International Journal Of Health Care Quality Assurance[JOURNAL]
Sun
200 papers
Investigating power styles and behavioural compliance for effective hospital administration.
Pathania A, Rasool G
Int J Health Care Qual Assur · 2019 Jul · PMID 31282263 · Publisher ↗
PURPOSE: The purpose of this paper is to examine the use of power tactics by hospital administrators in order to gain employee compliance. It attempts to understand the influence of power bases of hospital administrators...
PURPOSE: The purpose of this paper is to examine the use of power tactics by hospital administrators in order to gain employee compliance. It attempts to understand the influence of power bases of hospital administrators on the employee compliance using an analytic hierarchy process (AHP) technique. DESIGN/METHODOLOGY/APPROACH: The study adopted a mixed method technique and was conducted in two phases. In the first phase, qualitative analysis was carried out through content analysis of the anecdotes collected from the employees working in tertiary hospitals. Content analysis of responses aided in obtaining a list of criteria and sub-criteria affecting employee behavioural compliance. In the second phase, quantitative analysis was carried out using the AHP technique. While applying AHP, the issue pertaining to employee behavioural compliance with hospital's policies, procedures and related instructions was formulated in form of a hierarchy of one objective, two criteria, six sub-criteria and five alternatives established through literature review and content analysis. Furthermore, the subject matter experts were asked to conduct pairwise comparison wherein priority rankings were achieved. FINDINGS: The results indicated that reward power (25 per cent) is the most significant power style exercised by effective hospital administrators in achieving employee behavioural compliance followed by expert (24 per cent), referent (22 per cent) and legitimate powers (17 per cent). As coercive (12 per cent) came out to be the least preferred power style, it should be cautiously exercised by hospital administrators in the present day scenario. RESEARCH LIMITATIONS/IMPLICATIONS: The major limitation of this study is that the sample was drawn only from three tertiary hospitals in Jammu district that limits the generalizability of the findings in all the hospital settings across different regions. No attempt is made in this study to understand the variations with regard to demographics of the respondents that can be taken as a future research study. This study is cross-sectional in nature and provides the perspective of specific time. A longitudinal study could further provide insights into different time variations and the comparison and henceforth can be more comprehensive, thus supporting the generalizability of this study. PRACTICAL IMPLICATIONS: The study empirically identifies the relative importance of exercising power styles in order to gain employee behavioural compliance. The study helps in understanding the complex problem of behavioural compliance in hospital setting by examining the intensity of each factor affecting employee behavioural compliance. This knowledge is very critical in effective hospital management and getting the work done. The priority rankings obtained for power styles can be used for developing selection batteries and performance records of hospital administrators. As the behaviour of the employees is not static, there may exist the inherent limitations of adopted cross-sectional design for the present study. Furthermore, longitudinal study can be conducted at different time periods, to understand the variations in the patterns of employee's compliance behaviour and associated practiced power styles by hospital administrators. ORIGINALITY/VALUE: This is perhaps the first study that has scientifically attempted to integrate the power styles and analyzed their effective use in hospital administration. This research study has attempted to develop an elementary base for academicians, scholars as well as management practitioners on the effective use of power styles for achieving employee behavioural compliance in hospitals.
An assessment of education, in-service training and tenure prolongation as methods for enhancing nursing performance.
Asiamah N, Mensah HK, Ocra B
Int J Health Care Qual Assur · 2019 Jul · PMID 31282262 · Publisher ↗
PURPOSE: The purpose of this paper is to provide an empirical basis for considering in-service training, tenure prolongation and continuing education as methods for enhancing nursing performance. DESIGN/METHODOLOGY/APPRO...
PURPOSE: The purpose of this paper is to provide an empirical basis for considering in-service training, tenure prolongation and continuing education as methods for enhancing nursing performance. DESIGN/METHODOLOGY/APPROACH: A self-reported questionnaire was used to collect data from 532 nurses, who were selected using the simple random sampling method from ten hospitals in Accra North, Ghana. Confirmatory factor analysis (CFA) was used to test the study's hypotheses. FINDINGS: The resulting model is of good fit at 5 per cent significance level (=1.492, =0.222), with in-service training found to be the ultimate method for enhancing nursing performance. The fitted CFA model also shows that in-service training is positively associated with education and tenure at 1 per cent significance level (<0.001). The overall evidence suggests that training, continuing formal education and tenure prolongation are methods for improving nursing performance. ORIGINALITY/VALUE: Apart from its contribution to the literature, this study applies validated primary data to empirically identify key methods for enhancing nursing performance.
Nursing staff and patients' length of stay.
Moisoglou I, Galanis P, Meimeti E … +3 more , Dreliozi A, Kolovos P, Prezerakos P
Int J Health Care Qual Assur · 2019 Jul · PMID 31282261 · Publisher ↗
PURPOSE: The purpose of this paper is to investigate the effect of nurse staffing, nurse education and work experience on patients' length of stay (LOS) in the Greek public hospitals. DESIGN/METHODOLOGY/APPROACH: A cross...
PURPOSE: The purpose of this paper is to investigate the effect of nurse staffing, nurse education and work experience on patients' length of stay (LOS) in the Greek public hospitals. DESIGN/METHODOLOGY/APPROACH: A cross-sectional study, with retrospective administrative data, was implemented. From all seven Regional Health Authorities of Greece, 25 general surgical units in 17 public hospitals participated in the study. FINDINGS: All over the hospitals were studied, 32,287 patients ⩾17 years old and 203 nursing staff, who were working in the study units, were included in the analysis. According to the multivariate linear regression model, increased years of experience as a nurse (= -0.04, 95% CI= -0.06 to -0.02, =0.001) and increased percentage of registered nurse to the total nursing staff (= -1.18, CI= -1.88 to -0.47, =0.03) were associated with decreased patient LOS. ORIGINALITY/VALUE: This was the first extended study in Greece, which explored the relationship between nurse staffing, nurse education, work experience and the LOS. The role that nurse staffing play together with its characteristics in the provision toward the quality healthcare services has already been recognized worldwide. The findings revealed the great shortage of nursing staff and the significant correlation between the work experience and educational level to patients' LOS.
Survey of isolation room equipment and resources in an academic hospital.
Telford B, Healy R, Flynn E … +3 more , Moore E, Ravi A, Geary U
Int J Health Care Qual Assur · 2019 Jul · PMID 31282260 · Publisher ↗
PURPOSE: The purpose of this paper, a point prevalence study, is to quantify the incidence of isolation and identify the type of communicable diseases in isolation. The paper evaluates isolation precaution communication,...
PURPOSE: The purpose of this paper, a point prevalence study, is to quantify the incidence of isolation and identify the type of communicable diseases in isolation. The paper evaluates isolation precaution communication, availability of personal protective equipment (PPE) as well as other equipment necessary for maintaining isolation precautions. DESIGN/METHODOLOGY/APPROACH: A standardised audit tool was developed in accordance with the National Standards for the Prevention and Control of Healthcare Associated Infections (May 2009). Data were collected from 14 March 2017 to 16 March 2017, through observation of occupied isolation rooms in an academic hospital in Dublin, Ireland. The data were subsequently used for additional analysis and discussion. FINDINGS: In total, 14 per cent (125/869) of the total inpatient population was isolated at the time of the study. The most common isolation precaution was contact precautions (96.0 per cent). In all, 88 per cent of known contact precautions were due to multi-drug resistant organisms. Furthermore, 96 per cent of patients requiring isolation were isolated, 92.0 per cent of rooms had signage, 90.8 per cent had appropriate signs and 93.0 per cent of rooms had PPE available. Finally, 31 per cent of rooms had patient-dedicated and single-use equipment and 2.4 per cent had alcohol wipes available. PRACTICAL IMPLICATIONS: The audit tool can be used to identify key areas of noncompliance associated with isolation and inform continuous improvement and education. ORIGINALITY/VALUE: Currently, the rate of isolation is unknown in Ireland and standard guidelines are not established for the evaluation of isolation rooms. This audit tool can be used as an assessment for isolation room compliance.
Japanese surgical resource utilization in 2016.
Nakata Y, Watanabe Y, Narimatsu H … +3 more , Yoshimura T, Otake H, Sawa T
Int J Health Care Qual Assur · 2019 Jul · PMID 31282259 · Publisher ↗
PURPOSE: The purpose of this paper is to examine from the viewpoint of resource utilization the Japanese surgical payment system which was revised in April 2016. DESIGN/METHODOLOGY/APPROACH: The authors collected data fr...
PURPOSE: The purpose of this paper is to examine from the viewpoint of resource utilization the Japanese surgical payment system which was revised in April 2016. DESIGN/METHODOLOGY/APPROACH: The authors collected data from surgical records in the Teikyo University electronic medical record system from April 1 till September 30, 2016. The authors defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of medical doctors who assisted surgery, and the time of operation from skin incision to closure. An output was defined as the surgical fee. The authors calculated each surgeon's efficiency score using output-oriented Charnes-Cooper-Rhodes model of data envelopment analysis. The authors compared the efficiency scores of each surgical specialty using the Kruskal-Wallis and the Steel method. FINDINGS: The authors analyzed 2,558 surgical procedures performed by 109 surgeons. The difference in efficiency scores was significant ( = 0.000). The efficiency score of neurosurgery was significantly greater than obstetrics and gynecology, general surgery, orthopedics, emergency surgery, urology, otolaryngology and plastic surgery (<0.05). ORIGINALITY/VALUE: The authors demonstrated that the surgeons' efficiency was significantly different among their specialties. This suggests that the Japanese surgical reimbursement scales fail to reflect resource utilization despite the revision in 2016.
Leadership styles' influence on the quality of nursing care.
Alloubani A, Akhu-Zaheya L, Abdelhafiz IM … +1 more , Almatari M
Int J Health Care Qual Assur · 2019 Jul · PMID 31282258 · Publisher ↗
PURPOSE: The purpose of this paper is to investigate managers' leadership styles, from the perspective of registered nurses, and its effects on the quality of nursing care in both the private and public healthcare sector...
PURPOSE: The purpose of this paper is to investigate managers' leadership styles, from the perspective of registered nurses, and its effects on the quality of nursing care in both the private and public healthcare sectors. An additional aim is to assess the relationship between leadership styles and particular organisational outcomes. DESIGN/METHODOLOGY/APPROACH: The sample for this quantitative research study was comprised of 400 respondents, among which 50 were nurse managers, 150 were staff nurses and the remaining respondents were patients. Two questionnaires were used in this study: the multi-factor leadership questionnaire (MLQ) 5X short and a patient satisfaction with nursing care quality questionnaire (PSNCQQ). FINDINGS: A positive correlation was found between the transformational leadership style with leadership outcomes and the quality of nursing care (=0.811**, 0.759**, 0.789** and 0.877** for extra effort, job satisfaction, leader effectiveness and quality, respectively). PRACTICAL IMPLICATIONS: Although the sample study was extensive, a possible limitation is that the research utilised convenient sample who are working in the private and public healthcare sectors thus limiting the generalisability of the study. ORIGINALITY/VALUE: This study was proposed as a baseline for upcoming studies in areas of education, nursing practice, research and quality. Moreover, this study was expected to be imperative to the hospital's management, in order to improve the current level of leadership, education models and advancement programs for the healthcare sector's senior staff.
Reducing interruptions during medication preparation and administration.
Mortaro A, Pascu D, Pancheri S … +7 more , Mazzi M, Tardivo S, Bellamoli C, Ferrarese F, Poli A, Romano G, Moretti F
Int J Health Care Qual Assur · 2019 Jul · PMID 31282257 · Publisher ↗
PURPOSE: According to literature, interruptions during drug administration lead to a significant proportion of medication errors. Evidence on the effectiveness of interventions to reduce interruption is still limited. Th...
PURPOSE: According to literature, interruptions during drug administration lead to a significant proportion of medication errors. Evidence on the effectiveness of interventions to reduce interruption is still limited. The purpose of this paper is to explore main reasons for interruptions during drug administration rounds in a geriatric ward of an Italian secondary hospital and test the effectiveness of a combined intervention. DESIGN/METHODOLOGY/APPROACH: This is a pre and post-intervention observational study based on direct observation. All nurse staff (24) participated to the study that lead to observe a total of 44 drug dispensing rounds with 945 drugs administered to 491 patients in T0 and 994 drugs to 506 patients in T1. FINDINGS: A significant reduction of raw number of interruptions (mean per round from 17.31 in T0 to 9.09 in T1, <0.01), interruptions/patient rate (from 0.78 in T0 to 0.40 in T1, <0.01) and interruptions/drugs rate (from 0.44 in T0 to 0.22 in T1, <0.01) were observed. Needs for further improvements were elicited (e.g. a greater involvement of support staff). PRACTICAL IMPLICATIONS: Nurse staff should be adequately trained on the risks related to interruptions during drug administration since routine activity is at high risk of distractions due to its repetitive and skill-based nature. ORIGINALITY/VALUE: A strong involvement of both MB and leadership, together with the frontline staff, helped to raise staff motivation and guide a bottom-up approach, able to identify tailored interventions and serve concurrently as training instrument tool.
The Global call for action on infection prevention and control.
Avortri GS, Nabyonga-Orem J
Int J Health Care Qual Assur · 2019 Jul · PMID 31282256 · Publisher ↗
PURPOSE: Healthcare-associated infections (HAIs) constitute a major threat to patient safety and affect hundreds of millions of people worldwide. The World Health Organization in 2016 published guidelines on the core com...
PURPOSE: Healthcare-associated infections (HAIs) constitute a major threat to patient safety and affect hundreds of millions of people worldwide. The World Health Organization in 2016 published guidelines on the core components for infection prevention and control (IPC) programme. This was in response to a global call for focused action. The purpose of this paper is to examine and promote understanding of the tenets of the IPC guidelines and highlight their implications for implementation in low-income countries. DESIGN/METHODOLOGY/APPROACH: Drawing from personal experiences in leading the implementation of health programmes as well as a review of published and grey literature on IPC, authors discussed and proposed practical approaches to implement IPC priorities in low-income setting. FINDINGS: Availability of locally generated evidence is paramount to guide strengthening leadership and institutionalisation of IPC programmes. Preventing infections is everybody's responsibility and should be viewed as such and accorded the required attention. ORIGINALITY/VALUE: Drawing from recent experiences from disease outbreaks and given the heavy burden of HAIs especially in low-income settings, this paper highlights practical approaches to guide implementation of the major components of IPC.
Evidence based practice among healthcare providers: a cross-sectional study.
Kalavani K, Mohebbifar R, Rafiei S
Int J Health Care Qual Assur · 2019 Jun · PMID 31195935 · Publisher ↗
PURPOSE: Nowadays health systems in most of the countries are trying to build their healthcare provision system based on scientific knowledge based evidence. Evidence-based practice (EBP) is a crucial factor for quality...
PURPOSE: Nowadays health systems in most of the countries are trying to build their healthcare provision system based on scientific knowledge based evidence. Evidence-based practice (EBP) is a crucial factor for quality improvement focusing on compliance with clinical standards. The purpose of this paper is to assess evidence-based knowledge and skills among healthcare providers in Qazvin hospitals in 2016. DESIGN/METHODOLOGY/APPROACH: This was a descriptive study conducted among 300 health professionals working in hospitals affiliated by Qazvin University of Medical Sciences in 2016. A self-administered questionnaire was used to gather data on health providers' attitude, knowledge and skill regarding EBP. Descriptive statistics and multiple linear regressions were used to analyze data using SPSS 16 software. FINDINGS: A total of 254 participants (84.6 percent) completed the questionnaire in which their attitude, knowledge and skill toward EBP were assessed at a low level. Study results indicated that among different occupational groups, physicians and those with greater awareness toward EBP terminology had a more positive attitude compared with others. Furthermore, a higher level of knowledge and skill toward EBP was associated with being a physician and having a positive attitude toward the issue. PRACTICAL IMPLICATIONS: Given the importance of EBP and due to insufficient knowledge of healthcare providers about the issue, it is necessary to hold appropriate educational courses to empower health workforce in implementing EBP principles. ORIGINALITY/VALUE: The authors applied a self-administered questionnaire to assess health workforce knowledge and skills toward EBP. The results obtaining from the analysis not only highlights weaknesses related to service providers' knowledge and capabilities to implement EBP but also reveals facilities required for realization of the subject in hospital settings.
Experience-based co-design to improve a pulmonary rehabilitation programme.
Williams S, Turner AM, Beadle H
Int J Health Care Qual Assur · 2019 Jun · PMID 31195934 · Publisher ↗
PURPOSE: The purpose of this paper is to investigate patient perspectives on attending pulmonary rehabilitation (PR). This qualitative case study identifies the benefits and challenges to attending PR and presents areas...
PURPOSE: The purpose of this paper is to investigate patient perspectives on attending pulmonary rehabilitation (PR). This qualitative case study identifies the benefits and challenges to attending PR and presents areas of improvements as recommended by patients. DESIGN/METHODOLOGY/APPROACH: A qualitative case study of a UK case study based on a PR programme based on undertaking focus groups (=3) and interviews (=15) with current and former patients. FINDINGS: The findings report patient perspectives of the challenges and benefits of attending a PR programme along with recommendations on how the service could be improved. RESEARCH LIMITATIONS/IMPLICATIONS: The authors focussed solely on a UK PR programme, so the findings might not be applicable to other countries if PR is organised and provided in a unique way or setting. PRACTICAL IMPLICATIONS: This paper provides valuable insights to patient perspectives offrom patients attending PR programmes, which are useful to those running and designing these services. ORIGINALITY/VALUE: The findings identify the benefits and challenges for patients attending PR programmes and suggest areas where improvements can be made.
Gynecology healthcare professionals towards safety procedures in operation rooms aiming to enhanced quality of medical services in Greece.
Dinas K, Vavoulidis E, Pratilas GC … +8 more , Chatzistamatiou K, Basonidis A, Sotiriadis A, Zepiridis L, Pantazis K, Tziomalos K, Aletras V, Tsiotras G
Int J Health Care Qual Assur · 2019 Jun · PMID 31195933 · Publisher ↗
PURPOSE: The purpose of this paper is to investigate the attitudes of healthcare professionals in Greece toward safety practices in gynecological Operation Rooms (ORs). DESIGN/METHODOLOGY/APPROACH: An anonymous self-admi...
PURPOSE: The purpose of this paper is to investigate the attitudes of healthcare professionals in Greece toward safety practices in gynecological Operation Rooms (ORs). DESIGN/METHODOLOGY/APPROACH: An anonymous self-administered questionnaire was distributed to surgical personnel asking for opinions on safety practices during vaginal deliveries (VDs) and gynecological operations (e.g. sponge/suture counting, counting documentation, etc.). The study took place in Hippokration Hospital of Thessaloniki including 227 participants. The team assessed and statistically analyzed the questionnaires. FINDINGS: Attitude toward surgical counts and counting documentation, awareness of existence and/or implementation in their workplace of other surgical safety objectives (e.g. WHO safety control list) was assessed. In total, 85.2 percent considered that surgical counting after VDs is essential and 84.9 percent admitted doing so, while far less reported counting documentation as a common practice in their workplace and admitted doing so themselves (50.5/63.3 percent). Furthermore, while 86.5 percent considered a documented protocol as necessary, only 53.9 percent admitted its implementation in their workplace. Remarkably, 53.1 percent were unaware of the WHO safety control list for gynecological surgeries. ORIGINALITY/VALUE: Most Greek healthcare professionals are well aware of the significance of surgical counting and counting documentation in gynecology ORs. However, specific tasks and assignments are unclear to them. Greek healthcare professionals consider surgical safety measures as important but there is a critical gap in knowledge when it comes to responsibilities and standardized processes during implementation. More effective implementation and increased personnel awareness of the surgical safety protocols and international guidelines are necessary for enhanced quality of surgical safety in Greece.
The legal, governance and ethical implications of involving service users and carers in research.
Minogue V, Cooke M, Donskoy AL … +1 more , Vicary P
Int J Health Care Qual Assur · 2019 Jun · PMID 31195932 · Publisher ↗
PURPOSE: Service user and carer involvement in all aspects of the health and care research process, from co-applicant on funding applications to active engagement in a research study, is now a requirement for most resear...
PURPOSE: Service user and carer involvement in all aspects of the health and care research process, from co-applicant on funding applications to active engagement in a research study, is now a requirement for most research funders. However, as co-production increases and service users and carers take on more responsibilities, this involvement has legal, governance and ethical implications. The purpose of this paper is to raise awareness of the issues and consider potential solutions. DESIGN/METHODOLOGY/APPROACH: Experiences of engagement as co-applicants in research funding applications, of involvement as research study team members, and as co-researchers were gathered from a range of service user and carer experts. Consultation and a workshop gathered further evidence from a range of stakeholders across the research management community. FINDINGS: Service users and carers, who contribute to the research protocol and process, feel a strong sense of responsibility to ensure the high quality of a research study. However, they may be new to their roles, status and key responsibilities when acting as project team members, co-researchers or co-applicants engaging in funding applications. The responsibility of sponsors, grant holding organisations, funders and other members of the research community is to communicate with and support service users and carers in those roles. More needs to be done to understand the contractual, a legal and governance issues and responsibilities that are specific to service user and carer co-applicants, project team members and co-researchers, from both an organisational and individual service user and carer perspective. PRACTICAL IMPLICATIONS: The implications of the findings are to raise awareness of the practical, legal and ethical issues arising from this type of involvement and the potential risks arising from lack of cohesion or understanding. The review also highlights the concerns and barriers service users and carers may find in becoming involved. ORIGINALITY/VALUE: The findings highlight a range of issues for research regulators, sponsors and investigators to consider to ensure service users and carers can fulfil their responsibilities and be supported in doing so.
Enhancing organizational health literacy in a rural Missouri clinic: a qualitative case study.
Wray R, Weaver N, Adsul P … +7 more , Gautam K, Jupka K, Zellin S, Goggins K, Vijaykumar S, Hansen N, Rudd R
Int J Health Care Qual Assur · 2019 Jun · PMID 31195931 · Publisher ↗
PURPOSE: The purpose of this paper is to evaluate a collaborative effort between a health care organization and academic institution to strengthen organizational health literacy. DESIGN/METHODOLOGY/APPROACH: The interven...
PURPOSE: The purpose of this paper is to evaluate a collaborative effort between a health care organization and academic institution to strengthen organizational health literacy. DESIGN/METHODOLOGY/APPROACH: The intervention took place at a rural, federally qualified health clinic in Missouri between May 2009 and April 2011. Qualitative interviews of key informants were conducted before (=35) and after (=23) the intervention to examine program implementation and success in effecting organizational change. FINDINGS: Intervention activities helped establish a comprehensive understanding of health literacy. The project achieved moderate, fundamental and sustainable organizational change. The program successfully integrated health literacy practices into clinic systems and garnered leadership and organizational commitment, helped the workforce improve interpersonal communication and embedded practices making health education materials more accessible. ORIGINALITY/VALUE: The study points to programmatic, conceptual and methodological challenges that must be addressed for organizations to improve health literacy practices, and suggests change management strategies to advance organizational health literacy.
Appreciative enquiry peer review improving quality of services.
Burbach FR, Amani SK
Int J Health Care Qual Assur · 2019 Jun · PMID 31195930 · Publisher ↗
PURPOSE: Mental health service improvement initiatives often involve the setting of targets and monitoring of performance. The purpose of this paper is to describe the application of appreciative enquiry (AE), a radicall...
PURPOSE: Mental health service improvement initiatives often involve the setting of targets and monitoring of performance. The purpose of this paper is to describe the application of appreciative enquiry (AE), a radically different but complementary approach to quality assurance and improvement, to specialist mental health services across a health region. DESIGN/METHODOLOGY/APPROACH: This case study describes a regional quality improvement (QI) project involving 12 early intervention in psychosis (EIP) services in South West England. In total, 40 people were trained in AE interviewing skills and in non-reciprocal peer review visits 59 interviews were conducted involving 103 interviewees including service users, carers, clinicians, managers and commissioners. Immediate verbal feedback was provided and main themes summarised in individual reports to host teams using the following headings: team values, strengths, dreams and development plans. A thematic analysis was conducted on team reports and a project report produced which summarised the stages and results of this regional initiative. FINDINGS: All participants rated the experience as positive; it enhanced staff motivation and led to service development and improvement. RESEARCH LIMITATIONS/IMPLICATIONS: The experiences of these 12 EIP teams may not necessarily be generalisable to other services/regions but this positive approach to service improvement could be widely applied. PRACTICAL IMPLICATIONS: AE is applicable in large-scale QI initiatives. ORIGINALITY/VALUE: To the authors knowledge this is the first time that AE has been applied to large-scale mental health service improvement and innovation.
Structural empowerment and nurses' patient identification behaviors: a cross-sectional study.
Kim YM, Kim SY
Int J Health Care Qual Assur · 2019 Jun · PMID 31195929 · Publisher ↗
PURPOSE: The purpose of this paper is to identify the relationships between structural empowerment and patient identification behaviors of nurses. DESIGN/METHODOLOGY/APPROACH: The present study was a descriptive survey u...
PURPOSE: The purpose of this paper is to identify the relationships between structural empowerment and patient identification behaviors of nurses. DESIGN/METHODOLOGY/APPROACH: The present study was a descriptive survey using a self-reported questionnaire, following a quality improvement project at a hospital in South Korea. The participants included 984 registered nurses, who administer medication and transfusions to patients in the hospital. Data were analyzed using the -test, ANOVA, Scheffé's test, Pearson correlation coefficients and multiple regression analysis. FINDINGS: The patient identification behaviors of nurses were significantly correlated with opportunity, support, information, resources, formal power and informal power of structural empowerment. The support, information and informal power of structural empowerment, as well as the age and gender of the participants explained 10.7 percent of the variance in the patient identification behaviors of nurses. RESEARCH LIMITATIONS/IMPLICATIONS: The present study has some limitations. Although the data collected by the cross-sectional survey were analyzed, causal analysis could not have been conducted. Nursing managers can promote safety by creating a work environment that facilitates access to the support, information and resources needed for nurses to perform their duties effectively; providing opportunities for nurses to learn and develop professionally; acknowledging the achievements of nurses; and expanding their duties, so that nurses can demonstrate greater work flexibility. Future studies should investigate structural empowerment in multiple nursing organizations, and particularly the organizational characteristics that affect structural empowerment. ORIGINALITY/VALUE: The present study confirms that structural empowerment influences the patient identification behaviors of nurses.
An exploration of how domains of quality of care relate to overall care experience.
Shepherd AJ, Cowie J, Beattie M
Int J Health Care Qual Assur · 2019 Jun · PMID 31195928 · Publisher ↗
PURPOSE: The purpose of this paper is to determine the relative influence of the different domains of healthcare quality from the Care Experience Feedback Improvement Tool (CEFIT) and identify key predictors of healthcar...
PURPOSE: The purpose of this paper is to determine the relative influence of the different domains of healthcare quality from the Care Experience Feedback Improvement Tool (CEFIT) and identify key predictors of healthcare quality from the patients' perspective. Measurement is necessary to determine whether the quality of healthcare is improving. The CEFIT was developed as a brief measure of patient experience. It is important to determine the relative influence of the different domains of healthcare quality to further clarify how the CEFIT can be used and identify key predictors of healthcare quality from the patients' perspective. DESIGN/METHODOLOGY/APPROACH: In sum, 802 people with a healthcare experience during the previous 12 months were telephoned to complete the CEFIT questions and an additional 11-point global rating of patient experience. To estimate the influence of different domains of healthcare quality on patient overall ratings of quality of healthcare experience, the authors regressed the overall rating of patient experience with each component of quality (safety, effectiveness, timely, caring, enables system navigation and person-centred). FINDINGS: The authors found that all of the domains of the CEFIT influenced patient experience ratings of healthcare quality. Specifically, results show the degree of influence, the impact of demographics and how high scores for overall rating of patient experience can be predicted. ORIGINALITY/VALUE: The findings suggest that all of the CEFIT domains are important in terms of capturing the wholeness of the patient experience of healthcare quality to direct local quality improvement.
Patients' perspective of a dedicated biologic clinic for inflammatory arthritis.
Cefai E, Balzan D, Mercieca C … +1 more , Borg A
Int J Health Care Qual Assur · 2019 Jun · PMID 31195927 · Publisher ↗
PURPOSE: The purpose of this paper is to assess the patient's perspective on a dedicated clinic set up for patients diagnosed with an inflammatory arthritis who are being treated with a biologic. It proposes that dedicat...
PURPOSE: The purpose of this paper is to assess the patient's perspective on a dedicated clinic set up for patients diagnosed with an inflammatory arthritis who are being treated with a biologic. It proposes that dedicated clinics offer better overall care. The aim of this quality improvement survey is to evaluate the level of patient satisfaction with this clinic and identify any unmet needs. DESIGN/METHODOLOGY/APPROACH: This study was based on a quality improvement survey, which was developed using Zineldin's five qualities model and assessed various aspects pertaining to service quality and improvement. A structured interview approach was used and 44 consecutive patients were recruited. FINDINGS: This paper explores key aspects that influence patient satisfaction within a rheumatology outpatient setting such as education on arthritis and biologics and involvement in decision making. It provides insight on what patients value most and it also addresses organizational aspects that can have an impact on patient satisfaction. It suggests that service quality can be linked to the degree of patient satisfaction. RESEARCH LIMITATIONS/IMPLICATIONS: Direct interviewing of patients could have introduced a source of bias whilst questions are being answered. On the other hand, it provided an opportunity to clarify instantly any doubts and therefore avoiding any inadvertent errors. PRACTICAL IMPLICATIONS: This paper reinforces that specialized clinics enable the caring rheumatologist to provide better care for patients on biologics. Service providers should continue developing their services around the patient's needs and perspectives in order to continue improving the service. SOCIAL IMPLICATIONS: Dedicated biologic clinics allow more judicious monitoring of patients who are taking these highly efficacious but costly medications. ORIGINALITY/VALUE: This survey has reinforced that patients highly value dedicated clinics. These results strengthen the case that healthcare services should continue investing on specialized clinics.
Business process improvement methods in healthcare: a comparative study.
Ahmed ES, Ahmad MN, Othman SH
Int J Health Care Qual Assur · 2019 Jun · PMID 31195926 · Publisher ↗
PURPOSE: According to the literature concerned with this study, less than satisfactory outcomes have been achieved through implementing business process improvements methods (BPIMs) in industries, in general, and in heal...
PURPOSE: According to the literature concerned with this study, less than satisfactory outcomes have been achieved through implementing business process improvements methods (BPIMs) in industries, in general, and in healthcare, in particular. The existing methods used need to be enhanced in order to create more effective outcomes. There has also been a lack of studies documenting gaps or shortfalls in implementing BPIMs, to be presented to the BPI research community. Therefore, researchers of this paper have attempted to fill gaps between theory and practice. On the contrary, there is also a need to link practical outcomes in the healthcare domain with those of the BPI research community. The purpose of this paper is to review popular BPIMs, techniques and tools applied in the healthcare domain; it seeks to examine and highlight their significant roles, clarify their pros and cons, and find opportunities to enhance their impact on the achievement of more sustainable improvements in the healthcare domain. DESIGN/METHODOLOGY/APPROACH: This study has been carried out by using a methodology combining an in-depth literature review with a comparison framework, which is called as the "Framework for Comparing Business Process Improvement Methods." The framework is composed of seven dimensions and has been adapted from four recognized, related frameworks. In addition to the in-depth review of related literature and the adapted comparison framework, researchers have conducted several interviews with healthcare BPI practitioners in different hospitals, to attain their opinions of BPI methods and tools used in their practices. FINDINGS: The main results have indicated that significant improvements have been achieved by implementing BPIMs in the healthcare domain according to related literature. However, there were some shortfalls in the existing methods that need to be resolved. The most important of these has been the shortfall in representing and analyzing targeted domain knowledge during improvement phases. The tool currently used for representing the domain, specifically flowcharts, is very abstract and does not present the domain in a clear form. The flowchart tool also fails to clearly present the separation of concerns between business processes and the information systems processes that support a business in a given domain. PRACTICAL IMPLICATIONS: The findings of this study can be useful for BPI practitioners and researchers, mainly within the healthcare domain. The findings can help these groups to understand BPIMs shortfalls and encourage them to consider how BPIMs can be potentially improved. ORIGINALITY/VALUE: This researchers of this paper have proposed a comparison framework for highlighting popular BPIMs in the healthcare domain, along with their uses and shortfalls. In addition, they have conducted a deep literature review based on the practical results obtained from different healthcare institutions implementing unique BPIMs around the world. There has also been valuable interview feedback attained from BPI leaders of specific hospitals in Saudi Arabia. This combination is expected to contribute to knowledge of BPIMs from both theoretical and practical points of view.
Care living labs' effect on care organization and quality of working life.
Vereycken AY, De Kort L, Vanhootegem G … +1 more , Dessers E
Int J Health Care Qual Assur · 2019 May · PMID 31111786 · Publisher ↗
PURPOSE: There is a growing interest in living labs (a research concept in which innovations are co-created with end-users and tested in practice) as a method to test and develop health and social care innovations. Howev...
PURPOSE: There is a growing interest in living labs (a research concept in which innovations are co-created with end-users and tested in practice) as a method to test and develop health and social care innovations. However, little is known about their effect on the care organization and care providers' quality of working life. By using the Flanders Care Living Labs program (Belgium) as a case study, the purpose of this paper is to explore how innovations in a living lab context may affect those issues. DESIGN/METHODOLOGY/APPROACH: This qualitative study combined data from document analysis, in-depth interviews and focus groups involving 23 care innovation projects. Deductive category application was used for analyzing data. FINDINGS: Outcomes indicate that 22/23 care innovation projects resulted in organizational changes, and that 22 affected at least one care provider's quality of working life. Surprisingly, no project deliberately intended to affect the care organization and quality of working life. Future care innovation projects should focus on actual innovation and its implications for specific end-users, and on the broader organizational consequences and the possible effect on the care providers' work. ORIGINALITY/VALUE: This is the first study that specifically focused on care innovation's effect on the care organization and on the quality of working life within a living labs context.
Can Bahraini patients accept e-health systems?
Zolait A, Radhi N, Alhowaishi MM … +2 more , Sundram VPK, Aldoseri LM
Int J Health Care Qual Assur · 2019 May · PMID 31111785 · Publisher ↗
PURPOSE: The purpose of this paper is to examine whether Bahraini individuals accept e-health system and the prominent factors affecting e-health system adoption in Bahrain. DESIGN/METHODOLOGY/APPROACH: The authors adopt...
PURPOSE: The purpose of this paper is to examine whether Bahraini individuals accept e-health system and the prominent factors affecting e-health system adoption in Bahrain. DESIGN/METHODOLOGY/APPROACH: The authors adopted a quantitative and qualitative approach, i.e., a self-administered questionnaire, unstructured and a semi-structured interview, which were used to collect the data. A questionnaire was distributed to Bahraini residents selected randomly. The framework was based on the technology acceptance model (TAM) and theory of reasoned action (TRA). Important variables from both the TAM model and TRA theory were extracted and jointly used to build the research model. FINDINGS: The findings indicated that the most factors affecting e-health adoption are trust, health literacy and attitude. Additionally, people in the private and government sectors understand e-health benefits. PRACTICAL IMPLICATIONS: If healthcare professionals understand the factors affecting e-health system adoption from an individual and organisational perspective, then nurses, pharmacists and others will be more conscious about e-health and its adoption status. ORIGINALITY/VALUE: E-health system adoption has become increasingly important to governments, individuals, and researchers in recent years. A novel research framework, based on TAM and TRA, was used to produce a new integrated model.
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