multitiered daily rounding management in a high-acuity hospital.
Eamranond PP, Bhukhen A, DiPalma D … +4 more , Kunuakaphun S, Burke T, Rodis J, Grey M
Int J Health Care Qual Assur · 2020 Sep · PMID 32918544 · Publisher ↗
PURPOSE: The purpose of this explanatory case study is to explain the implementation of interprofessional, multitiered lean daily management (LDM) and to quantitatively report its impact on hospital safety. DESIGN/METHOD...
PURPOSE: The purpose of this explanatory case study is to explain the implementation of interprofessional, multitiered lean daily management (LDM) and to quantitatively report its impact on hospital safety. DESIGN/METHODOLOGY/APPROACH: This case study explained the framework for LDM implementation and changes in quality metrics associated with the interprofessional, multitiered LDM, implemented at Saint Francis Hospital and Medical Center (SFHMC) at the end of 2018. Concepts from lean, Total Quality Management (TQM) and high reliability science were applied to develop the four tiers and rounding components of LDM. A two-tailed -test analysis was utilized to determine statistical significance for serious safety events (SSEs) comparing the intervention period (January 2019-December 2019) to the baseline period (calendar years 2017 and 2018). Other quality and efficiency metrics were also tracked. FINDINGS: LDM was associated with decreased SSEs in 2019 compared to 2017 and 2018 ( ≤ 0.01). There were no reportable central line-associated blood stream infection (CLABSI) or catheter-associated urinary tract infection (CAUTI) for first full calendar quarter in the hospital's history. Hospital-acquired pressure injuries were at 0.2 per 1,000 patient days, meeting the annual target of <0.5 per 1,000 patient days. Outcomes for falls with injury, hand hygiene and patient experience also trended toward target. These improvements occurred while also observing a lower observed to expected length of stay (O/E LOS), which is the organizational marker for hospital's efficiency. RESEARCH LIMITATIONS/IMPLICATIONS: LDM may contribute greatly to improve safety outcomes. This observational study was performed in an urban, high-acuity, low cost hospital which may not be representative of other hospitals. Further study is warranted to determine whether this model can be applied more broadly to other settings. PRACTICAL IMPLICATIONS: LDM can be implemented quickly to achieve an improvement in hospital safety and other health-care quality outcomes. This required a redistribution of time for hospital staff but did not require any significant capital or other investment. SOCIAL IMPLICATIONS: As hospital systems move from a volume-based to value-based health-care delivery model, dynamic interventions using LDM can play a pivotal role in helping all patients, particularly in underserved settings where lower cost care is required for sustainability, given limited available resources. ORIGINALITY/VALUE: While many hospital systems promote organizational rounding as a routine quality improvement process, this study shows that a dynamic, intense LDM model can dramatically improve safety within months. This was done in a challenging urban environment for a high-acuity population with limited resources.
Patient satisfaction with perioperative nursing care in a tertiary hospital in Ghana.
Anaba P, Anaba EA, Abuosi AA
Int J Health Care Qual Assur · 2020 Sep · PMID 32897662 · Publisher ↗
PURPOSE: Promoting patient satisfaction is crucial for healthcare quality improvement. However, literature on patient satisfaction with nursing care in Ghana is limited. The aim of this study was to assess patient satisf...
PURPOSE: Promoting patient satisfaction is crucial for healthcare quality improvement. However, literature on patient satisfaction with nursing care in Ghana is limited. The aim of this study was to assess patient satisfaction with perioperative nursing care in Korle-Bu Teaching Hospital, the largest tertiary hospital in Ghana. DESIGN/METHODOLOGY/APPROACH: The study was a cross-sectional study. A sample of one hundred ( = 100) in-patients in the surgical department were interviewed. Statistical Package for Social Science (SPSS), version 22, was used to analyze the data. The results were presented using univariate, bivariate and multivariate analyses. FINDINGS: It was found that majority of the respondents were males (53%), employed (56%) and insured (85%). It was also found that eight in ten respondents were satisfied with the perioperative nursing care. Overall patient satisfaction with perioperative nursing care was significantly associated with information provision ( < 0.001), nurse-patient relationship ( < 0.001), fear and concern ( < 0.05) and discomfort and need ( < 0.05). At the multivariate level, overall patient satisfaction was significantly influenced by nurse-patient relationship ( = 0.430, = 0.002). ORIGINALITY/VALUE: There is limited literature on nursing care in surgical departments and rarely are patients' views considered in assessing quality of perioperative care, especially in Low- and Middle- Income Countries (LMICs). This study is a modest contribution to the literature on patient satisfaction with perioperative nursing care in Ghana.
Knowledge mapping of hospital accreditation research: a coword analysis.
Karamali M, Bahadori M, Ravangard R … +1 more , Yaghoubi M
Int J Health Care Qual Assur · 2020 Sep · PMID 32886458 · Publisher ↗
PURPOSE: Hospital accreditation has been adopted internationally as a way and solution for healthcare quality improvement in hospitals. The purpose of this study was to review and knowledge mapping of bibliographic data...
PURPOSE: Hospital accreditation has been adopted internationally as a way and solution for healthcare quality improvement in hospitals. The purpose of this study was to review and knowledge mapping of bibliographic data about "Hospital Accreditation" and assess the current quantitative trends. DESIGN/METHODOLOGY/APPROACH: Scientometric methods and knowledge visualization using the coword analysis techniques conducted in three steps based on the data related to the field of hospital accreditation from 1975 to 2018 obtained from the MEDLINE database. Bibliographic data for titles, abstracts and keywords articles were saved in CSV format and MEDLINE templates by applying filters. Data extracted were exported into an Excel spreadsheet and were preprocessed. The authors applied the text mining and visualization using VOSviewer software. FINDINGS: Hospital accreditation studies have been increased rapidly over the past 30 years. 6,661 documents in the field of hospital accreditation had been published from 1975 to 2018. Hospitals or organizations active in the field of hospital accreditation were in the United States, Italy and Canada. The 10 most productive authors identified in the area of hospital accreditation with a higher influence were identified. "The United States", "accreditation", "Joint commission on accreditation" and "quality assurance, healthcare" had, respectively, the highest frequency. The cluster analysis identified and categorized them into four major clusters. Hospital accreditation field had a close relationship with the quality improvement, patient safety, risk and standards. ORIGINALITY/VALUE: Hospital accreditation had focused on the scopes of implementation of accreditation programs, adherence to JCI standards, and focus on safety and quality improvement. Future studies are recommended to be conducted on design interventions and paying attention to all dimensions of hospital accreditation.
Editorial.
Chandra C
Int J Health Care Qual Assur · 2020 Aug · PMID 32840970 · Publisher ↗
Abstract loading — click title to view on PubMed.
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