Sui Pheng, Low
This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...
It has become essential for hospital managers to understand and measure consumer perspectives and service quality gaps, so that any perceived gap in delivery of service is identified and suitably addressed. A study was conducted at a peripheral service hospital to ascertain any service gap between consumer expectations and perceptions in respect of the hospital outpatient department (OPD) services. A cross-sectional study was conducted using SERVQUAL as the survey instrument, the instrument being validated for use in the hospital environment. Consumer ratings across 22 items of the survey instrument were collected in paired expectation and perception scores and then service quality gaps were identified and statistically analysed. Service quality gaps were identified to exist across all the five dimensions of the survey instrument, with statistically significant gaps across the dimensions of 'tangibles' and 'responsiveness.' The quality gaps were further validated by a total unweighted SERVQUAL score of (-) 1.63. The study concludes that significant service quality gaps existed in the delivery of the hospital OPD services, which need to be addressed by focused improvement efforts by the hospital management.
Self, Donald R; Hegji, Charles E; Self, Robin M
In this analysis, we study the relationship between hospital quality and hospital profits for a sample of 88 Alabama (USA) hospitals. Quality is measured by three groups of procedures performed on newly admitted patients as suggested by the Center for Medicare and Medicaid Services and the Health Quality Alliance (HQA) as well as a weighted quality measure. Profit is measured for eight hospital services. Profits from cardiac care were most responsive to the quality measures studied. Moreover, profits from six of the inpatient services increased as the weighted quality measure increased. Finally, in two cases quality increased with the relative number of employees a hospital utilized.
Quality of pharmaceutical services can be measured at the levels of the structure, process and outcome. Although quality assessments of pharmaceutical services are common in many parts of the world, there is limited information on the quality of hospital pharmacy services in Ethiopia. This study attempted to assess the ...
Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad
Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.
Zarei, Ehsan; Daneshkohan, Abbas; Khabiri, Roghayeh; Arab, Mohammad
The trust is meant the belief of the patient to the practitioner or the hospital based on the concept that the care provider seeks the best for the patient and will provide the suitable care and treatment for him/her. One of the main determinants of patient's trust is the service quality. This study aimed to examine the effect of quality of services provided in private hospitals on the patient's trust. In this descriptive cross-sectional study, 969 patients were selected using the consecutive method from eight private general hospitals of Tehran, Iran, in 2010. Data were collected through a questionnaire containing 20 items (14 items for quality, 6 items for trust) and its validity and reliability were confirmed. Data were analyzed using descriptive statistics and multivariate regression. The mean score of patients' perception of trust was 3.80 and 4.01 for service quality. Approximately 38% of the variance in patient trust was explained by service quality dimensions. Quality of interaction and process (P quality of the environment had no significant effect on the patients' degree of trust. The interaction quality and process quality were the key determinants of patient's trust in the private hospitals of Tehran. To enhance the patients' trust, quality improvement efforts should focus on service delivery aspects such as scheduling, timely and accurate doing of the service, and strengthening the interpersonal aspects of care and communication skills of doctors, nurses and staff.
Pai, Yogesh P; Chary, Satyanarayana T
Purpose - Although measuring healthcare service quality is not a new phenomenon, the instruments used to measure are timeworn. With the shift in focus to patient centric processes in hospitals and recognizing healthcare to be different compared to other services, service quality measurement needs to be tuned specifically to healthcare. The purpose of this paper is to design a conceptual framework for measuring patient perceived hospital service quality (HSQ), based on existing service quality literature. Design/methodology/approach - Using HSQ theories, expanding existing healthcare service models and literature, a conceptual framework is proposed to measure HSQ. The paper outlines patient perceived service quality dimensions. Findings - An instrument for measuring HSQ dimensions is developed and compared with other service quality measuring instruments. The latest dimensions are in line with previous studies, but a relationship dimension is added. Practical implications - The framework empowers managers to assess healthcare quality in corporate, public and teaching hospitals. Originality/value - The paper helps academics and practitioners to assess HSQ from a patient perspective.
Full Text Available Abstract Background Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. Methods A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. Results The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2 and 4.02(SD = 0.6, respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p Conclusion The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.
Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee
The present study explored nurses' and patients' expectations of nursing service quality, their perception of performance of nursing service quality performed by nurses, and compared nursing service quality, as perceived by nurses and patients. The sample consisted of 162 nurses and 383 patients from 11 inpatient wards/units in a tertiary care hospital in the Maldives. Data were collected using the Service Quality scale, and analyzed using descriptive statistics and the Mann-Whitney U-test. The results indicated that the highest expected dimension and perceived dimension for nursing service quality was Reliability. The Responsiveness dimension was the least expected dimension and the lowest performing dimension for nursing service quality as perceived by nurses and patients. There was a statistically significant difference between nursing service quality perceived by nurses and patients. The study results could be used by nurse administrators to develop strategies for improving nursing service quality so that nursing service delivery process can be formulated in such a way as to reduce differences of perception between nurses and patients regarding nursing service quality. © 2011 Blackwell Publishing Asia Pty Ltd.
Zarei, Asghar; Arab, Mohammad; Froushani, Abbas Rahimi; Rashidian, Arash; Ghazi Tabatabaei, S Mahmoud
Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2) and 4.02(SD = 0.6), respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p education level, and previous hospitalization in that same hospital. Also, there was a significant difference between the perception scores based on insurance coverage, average length of stay, and patients' health conditions on discharge. The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.
Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.
Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki
The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. We defined social media-based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media-based key quality factors for hospitals. To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and
De Giusti, Maria; Tufi, Daniela; Tassoni, Alessandra; Del Cimmuto, Angela; Villari, Paolo
The aim of this study was to evaluate the effectiveness of the hospital food service of the Azienda in preserving microbiological quality and temperature of cooked foods during the distribution to the different wards of the hospital. During three years, microbiological parameters and temperatures were monitored in the central kitchen before distribution (T0), in the first (T1) and in the last ward (T2) of the distribution route during a three-year period for a total of 337 analytical determinations. Temperature values before distribution improved during the study period, whereas the capacity of keeping adequate temperature values during the distribution decreased over time, in spite of the introduction of a new technology after the first year of the study. No significant deteriorations of the microbiological quality of the cooked foods were detected. The results of the study clearly indicate that an integrated approach involving new technology, work organization and personnel training is needed in preserving food quality in hospitals.
Lubis, Arlina Nurbaity; Lumbanraja, Prihatin; Lubis, Rahmawaty; Hasibuan, Beby Kendida
Service sector increases rapidly especially in Indonesia. This can be seen from the distribution of the percentage of Product Domestic Bruto (PDB) based on job vacancy showing that the service sector contribution approaches 50%. One of the service/care industries with rapid growth is healthcare service. It can be seen from the government plan year 2015-2016 to do healthcare reinforcement. Generally, healthcare is identically related to hospital. A hospital is a professional healthcare institu...
rate and hence meeting patient satisfaction improves the utilization of health services. Methodology. In Harari region there are two secondary (Zonal) hospitals under the Regional Health Bureau, which act as major referral hospitals for the whole of the eastern part of Ethiopia. A cross-sectional survey was conducted in.
Wisniewski, Mik; Wisniewski, Hazel
The issues surrounding the measurement and provision of service quality in a health care setting are becoming increasingly important to nursing. This research study aims to apply the SERVQUAL measurement instrument in a Scottish colposcopy clinic. The study involved adapting the SERVQUAL instrument to the colposcopy setting and asking a sample of patients to complete the questionnaire. Patient expectations of service were obtained on first attendance at the clinic. Patient perceptions of service received were obtained on completion of treatment. Perceptions and expectations are then compared to identify where the largest service gaps exist. Although patient satisfaction with the overall service provided was generally high, the instrument provided evidence of where specific service improvements were needed. The largest service quality gap was for the reliability of service. The research also revealed the need for improved premises. Although the study has a limited sample size, it does appear that the SERVQUAL instrument has a useful diagnostic role to play in assessing and monitoring service quality in nursing, enabling nursing staff to identify where improvements are needed from the patients' perspective. The study has raised a number of issues which would form the basis for useful further research. Service quality from the patients' perspective should be routinely monitored and assessed. The findings should be useful to nursing staff seeking to assess, and improve, service quality.
Arab, M; Tabatabaei, Sm Ghazi; Rashidian, A; Forushani, A Rahimi; Zarei, E
Service quality is perceived as an important factor for developing patient's loyalty. The aim of this study was to determine the hospital service quality from the patients' viewpoints and the relative importance of quality dimensions in predicting the patient's loyalty. A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 items about the service quality and 3 items about the patient's loyalty. Exploratory factor analysis was employed to extracting the dimensions of service quality. Also, regression analysis was performed to determining the relative importance of the service quality dimensions in predicting the patient's loyalty. The mean score of service quality and patient's loyalty was 3.99 and 4.16 out of 5, respectively. About 29% of the loyalty variance was explained by the service quality dimensions. Four quality dimensions (Costing, Process Quality, Interaction Quality and Environment Quality) were found to be key determinants of the patient's loyalty in the private hospitals of Tehran. The patients' experience in relation to the private hospitals' services has strong impact on the outcome variables like willingness to return to the same hospital and reuse its services or recommend them to others. The relationship between the service quality and patient's loyalty proves the strategic importance of improving the service quality for dragging and retaining patients and expanding the market share.
Banks, Merrilyn; Hannan-Jones, Mary; Ross, Lynda; Buckley, Ann; Ellick, Jennifer; Young, Adrienne
To develop and test the reliability of a Meal Quality Audit Tool (MQAT) to audit the quality of hospital meals to assist food service managers and dietitians in identifying areas for improvement. The MQAT was developed using expert opinion and was modified over time with extensive use and feedback. A phased approach was used to assess content validity and test reliability: (i) trial with 60 dietetic students, (ii) trial with 12 food service dietitians in practice and (iii) interrater reliability study. Phases 1 and 2 confirmed content validity and informed minor revision of scoring, language and formatting of the MQAT. To assess reliability of the final MQAT, eight separate meal quality audits of five identical meals were conducted over several weeks in the hospital setting. Each audit comprised an 'expert' team and four 'test' teams (dietitians, food services and ward staff). Interrater reliability was determined using intra-class correlation analysis. There was statistically significant interrater reliability for dimensions of Temperature and Accuracy (P food service-led teams scoring higher on these dimensions. 'Test' teams reported that MQAT was clear and easy to use. MQAT was found to be reliable for Temperature and Accuracy domains, with further work required to improve the reliability of the Appearance and Sensory dimensions. The systematic use of the tool, used in conjunction with patient satisfaction, could provide pertinent and useful information regarding the quality of food services and areas for improvement. © 2017 Dietitians Association of Australia.
Full Text Available This is an explanatory research, analyzing the hospital image as a moderating variable on the effect of hospital service quality on customer perceived value and trust. Research was conducted at several hospitals in Surabaya Indonesia, especially to outpatients. Data was collected by survey to the outpatients of the hospitals. The purpose of this research was empirically examining the effects of hospital service quality on customer perceived value and customer trust, examine effects of customer perceived value and customer trust on customer loyalty. Moreover This research also examined the variable of hospital image as a moderating variable in the effects of hospital service quality on customer perceived value and customer trust. The result of this research gave a perspective to hospital management about the importance of building patient trust, since trust is very important, even more important than satisfaction level. Further studies with more emphasis on identifying the factors building patient trust to the hospital in order to raise customer loyalty should be conducted.
Health care delivery has become one of the fundamental issues being given attention by governments of most developing countries. The Objective of this study therefore is to examine how Customer Relationship Management can be employed to bring about improve health service quality in Nigeria. The data for the study ...
İbrahim H. Kayral
Full Text Available The purpose of healthcare services is to protect and improve individuals’ physical, mental and social health and ensure its continuity to increase the level of welfare and happiness in the society. As in all service organizations, service quality has an important place in healthcare organizations. Therefore, measuring the impacts of the efforts made by enterprises for service quality and the clients’ perceptions of the services provided, assessing how their perceptions differ in different dimensions of quality, and taking new measures according to the results are the key to continuous improvement. In this study, with respect to the abovementioned issues, perception of the quality of services provided in the field of health by those who receive them is compared according to different types of hospitals providing such service, and evaluations are made accordingly. Thus, whether patients’ perceptions of service quality differ according to hospital types, in what dimensions of quality these differences occur and perceived quality by different patient profiles like age, sex, incomes etc. are assessed. In the measurement of service quality, a set of 34 questions with six dimensions was used, which was used by Kara, Tarım and Zaim (2003 in several hospitals and then used in several research studies in Turkey on service quality in healthcare enterprises (Çaha, 2007; Kara, 2006. Based on the findings of the research, it can be said that public general branch hospitals are perceived as quality at the same level with private hospitals and even they reach higher levels of patient satisfaction. On the other hand, when the sub-dimensions of quality are examined, it is seen that public hospitals are still behind private hospitals in terms of physical quality.
Torun, Nazan; Celik, Yusuf; Younis, Mustafa Z
The level of competition among hospitals in Turkey was analyzed for the years 1990 through 2006 using the Herfindahl-Hirschman Index (HHI). Multiple and simple regression analyses were run to observe the development of competition among hospitals over this period of time, to examine likely determinants of competition, and to calculate the effects of competition on efficiency and quality in individual hospitals. This study found that the level of competition among hospitals in Turkey has increased throughout the years. Also, competition has had a positive effect on the efficiency of hospitals; however, it did not have a significant positive effect on their quality. Moreover, there are important differences in the level of competition among hospitals that vary according to the geographical region, the type of ownership, and the type of hospital. This study is one of the first to evaluate the effects of health policies on competition as well as the effects of increasing competition on hospital quality and efficiency in Turkey.
Full Text Available Purpose: The aims of this study are twofold: first, it attempts to investigate service attributes in a hospital front office; and second, to identify strategies to improve those service attributes. Design/methodology/approach: This study used integration of Quality Function Deployment and Kano Model. The research instrument, which takes the SERVQUAL model as its starting point, was developed using a comprehensive set of techniques, including a literature review of relevant topics, interviews and focus group discussions. Using a sample of 140 customers of an international hospital situated in Yogyakarta, Indonesia, 14 service attributes required by customers were identified. The attributes, which were further categorised into 5 attractive, 4 one-dimensional and 5 ‘must-be’ attributes, were analysed using the Kano Model. Findings: Using the integrated QFD and Kano Model, the service attributes needed for improvement were identified. The results are different from those when the company used either SERVQUAL or QFD alone. This study also reveals that benchmarking with competitor might produce misleading results. The results are different when the analysis combined a comprehensive method of QFD and Kano Model. Practical implications: Service providers will benefit from the findings of this study, as both the service attributes and technical requirements that require improvement as a priority are identified. Originality/value: It is the first time that front office quality of hospital is examined using integrated method of SERVQUAL, QFD and Kano Model. The recommendations proposed from this comprehensive method offer novel solution that has never been found in existing study.
Kim, Jinkyung; Han, Woosok
To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents' and organizational characteristics. The most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality. The findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employeeperceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in longterm care hospitals and designing more comprehensive national evaluation criteria.
Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad
Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. This cross-sectional study was conducted in the year 2010. The study's sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers.
Full Text Available Consumer’s perceptions about the health care services play an important role when choosing a hospital. The quality of service is crucial to both the outpatients and the service providers. The dimensions of the service quality are reliability, responsiveness, assurance, empathy, and tangibles. Customer’s expectations and experiences vary with services. When there is a shortfall between expectation of service level and perception of actual service delivery, it is called customer gap. The causes of customer gap include; not knowing what customers expect, not selecting the right service designs and standards, not delivering to service standards and not matching performance to promises. This paper focuses on the level of service quality rendered by SRM’s hospital, the patient-physicians’ relationship and to examine the pre and post service of outpatients in the SRM’s hospital. A structured questionnaires and interviews were constructed to provide answers to the research questions using a sample size of 50 [employees and outpatients]. It was found out that some outpatients were satisfied with the services rendered by the hospital with reservations for more improvement. It was also found out that, there were gaps between the outpatients’ expectation and perception about the service rendered by the hospital. It was recommended that a competent marketing executive should be employed since marketing is the voice of the healthcare industry.
Arasli, Huseyin; Ekiz, Erdogan Haktan; Katircioglu, Salih Turan
The purpose of this research is to develop and compare some determinants of service quality in both the public and private hospitals of Northern Cyprus. There is considerable lack of literature with respect to service quality in public and private hospitals. Randomly, 454 respondents, who have recently benefited from hospital services in Famagusta, were selected to answer a modified version of the SERVQUAL Instrument. The instrument contained both service expectations and perceptions questions. This study identifies six factors regarding the service quality as perceived in both public and private Northern Cyprus hospitals. These are: empathy, giving priority to the inpatients needs, relationships between staff and patients, professionalism of staff, food and the physical environment. Research results revealed that the various expectations of inpatients have not been met in either the public or the private hospitals At the micro level, the lack of management commitment to service quality in both hospital settings leads doctors and nurses to expend less effort increasing or improving inpatient satisfaction. Hospital managers should also satisfy their employees, since job satisfaction leads to customer satisfaction and loyalty. Additionally, hospital administrations need to gather systematic feedback from their inpatients, establish visible and transparent complaint procedures so that inpatients' complaints can be addressed effectively and efficiently. The hospitals need to organize training sessions based on the critical importance of service quality and the crucial role of inpatient satisfaction in the health care industry. Future studies should include the remaining regions in Cyprus in order to increase research findings' generalizability. Additionally, including other dimensions such as hospital processes and discharge management and co-ordination may provide further insights into understanding inpatients' perceptions and intentions.
Franzin-Garrec, Martine; Hoden, Romy
Hospital at home structures are healthcare institutions in their own right, with the same obligations in terms of governance with regard to quality of care and risk management. However, hospital at home services are characterised by the remote management of the activity and the nursing staff, with specific constraints. Copyright © 2016. Published by Elsevier Masson SAS.
De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro
Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.
Background Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. Methods This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Results Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. Conclusion According to the results, this hospital was not able to meet patients’ expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients. PMID:25064475
Aghamolaei, Teamur; Eftekhaari, Tasnim Eghbal; Rafati, Shideh; Kahnouji, Kobra; Ahangari, Shamsieh; Shahrzad, Mohammad Esmaeil; Kahnouji, Ataollah; Hoseini, Seyedeh Hamideh
Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. According to the results, this hospital was not able to meet patients' expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients.
Al-Borie, Hussein M; Damanhouri, Amal M Sheikh
Saudi Arabian hospital performance, vis-á-vis patient satisfaction with service provision, has emerged as a key policy and planning concern. Keeping in view public and private hospital service quality, this article seeks to provide guidelines to the on-going Saudi Arabian health service reorganization, which emphasizes decentralization, bed-capacity expansion, research-based policymaking and initiatives in the health insurance sector. The article outlines an empirical study that compares patient satisfaction with service quality in Saudi Arabian public and private sector hospitals. The authors employ a stratified random sample (1,000 inpatients) from five Saudi Arabian public and five private hospitals. Data were collected through questionnaire using the SERVQUAL scale. For reducing the language bias the questionnaire was translated into Arabic. The response rate was 74.9 percent. Data were analyzed using SPSS and appropriate descriptive and inferential statistical techniques. Cronbach's alpha for five service-quality dimensions (tangibles, reliability, responsiveness, safety and empathy) were high and the SERVQUAL instrument proved to be reliable, valid and appropriate. The results showed that sex, education, income and occupation were statistically significant in influencing inpatients' satisfaction, and all the null hypotheses were rejected. Only inpatient age was not significant. The study highlights service quality influence in the design of broader healthcare strategies for Saudi Arabian public and private hospitals. It demands that management researchers and analysts must identify regional service quality consistencies and related inpatient demographic indicators. The study offers some insights into, and guidance for, hospital quality assurance in Saudi Arabia in general and the urban hospital setting in the Middle-East in particular.
Akpan, Etukumana Etiobong; Bassey, Orie Jacob
Quality of service delivery remains the most important issue in hospitals since patients expect higher standard care and services. This quality service is rooted in the culture of the health care organization. Therefore,this study seeks to determine health workers' perception on the quality of service and corporate culture at University of Uyo Teaching hospital, Uyo, Nigeria. A cross-sectional descriptive study was carried out. Using structured questionnaire and convenient sampling technique, data were collected from 250 hospital workers.The responses on questions to elicit the hospital's quality of service and corporate culture were rated on a five-point Likert Scale as follows; Strongly Agree (SA), Agree (A), Neutral(N), Disagree (D) and Strongly Disagree (SD). Data entry and analysis were performed using Epi Info 3.2.2 (CDC, Atlanta, Georgia, USA). The minimum and maximum ages of the respondents were 21 years and 60 years respectively. The mean, median and mode ages in the respondents were 34.6 (± 7.88) years, 33 years, and 30 years respectively. Majority of the study respondents were in the age group of 31-40 years (30%), female (56.8%) and Doctors (36%). The respondents' positive perception on quality of service offered by the hospital was 69.2% (OR 5.05, 95% CI 3.39-7.52, P quality services as obtained in other hospitals. Majority of the workers in all the professions except Medical Doctors accepted that the hospital values the individual workers. Majority of the Pharmacists and Non-clinical staff accepted that the hospital management was flexible and understands the importance of balancing their work and personal life. Majority of the Doctors, Pharmacists and laboratory/image scientists did not accept that top management communicates changes in decisions that affect employees. The perception of health workers on the quality of service rendered by the University of Uyo Teaching Hospital was satisfactory. However, the hospital needs to improve on its
Shafiq, Muhammad; Naeem, Muhammad Azhar; Munawar, Zartasha; Fatima, Iram
Hospitals vary from one another in terms of their specialty, services offered, and resource availability. Their services are widely measured with scales that gauge patients' perspective. Therefore, there is a need for research to develop a scale that measures hospital service quality in Asian hospitals, regardless of their nature or ownership. To address this research need, this study adapted the SERVQUAL instrument to develop a service quality measurement scale. Data were collected from inpatients and outpatients at 9 different hospitals, and the scale was developed using structural equation modeling. The developed scale was then validated by identifying service quality gaps and ranking the areas that require managerial effort. The findings indicated that all 5 dimensions of SERVQUAL are valid in Asian countries such as Pakistan, with 13 items retained. Reliability, tangibility, responsiveness, empathy, and assurance were ranked first, second, third, fourth, and fifth, respectively, in terms of the size of the quality gap. The gaps were statistically significant, with values ≤.05; therefore, hospital administrators must focus on each of these areas. By focusing on the identified areas of improvement, health care authorities, managers, practitioners, and decision makers can bring substantial change within hospitals.
LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad
TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs.
Nekoei-Moghadam, Mahmood; Amiresmaili, Mohammadreza
Although quality orientation is one of the main priorities of any progressive organization, quality evaluation in organizations providing services such as hospitals is one of the key challenges, because in this sector quality is determined by many intangible factors. Applying the service quality gap model is one of the common tools for quality evaluation in the service sector. This paper seeks to evaluate this issue. The present descriptive study was carried out through a cross-sectional method in 2008. The participants of this study were patients who had been referred to Kerman University of Medical Sciences hospitals. The sample comprised 385 patients, the data were collected by SERVQUAL as a standard questionnaire, and data analysis was carried out on 385 completed questionnaires. In all five dimensions of quality, a gap was observed between patients' perceptions and expectations as follows: Assurance: -1.28, Empathy: -1.36, Responsiveness: -1.80, Tangibles: -1.86 and Reliability: -1.69. A paired T-test showed that the differences between quality perceptions and expectations are significant (p value SERVQUAL approach to hospital services of a developing country.
Jafar Sadegh Tabrizi
Full Text Available Background and objectives: The satisfaction of emergency department (ED patients is considered as an important indicator of hospitals quality. This study aimed to evaluate service quality (SQ from patients’ perspective in ED. Material and Methods: A cross-sectional study was conducted with 120 admitted patients in emergency department of Imam Reza hospital of Tabriz University of Medical Sciences in 2011. Service Quality was measured using researcher-developed questionnaire. Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0. 827. A measure of service quality was derived by combining the relative importance and actual performance of ED staffs. Service Quality was calculated using SQ = 10–(Importance×Performance. Independent Samples Test and Analysis of Variance were conducted to compare SQ score between categorical variables. Data were analyzed using the SPSS-17 statistical package. Results: From the customers’ point of view, the average service quality score was 8.77 of 10. Furthermore, confidentiality, dignity and availability achieved the highest and of nutritional services, safety, cost and continuity of care got the lowest SQ scores from the patients’ perspective. Conclusion : Improving quality of delivered care in ED depends on the understanding of the current situation and its weaknesses. It is possible to improve quality of delivered care by implementing effective interventions according to the results of study findings and by considering focus on dimensions which have worst quality.
Desombre, T; Eccles, G
This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.
Romon, Iñigo; Lozano, Miguel
Background Transfusion services in the European Union must implement quality management systems to improve quality. Quality indicators (QI) play a key role in quality management because they can supply important information about the performance of the transfusion service, which can then be used for benchmarking. However, little is known about the actual use of QI in hospitals. We tried to ascertain the use and characteristics of QI in Spanish hospital transfusion services. Materials and methods We performed a survey among transfusion services in order to learn which QI they use. We classified indicators into categories and concepts, according to the steps of the transfusion process or the activities the indicators referred to. Results Seventy-six hospitals (17.9% of the hospitals actively transfusing in the country) reported 731 QI. Twenty-two of them (29%) were tertiary level hospitals. The number of indicators per hospital and by activity varied greatly. QI were assigned to some basic categories: transfusion process (23% of indicators), transfusion activity and stock management (22%), haemovigilance (20%), stem cell transplantation (9%), transfusion laboratory (9%), quality management system (8%), blood donation (3.4%), apheresis and therapeutic activities (2.5%) and immunohaematology of pregnancy (2%). Discussion Although most hospitals use QI in their quality management system and share a core group of indicators, we found a great dispersion in the number and characteristics of the indicators used. The use of a commonly agreed set of QI could be an aid to benchmarking among hospitals and to improving the transfusion process. PMID:27483486
Pouragha, Behrouz; Zarei, Ehsan
The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson's correlation, and multivariate regression methods with the SPSS.18 software. According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction.
Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu
Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (pservice quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.
Ana Stranjancevic; Iva Bulatovic
One of the greatest challenges for stakeholders is to ensure customer satisfaction, especially in service industries such as tourism and hospitality. The aim of this paper is to show that restaurant guest satisfaction depends on numerous factors as well as to show the connection between satisfaction and loyalty. Customer satisfaction and loyalty are excellent indicators of service quality. For the purpose of this paper, empirical survey was conducted and the results of the research were analy...
Emmanuel Olateju Oyatoye
Full Text Available Introduction: Patients are recently more aware and conscious. This is because of the belief that a high level of quality can translate into patient satisfaction. This is critical for healthcare providers as they deal with life. This recognition by both the service provider and service receivers made the government to establish units of service commission (SERVICOM in each of the governmental agencies including hospitals in Nigeria to monitor the level of quality of service delivery. However, to what extent do patients’ perceptions about health services seem to have been largely recognized remain unclear by health care providers, despite the (SERVICOM units in public institutions in Nigeria? Method: A cross-sectional analytical study using convenient sample method, based on the fact that not every patient of the selected hospitals can be chosen, was performed on 400 patients who received health services at four different public hospitals in Ogun state Nigeria. The selection of these hospitals was based on the zones in the state (Egba, Ijebu, Remo and Yewa area of Ogun-state. The instrument was a valid and reliable analytical hierarchy process based questionnaire containing five service quality dimensions. Data were analyzed using SPSS, Expert choice and Microsoft Excel software to determine the perception of patients towards service quality delivery in pairwise comparison of judgment consistent at less than 10%. Results:The results showed the composite priorities of the patients’ perception with respect to determinants of the patients’ perception towards quality of services delivered in the public hospitals in Nigeria. The most important factor to patients was the reliability dimension with composite priority 0.24 or 24% followed by the responsiveness dimension with 0.22 assurance dimension 0.21, tangibility dimension with 0.21, and the least determinant factor was the empathy dimension with 0.1101. Conclusion: Based on the results, the
H Zare Ahmadabadi
Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.
Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid
The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (-0.88) and responsiveness (-0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. There were gaps between the patients' perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time.
Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid
Introduction The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. Methods In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. Results There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (−0.88) and responsiveness (−0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. Conclusion There were gaps between the patients’ perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time. PMID:27123218
Aman, Bakhtiar; Abbas, Faisal
To determine patients' perception regarding service and quality of healthcare at public-sector institutions. The descriptive quantitative study was conducted in Kohat district, Pakistan, between July and December 2014, and focussed on 30 variables to assess the participants' perceptions of the actual healthcare service quality delivered. SERVQUAL instrument was used to measure the reliability and cronbach alpha was calculated to measure the reliability and validity of the instrument. A total of 200 questionnaires were distributed and 157(78.5%) were received back fully filled. Of them, 105(67%) were men and 52(33%) were women.The mean value of Assurance parameter was 3.05±0.88, indicating trust in public hospitals was high as they had experienced and capable doctors. On the other hand, the lowest mean value of 2.61±0.84 was for Empathy, highlighting the fact that public hospitals lacked the ability to handle patients' problem properly, services were not offered in time and they were short of staff. Public hospitals were largely seen as failing to deliver quality service.
Qolipour, Mohammad; Torabipour, Amin; Khiavi, Farzad Faraji; Malehi, Amal Saki
Assessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals. To validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach's alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software. The content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach's alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire. The results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals.
Qolipour, Mohammad; Torabipour, Amin; Khiavi, Farzad Faraji; Malehi, Amal Saki
Introduction Assessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals. Methods To validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach’s alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software. Results The content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach’s alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire. Conclusion The results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals. PMID:28461863
Donini, L M; Castellaneta, E; De Guglielmi, S; De Felice, M R; Savina, C; Coletti, C; Paolini, M; Cannella, C
Malnutrition due to undernutrition or overnutrition is highly prevalent in hospital in-patients and it decisively conditions patients clinical outcome. One of the most influencing factors of malnutrition in hospitalized patients is--at least in part--the Catering Service Quality. Is to verify, over a 5 year period, the course of the quality of the institutional Catering Service, verifying the effectiveness of the quality improvement process used. Quality control was performed by objective (meal order accuracy, proper distribution of food in trolleys, route time from the kitchen to the ward and time of food distribution, food weight and temperature, waste assessment) and subjective assessment (quality was measured by giving the patients a questionnaire after meals). The survey included: 572 meals and 591 interviews. A significant amount of "qualitative" errors (lack of respect for patient preferences or at the moment of supplying the food trolley) have been found. Over the time and the amount of patients that wasted a considerable amount of the portion served was considerably reduced food temperature have been improved. Also patient satisfaction with menu variability, portion size, temperature and cooking quality improved over time. The overall ratings of meals under observation improved too in fact, positive opinions ranged from 18% in 2002 to 48.3% in 2006. Ongoing research and quality verification, which include all catering service workers, yields a constant improvement in quality. Patients in healthcare settings should receive a service they appreciates, but it should be--at the same time--correct from a nutritional point of view. For this reason, it is necessary a continuous mediation between customers satisfaction and nutritionists work, dieticians and nursing staff. From this point of view the educational approach becomes essential to feed patient compliance to dietetic treatment that will continue after discharge.
Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S
Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of
Asgar Aghaei Hashjin
Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA
Full Text Available In order to give everyone access to quality care, this study attempts to make quality awareness, highlighting the importance of the implementation of the quality management system in health care facilities. The objective of our work is to make a quality awareness, to analyze the current situation and to provide recommendations. The analysis of the existing situation consists of identifying, describing, and analyzing the key processes implemented, listing the dysfunctions, classifying them, deciding on the corresponding actions and putting in place indicators and dashboards, which will help track improvements. The overall situation of the hospital regarding the requirements of ISO 9001 indicated a respect of about 28% of the requirements of the standard. The state of the premises of the establishment does not indicate a clear organization at the hospital. The hospital environment is a prerequisite to the establishment of a system of quality management that enables you to deploy a clear and shared policy to improve the quality of care and services.
Fischer, W W; Reel, L B
Hospitals are turning to total quality management (TQM) to lower costs of providing care. A hospital library in a TQM environment needs to embrace corporate goals while maintaining its accountability as a contributor to quality patient care. Alliant Health System (AHS) Library at Norton Hospital and Kosair Children's Hospital in Louisville, Kentucky, conducted a study to establish TQM benchmarks and to examine the significance of its role in clinical care. Using a methodology designed to allow both library user and nonuser to respond, 2,091 surveys were distributed to physicians and nursing and allied health personnel. Areas surveyed included frequency of library use, impact of information received on clinical judgments, cognitive value of the information, and satisfaction with library products and services. Results confirm that the library has a substantial clinical role. Eighty-eight percent of reporting physicians agreed that information from the library contributed to higher quality care. Nursing and allied health were less convinced of the importance of the library's clinical role. Sixty-nine percent of nursing personnel and 58% of allied health personnel agreed that the library contributed to higher quality care. Nursing and allied health personnel also used the library less frequently than physicians. With these results as benchmarks, improving the clinical role of the library will take commitment to the TQM process and a willingness to change.
Yazdi-Feyzabadi, Vahid; Gozashti, Mohammad Hossein; Komsari, Samane; Mohammadtaghizadeh, Sedigheh; Amiresmaili, Mohammadreza
Clinical education is one of the most important components of the resource generation function of health systems, and it has a very important role in graduates' competency with respect to effective, practical education. This study aimed to assess the quality of clinical services in Kerman's teaching hospitals located in southeastern Iran. This cross-sectional study was conducted in 2011 on 303 medical students at different levels of medical education at Kerman's teaching hospitals. A modified SERVQUAL instrument was used to collect the data after its validity and reliability were checked. The data were analyzed by SPSS 18.0 using the paired t-test, Kruskal-Wallis, and post hoc tests, when appropriate. In all five dimensions of quality, gaps were observed between students' perceptions and expectations as follows: Assurance (mean = -1.18), Responsiveness (-1.56), Empathy (-1.4), Reliability (-1.27), and Tangibles (-1.21). There was a significant difference between the quality perceptions and expectations of the medical students (p teaching hospitals in the study did not meet the students' expectations at any of the three educational levels. As we precisely assessed the dimensions and items that had the higher quality gaps, it was apparent that, for most part, clinical education officials could improve the quality by designing interventions, which would not be very difficult to do.
Spolaore, P; Murolo, G; Vafiadaki, A; Sartori, R; Sommavilla, M
In this article we describe a project about reorganisation of dietetic and hospital food service which aims to implement a food safety quality system from the prospective of risk management approach. The main objective is to develop structural and systematic activities from the medical direction point of view on all those activities concerning with hospital food service and dietetic with the following actions: 1) epidemiologic surveillance, 2) monitoring and output control, 3) education, training and information for staff and patients. The operative context is particularly complex for many reasons: the prevalent tendency to outsourcing for food service, the involvement of many professionals and several medical and non medical units. Actually after the redefinition of the main tasks (food hygiene and dietetic are the first functions) the organizational analysis, we have already done the corrective actions finalized to the improvement of quality and it is going to be ready a list of quality indicators to evaluate and continuous monitoring efficacy on the same corrective actions.
Dwyer, Trudy; Craswell, Alison; Rossi, Dolene; Holzberger, Darren
Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia. Donabedian's structure, process and outcome framework was applied to evaluate the quality of the NP model of care. The Australian Nurse Practitioner Study standardised interview schedules for evaluating NP models of care guided the semi-structured interviews of nine health professionals (including ACF nurses, medical doctors and allied health professionals), four ACF residents and their families and two NPs. Theory driven coding consistent with the Donabedian framework guided analysis of interview data and presentation of findings. Structural dimensions identified included the 'in-reach' nature of the HA service, distance, limitations of professional regulation and the residential care model. These dimensions influenced the process of referring the resident to the NP, the NPs timely response and interactions with other professionals. The processes where the NPs take time connecting with residents, initiating collaborative care plans, up-skilling aged care staff and function as intra and interprofessional boundary spanners all contributed to quality outcomes. Quality outcomes in this study were about timely intervention, HA, timely return home, partnering with residents and family (knowing what they want) and resident and health professional satisfaction. This study provides valuable insights into the contribution of the NP model of care within an aged care
Alghamdi, Faris S
To examine the impact of service quality perception on patient satisfaction and determine which dimension from 5 dimensions (tangible, reliability, responsive, assurance, and empathy) has the greatest impact on patient satisfaction. A total of 183 eligible patients participated in this study. This study was conducted in Al-Baha province, Saudi Arabia from June 2013 to August 2013. We utilized the cross-sectional method, using a modified Assessment of Service Quality questionnaire to collect the data. To test the study hypothesis, multiple regression analysis was carried out. Analysis of variance revealed that the overall result showed a statistically significant impact of health service quality on patient satisfaction (p=0.000). The beta-weights (beta) suggested that the empathy dimension had the greatest influence on patient satisfaction (beta=0.476), followed by tangible (beta=0.198) and responsiveness dimensions (beta=0.164). Patient satisfaction was influenced by health service quality, with the empathy dimension as the greatest influence on patient satisfaction. Therefore, it should be considered a priority by government hospitals to train doctors in interpersonal relationship skills to enhance the doctor-patient relationship.
Rizvi, Zainab; Usmani, Rabia Arshed; Rizvi, Amna; Wazir, Salim; Zahra, Taskeen; Rasool, Hafza
Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely "procedure, sterilization, conduct and competency of doctor" was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was ≥60, the dimension was 'good quality'. Whereas quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (pservice quality of therapeutic and diagnostic procedures in public hospitals should be routinely monitored from the patients
Full Text Available One of the greatest challenges for stakeholders is to ensure customer satisfaction, especially in service industries such as tourism and hospitality. The aim of this paper is to show that restaurant guest satisfaction depends on numerous factors as well as to show the connection between satisfaction and loyalty. Customer satisfaction and loyalty are excellent indicators of service quality. For the purpose of this paper, empirical survey was conducted and the results of the research were analyzed by statistical method. Factors which affect customer satisfaction are: kind staff, professionalism, speed of service, food quality, ambience and comfort. This implicates a special need for the introduction of strong Human Resource Management, food safety standards (e.g. HACCP and effective space planning. The study implies that the care for quality of products and services is necessary at all levels and that it is impossible to ensure the customer satisfaction or create customer loyalty without strong management system (including space projecting and without controlling it.
U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...
Oluchi C. Okeke
Full Text Available Considering the need for quality health information and resultant health care services in any society, this study was carried out to look into the status of library and information resources and services provided by medical libraries in Enugu State, Nigeria. The main objective of the study was to find out the information resources and services available for medical library users towards quality health care provision. Five (5 medical libraries of major teaching hospitals were used for the study with 980 registered users as the study population from where 245 users were sampled. Observation checklist was used to collect data on resources while questionnaire was used to collect data from the respondents on the services provided. The Medical Library Association Standard guided the analysis of data from observation while frequency counts and mean scores were used to analyze data from the questionnaire. Major findings showed that even though some of the required resources and services are available and provided the medical libraries, most of the required resources and services are not adequately provided by these libraries.
Nadi, Aliasghar; Shojaee, Jalil; Abedi, Ghassem; Siamian, Hasan; Abedini, Ehsan; Rostami, Farideh
Hospital's success depends on patients' expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients' perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive - analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients' perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The Kruskal-Wallis test, the difference observed in these three hospitals were significant. The results showed that patients' expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed that necessary for managers and relevant authorities to plan and pay
Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.
Nadi, Aliasghar; Shojaee, Jalil; Abedi, Ghassem; Siamian, Hasan; Abedini, Ehsan; Rostami, Farideh
Background: Hospital’s success depends on patients’ expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients’ perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. Materials and Methods: This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive – analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. Results: The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients’ perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The Kruskal–Wallis test, the difference observed in these three hospitals were significant. Conclusion: The results showed that patients’ expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed
Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.
Shafii, Milad; Rafiei, Sima; Abooee, Fatemeh; Bahrami, Mohammad Amin; Nouhi, Mojtaba; Lotfi, Farhad; Khanjankhani, Khatere
Hospitals as integrated parts of the wide-ranging health care systems have dominant focus on health care provision to meet, maintain and promote people's health needs of a community. This study aimed to assess the service quality of teaching hospitals of Yazd University of Medical Sciences using Fuzzy Analytical Hierarchy Process (FAHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). A literature review and a qualitative method were used to obtain experts' viewpoints about the quality dimensions of hospital services to design a questionnaire. Then, using a self-made questionnaire, perceptions of 300 patients about the quality of delivered services were gathered. Finally, FAHP was applied to weigh each quality dimension and TOPSIS method to rank hospital wards. Six dimensions including responsiveness, assurance, security, tangibles, health communication and Patient orientation were identified as affecting aspects of hospital services quality among which, security and tangibles got the highest and lowest importance respectively (0.25406, 0.06883). Findings also revealed that in hospital A, orthopedics and ophthalmology wards obtained the highest score in terms of quality while cardiology department got the lowest ranking (0.954, 0.323). In hospital B, the highest and the lowest ranking was belonged to cardiology and surgical wards (0.895, 0.00) while in hospital C, surgical units were rated higher than internal wards (0.959, 0.851). Findings emphasized that the security dimension got the lowest ranking among SERVQUAL facets in studied hospitals. This requires hospital executives to pay special attention to the issue of patients' security and plan effectively for its promotion.
Full Text Available This paper presents an empirical investigation to measure different dimensions of hospital service quality (HSQ by gap analysis and patient satisfaction (PS. It also attempts to measure patients’ satisfaction with three dimensions extracted from exploratory factor analysis (EFA by Principle component analysis method and conformity factor analysis (CFA. In addition, the study analyzes relationship between HSQ and PS in the context of Iranian hospital services, using structural equation modeling (SEM from patients’ perspectives. The maximum gap observed in “responsiveness” and the minimum one in “assurance”. In addition, patients had the most satisfaction in “trust” with the mean of 3.83 followed by “General Satisfaction” with the mean of 3.68 and they had the least satisfaction in “Acceptance” with the mean of 3.53. Two measurement models were used for measuring hospital service quality and patient satisfaction and one structural model, which showed the relationship between them. The result of this study showed that there was a positive and significant impact from hospital service quality on patient satisfaction (0.463. In addition, there was a positive and significant relationship between hospital service quality and five dimensions. Furthermore, it was shown that patient satisfaction and three dimensions (General Satisfaction, Trust, and Acceptance were associated with each other, significantly and positively. At last management strategies and practical suggestions were presented to hospital.
Shaw, C.D.; Groene, O.; Botje, D.; Suñol, R.; Kutryba, B.; Klazinga, N.; Bruneau, C.; Hammer, A.; Wang, A.; Arah, O.A.; Wagner, C.
Objective: To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design: A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management
Full Text Available During the last years, costumer satisfaction analysis is becoming more and more important in evaluating the service quality of the sanitary system. Typically the construct ‘satisfaction’ is assumed to be a not observable variable, that is a latent variable. In this paper we illustrate and compare two different methods for analyzing latent variable models. The first one is the structural equation models with Lisrel, the second one is the generalized linear latent variable models. The comparison is performed through an application of the satisfaction analysis to a real data set referred to the patients of a hospital in Bologna. The results highlights the methodological and the applicative similarity and dissimilarity between the two methods.
Ebin J Arries
Full Text Available Quality service delivery to the consumer of health is a legal reality as it is emphasised in the White Paper on the Transformation of Public Service delivery (South Africa, 1997. The guiding philosophy adopted within this framework is that of Batho Pele, which means placing the consumer at the centre of healthcare service delivery. Increasing attention has been paid to hospital processes from a quality perspective. By analogy, outpatient departments can be viewed as industrial plants where technological know-how is transferred to patients through service delivery, which is a cornerstone of a hospital’s business. Outpatients, as consumers of healthcare, draw conclusions about the quality of service delivery based on their experiences of such services. In this vein, an outpatient’s experience of a particular service is an indicator of his/her level of satisfaction with the quality of that service. No South African study can be found in the literature on out-patients’ experiences of quality service delivery. This study’s purpose is to explore and describe outpatients’ experiences of the quality of service delivery at a teaching hospital in Gauteng. A qualitative, explorative, descriptive study that was contextual in nature was conducted to achieve this aim. Focus group interviews were conducted with outpatients who met the selection criteria. Open coding was used to analyse the contents from the transcripts and field notes typed verbatim. Strategies for trustworthiness, namely co-coding, prolonged engagement, triangulation and adequate referencing, were employed to ensure the credibility of the study and research findings. The results reflect themes that were reduced into two main categories, namely positive and negative experiences. The positive experiences reflect outpatients’ experience of their relationship with medical staff and their satisfaction with the quality of medical care. Negative experiences relate predominantly to a lack
Full Text Available Quality service delivery to the consumer of health is a legal reality as it is emphasised in the White Paper on the Transformation of Public Service delivery (South Africa, 1997. The guiding philosophy adopted within this framework is that of Batho Pele, which means placing the consumer at the centre of healthcare service delivery. Increasing attention has been paid to hospital processes from a quality perspective. By analogy, outpatient departments can be viewed as industrial plants where technological know-how is transferred to patients through service delivery, which is a cornerstone of a hospital’s business. Outpatients, as consumers of healthcare, draw conclusions about the quality of service delivery based on their experiences of such services. In this vein, an outpatient’s experience of a particular service is an indicator of his/her level of satisfaction with the quality of that service. No South African study can be found in the literature on out-patients’ experiences of quality service delivery. This study’s purpose is to explore and describe outpatients’ experiences of the quality of service delivery at a teaching hospital in Gauteng. A qualitative, explorative, descriptive study that was contextual in nature was conducted to achieve this aim. Focus group interviews were conducted with outpatients who met the selection criteria. Open coding was used to analyse the contents from the transcripts and field notes typed verbatim. Strategies for trustworthiness, namely co-coding, prolonged engagement, triangulation and adequate referencing, were employed to ensure the credibility of the study and research findings. The results reflect themes that were reduced into two main categories, namely positive and negative experiences. The positive experiences reflect outpatients’ experience of their relationship with medical staff and their satisfaction with the quality of medical care. Negative experiences relate predominantly to a lack
Fuad Husain Akbar
Full Text Available Patient satisfaction against the quality of dental health services was a comparison between the perception of care received by expectation before getting treatment. The research was conducted at Tenriawaru general hospital in Bone regency based on the five dimensions of service quality, they were the assurance, empathy, responsiveness, physical appearance, and medical services by using Likert scale. The study was descriptive with a sample of 65 people. The research subjects were all visitors (patient dental polyclinic of Tenriawaru general hospital in Bone regency. Results showed patient satisfaction on dimensions of assurance 84.6% falling into the category satisfied. On the dimensions of empathy showed 81.5% of patients satisfied. On the dimensions of responsiveness showed 36.9% of patients satisfied. On the dimensions of physical appearance showed 84.6% of patients satisfied. On the dimensions of medical services showed 72.3% of patients satisfied. Based on the result of patient satisfaction against the quality of dental health services at the dental polyclinic of Tenriawaru general hospital in Bone regency which reviewed from five dimensions showed patients satisfied against the quality of dental health services at Tenriawaru general hospital in Bone regency.
Full Text Available The main problem in public service particularly health care service is the public’s increasing demand for better quality of service. Therefore, hospitals as one of the means of health care providers should be able to increase public satisfaction. This is important to win the trust of patients and/or families of patients who come for treatment. The lack of patients’ satisfaction in the quality of service in hospitals in Indonesia contributes to the Indonesians’ choice of medical treatment abroad. Therefore, the study aims to determine the influence of quality of services provided by the hospital toward patients’ satisfaction. This quantitative research surveyed patients in Hospital Y in Padang city using questionnaire as a research instrument. The population is all the patients and/or families of patients who are served in the hospital during the data collection in the month of May to August 2014. A sample of 100 people was selected using accidental sampling. The collected data were analyzed using frequencies, percentages and averages using SPSS version16 for windows. Simple linear regression analysis technique was used for data analysis. Location of the study was a private hospital located in the city of Padang, West Sumatra Province, which in this research is referred as private hospital Y. The results of this study indicates that there is a significant relation between the quality of service to the citizen satisfaction with the regression equation Y = 44.967 + 2.612 X with value of correlation (r = 0.760, and the influence of quality of service to the public satisfaction in 57.8%. Then the results Achievement Level Respondents (TCR in the quality of public services obtained a value of 74.8% with quite good category and to the satisfaction of the public to the TCR value of 75.3%with quite good category. It shows the quality of care in hospitals Y must be improved in order to obtain an increase in user satisfaction of the people who
Bahadori, Mohammadkarim; Ravangard, Ramin; Yaghoubi, Maryam; Alimohammadzadeh, Khalil
Background: Military hospitals are responsible for preserving, restoring and improving the health of not only armed forces, but also other people. According to the military organizations strategy, which is being a leader and pioneer in all areas, providing quality health services is one of the main goals of the military health care organizations. This study was aimed to evaluate the service quality of selected military hospitals in Iran based on the Joint Commission International (JCI) standards and comparing these hospitals with each other and ranking them using the analytic hierarchy process (AHP) technique in 2013. Materials and Methods: This was a cross-sectional and descriptive study conducted on five military hospitals, selected using the purposive sampling method, in 2013. Required data collected using checklists of accreditation standards and nominal group technique. AHP technique was used for prioritizing. Furthermore, Expert Choice 11.0 was used to analyze the collected data. Results: Among JCI standards, the standards of access to care and continuity of care (weight = 0.122), quality improvement and patient safety (weight = 0.121) and leadership and management (weight = 0.117) had the greatest importance, respectively. Furthermore, in the overall ranking, BGT (weight = 0.369), IHM (0.238), SAU (0.202), IHK (weight = 0.125) and SAB (weight = 0.066) ranked first to fifth, respectively. Conclusion: AHP is an appropriate technique for measuring the overall performance of hospitals and their quality of services. It is a holistic approach that takes all hospital processes into consideration. The results of the present study can be used to improve hospitals performance through identifying areas, which are in need of focus for quality improvement and selecting strategies to improve service quality. PMID:25250364
Bahadori, Mohammadkarim; Ravangard, Ramin; Yaghoubi, Maryam; Alimohammadzadeh, Khalil
Military hospitals are responsible for preserving, restoring and improving the health of not only armed forces, but also other people. According to the military organizations strategy, which is being a leader and pioneer in all areas, providing quality health services is one of the main goals of the military health care organizations. This study was aimed to evaluate the service quality of selected military hospitals in Iran based on the Joint Commission International (JCI) standards and comparing these hospitals with each other and ranking them using the analytic hierarchy process (AHP) technique in 2013. This was a cross-sectional and descriptive study conducted on five military hospitals, selected using the purposive sampling method, in 2013. Required data collected using checklists of accreditation standards and nominal group technique. AHP technique was used for prioritizing. Furthermore, Expert Choice 11.0 was used to analyze the collected data. Among JCI standards, the standards of access to care and continuity of care (weight = 0.122), quality improvement and patient safety (weight = 0.121) and leadership and management (weight = 0.117) had the greatest importance, respectively. Furthermore, in the overall ranking, BGT (weight = 0.369), IHM (0.238), SAU (0.202), IHK (weight = 0.125) and SAB (weight = 0.066) ranked first to fifth, respectively. AHP is an appropriate technique for measuring the overall performance of hospitals and their quality of services. It is a holistic approach that takes all hospital processes into consideration. The results of the present study can be used to improve hospitals performance through identifying areas, which are in need of focus for quality improvement and selecting strategies to improve service quality.
Full Text Available Background: Managerial knowledge and skills as well as profound understanding of goals and objectives of management determine the effectiveness and efficiency in all areas of managerial activities. In particular, this applies to the quality of healthcare services, perceived as a compliance between the effects (of medical treatment and the assumed relevant objectives (defined/desired health condition. The aim of the research was to distinguish and define the way the health service quality is perceived by the hospital managerial personnel. Material and Methods: The questionnaire was mailed to 836 members of the managerial personnel of public hospitals in the Łódź province. Of this number 122 questionnaires were returned. Results: Only 22 (18.49% of respondents presented the definition of quality. Attempts to meet patients’ expectations and to satisfy them were found to be the prevailing perception of the healthcare quality and 96.64% of respondents considered competences of medical staff contributory. Almost 64% of respondents disagree with the opinion that the number of medical staff does not affect the service quality. According to the respondents, a 46% increase in financial resources on average could significantly improve the quality of healthcare services. More than half (66.76% of respondents claim that healthcare services that are available cover 82% of patients’ needs. Almost 57% (56.52% of respondents consider that the subordinate- superior relationship influences their work involvement. According to 42.61% of respondents, the offered incentives encourage actions for the quality improvement. Conclusions: The results of the research indicate the need to develop a clear cut definition of the health service quality by the managerial personnel of public hospitals and to change their understanding, perception and treatment of the discussed issue, which provides a basis for the effective and efficient hospital management. Med Pr 2016
Fuad Husain Akbar
Full Text Available Patient satisfaction against the quality of dental health serviceswas a comparison between the perception of care received by expectation before getting treatment. The Research was conducted at Tenriawaru General Hospital in Bone Regency based on the five dimensions of service quality, they were the assurance, empathy, responsiveness, physical appearance, and medical services by using Likert scale. The study was descriptive with a sample of 65 people. The research subjects were all visitors (patient Dental Polyclinic of Tenriawaru General Hospital in Bone Regency. Results showed patient satisfaction on dimensions of assurance 84.6% falling into the category satisfied. On the dimensions of empathy showed 81.5% of patients satisfied. On the dimensions of responsiveness showed 36.9% of patients satisfied. On the dimensions of physical appearance showed 84.6% of patients satisfied. On the dimensions of medical services showed 72.3% of patients satisfied. Based on the result of patient satisfaction against the quality of dental health services at the Dental Polyclinic of Tenriawaru General Hospital in Bone Regency which reviewed from five dimensions showed patients satisfied against the quality of dental health services at Tenriawaru General Hospital in Bone Regency.
Full Text Available Background . The provision of medical services to patients according to their expectations and needs is necessary for the comfort and quality of life of patients, as well as for the standardization of hospital procedures. In recognizing these needs and expectations, an important step is the verification of provided services in order to improve their quality. The present study was designed to determine differences in service quality, as evaluated by hospitalized patients. Objectives . The analysis of the subjective feelings of hospitalized patients concerning service quality in the context of the application of the SER VQUAL method – a pilot study. Material and methods. The study was conducted in a Lower Silesian hospital in a group of 29 young patients (women: 16, men: 13, average age: 16 diagnosed with kidney disease. In the study a standard sheet of 22 SER VQUAL statements was used, and an analysis of the validity of 5 quality areas important for the patient was conducted. Results. According to the respondents, the most important of all 5 features directly affecting the quality of life during treatment is the ability and skill of the ward staff to provide medical services, so-called reliability – 24.48%. In turn, the least important of all the study characteristics was the aesthetics and ergonomics of rooms, the presence of appropriate equipment, the so-called material dimension – 15.31%. Furthermore, service quality gaps were visible in all five service quality dimensions. Conclusions . 1. The SER VQUAL method helps to identify discrepancies between the perceptions of patients’ expectations in all dimensions of the quality of provided medical services. 2. For the patients the least important is the material dimension, and the most affecting is the dimension associated with the reliability of the medical services. 3. Improvement of the level of satisfaction with the quality of medical services requires proper planning and effective
Rodríguez-Saldana, Joel; Rosales-Campos, Andrea C; Rangel León, Carmen B; Vázquez-Rodríguez, Laura I; Martínez-Castro, Francisco; Piette, John D
To survey a large sample of type 2 diabetes mellitus (T2DM) patients in Mexico City to determine if patient experience, access to basic services, treatment, and outcomes differed between those with social security coverage and those without. From 2001-2007 a total of 1 000 individuals with T2DM were surveyed in outpatient clinics of the three largest public ophthalmology hospitals in Mexico City. Patients reported information about their health status and receipt of basic diabetes services, such as laboratory glycemic monitoring and diabetes education. Rates were compared between those with (n = 461) and without (n = 539) social security. Almost half of the patients (46%) in these public facilities were social security patients that were unable to access other services and had to pay out-of-pocket for care. Half of respondents were originally identified as potentially diabetic based on symptom complaints (51%), including 11% with visual impairment. Most patients (87.9%) reported that their glycemic level was being monitored exclusively via fasting blood glucose testing or random capillary blood glucose tests; only 5.3% reported ever having a glycated hemoglobin test. While nearly all respondents reported an individual physician encounter ever, only 39% reported ever receiving nutrition counseling and only 21% reported attending one or more sessions of diabetes education in their lifetime. Processes of care and outcomes were no different in patients with and those without social security coverage. In Mexico, the quality of diabetes care is poor. Despite receiving social security, many patients still have to pay out-of-pocket to access needed care. Without policy changes that address these barriers to comprehensive diabetes management, scientific achievements in diagnosis and pharmacotherapy will have limited impact.
María de las Mercedes Cuba Venereo
Full Text Available La calidad es un concepto clave hoy día para los servicios sanitarios. Ella es considerada una variable esencial por la mayoría de las organizaciones. No es posible hablar de buena gestión en un centro o servicio sanitario, si no se incorpora un sistema de mejora continua de la calidad, ya que hay suficiente evidencia para afirmar que dichos programas son un instrumento para elevar la eficiencia clínica y económica. Esto ha provocado una larga carrera hacia la acreditación y evaluación externa por entidades que puedan dar fe del nivel de calidad alcanzado por la organización. Es por ello que lograr un sistema de acreditación de farmacias hospitalarias, con fines no solo evaluativos sino de crecimiento y desarrollo, sería una respuesta a esta necesidad. Cabe señalar la importancia de que dicho programa se ajuste a la realidad existente en Cuba y se pueda adaptar dinámicamente a las diferentes situaciones que se presentarán.Quality is a key concept for health services today and considered as a fundamental variable for most of the organizations. It is impossible to speak about good management in a health care service or center if a permanent quality improvement system is not involved since enough evidence indicates that such programs are tools for higher clinical and economic efficiency. The aforementioned has brought about a long run for accreditation and external evaluation by agencies that are able to endorse the quality level attained by the organization in question. This is why implementing an accreditation system for hospital pharmacies, not only for evaluation but for growth and development, would be an appropriate response to this requirement. There should be pointed out the importance of adapting this program to the existing realities of Cuba and of adjusting it in a dynamic way to the many situations that may come up.
Cabrera-Arana, Gustavo A; Londoño-Pimienta, Jaime L; Bello-Parías, León D
Validating an instrument for measuring the perceived quality of services received by people using hospitals forming part of the Colombian Ministry of Social Protection's restructuring, redesigning and modernisation programme for health-service providing networks. Sánchez and Echeverri's guidelines for validating health quality measurement scales were followed due to the lack of a valid instrument for doing this in Colombia. Conceptual synthesis led to identifying a structure of constituent indicators, domains and sub-domains regarding the perception of health service quality. A list of reactions (having a scale for categorising the replies) was analysed according to the validity of appearance, construct, criteria and utility as criteria for sensitivity and usefulness. Successive revisions and three rounds of field-trials led to producing PECASUSS, an acronym given to the instrument for measuring users' perception of health service quality (Percepción de Calidad Según Usuarios de Servicios de Salud). The guidelines effectively orientated the validation of the instrument required for measuring the perceived quality of health services received by people using hospitals forming part of the programme.
Lee, Mi Aie; Kim, Eunjeong
This study was performed to investigate the relationship among reciprocity, emotional labor, nursing service quality and intent to leave, and to identify factors influencing nursing service quality and intent to leave. This study was a cross-sectional survey. Participants were 300 nurses working at five general hospitals in two provincial cities in Gyeongsang Province, Korea. From May 1 to June 30, 2014, data were collected using structured questionnaires and analyzed with SPSS/PC ver 20.0 programs. There were relationships between reciprocity and nursing service quality, and intent to leave, and between emotional labor and intent to leave. Participants' general characteristics, reciprocity and emotional labor explained 48.4% of variance in nursing service quality and participants' general characteristics and these two independent variables explained 31.9% of intent to leave. These findings indicate that from the perception of hospital nurses, reciprocity and emotional labor are both very important factors to improve the quality of nursing service and decrease the intent to leave. So nursing managers should try to develop various personnel management programs focused on human emotions, and create a mutual respectable organizational culture and work environment.
Full Text Available The quality of service is an evaluation which focused on customer’s awareness about a structural construction of a service or product that involves 5 main aspects which are tangibility, empathy, responsiveness, reliability and assurance. Based on monthly reports of pharmacy installation only about 30% of patients buy drugs in the Anggrek out patient depo out off patients visiting Anggrek out patient specialist clinic in Dr. Hasan Sadikin Hospital. The aim of this study is to determine the effect of service quality and customer satisfaction to purchase intention in the Anggrek out patient depo Hasan Sadikin hospital at Bandung. The method used in this study is analytical survey with cross sectional design. The samples used were 200 patients, consist of 104 customers who have visited more than one times and 96 first visit costumer to this clinic. Data was collected using a questionnaire and analyzed using Smart PLS V 2.0 software. The results of this study showed that the service quality with tangible dimensions, reliability, responsiveness, assurance, and empathy are affecting the customer satisfaction with a score of 12.755 t-count (greater than t-table 1.983 and a positive value of the original sample of 0.800. Customer satisfaction affecting the customer purchase intentions with t-count is greater than t-table values of 5.012 and 0.726 of the original positive sample. While the service quality does not directly influence customer purchase intention with the t-test is smaller than t-table is 1.455 and the negative of the original sample -0.287. Some of service quality influence customers that causes not purchasing drugs from the out patient depo there are effect of unavailability of counseling, long waiting time of service, the need for special counseling room, a spacious waiting room, and the completeness of drug availability.
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.
Full Text Available Abstract Fenomenon and comunity problem in goverment hospital management not aware to wont and need public. Silent safety and consumen satisfaction is fenomenon lack quallity care. Goal this research goal for analysis about influence of policy implementation of hospital change institution status to the quality of patien service in Hospital. Kind of reserch is the quantity desain on approach the eksplanatory survey research analysis regresi linier multipel with analysis method validitas product moment pearson exam and reliability exam is alpha cronbach technique to hypotesis exam is path analysis and statistic exam t. Datum transformation is Skala Likert with measurement the method succesive interval. The population one thausand seventh two person with sample technique stratified random sampling the instrument research is quesioner and interview patien on caunter imforman. The result of assuming research that it is anticipated that implementation of change policy of institution status of hospital X there is significant influence to quality of service of patient Y is 66.31 and the other factor e is 33.69. In the implementation factor is significant to positif influence to quality service is communication X1 is 049 human resources X2 is 025 disposition X3 is 032 and structure birocratic X4 is 033. The conculsion from four factor independen variable X is the implementation of policy to quality service patient Y to influence and can receive in knowledge. To concept the development in implementation of policy need culture job factor because every product policy to contac direct with the community as to basic public policy.
Sibley, Rachel A; Charubhumi, Vanessa; Hutzler, Lorraine H; Paoli, Albit R; Bosco, Joseph A
The Center for Medicare and Medicaid Services (CMS) is transitioning Medicare from a fee-for-service program into a value-based pay-for-performance program. In order to accomplish this goal, CMS initiated 3 programs that attempt to define quality and seek to reward high-performing hospitals and penalize poor-performing hospitals. These programs include (1) penalties for hospital-acquired conditions (HACs), (2) penalties for excess readmissions for certain conditions, and (3) performance on value-based purchasing (VBP). The objective of this study was to determine whether high-volume total joint hospitals perform better in these programs than their lower-volume counterparts. We analyzed data from the New York Statewide Planning and Research Cooperative System database on total New York State hospital discharges from 2013 to 2015 for total knee and total hip arthroplasty. This was compared to data from Hospital Compare on HAC's, excess readmissions, and VBP. From these databases, we identified 123 hospitals in New York, which participated in all 3 Medicare pay-for-performance programs and performed total joint replacements. Over the 3-year period spanning 2013-2015, hospitals in New York State performed an average of 1136.59 total joint replacement surgeries and achieved a mean readmission penalty of 0.005909. The correlation coefficient between surgery volume and combined performance score was 0.277. Of these correlations, surgery volume and VBP performance, and surgery volume and combined performance showed statistical significance (P quality, as well as joint replacement volumes and VBP performance, specifically. These findings are consistent with previously reported associations between patient outcomes and procedure volumes. However, a relationship between joint replacement volume and HAC scores or readmission penalties could not be demonstrated. Copyright © 2016 Elsevier Inc. All rights reserved.
Fatima, Iram; Humayun, Ayesha; Anwar, Muhammad Imran; Iftikhar, Adil; Aslam, Muhammad; Shafiq, Muhammad
Objectives Service quality is one of the important gears to appraise services and determine the gray areas that need improvement. In countries with a resource-poor health system, the first step of measuring quality is yet to be taken. This study seeks to inform policy makers in developing contextual service quality models by identifying service quality gaps in tertiary care teaching hospitals using patients’ perspective. Methods A cross-sectional study was performed using multistage cluster sampling, and a modified version of the SERVQUAL (SERV-service, QUAL-quality) instrument was administered to determine patient’s expectations and perceptions. A total of 817 completed questionnaires were obtained from patients and/or their attendants using convenience sampling. Results Data analysis revealed statistically significant negative quality gaps between expectations and perceptions of tangibility, reliability, empathy, assurance, responsiveness, and communication. The difference in mean expectation and perception for responsiveness across the sexes was significant (p quality were independent of sex. Educational status showed significant difference in expectation and perception in responsiveness (p service quality: p service departments showed no relationship with any of the perceived or expected dimension of service quality of hospitals. Conclusions Tertiary care hospitals failed to meet patients’ expectations in all major areas of service quality, posing a question of how hospitals implement and evaluate their quality assurance policy. PMID:28804582
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…
Keramidou, Ioanna; Triantafyllopoulos, Loukas
The influence of the financial crisis on the efficiency of Greek public hospitals has been widely debated. Despite this increasing interest in such research, the question of to what extent the recent reforms in the Greek National health care system were effective in establishing a health care structure and process that provide better results for patients has yet to be fully investigated. As a step in this direction, the paper focuses on patient's experience with public hospital care quality before and during the economic crisis. A questionnaire survey was carried out among 1872 patients discharged from 110 out of the total of 124 Greek public hospitals. Patients' perceptions were analysed using a structural equation modelling approach. The findings reveal that public hospital service quality is at a medium level (66.2 on a scale from 1 to 100) over 2007-2014, presenting a decreasing trend during the recession. Policies to address the crisis may have contributed to a reduction in hospital expenditures, but at the same time patients were increasingly dissatisfied with the technical care. Consequently, there is a need for reforms aimed at the achievement of productivity gains, responsibility, and transparency in the management of productive resources, by enabling health organisations to reduce their costs without a deterioration in the quality of care. Copyright © 2017 Elsevier B.V. All rights reserved.
Assessment of Sleep Quality and Effects of Relaxation Exercise on Sleep Quality in Patients Hospitalized in Internal Medicine Services in a University Hospital: The Effect of Relaxation Exercises in Patients Hospitalized.
Alparslan, Güler Balci; Orsal, Özlem; Unsal, Alaettin
This study aims to assess sleep quality and determine the effects of relaxation exercise on sleep quality in patients hospitalized in internal medicine services. In total, 47 patients comprised the control group and did not engage in the exercise intervention--the progressive muscle relaxation exercise, whereas 235 patients were assigned to the intervention group (N = 282). In this study, Description Questionnaire Form and the Pittsburg Sleep Quality Index (PSQI) were used. Most patients (73.8%) had poor sleep quality. The mean pre- and postexercise PSQI scores of the patients in the interventional group were 8.7 ± 4.0 and 6.1 ± 3.3, respectively. The mean pre- and postexercise PSQI scores of the control patients were 6.6 ± 3.5 and 5.6 ± 2.7, respectively. According to this study, the exercises significantly enhanced the quality of sleep. Patients should be encouraged by nurses to perform relaxation exercises.
Pai, Yogesh P; Chary, Satyanarayana T
The purpose of this paper is to review the service quality dimensions established in various studies conducted across the world specifically applied to health care. Studies conducted on quality of care selected from literature databases - Ebsco, Emerald Insight, ABI/Inform - was subjected to a comprehensive in-depth content analysis. Service quality has been extensively studied with considerable efforts taken to develop survey instruments for measuring purposes. The number of dimensional structure varies across the studies. Self-administered questionnaire dominates in terms of mode of administration adopted in the studies, with respondents ranging from 18 to 85 years. Target sample size ranged from 84-2,000 respondents in self-administered questionnaires and for mail administration ranged from 300-2,600 respondents. Studies vary in terms of the scores used ranging from four to ten-point scale. A total of 27 of the studies have used EFA, 11 studies have used structural equation modelling and eight studies used gap scores. Cronbach's alpha is the most commonly used measure of scale reliability. There is variation in terms of measuring the content, criteria and construct validation among the studies. The literature offers dimensions used in assessing patient perceived service quality. The review reveals diversity and a plethora of dimensions and methodology to develop the construct discussed. The reported study describes and contrasts a large number of service-quality measurement constructs and highlights the usage of dimensions. The findings are valuable to academics in terms of dimensions and methodology used, approach for analysis; whereas findings are of value to practitioners in terms of the dimensions found in the research and to identify the gap in their setting.
Full Text Available With new testing technologies, task-shifting and rapid scale-up of HIV testing services in high HIV prevalence countries, assuring quality of HIV testing is paramount. This study aimed to explore various cadres of providers' experiences in providing HIV testing services and their understanding of elements that impact on quality of service in Zambia.Sixteen in-depth interviews and two focus group discussions were conducted with HIV testing service providers including lay counselors, nurses and laboratory personnel at purposively selected HIV testing sites at a national reference hospital in Lusaka. Qualitative content analysis was adopted for data analysis.Lay counselors and nurses reported confidentiality and privacy to be greatly compromised due to limited space in both in- and out-patient settings. Difficulties in upholding consent were reported in provider-initiated testing in in-patient settings. The providers identified non-adherence to testing procedures, high workload and inadequate training and supervision as key elements impacting on quality of testing. Difficulties related to testing varied by sub-groups of providers: lay counselors, in finger pricking and obtaining adequate volumes of specimen; non-laboratory providers in general, in interpreting invalid, false-negative and false-positive results. The providers had been participating in a recently established national HIV quality assurance program, i.e. proficiency testing, but rarely received site supervisory visits.Task-shifting coupled with policy shifts in service provision has seriously challenged HIV testing quality, protection of confidentiality and the process of informed consent. Ways to better protect confidentiality and informed consent need careful attention. Training, supervision and quality assurance need strengthening tailored to the needs of the different cadres of providers.
Bakan, Ismail; Buyukbese, Tuba; Ersahan, Burcu
This paper attempts to measure patients' perceptions of the quality of services in public and private healthcare centers in Turkey. The main aim was to examine the impact of the dimensions of patient-perceived total quality service (TQS) on patients' satisfaction. The research framework and hypotheses are derived from a literature review of service quality and quality in the healthcare industry. The research data were collected through questionnaires and then statistically analyzed using descriptive statistics, Pearson product moment correlation and linear regression. The results suggest that service quality perceptions positively influence patient satisfaction with overall hospital care (SOHC). The most important factors identified in the regression model regarding patient SOHC are the quality of the hospital's social responsibility, administrative processes and overall experience of medical care received. These factors explain 74% of the variance in SOHC. The findings of the study can be used to improve TQS in both private and public hospitals. Copyright © 2013 John Wiley & Sons, Ltd.
Fatima, Iram; Humayun, Ayesha; Anwar, Muhammad Imran; Iftikhar, Adil; Aslam, Muhammad; Shafiq, Muhammad
Service quality is one of the important gears to appraise services and determine the gray areas that need improvement. In countries with a resource-poor health system, the first step of measuring quality is yet to be taken. This study seeks to inform policy makers in developing contextual service quality models by identifying service quality gaps in tertiary care teaching hospitals using patients' perspective. A cross-sectional study was performed using multistage cluster sampling, and a modified version of the SERVQUAL (SERV-service, QUAL-quality) instrument was administered to determine patient's expectations and perceptions. A total of 817 completed questionnaires were obtained from patients and/or their attendants using convenience sampling. Data analysis revealed statistically significant negative quality gaps between expectations and perceptions of tangibility, reliability, empathy, assurance, responsiveness, and communication. The difference in mean expectation and perception for responsiveness across the sexes was significant (p quality were independent of sex. Educational status showed significant difference in expectation and perception in responsiveness (p quality: p quality of hospitals. Tertiary care hospitals failed to meet patients' expectations in all major areas of service quality, posing a question of how hospitals implement and evaluate their quality assurance policy.
Loures, Carlos Augusto da Silva; Campomar, Marcos Cortez
The aim of this paper is to study the use of physical evidence as a way to generate service quality perceptions from clients of hospitals. The realization of an exploratory research is directly related to the low academic production on the subject in Brazil. In the first part of the paper we present a literature review including: the importance of services; health care services; service quality; and physical evidence. In the second part of the paper are presented the methodology and the resul...
Özkil, Ali Gürcan
believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable......, adaptable and scalable. Robots have to be semi-autonomous, and should reliably navigate in large and dynamic environments in the hospital. The complexity of the problem has to be manageable, and the solutions have to be flexible, so that the system can be applicable in real world settings. This thesis...... summarizes the efforts to address these issues. Upon the analysis of the transportation tasks and how they are currently handled in hospitals, a navigation system is envisaged. Visual tags are a part of this system, and a survey was conducted to find out the most prominent ones to be used in mobile robot...
Koh, Christina Y; Inaba, Colette S; Sujatha-Bhaskar, Sarath; Nguyen, Ninh T
The Centers for Medicare & Medicaid Services (CMS) recently released the Overall Hospital Quality Star Rating to help patients compare hospitals based on a 5-star scale. The star rating was designed to assess overall quality of the institution; thus, its validity toward specifically assessing surgical quality is unknown. To examine whether CMS high-star hospitals (HSHs) have improved patient outcomes and resource use in advanced laparoscopic abdominal surgery compared with low-star hospitals (LSHs). Using the University HealthSystem Consortium database (which includes academic centers and their affiliate hospitals) from January 1, 2013, through December 31, 2015, this administrative database observational study compared outcomes of 72 662 advanced laparoscopic abdominal operations between HSHs (4-5 stars) and LSHs (1-2 stars). The star rating includes 57 measures across 7 areas of quality. Patients who underwent advanced laparoscopic abdominal surgery, including bariatric surgery (sleeve gastrectomy, Roux-en-Y gastric bypass), colorectal surgery (colectomy, proctectomy), or hiatal hernia surgery (paraesophageal hernia repair, Nissen fundoplication), were included. Risk adjustment included exclusion of patients with major and extreme severity of illness. Main outcome measures included serious morbidity, in-hospital mortality, intensive care unit admissions, and cost. A total of 72 662 advanced laparoscopic abdominal operations were performed in patients at 66 HSHs (n = 38 299; mean [SD] age, 51.26 [15.25] years; 12 096 [31.5%] male and 26 203 [68.4%] female; 28 971 [75.6%] white and 9328 [24.4%] nonwhite) and 78 LSHs (n = 34 363; mean [SD] age, 49.77 [14.77] years; 9902 [28.8%] male and 24 461 [71.2%] female; 21 876 [67.6%] white and 12 487 [32.4%] nonwhite). The HSHs were observed to have fewer intensive care unit admissions (1007 [2.6%] vs 1711 [5.0%], P abdominal surgery. No significant difference was found in serious morbidity between HSHs and
Hayes, Blanaid; Fitzgerald, Deirdre; Doherty, Sally; Walsh, Gillian
Objectives To identify and rank the most significant workplace stressors to which consultants and trainees are exposed within the publicly funded health sector in Ireland. Design Following a preliminary semistructured telephone interview, a Delphi technique with 3 rounds of reiterative questionnaires was used to obtain consensus. Conducted in Spring 2014, doctors were purposively selected by their college faculty or specialty training body. Setting Consultants and higher specialist trainees who were engaged at a collegiate level with their faculty or professional training body. All were employed in the Irish publicly funded health sector by the Health Services Executive. Participants 49 doctors: 30 consultants (13 male, 17 female) and 19 trainees (7 male, 12 female). Consultants and trainees were from a wide range of hospital specialties including anaesthetics, radiology and psychiatry. Results Consultants are most concerned with the quality of healthcare management and its impact on service. They are also concerned about the quality of care they provide. They feel undervalued within the negative sociocultural environment that they work. Trainees also feel undervalued with an uncertain future and they also perceive their sociocultural environment as negative. They echo concerns regarding the quality of care they provide. They struggle with the interface between career demands and personal life. Conclusions This Delphi study sought to explore the working life of doctors in Irish hospitals at a time when resources are scarce. It identified both common and distinct concerns regarding sources of stress for 2 groups of doctors. Its identification of key stressors should guide managers and clinicians towards solutions for improving the quality of patient care and the health of care providers. PMID:26700286
Wang, Hsiu-Ling; Huang, Jun-Ying; Howng, Shen-Long
The reimbursement system changed from fee-for-service to fixed prospective payments in Taiwan, the effect on the physician-patient's relationship is worth being studied. We examined the relationship between patient visit experience, cost perceptions and the two important aspects of quality of care, curing and interpersonal performance, and patients' loyalty to the hospital physicians. A total of 404 patients from an acute care hospital in Taiwan, Kaohsiung Medical University Hospital (KMUH), were investigated using a self-administered mailing survey. All measures including patient loyalty (PL), curing service quality (CSQ), interpersonal service quality (ISQ), visit experience (VE) and perceived switching costs (PSC), were adapted and modified from existing scales. Our results showed that the physician's CSQ and ISQ positively affected patients' loyalty to KMUH. The interaction between the main effects of service quality, patients' VE and three types of switching visit costs, yielded additional insights into the importance of service quality for patient retention. The CSQ of physicians becomes a more important determinant of loyalty than ISQ as patients' VE increases. The importance of CSQ and ISQ increases in relation to PL as the perceived procedural and relational costs of changing care providers increases. Neither CSQ nor ISQ has a reduced relationship with PL as the perceived financial costs of switching hospitals increase. Our study indicates that the impact of CSQ and ISQ on loyalty varies according to the perceived visit costs of changing hospitals and the patients' VE.
Full Text Available Background: One of the fatal side effects of transfusion is transfusion reactions. The incidence of transfusion reaction in Sanglah Hospital is still relatively high and far from national target which is 0.01%. To achieve the target of quality, it is necessary to set up an active program so that the number of incidence of transfusion reactions can be decreased. Methods: Pre and posttest interventional study was conducted for 6 months in Sanglah Hospital Bali. All nurses in wards which is blood product frequently used was involved in this study. The intervention in this study was in the form of education and training programs on the application of the closed system and cold chain in the distribution of blood products as well as improved service system. Results: The results showed a decline in the incidence of transfusion reactions occurred every month during the study. The incidence of transfusion reactions occurred each month was 0.77%, 0.56%, 0.5%, 0.49%, 0.45% and 0.38% respectively. The average reduction in the incidence of transfusion reactions was 0.08% every month. The type of transfusion reaction that occurred was 59% urticaria, 29% fever, 7% shortness of breath, 4% fever and chills, and 1% shock. Conclusion: Education and training programs on the application of the cold chain system and closed system in the distribution of blood products as well as the improvement of service system helped reduce the number of the incidence of transfusion reactions in Sanglah Hospital Bali.
Sandra McKeown, MLIS
Conclusions: Our results demonstrate the limitations of written communication in the context of librarian-mediated literature searching and suggest a multifaceted approach to quality improvement efforts.
Shirzadi, Seyed Majid; Raeissi, Pouran; Nasiripour, Amir Ashkan; Tabibi, Seyed Jamaleddin
The hospitality design of a hospital is a complex process that depends on careful planning, systematic thinking, and consideration of various factors. This study aimed to determine the viewpoints of patients and their relatives on factors affecting hospital hotel services in Iran in 2015. The results of this study can be used to design a suitable model for the assessment and improvement of hospitality service quality. In this cross-sectional descriptive study, 10 hospitals of Iran were included. The subjects of the study included 480 patients and their companions from different internal and surgical wards. Simple random sampling method was performed at the hospitals, where patients were selected through stratified sampling based on hospital wards, and in each ward, through systematic sampling based on the bed numbers. A researcher-made questionnaire was used as the study tool which was developed through reviewing the literature and opinions of experts. Its internal reliability was determined based on Cronbach's alpha coefficient (α =0.85). In reviewing the eleven aspects of hospital hotel services regarding the patients' and their companions' viewpoint, services related to all aspects, whether human, economic, operational, personnel identification, safety, health care services, physical, clinical welfare, cultural, patient guidance, or public welfare services, received mean scores of higher than three (out of five). The present study showed that in the patients' and their companions' viewpoint, factors affecting hospital hotel services in the country are very important. The tool used in this study can be a criterion for assessing the status of the hotel services of the country's major hospitals, so accordingly, the assessment and improvement of the existing conditions can be possible.
Shirzadi, Seyed Majid; Raeissi, Pouran; Nasiripour, Amir Ashkan; Tabibi, Seyed Jamaleddin
Background: The hospitality design of a hospital is a complex process that depends on careful planning, systematic thinking, and consideration of various factors. This study aimed to determine the viewpoints of patients and their relatives on factors affecting hospital hotel services in Iran in 2015. The results of this study can be used to design a suitable model for the assessment and improvement of hospitality service quality. Materials and Methods: In this cross-sectional descriptive study, 10 hospitals of Iran were included. The subjects of the study included 480 patients and their companions from different internal and surgical wards. Simple random sampling method was performed at the hospitals, where patients were selected through stratified sampling based on hospital wards, and in each ward, through systematic sampling based on the bed numbers. A researcher-made questionnaire was used as the study tool which was developed through reviewing the literature and opinions of experts. Its internal reliability was determined based on Cronbach's alpha coefficient (α =0.85). Results: In reviewing the eleven aspects of hospital hotel services regarding the patients’ and their companions’ viewpoint, services related to all aspects, whether human, economic, operational, personnel identification, safety, health care services, physical, clinical welfare, cultural, patient guidance, or public welfare services, received mean scores of higher than three (out of five). Conclusion: The present study showed that in the patients’ and their companions’ viewpoint, factors affecting hospital hotel services in the country are very important. The tool used in this study can be a criterion for assessing the status of the hotel services of the country's major hospitals, so accordingly, the assessment and improvement of the existing conditions can be possible. PMID:27904592
Seyed Majid Shirzadi
Full Text Available Background: The hospitality design of a hospital is a complex process that depends on careful planning, systematic thinking, and consideration of various factors. This study aimed to determine the viewpoints of patients and their relatives on factors affecting hospital hotel services in Iran in 2015. The results of this study can be used to design a suitable model for the assessment and improvement of hospitality service quality. Materials and Methods: In this cross-sectional descriptive study, 10 hospitals of Iran were included. The subjects of the study included 480 patients and their companions from different internal and surgical wards. Simple random sampling method was performed at the hospitals, where patients were selected through stratified sampling based on hospital wards, and in each ward, through systematic sampling based on the bed numbers. A researcher-made questionnaire was used as the study tool which was developed through reviewing the literature and opinions of experts. Its internal reliability was determined based on Cronbach's alpha coefficient (α =0.85. Results: In reviewing the eleven aspects of hospital hotel services regarding the patients' and their companions' viewpoint, services related to all aspects, whether human, economic, operational, personnel identification, safety, health care services, physical, clinical welfare, cultural, patient guidance, or public welfare services, received mean scores of higher than three (out of five. Conclusion: The present study showed that in the patients' and their companions' viewpoint, factors affecting hospital hotel services in the country are very important. The tool used in this study can be a criterion for assessing the status of the hotel services of the country's major hospitals, so accordingly, the assessment and improvement of the existing conditions can be possible.
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
This student activity book contains pencil-and-paper activities for use in a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The activities are organized into 29 chapters on the following topics: hospitality services industry; professional ethics; organization/management structures in…
Jonny; Nasution, Januar
Value stream mapping is a tool which is needed to let the business leader of XYZ Hospital to see what is actually happening in its business process that have caused longer lead time for self-produced medicines in its pharmacy unit. This problem has triggered many complaints filed by patients. After deploying this tool, the team has come up with the fact that in processing the medicine, pharmacy unit does not have any storage and capsule packing tool and this condition has caused many wasting times in its process. Therefore, the team has proposed to the business leader to procure the required tools in order to shorten its process. This research has resulted in shortened lead time from 45 minutes to 30 minutes as required by the government through Indonesian health ministry with increased %VA (valued added activity) or Process Cycle Efficiency (PCE) from 66% to 68% (considered lean because it is upper than required 30%). This result has proved that the process effectiveness has been increase by the improvement.
Ahmed, Mohamed; Jones, Eleri; Redmond, Elizabeth; Hewedi, Mahmoud; Wingert, Andreas; Gad El Rab, Mohamed
The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food. Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK. The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations. Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals. The paper identifies opportunities for enhancing hospital food production systems. The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.
De Jonge, M.; Van der Linden, W.P.M.; Willems, H.X.
In this paper we explore the idea that by combining different sources of information in a hospital environment, valuable e-services canbe developed that may help in reducing cost and improving quality of service. Companies, like Philips Medical Systems, may have a compe-titive advantage, because
Diez-Garcia Rosa; de Sousa Anete; Proença Rossana Pacheco da Costa; Leandro-Merhi Vania; Martinez Edson
Abstract Background Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. Methods Investigation of the Hospital Food and Nutrition Service (HFNS) of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ) and hospital food service quality (FSQ). HFN...
Vermont Center for Geographic Information — Hospital service areas (HSAs) are organized by towns and are based on inpatient discharges where the diagnosis indicated the need for immediate care. Plurality...
U.S. Department of Health & Human Services — This file is derived from the calendar year inpatient claims data. The records contain number of discharges, length of stay, and total charges summarized by provider...
Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.
Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk
Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and
Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan
This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.
Take, Naoki; Byakika, Sarah; Tasei, Hiroshi; Yoshikawa, Toru
This study aimed at analyzing the effect of 5S practice on staff motivation, patients' waiting time and patient satisfaction with health services at hospitals in Uganda. Double-difference estimates were measured for 13 Regional Referral Hospitals and eight General Hospitals implementing 5S practice separately. The study for Regional Referral Hospitals revealed 5S practice had the effect on staff motivation in terms of commitment to work in the current hospital and waiting time in the dispensary in 10 hospitals implementing 5S, but significant difference was not identified on patient satisfaction. The study for General Hospitals indicated the effect of 5S practice on patient satisfaction as well as waiting time, but staff motivation in two hospitals did not improve. 5S practice enables the hospitals to improve the quality of services in terms of staff motivation, waiting time and patient satisfaction and it takes as least four years in Uganda. The fourth year since the commencement of 5S can be a threshold to move forward to the next step, Continuous Quality Improvement.
Wright, James R
- The first major project of the American College of Surgeons (Chicago, Illinois), founded in 1913, was implementing Minimum Standards for Hospitals. The 1918 standard (1) established medical staff organizations in hospitals; (2) restricted membership to licensed practitioners in good standing; (3) mandated that the medical staff work with hospital administration to develop and adopt regulations and policies governing their professional work; (4) required standardized, accessible medical records; and (5) required availability of diagnostic and therapeutic facilities. One hundred years ago, these were radical expectations. - To describe the origin, "marketing," and voluntary adoption of the 1918 standards, and to describe how the evolution of those standards profoundly affected laboratory medicine after 1926. - Available primary and secondary historical sources were reviewed. - The college had no legal mandate, so it used a highly consultative approach, funded by its membership and the Carnegie Foundation (New York, New York), to establish the Minimum Standards, followed by a nonthreatening mechanism to determine which hospitals met them. Simultaneously, the college educated the public to fuel their expectations. Compliance by more than 100-bed hospitals in the United States and Canada, although entirely voluntary, rose from negligible when first implemented in 1918 to more than 90% in only a few years. From 1922 to 1926, the American Society for Clinical Pathology (Chicago, Illinois) worked creatively with the college to establish Minimum Standards for "adequate" laboratory services. - The birth and implementation of this program exemplifies how a consultative approach with full engagement of grassroots stakeholders facilitated a voluntary, rapid, sweeping North America-wide change-management process. This program eventually evolved into the Joint Commission (Oakbrook Terrace, Illinois).
Harding, April; Preker, Alexander S
... hospitals play a critical role in ensuring delivery of health services, less is known about how to improve the efficiency and quality of care provided. Much can be learned in this respect from the experiences of hospital reforms initiated during the 1990s. Innovations in Health Service Delivery: The Corporatization of Public Hospitals is an a...
Sivabrovornvatana, Nilubon; Siengthai, Sununta; Krairit, Donyaprueth; Paul, Himangshu
This article aims to explore the relationship between technology and quality management for enhancing Thai hospital service quality. The paper presents the findings of an exploratory study that investigates service quality from the customer and service provider perception. In-depth interviews were conducted with respondents in Thai hospitals. The interviews explored service-related factors that patients and service providers perceive to be important for hospital services. The first interview group consisted of professionals as internal customers in direct contact with external customers, while the second group consisted of external customers of the same hospitals. The study's outcomes clearly suggest factors that make significant contribution to service quality. These factors can be categorized according to five SERVQUAL dimensions (reliability, responsiveness, assurance, empathy, and tangibility), although some factors required slightly different interpretation. The findings suggest that hospitals can develop an appropriate approach to their advantage, which can yield sustainable improvement in service quality as perceived by patients and professionals. Hospitals can make better quality decisions based on structured measurement and knowledge. It is recommended that managers apply this knowledge for successful implementation of activities related to service quality in their organizations.
Kathleen Carey; James F. Burgess; Gary J. Young
...: changes in service provision by general hospitals in local markets. Results suggest that general hospitals are stepping up their own offerings of services that are in direct competition with those of specialty hospitals...
Purwadi, Moh. Hasyim; Sudiro, Sudiro; Purnami, Cahya Tri
Perinatal service is one of eminent services in Kraton Hospital. Limitation of trained staff andless completeness of equipment as well as less leadership supports for “infant caringhospital” has been problems in the perinatal service in Kraton Hospital.ResearchObjective was to analyze influence of leadership practice perception to service qualityperception in perinatal room Kraton Hospital. Type of research was observationalquantitative analytic, with cross sectional approach. Data collection...
Full Text Available The objective of this study was to evaluate the perception of hospital pharmacists regarding quality of pharmaceutical care services in Khyber Pakhtunkhwa (KPK Province, Pakistan, through qualitative as well as quantitative approach. For qualitative study, snow ball sampling technique was used. In quantitative part, a cross-sectional study was conducted in 112 hospital pharmacists (out of 128 accessed ones from both private and public hospitals in six major divisions (divisions are the third tier of government in Pakistan, between the provinces and districts of KPK. The qualitative study yielded five major themes during thematic analysis: (a patients reporting, (b lack of patient counseling, (c lack of participation in health awareness programs, (d pharmacists reducing the prescribing errors, and (e insufficient number of pharmacists. A great proportion (67.9% of the pharmacists was unsatisfied with their participation in health awareness programs. Findings of both phases revealed that hospital pharmacists in Pakistan are not actively participating in the provision of pharmaceutical care services. They are facing various hurdles for their active participation in patient care; major obstacles include the unavailability of sufficient number of pharmacists, lack of appropriate time for patient counseling, and poor relationship between pharmacists and other health care providers.
U.S. Department of Health & Human Services — CMS is pursuing a vision to improve the quality of health care by expanding the information available about quality of care and through direct incentives to reward...
Frey, Rosemary; Gott, Merryn; Raphael, Deborah; O'Callaghan, Anne; Robinson, Jackie; Boyd, Michal; Laking, George; Manson, Leigh; Snow, Barry
Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting. The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence. A purposive sample of clinical staff members (598) in a 710-bed hospital were surveyed regarding their experiences of palliative care delivery and their education needs. On average, the clinical staff rated the quality of care provided to people who die in the hospital as 'good' (x̄=4.17, SD=0.91). Respondents also reported that 19.3% of their time was spent caring for end-of-life patients. However, only 19% of the 598 respondents reported having received formal palliative care training. In contrast, 73.7% answered that they would like formal training. Perceived confidence in palliative care delivery was significantly greater for those clinical staff with formal palliative care training. Formal training in palliative care increases clinical staff perceptions of confidence, which evidence suggests impacts on the quality of palliative care provided to patients. The results of the study should be used to shape the design and delivery of palliative care education programmes within the acute hospital setting to successfully meet the needs of all clinical staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Sonntag, H G; Möller, J
Due to the law of health reform and health structure the hospitals in the Federal Republic of Germany are asked to not only think about cost reduction but at the same time to also face the requirements of quality management (QM) and quality assurance (QA). For the field of medical and care taking treatment of patients in the hospital the term "quality" can be described as the total of characteristics of the medical services necessary for the realization of all requirements which lead to an optimal patient treatment. Hospital hygiene as part of hygiene in the broader sense deals with the bases of disease prevention of all persons actively or passively connected with the institution hospital as well as with the natural and social hospital environment and, thus, in every respect proves to be a guide discipline for the realization of QM and QA in the hospital. For the realization of an overall concept for QM and QA in the hospital three categories of quality have proved to be worthwhile, namely the structure quality which deals with the quality related arrangement of the frame conditions of hospital productivity the process quality which comprises the improvement of diagnostic, therapeutic, care taking and medical activities in the hospital as well as interactions between the hospital staff and the patient or his relatives, and the outcome quality, which judges the changes in the patient's condition by means of predefined target values. Furthermore, QM in the hospital needs detailed informative activities (initial stage of information) as well as motivating measures (initial stage of conduct) whereas latter has to be considered as an essential basis for a staff-related realization of quality assurance measures in the hospital. Possibilities for a practical realization of QM and QA are shown by means of the modular concept established in the Clinics of the University of Heidelberg. Thereby, one could experience that a successful QM in the hospital requires the declared
Diley, Ian; Badrinath, Padmanabhan; Annon, Sarah
This study assessed whether the 14 National Health Service (NHS) acute trusts reviewed by Sir Bruce Keogh in July 2013 were performance outliers on the Acute Trust Quality Dashboard (ATQD) and examined whether high mortality indices results are associated with increased numbers of quality risk alerts and alarms. The proportion of dashboard indicators rated amber or red in the Keogh Review trust group was compared with that for all trusts. Quality performance at primary care level was assessed for lead Clinical Commissioning Groups (CCG) of Keogh Review trusts through the national General Practice High Level Indicators. England. The study examined the performance of all acute NHS trusts in England and the performance of the lead CCGs for all acute NHS trusts included in the Keogh Review. The primary outcome was the proportion of alerts and alarms identified in the summer 2013 ATQD. The mean proportion of indicators scored as alert or alarm across all trusts was 14.1% (13.5-14.7%). For Keogh Review trusts, the mean was 14.5% (12.6-16.4%). There was no significant difference between Keogh Review trusts and all acute trusts in numbers of alerts or alarms or for lead CCG quality performance. This study finds no evidence to suggest the trusts reviewed by Sir Bruce Keogh in spring 2013 were outliers for overall quality of care as defined by the ATQD. The use of mortality indices alone to identify potential quality outliers in secondary care may not be sufficient.
Strub, Richard; Lynnes, Christopher; Hearty, Thomas; Won, Young-In; Fox, Peter; Zednik, Stephan
A report describes the Data Quality Screening Service (DQSS), which is designed to help automate the filtering of remote sensing data on behalf of science users. Whereas this process often involves much research through quality documents followed by laborious coding, the DQSS is a Web Service that provides data users with data pre-filtered to their particular criteria, while at the same time guiding the user with filtering recommendations of the cognizant data experts. The DQSS design is based on a formal semantic Web ontology that describes data fields and the quality fields for applying quality control within a data product. The accompanying code base handles several remote sensing datasets and quality control schemes for data products stored in Hierarchical Data Format (HDF), a common format for NASA remote sensing data. Together, the ontology and code support a variety of quality control schemes through the implementation of the Boolean expression with simple, reusable conditional expressions as operands. Additional datasets are added to the DQSS simply by registering instances in the ontology if they follow a quality scheme that is already modeled in the ontology. New quality schemes are added by extending the ontology and adding code for each new scheme.
Mohammad Javad Akbarian Bafghi
Full Text Available Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.
Casey, Michelle M.; Prasad, Shailendra; Klingner, Jill; Moscovice, Ira
Context: Quality measures focused on outpatient settings are of increasing interest to policy makers, but little research has been conducted on hospital outpatient quality measures, especially in rural settings. Purpose: To evaluate the relevance of Centers for Medicare and Medicaid Services' (CMS) outpatient quality measures for rural hospitals,…
Canel, Cem; Mahar, Steve; Rosen, Drew; Taylor, John
Healthcare providers need the information contained in patient records to provide high-quality services. To be effective, patient record assembly must be completed in a timely manner. This study aims to analyse the medical records assembly process for a hospital in Southeastern United States having difficulty meeting standard completion times established by the Joint Commission on the Accreditation of Healthcare Organization. Several quality improvement tools were used to evaluate and improve the assembly process. As a result of the study, a new procedure was implemented. Consequently, the hospital reduced the time required to assemble medical records, thereby improving efficiency and effectiveness. There are hopes to further improve the process. The study provides guidance on how statistical process control techniques can be applied to improve hospital services. The techniques employed can be used to analyze and improve any process. However, results are limited to improving medical record assembly processes at one particular hospital. Past studies considered the application of various statistical process control techniques for improving healthcare quality. The study extends research by employing process improvement efforts to understand and develop medical record assembly in a regional hospital via process flow diagramming and control charts.
Carey, Kathleen; Burgess, James F; Young, Gary J
To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.
such as screening for breast and cervical cancer and certain sexually transmitted diseases . National Perinatal Information Center (NPIC) NPIC is a...data for a subset of these measures. 31A hysterectomy is the surgical removal of part, or all, of the uterus. 32Chlamydia is a sexually transmitted ...care performance measures and includes measures of preventive services for women such as screening for breast and cervical cancer and certain sexually
Hizmet Kalitesi - Müşteri Memnuniyeti İlişkisinin Hastane Türlerine Göre Karşılaştırılması : Devlet, Özel ve Üniversite Hastaneleri Uygulaması = An Analysis of the Relationship Between Service Quality and Customer Satisfaction According to Type of Health Services Provider : An Application at Public, Private and University Hospitals
Full Text Available Current study attempted to identify dimensions of hospital service quality and analyzed relationships between service quality dimensions and overall patient satisfaction within different hospital service provider categories. The research was conducted with 225 patients at public, university and private hospitals in two southern metropolis of Turkey. Patients' service quality perceptions were measured with four factors; services before the treatment, physician services, care for private needs-laboratory services and perceptions about physical environment. First factor analysis and variance analysis was conducted. Then it was followed by regression analyses. Multiple regression analyses revealed that services before the treatment and perceptions about physical environment were significant determiners of overall patient satisfaction at public hospitals whereas physician services, care for private needs-laboratory services and perceptions about physical environment were significant indicators of overall patient satisfaction at university hospitals. As for private hospitals, all four factors show significant relationships with overall patient satisfaction.
Full Text Available Services are today the dominant sector of the economic activity both in terms of economic performance and labor utilization. Becoming an essential part of today’s society, they are considered the basis of a healthy economy, fact that has increased the importance of services and the research in the field. One of the biggest challenges regarding this sector is the evaluation and assurance of quality. There is still a lack of unanimity regarding the definitions, measurement procedures and the aspects that need to be provided and measured. Through this article we intend to treat these subjects and provide a broad perspective on this topic. Thus, we hope to highlight some practices and directions that could be relevant for the organizations in this field.
Ellicott, Michael A.; Conard, Rodney J.
Recent experiences of manufacturing and commercial service industries provide insights to college facilities managers for combining downsizing with quality improvement. The Service Excellence Model emphasizes creation of shared responsibility, focus on core service processes, empowerment of cross-functional process-improvement teams, performance…
Babakus, E; Mangold, W G
Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified.
Diez-Garcia, Rosa Wanda; de Sousa, Anete Araújo; Proença, Rossana Pacheco da Costa; Leandro-Merhi, Vania Aparecida; Martinez, Edson Zangiacomi
Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. Investigation of the Hospital Food and Nutrition Service (HFNS) of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ) and hospital food service quality (FSQ). HFNS was also evaluated with respect to human resources per hospital bed and per produced meal. Comparison between public and private institutions revealed that there was a statistically significant difference between the number of hospital beds per HFNS staff member (p = 0.02) and per dietitian (p hospital type (general) and presence of a clinical dietitian. FSQ was affected by institution size: large and medium-sized hospitals were significantly better than small ones. Food and nutritional care in hospital is still incipient, and actions concerning both nutritional care and food service take place on an irregular basis. It is clear that the design of food and nutritional care in hospital indicators is mandatory, and that guidelines for the development of actions as well as qualification and assessment of nutritional care are urgent.
McHugh, Matthew D.; Stimpfel, Amy Witkoski
As the primary providers of round-the-clock bedside care, nurses are well positioned to report on hospital quality of care. Researchers have not examined how nurses’ reports of quality correspond with standard process or outcomes measures of quality. We assess the validity of evaluating hospital quality by aggregating hospital nurses’ responses to a single item that asks them to report on quality of care. We found that a 10% increment in the proportion of nurses reporting excellent quality of...
Penm, Jonathan; Chaar, Betty; Moles, Rebekah
Non-communicable diseases have become an increasing problem in the Pacific Island countries (PICs). With the medical supply system often attached to hospitals in PICs, the training of hospital pharmacy staff has become increasingly important. This study aimed to explore hospital pharmacy services in the PICs using these validated surveys (BS26-27 and BS28-31 surveys) focusing upon hospital pharmacists' influence on prescribing and quality use of medicines. The BS26-27 and BS28-31 surveys were distributed online to pharmacy directors in hospitals in the PICs in 2011 and 2013, respectively. Surveys were made available in both English and French. In total, data from 55 hospitals were received (77% of the hospital sample in PICs) for either the BS26-27 or BS28-31 survey. From the responses received, 97% (36/37) of hospitals had a formulary, with 81% (26/32) of hospitals having a Pharmacy and Therapeutics (P&T) committee. Furthermore, 67% (24/36) of respondents stated that they provided some sort of clinical pharmacy service. On average, hospitals had two pharmacists involved in clinical pharmacy services. In BS28-31, over 75% (n=27) of respondents believed having a strong relationship with other health care professionals, having effective communication skills and taking professional responsibility for the medicines prescribed as 'mostly' or 'strongly' facilitating clinical services. Hospital pharmacists' participation on P&T committee and clinical services is common in the PICs. Such services enhance medication selection and reduce wastage. Although there are still too few hospital pharmacists in PICs, additional support aimed at enhancing their team building and communication skills will allow them to expand their roles and continue to improve patient health outcomes. © 2014 John Wiley & Sons, Ltd.
A quality of service (QoS) management framework for systems is presented that satisfies application needs along multiple dimensions such as timeliness, reliability, cryptographic security and other application specific quality requirements...
Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid
.5-24.9 kg/m2 were defined as normal weight. Individuals with BMI DESIGN: We undertook a 3-year retrospective study of the relationship between obesity and use of hospital resources. Data on hospital contacts and costs were obtained from The National Patient...... Registry and DRG. Analyses were performed using two-part models and Poisson regression. Outcome variables were costs and hospital contacts. RESULTS: This study has demonstrated that obese individuals have a greater use of hospital services and greater hospital costs compared with normal weight individuals...
Woodside, A G; Frey, L L; Daly, R T
Based on the service quality and script theory literature, a framework of relationships among service quality, customer satisfaction, and behavioral intention for service purchases is proposed. Specific models are developed from the general framework and the models are applied and tested for the highly complex and divergent consumer service of overnight hospital care. Service quality, customer satisfaction, and behavioral intention data were collected from recent patients of two hospitals. The findings support the specific models and general framework. Implications for theory, service marketing, and future research are discussed.
Full Text Available Abstract Background Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. Methods Investigation of the Hospital Food and Nutrition Service (HFNS of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ and hospital food service quality (FSQ. HFNS was also evaluated with respect to human resources per hospital bed and per produced meal. Results Comparison between public and private institutions revealed that there was a statistically significant difference between the number of hospital beds per HFNS staff member (p = 0.02 and per dietitian (p Conclusions Food and nutritional care in hospital is still incipient, and actions concerning both nutritional care and food service take place on an irregular basis. It is clear that the design of food and nutritional care in hospital indicators is mandatory, and that guidelines for the development of actions as well as qualification and assessment of nutritional care are urgent.
Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Program Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Provider-Based Status of Indian Health Service and Tribal Facilities and Organizations; Costs Reporting and Provider Requirements; Agreement Termination Notices. Final rule.
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey
Wimsatt-Fraim, Teresa S.
A program was conducted to improve the quality of food service through the training of 44 food and nutrition service employees in a 200-bed hospital. A 12-week quality control program was implemented to address four key areas: food temperatures, food accuracy, food quality, and dietary personnel. Learning strategies, emphasizing critical thinking…
Carey, Kathleen; Stefos, Theodore
This paper explores the relationship between the cost and quality of hospital care from the perspective of applied microeconomics. It addresses both theoretical and practical complexities entailed in incorporating hospital quality into the estimation of hospital cost functions. That literature is extended with an empirical analysis that examines the use of 15 Patient Safety Indicators (PSIs) as measures of hospital quality. A total operating cost function is estimated on 2,848 observations from five states drawn from the period 2001 to 2007. In general, findings indicate that the PSIs are successful in capturing variation in hospital cost due to adverse patient safety events. Measures that rely on the aggregate number of adverse events summed over PSIs are found to be superior to risk-adjusted rates for individual PSIs. The marginal cost of an adverse event is estimated to be $22,413. The results contribute to a growing business case for inpatient safety in hospital services.
Ladhari, Riadh; Rigaux-Bricmont, Benny
The aim of this research is to propose and test a model of the causal relationships among the constructs of perceived service quality, consumption emotions, and satisfaction among users of public hospital services. The conceptual model proposed in this study postulates that: (a) perceived service quality is positively related to positive emotions and negatively related to negative emotions; (b) perceived service quality is positively related to patient satisfaction; and (c) positive emotions are positively related to patient satisfaction and negative emotions are negatively related to patient satisfaction. The model was tested with data from an empirical study in the Canadian public hospital setting. Data were collected from 314 respondents. The relationships between the constructs were tested using structural equation modeling by means of the EQS software. All hypothesized relationships were supported. The results confirm that perceived service quality exerts both direct and indirect effects (through positive and negative emotions) on satisfaction. The study demonstrates that emotions play an important role in determining satisfaction with hospital services.
Ribeiro, José Mendes
We analyze Brazilian health system in comparative perspective. Middle income beneficiaries migration to pre-paid private insurance makes Brazilian case similar to United States. Public hospital services delivery shows an important retrenchment enhanced by demographic growth and new expectations due to constitutional definitions. Retrenchment is selective and concentrates on obstetric and clinic services and private for-profit services. To ensure equal access it is necessary to improve public spending; diminish out-of-pocket spending; develop organizational reforms; improve government capacity.
Medicare and Medicaid programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; physician-owned hospitals: data sources for expansion exception; physician certification of inpatient hospital services; Medicare Advantage organizations and Part D sponsors: CMS-identified overpayments associated with submitted payment data. Final rule with comment period.
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2015 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. In this document, we also are making changes to the data sources permitted for expansion requests for physician-owned hospitals under the physician self-referral regulations; changes to the underlying authority for the requirement of an admission order for all hospital inpatient admissions and changes to require physician certification for hospital inpatient admissions only for long-stay cases and outlier cases; and changes to establish a formal process, including a three-level appeals process, to recoup overpayments that result from the submission of erroneous payment data by Medicare Advantage (MA) organizations and Part D sponsors in the limited circumstances in which the organization or sponsor fails to correct these data.
... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, nursing facility services, and intermediate care facility services for individuals age 65 or older in institutions for...
Mitreva, Elizabeta; Miteva, Natasa; Saneva, Dusica
Quality assessment is one of the greatest challenges of hotel industry. Given its complex nature, numerous technics help in quality measurement, assessment and management. Following this it can be achieved full quality management and with that sustainable business development to the satisfaction of all stakeholders. In service industries quality is measured according to consumers’ expectation and perception. The aim of this paper is to, through literature review, to get the importance of qual...
Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia
Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.
Full Text Available Background and Objectives : Due to unique characteristics of the health sector, measuring the efficiency and quality of services provided are the top priorities of the Ministry of Health and Medical Education. In health systems, an appropriate response to the needs and demands of patients is a priority. This study was conducted to assess hospital’s services quality using logit model for prioritizing service attributes based on patients’ perception in 2012. Material and Methods : In this descriptive cross-sectional study, 330 patients in Imam Khomeini Hospital in Tehran were entered into the study based on Cochran method. Data were gathered using questionnaire in 5 dimensions and 10 scenarios. Reliability and validity of the questionnaire were approved. Data were input into STATA software 10th edition and utility function was estimated to calculate the marginal utility specifications. Results : According to the patients’ perception, type of examination and treatment was ranked as the first and cleaning services of the departments and toilets was ranked as the last priority. The results about waiting time between hospital arrival until admission was negative which means reverse influence on patient perception of quality. Except cleaning services of the departments and toilets and handling patients, other features had significant relationship with patient preferences. Conclusion : In order to increase the desirability of visiting patients in hospitals and delivering high quality services and considering patient preferences; hospital administrators need to be focused on improving the quality of the programs.
Domingo, Rene T
Operating simultaneously like a repair shop, prison, and hotel, hospitals are prone to seven common pitfalls in customer service. Patient care is often fragmented, inscrutable, inflexible, insensitive, reactive, myopic, and unsafe. Hospitals are vying to be more high-tech, rather than high-touch even though staff engagement with patients rather than facilities and equipment strongly influence patient satisfaction. Unless processes, policies, and people are made customer-centered, the high quality of the hospital's human and hardware resources will not translate into high patient satisfaction and patient loyalty.
Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil
specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. Conclusions: This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends......Background: The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Methods...... management, referral pathways, patient’s education and reassurance, convenience and comfort, patient’s satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Results: Our study showed that highly experienced headache centres treated their patients in general very well...
Fraihi, Khalid J. Al; FAMCO, Dip; FAMCO, Fellow; Latif, Shahid A.
Objectives: To investigate perceptions and expectations of patients regarding hospital outpatient services by using a service quality gap model and factors influencing such gaps. Methods: In this cross-sectional descriptive study conducted between October and November 2014 in the outpatient waiting areas of a hospital in the Eastern Province of Saudi Arabia, a sample of 306 patients was selected by convenience sampling technique. The data was collected through an Arabic version of the service quality (SERVQUAL) questionnaire consisting of 2 parts: patients’ demographic characteristics, and 22 items scales of patients’ expectations and perceptions of SERVQUAL. The data was analyzed by confirmatory factor analysis, independent, and paired t samples tests and one way analysis of variance test. Results: The results showed that the proposed model for service quality dimensions had a good fit by satisfying the recommended values. The patients’ expectations exceeded perceptions in all service quality dimensions indicating statistically significant service quality gaps (t=26.3, pservices showed highest service quality gap, while observation of privacy showed the smallest service quality gap in the statements. The study showed a significant association between gender, age, education, multiple visits, and service quality dimensions. Conclusion: The proposed model is valid and reliable and significant service quality gaps of all 5 dimensions need to be prioritized and addressed by focused improvement efforts of hospital management. PMID:27052285
Batagan, Lorena; Pocovnicu, Adrian; Capisizu, Sergiu
A characteristic of today's society is the increasing use of modern information and communication technologies in all areas. Computer applications, called e-services, are being developed to provide efficient access to services, electronically. Quality management systems are needed to provide a consistent way to select, evaluate, prioritize and…
Muhlestein, David B; Wilks, Chrisanne E A; Richter, Jason P
Consumer-directed policies, including health savings accounts, have been proposed and implemented to involve individuals more directly with the cost of their health care. The hope is this will ultimately encourage providers to compete for patients based on price or quality, resulting in lower health care costs and better health outcomes. To evaluate American hospital websites to learn whether hospitals advertise directly to consumers using price or quality data. Structured review of websites of 10% of American hospitals (N=474) to evaluate whether price or quality information is available to consumers and identify what hospitals advertise about to attract consumers. On their websites, 1.3% (6/474) of hospitals advertised about price and 19.0% (90/474) had some price information available; 5.7% (27/474) of hospitals advertised about quality outcomes information and 40.9% (194/474) had some quality outcome data available. Price and quality information that was available was limited and of minimal use to compare hospitals. Hospitals were more likely to advertise about service lines (56.5%, 268/474), access (49.6%, 235/474), awards (34.0%, 161/474), and amenities (30.8%, 146/474). Insufficient information currently exists for consumers to choose hospitals on the basis of price or quality, making current consumer-directed policies unlikely to realize improved quality or lower costs. Consumers may be more interested in information not related to cost or clinical factors when choosing a hospital, so consumer-directed strategies may be better served before choosing a provider, such as when choosing a health plan.
Ali Mohammad Mosadeghrad
Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production o...
Gravelle, Hugh; Santos, Rita; Siciliani, Luigi
We examine whether a hospital's quality is affected by the quality provided by other hospitals in the same market. We first sketch a theoretical model with regulated prices and derive conditions on demand and cost functions which determine whether a hospital will increase its quality if its rivals increase their quality. We then apply spatial econometric methods to a sample of English hospitals in 2009-10 and a set of 16 quality measures including mortality rates, readmission, revision and redo rates, and three patient reported indicators, to examine the relationship between the quality of hospitals. We find that a hospital's quality is positively associated with the quality of its rivals for seven out of the sixteen quality measures. There are no statistically significant negative associations. In those cases where there is a significant positive association, an increase in rivals' quality by 10% increases a hospital's quality by 1.7% to 2.9%. The finding suggests that for some quality measures a policy which improves the quality in one hospital will have positive spillover effects on the quality in other hospitals.
Tsai, Yafang; Wu, Shih-Wang
The purpose of this article was to explore the structural relationships among internal marketing, organizational commitment and service quality and to practically apply the findings. Internal marketing is a way to assist hospitals in improving the quality of the services that they provide while executing highly labour-intensive tasks. Through internal marketing, a hospital can enhance the organizational commitment of its employees to attain higher service quality. This research uses a cross-sectional study to survey nursing staff perceptions about internal marketing, organizational commitment and service quality. The results of the survey are evaluated using equation models. The sample includes three regional hospitals in Taiwan. Three hundred and fifty questionnaires were distributed and 288 valid questionnaires were returned, yielding a response rate of 82.3%. The survey process lasted from 1 February to 9 March 2007. The data were analysed with SPSS 12.0, including descriptive statistics based on demographics. In addition, the influence of demographics on internal marketing, organizational commitment and service quality is examined using one-way anova. The findings reveal that internal marketing plays a critical role in explaining employee perceptions of organizational commitment and service quality. Organizational commitment is the mediator between internal marketing and service quality. The results indicate that internal marketing has an impact on both organizational commitment and service quality. Internal marketing should be emphasized to influence frontline nursing staff, thereby helping to create better organizational commitment and service quality. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
The accreditation of the ISO 9001 certification (ISO = International Standard Organization) is an external evaluation procedure carried out by independent experts, whose object is the analysis of the operational methods and practices of a medical care facility (e.g. hospital, private clinic, general practitioner's or dentist's practice) which decided to assume the concept, implementation and control of its own quality policy. The whole accreditation procedure represents the basic structure of a continuous dynamic progressiveness within a cabinet eager to offer outstanding quality. Moreover, it guarantees active and voluntary participation of every single member of the medical administration or technical team involved in the realization of this primary objective. In other words, we are talking about a very strong dynamic innovation leading to a change of views and the improvement of communication means, while simultaneously enhancing the security and quality aspects of medical care. The continuous guarantee of high quality medical care calls for precise planning and systematization of actions. First of all, these actions are defined, analyzed and listed in precise work procedures. As they are defined with the agreement of the whole team, they implicate respect and self control. This requires of course transparency of the treatment methods, whose different steps and procedures are described in detail in a logogramm set up in common.
Schoten, S. van; Groenewegen, P.; Wagner, C.
Context: Quality systems were implemented in healthcare institutions to assure and improve the quality of care. Despite the fact that all Dutch hospitals have implemented a quality system, incidents persist to surface. How could this be explained? The current research was set out to gain thorough
Purificación Cerro López
Full Text Available The following work tries to evaluate the satisfaction degree of the dialysis patients regarding the health attention received, and to identify the problems related to the health care services. To achieve this goal a qualitative-quantitative study was designed. The study population were patients who receive renal substitutive treatment in the Nuestra Señora de la Candelaria University Hospital (HUNSC. Quantitative data were collected by using the questionnaire (SERVQHOS to 71% of the total population. Each item was punctuated in a Likert scale according to the degree of satisfaction (from 1 to 5. The SPSS 13.0 statistical program was used for the data analysis. Qualitative data were collected by formulating an open question which was answered on personal diaries written by some of these patients. The average global satisfaction obtained was 4. The professionalism of the sanitary personnel is among the better aspects valued (4.2 and the transport services among the worse valued (2.1. It was not found statistical significant relation between the analyzed variables and the patients satisfaction degree. Regarding the outcomes of the qualitative analysis, it contributes us very useful information to identify susceptible aspects to improve related to the medical and nursing attention, transport services, ward environment and other resources.
Patient satisfaction has traditionally been linked to the quality of services given and the extent to which specific needs are met. Satisfied patients are likely to come back for the services and recommend services to others6. Various factors including attitude of staff, cost of care, time spent at the hospital and doctor ...
... of genuine hospitality in individuals. This paper describes the development of a suite of questions designed to measure these qualities in individuals. This paper describes the development of the instrument and argues for the application of the instrument in wider array of tourist and other contexts than are described here.
Full Text Available The issue of service quality is one of the essential areas of marketing theory and practice, as high quality can lead to customer satisfaction and loyalty, i.e. successful business results. It is vital for any company, especially in services sector, to understand and grasp the consumers' expectations and perceptions pertaining to the broad range of factors affecting consumers' evaluation of services, their satisfaction and loyalty. Hospitality is a service sector where the significance of these elements grows exponentially. The aim of this study is to identify the significance of individual quality components in hospitality industry. The questionnaire used for gathering data comprised 19 tangible and 14 intangible attributes of service quality, which the respondents rated on a five-degree scale. The analysis also identified the factorial structure of the tangible and intangible elements of hotel service. The paper aims to contribute to the existing literature by pointing to the significance of tangible and intangible components of service quality. A very small number of studies conducted in hospitality and hotel management identify the sub-factors within these two dimensions of service quality. The paper also provides useful managerial implications. The obtained results help managers in hospitality to establish the service offers that consumers find the most important when choosing a given hotel.
Presentation descibes results from two studies of water quality and pathogen occurrence in water and biofilm samples from two area hospitals. Includes data on the effectiveness of copper/silver ionization as a disinfectant.
Jäger, Matthias; Ospelt, Isabelle; Kawohl, Wolfram; Theodoridou, Anastasia; Rössler, Wulf; Hoff, Paul
This study aims at investigating the formal and content-related quality of medical certificates directing compulsory hospital admissions before the scheduled alteration of the Swiss civil legislation in January 2013. A comparison between physicians with different professional backgrounds concerning certificates and patients was conducted. Retrospective investigation of medical records of involuntary inpatients at the University Hospital of Psychiatry in Zurich during a period of six months (N=489). Considerable deficits concerning formal and particularly content-related aspects of the certificates were found. Psychiatrists issued certificates of the highest quality followed by emergency physicians, hospital doctors and general practitioners. Patients differed with respect to several sociodemographic and clinical variables. The quality of certificates directing involuntary hospital admission has to be improved considering the impact on the individual concerned. The consequences of the new legislation on the quality of the admission practices should be inquired in order to improve professional training on the issue.
Full Text Available Objective level of product is a combination of material elements. They are supplemented by satisfying highly heterogeneous and complex motivations, representing highly diverse subjective functions associated to product until individualization for each type of consumption. Thus it observes highly surprising developments of subjective function associated with a product and which determines in the consumer's opinion the quality level of the product. The present study examines the role of associated services covering the subjective function of the product in view of the fact that the utility or subjective function is dependent on elements such as style, fashion and fads. Consumers will no longer accept products with average quality of related services. For a company that wants to stay in the market and achieve profitability, the only solution is moving towards a complete product package type goods-services. Associated services are thus an indicator of quality and the best customer loyalty insurance policy, there is a close relationship between the quality of services provided by a firm, customer satisfaction and company profitability.
Bail, Kasia; Hudson, Charles; Grealish, Laurie; Shannon, Kay; Ehsen, Saraah; Peut, Ann; Gibson, Diane; Draper, Brian; Karmel, Rosemary
To obtain information about aged care services in rural New South Wales public hospitals, and to describe key operational aspects of their service delivery models. A mixed methods design was used to combine data collected from: (i) a survey of public hospitals and (ii) qualitative site visits in a sample of eleven rural sites. Rural public hospitals in NSW, Australia. Qualitative data were collected from multidisciplinary clinicians, managers and community service providers who participated in site visits in 2010 and from surveys of NSW public hospitals in 2009/10 about aged care and dementia services. Survey and site visit findings demonstrated that rural hospitals have fewer secure beds for managing patients with disturbed behaviour due to dementia and delirium and fewer speciality aged care staff than metropolitan hospitals. Site visit participants also described how secure environments can aid care for people with dementia even in the absence of clinical specialists. The care of people with dementia in rural hospitals is constrained by access to specialist aged care staff and the physical environment of the hospital. Clinicians are adept at maximising resources to manage diagnosis and transitions for people with dementia. Further understanding of how key operational aspects of clinical leadership and environmental modifications impact on a range of patient outcomes would be valuable. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
Ali Mohammad Mosadeghrad
Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.
Cheng, Shou-Hsia; Wei, Yu-Jung; Chang, Hong-Jen
Quality of care rather than price is the main concern in health care. However, does price not matter at all? To investigate what quality and cost factors influence whether patients perceive health care services as expensive and will recommend a hospital to other patients, the authors analyzed data from a national survey of patients in Taiwan in 2002. A total of 6725 subjects returned questionnaires. Results from logistic regression models showed that (1) a patient's perception of expense was determined simultaneously with the perceived quality and the out-of-pocket price of care, (2) a patient's perception of hospital quality appeared to be the most important determinant for recommending a hospital, and(3) while the out-of-pocket price did not affect a patient's recommendation, the perceived expense of the services did. The perceived value rather than the price itself-is the essence of quality competition in Taiwan's health care market.
Ferrua, Marie; Sicotte, Claude; Lalloué, Benoît; Minvielle, Etienne
The strategy of publicly reporting quality indicators is being widely promoted through public policies as a way to make health care delivery more efficient. To assess general practitioners' (GPs) use of the comparative hospital quality indicators made available by public services and the media, as well as GPs' perceptions of their qualities and usefulness. A telephone survey of a random sample representing all self-employed GPs in private practice in France. A large majority (84.1%-88.5%) of respondents (n = 503; response rate of 56%) reported that they never used public comparative indicators, available in the mass media or on government and non-government Internet sites, to influence their patients' hospital choices. The vast majority of GPs rely mostly on traditional sources of information when choosing a hospital. At the same time, this study highlights favourable opinions shared by a large proportion of GPs regarding several aspects of hospital quality indicators, such as their good qualities and usefulness for other purposes. In sum, the results show that GPs make very limited use of hospital quality indicators based on a consumer choice paradigm but, at the same time, see them as useful in ways corresponding more to the usual professional paradigms, including as a means to improve quality of care.
Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei
Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.
Filistrucchi, L.; Ozbugday, F.C.
Abstract: Using a newly constructed dataset on German hospitals, which includes 24 process and outcome indicators of clinical quality, we test whether quality has increased in various clinical areas since the introduction of mandatory quality reports and the online publication of part of the
Jouyani, Yasser; Bahrampour, Mina; Barouni, Mohsen; Dehnavieh, Reza
Due to the importance and uniqueness of the characteristics of the health sector, one of the most important priorities of the Ministry of Health is measuring the efficiency and quality of services which are provided for the people who refer to the health sectors. In all health systems, responding to the needs and wishes of patients is a crucial priority. The main purpose of this study is to prioritize the features of the services from the perspective of patients, by applying the Logit model. This study is a descriptive cross-sectional study and in terms of results it can be classified to an applied study. Data were collected by a questionnaire filled by 330 patients in Imam Khomeini hospital, and for estimating the utility function the software STATA version 10 was applied. In this study the preferences of patients who admitted to hospitals were identified by calculating the marginal utility of the characteristics, where we also used Marginal Rate substitutions (MRS). Determination of the marginal utility characteristics shows that the first priority in receiving hospital services is the type of examination, and the last priority in the cleaning service of the sections and restrooms . Waiting time between hospital arrivals and admission has a negative sign which indicates a negative impact on patient preference. The results of this study are consistent with studies by Kara Hanson and Barbara Mc Clean, where in their study they also showed that by the patient's perspective, hospital examination is the most important quality characteristic (coefficient = 2.78). In other words, the ultimate purpose of the hospital visit is the quality of service and examination, where many patients are willing to wait longer or pay higher costs to get the best services.
Angell, Robert J.; Heffernan, Troy W.; Megicks, Phil
Purpose: Measuring service quality in higher education is increasingly important for attracting and retaining tuition-based revenues. Nonetheless, whilst undergraduates have received substantial academic exposure, postgraduate-based research has been scant. Consequently, the objectives of this paper are threefold: first, to identify the service…
Rabbani, Fauziah; Pradhan, Nousheen Akber; Zaidi, Shehla; Azam, Syed Iqbal; Yousuf, Farheen
The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework. Using a cross-sectional study design, two rural health centers (RHCs) contracted out to Aga Khan Health Service, Pakistan were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson χ2, Fisher's Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities. Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients' inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p=0.006). The study shows that contracting out initiatives have the potential to improve MNH care. This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.
Full Text Available In general, people spent more than 80∼90% of living time in the indoor every day, human health and indoor environmental quality are closely related. The hospital has a complex and unique environmental characteristics, medical personnel and patients are prolonged exposed to risk factors in a variety of environments. Therefore, the merits of indoor air quality in the hospital, not only has a threat to the health of medical personnel and patients, but also will directly affect the quality and efficiency of health care work. A regular monitoring can, improve and maintain a well of indoor air quality, thus ensuring the safety maintenance of medical personnel and patients in hospital, it has become an important issue for hospital. This study has literatures review to collate and analyse that are related issues with indoor air quality. Then measures the indoor air quality test with direct-reading instruments. In selected hospital of this study were field-tested, then use the measured data in the field, discussion and analysis of the causes of air pollutants and the establishment of the sensing area of pollutants Concentration empirical mode.
Full Text Available Introduction: Measuring parental satisfaction is of major importance for pediatric hospitals and the key component of evaluating the quality of services provided to health services. Aim: To assess the degree of parental satisfaction from the care provided to their hospitalized children.Methodology: A descriptive study conducted using a convenience sample of parents of hospitalized children in two public pediatric hospitals in Athens. Data collection was completed in a period of 3 months. 352 questionnaires were collected (response rate 88%. The Pyramid Questionnaire for parents of hospitalized children was used which estimates the degree of parental satisfaction from the care provided to their hospitalized child.Results: More parents were satisfied with health care professionals’ behavior (81,9%, the supplied care (78,2% and the information provision to parents regarding the hospitalized child’s disease (71,9%. In contrast, less parents were satisfied with their hospitalized child’s involvement in care (52,3% and the accessibility to the hospital (39,5%. The overall parental satisfaction ranged in very good level (76,8% and it was higher on hospital A (78,8%, among married parents (77,4% and those not al all concerned or concerned less for child’s illness (83,1%. Logistic regression model showed that hospitalization in hospital B and the great concern for child’s illness and its complications decreased ovewrall satisfaction by 24% and 17% respectively. Conclusions: The assessment of the degree of parental satisfaction is the most important indicator of hospitals’ proper functioning. From our study certain areas need improvement, such as: the parental involvement in child’s care, information provision, the accessibility to the hospital, the communication and the interpersonal health care in order greater satisfaction to be achieved.
Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank
A service dog is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Some psychiatric patients may depend on a service dog for day-to-day functioning. The Americans with Disabilities Act (ADA) established certain rights and responsibilities for individuals with disabilities and health care providers. Psychiatric hospitalization of a patient with a service dog may pose a problem and involves balancing the requirement to provide safe and appropriate psychiatric care with the rights of individuals with disabilities. This Open Forum examines issues that arise in such circumstances, reviews the literature, and provides a foundation for the development of policies and procedures.
Full Text Available For any quality evaluation in sports, science, education, and so, it is useful to collect data to construct a strategy to improve the quality of services offered to the user. For this purpose, we use statistical software packages for data processing data collected in order to increase customer satisfaction. The principle is demonstrated by the example of the level of student satisfaction ratings Belgrade Polytechnic (as users the quality of institutions (Belgrade Polytechnic. Here, the emphasis on statistical analysis as a tool for quality control in order to improve the same, and not the interpretation of results. Therefore, the above can be used as a model in sport to improve the overall results.
Mohammad Zare Zadeh
Full Text Available Introduction: Quality of services extremely depends on how personnel have contact and interaction with the clients. Moreover, the personnel’s attitudes and their behaviors with the clients significantly affect clients’ perception of quality of services and consequently influence their satisfaction as well as their absorption to the services of an institution. This study intends to investigate the supervisor’s attitude towards the effect of persons or the personal element (as one of the elements of the service marketing mix on choosing the hospital by the patients and their companions. Materials and Methods: This cross-sectional descriptive study conducted in the winter of 2012. The study participant involved 35 supervisors in Yazd educational hospitals of Shahid Sadoughi University of Medical Sciences; Shahid Rahnemoun and Afshar. The research data were gleaned via a researcher-made questionnaire on factors of the marketing mix which its validity and reliability were confirmed. Data analysis was performed using SPSS software. Results: Results revealed that supervisor’s belief in the increasing of market share of a hospital services in public hospitals are consist of: 1-Physical evidence 2- Service or product 3- People or persons 4- Efficiency and quality 5- Process 6- Distribution 7-Promotion or propagation and 8- Price. Therefore, the significance of the personnel role in absorption of a definite patient involves the third element in choosing the hospital by the patients. Conclusion: Based on this study, since the third factor in clients’ (patients, etc. choices of hospital are the personnel and persons who provide services, it is confirmed that in service-based organizations like hospitals, the most important elements of quality of services in retaining and absorbing new clients and surviving the organization are the personnel activities who has been connected with organization clients. Moreover, it is regarded as a vital factor in
Preston, A P; Saunders, I W; O'Sullivan, D; Garrigan, E; Rice, J
Hospitals need excellent leadership to be efficient in the use of scarce stakeholder resources and to be effective in the competitive provision of services to multiple customers. This study was conducted with the cooperation of the executive team at a large government-funded hospital in Brisbane. It focused on understanding the conceptual models of leadership held by members of the executive and comparing this model with an externally derived model of leadership. Performance on the local model was estimated by cross-linking performance assessment on the external model. Members of the executive espoused, and were also rated by others in the hospital as practising, to a moderate degree, a transformational style of leadership. An overall evaluation of quality practice in the hospital revealed the use of data, the understanding of processes and the formation of supplier partnerships as the areas of hospital activity most limiting the ability to improve. The implications of the conceptual model and performance levels are discussed in relation to the introduction of quality management practice in the hospital, and in terms of management development. A complementary paper focusing on quality implementation as perceived at different staff levels in the hospital is in preparation.
Tomescu Ada Mirela
Full Text Available Tourism has a significant environmental, economic and socio-cultural impact, which makes it important for environmental initiatives.The Rio Earth Summit (1992 was a milestone for these initiatives, having introduced the concept of sustainable development, its major principles and recommendations of implementation. So, the ecological movement grew globally more and more by widely disseminated actions among various bodies as the governments, associations, businesses, academics, NGOs and communities.In European Union eco-labelling scheme, is a voluntary initiative to promote products and services which have the potential to reduce negative environmental impacts, as compared to the other products and services in the same product or service group, thus contributing to the efficient use of resources and a high level of environmental protection. This shall be pursued through the provision of guidance and accurate, non-deceptive and scientifically based information to consumers on such products and services. In fact this is official approach known as EU-Ecolabel Scheme, launched in 2005.In general, the idea of sustainable development, and eco-attitude of many of the activities carried out in different economic sectors have been encouraged to be certified, and to adopt sustainable practices to improve their environmental practices, and to inform and educate their clients regarding their friendly-environmental policies. The tourism sector adopted all of these.One by one in hospitality industry have emerged new trends, new destinations. Some of these trends are as well connected to environmental policy, eco-initiatives that certify EMS (Environmental Management System and to use of eco-label in hospitality industry.For years, the tourism sector in Romania was declared a strategic sector. Within this framework, we decided to examine this area, the specific topic of eco-labelling and quality of lodging services in Romania. This paper proposes a short
Siemens, Waldemar; Meerpohl, Joerg J; Antes, Gerd; Meffert, Cornelia; Xander, Carola; Stock, Stephanie; Mueller, Dirk; Schwarzer, Guido; Becker, Gerhild
Objective To assess the effect of specialist palliative care on quality of life and additional outcomes relevant to patients in those with advanced illness. Design Systematic review with meta-analysis. Data sources Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and trial registers searched up to July 2016. Eligibility criteria for selecting studies Randomised controlled trials with adult inpatients or outpatients treated in hospital, hospice, or community settings with any advanced illness. Minimum requirements for specialist palliative care included the multiprofessional team approach. Two reviewers independently screened and extracted data, assessed the risk of bias (Cochrane risk of bias tool), and evaluated the quality of evidence (GRADE tool). Data synthesis Primary outcome was quality of life with Hedges’ g as standardised mean difference (SMD) and random effects model in meta-analysis. In addition, the pooled SMDs of the analyses of quality of life were re-expressed on the global health/QoL scale (item 29 and 30, respectively) of the European Organization for Research and Treatment of Cancer QLQ-C30 (0-100, high values=good quality of life, minimal clinically important difference 8.1). Results Of 3967 publications, 12 were included (10 randomised controlled trials with 2454 patients randomised, of whom 72% (n=1766) had cancer). In no trial was integration of specialist palliative care triggered according to patients’ needs as identified by screening. Overall, there was a small effect in favour of specialist palliative care (SMD 0.16, 95% confidence interval 0.01 to 0.31; QLQ-C30 global health/QoL 4.1, 0.3 to 8.2; n=1218, six trials). Sensitivity analysis showed an SMD of 0.57 (−0.02 to 1.15; global health/QoL 14.6, −0.5 to 29.4; n=1385, seven trials). The effect was marginally larger for patients with cancer (0.20, 0.01 to 0.38; global health/QoL 5.1, 0.3 to 9.7; n=828, five trials) and especially for those who
Chao, Chia Chen; Jen, Wen Yuan; Li, Yu-Chuan; Chi, Y P; Chen, Chang-I; Feng, Chen Chjeh
Improving healthcare service quality for illness of treatment, illness prevention and patient service is difficult for most hospitals because the hospitals are lack adequate resources and labor. In order to provide better healthcare service quality for patients, mobile technology can be used to manage healthcare in a way that provides the optimal healthcare service for patients. Pursuing utilization of mobile technology for better patient service, Taipei Medical University Municipal W. F. Teaching Hospital has implemented a mobile healthcare service (m-HS) system to increase healthcare service quality. The m-HS system improves the quality of medical care as well as healthcare service. The m-HS is a multi-functional healthcare management agent, meets the mobile tendency of the present society. This study seeks to discuss the m-HS architecture and workflow processes. We believe the m-HS does have the potential to improve healthcare service quality. Finally, the conclusions and suggestions for the m-HS are given.
Kerfoot, Karlene M
A patient's decision to recommend a health care organization and the patient's loyalty scores are largely determined by the interaction patients and their families have with the nurses. Hospitality is how the delivery of that product makes the person feel and is a dialogue that requires the server to be "on the guest's side" throughout the experience. The challenge for health care is to help our patients and their families transcend the usual routine care of our health care world and to experience an emotional connection that provides that sense of affiliation and emotional kinship with the organization and the staff. Moving from the service mindset in health care to the hospitality mindset that engages people positively and emotionally is what healing is all about.
The object of the doctoral dissertation is financial audit service quality (further – audit service quality). The aim of the doctoral dissertation is to conceptualize audit service quality and based on the conceptual model to analyse and evaluate audit service quality in Lithuania while providing recommendations for quality improvements. The aim is achieved while applying following research methods: analysis of scientific literature, content analysis, questionnaire survey, expert judgement. ...
Full Text Available Abstract Background A variety of approaches have been used to contain escalating hospital costs. One approach is intensifying price competition. The increase in price based competition, which changes the incentives hospitals face, coupled with the fact that consumers can more easily evaluate the quality of hotel services compared with the quality of clinical care, may lead hospitals to allocate more resources into hotel rather than clinical services. Methods To test this hypothesis we studied hospitals in California in 1982 and 1989, comparing resource allocations prior to and following selective contracting, a period during which the focus of competition changed from quality to price. We estimated the relationship between clinical outcomes, measured as risk-adjusted-mortality rates, and resources. Results In 1989, higher competition was associated with lower clinical expenditures levels compared with 1982. The trend was stronger for non-profit hospitals. Lower clinical resource use was associated with worse risk adjusted mortality outcomes. Conclusions This study raises concerns that cost reductions may be associated with increased mortality.
Sultana, Sarmin; Rana, Shohel
The customer‘s standard of living and consciousness is demanding the importance of service quality. Service quality is mandatory to provide added value to the customers, retain and make loyal customers. This paper focuses on the customer expectation, customer perception and the gap between customer expectation and perception to measure the service quality. We have analyzed the service quality which has a great impact on customer satisfaction.
Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.
This workshop guide is a unit of study for teaching dietetic assistants to work with quality control in a nursing home or hospital. The objective of the unit is to enable the students to develop and expand a dietetic services administrative and clinical quality assurance program in his or her own institution. Following the unit objective, the unit…
Perception and Satisfaction with Quality of Antenatal Care Services among Pregnant Women at the University College Hospital, Ibadan, Nigeria. ... Items in the questionnaire included sociodemographic and obstetric variables, assessment of quality of amenities, waiting time and level of satisfaction. Data analysis was done ...
Arif Mohammad Arshad; Qin Su
The purpose of writing this paper is to present the relationship between service delivery innovation and service quality in service organizations and to establish a research conceptual framework about this relationship...
Full Text Available Much research has been conducted regarding how reference librarians can evaluate and improve the quality of the answers they provide to users' inquiries. There has been considerably less discussion, however, concerning how to improve the quality of the delivery of those answers, and to upgrade the overall quality of reference services as a whole. Suggestions for improving the quality of service contained within the business literature may be applied to improve library services as well. In this paper the use of Quality Function Deployment (QFD as a tool for improving reference services quality is explored and an adapted framework referred to as service quality function deployment is proposed.
Bar-Ratson, Edna; Dreiher, Jacob; Wirtheim, Eytan; Perlman, Lily; Gruzman, Carlos; Rosenbaum, Ziv; Davidson, Ehud
Accreditation is a process for assessing the healthcare organization, to determine if it meets a set of requirements designed to improve quality of care. White research regarding the benefits of accreditation is lacking, accreditation has been shown to be associated with promoting quality. Accreditation differs from licensing and quality assurance audits such as ISO. In various countries, the accreditation processes have been in operation in heaLthcare organization for decades. In the U.S.A., the Leading organization for accreditation of healthcare organizations is the Joint Commission. Accreditation Canada is the leading authority for accreditation in Canada. The Australian Council for Healthcare Standards and the King's Fund in the United Kingdom are other noted authorities for accreditation. Several European countries have initiated accreditation programs and some are in the process of implementing such programs. In Israel, no national accreditation system exists, although the Ministry of Health conducts audits on specific issues, and for relicensing of hospitals, and the Scientific Council of the Israel Medical Association conducts audits for recognizing a department as suitable for residency. Clalit Health Services is the first healthcare organization in Israel to gain Joint Commission International (JCI) accreditation. Three hospitals run by Clalit (Ha'emek, Meir and Soroka) have been accredited by JCI, and another four are in the process of accreditation by JCI. An organized national accreditation scheme in Israel is a challenging process, yet it appears to be a central act for promoting the quality of care in hospitals.
Machado, Juliana Pires; Martins, Ana Cristina Marques; Martins, Mônica Silva
Quality assessment of hospital services has drawn growing international attention, driven by demand from funders, providers, practitioners, and patients. The objective of this study was to review the literature on hospital quality assessment in Brazil and analyze the main approaches, methodologies, and indicators used in the studies. The research design was a systematic literature review of scientific articles and doctoral and Master's theses published from 1990 to 2011. The review identified 2,169 documents, and 62 were included in the review, representing 48 separate studies. Most studies used secondary data and analyzed effectiveness, adequacy, safety, and efficiency, emphasizing the application of mortality rate, adequacy rate, adverse events rate, and length of stay. Methods to control differences in patient risks were mostly applied. This review identified central elements for both the development of this theme and the improvement of hospital care in Brazil.
Валько, А. М.; National Aviation University
Conceptual approach to operation of transportation enterprises following the principles of quality management is analyzed. Components of service quality as a product of the enterprise activity are identified. The main approaches to the indicators of evaluating the transportation service quality are considered. The problems of formulating the indicators of service management in the transportation and technological sphere are defined. The main parametric principles of transport service quality...
Hetherington, R W
The purpose of this paper is to explore some aspects of a general theoretical model within which research on the organizational impacts of quality assurance programs in hospitals may be examined. Quality assurance is conceptualized as an organizational control mechanism, operating primarily through increased formalization of structures and specification of procedures. Organizational effectiveness is discussed from the perspective of the problem-solving theory of organizations, wherein effective organizations are those which maintain at least average performance in all four system problem areas simultaneously (goal-attainment, integration, adaptation and pattern-maintenance). It is proposed that through the realization of mutual benefits for both professionals and the bureaucracy, quality assurance programs can maximize such effective performance in hospitals.
Isaac, Thomas; Zaslavsky, Alan M; Cleary, Paul D; Landon, Bruce E
The extent to which patient experiences with hospital care are related to other measures of hospital quality and safety is unknown. METHODS; We examined the relationship between Hospital Consumer Assessment of Healthcare Providers and Systems scores and technical measures of quality and safety using service-line specific data in 927 hospitals. We used data from the Hospital Quality Alliance to assess technical performance in medical and surgical processes of care and calculated Patient Safety Indicators to measure medical and surgical complication rates. The overall rating of the hospital and willingness to recommend the hospital had strong relationships with technical performance in all medical conditions and surgical care (correlation coefficients ranging from 0.15 to 0.63; pquality of care, supporting their validity as summary measures of hospital quality. Further study may elucidate implications of these relationships for improving hospital care.
van Dijk, F. J.; de Kort, W. L.; Verbeek, J. H.
Interest in the quality of instruments for occupational health services is growing as a result of European legislation on preventive services stressing, for example, risk identification and assessment. The quality of the services can be enhanced when the quality of the applied instruments can be
Hernon, Peter; Nitecki, Danuta A.
Examines the concept of service quality in libraries. Highlights include assessment; service quality versus user satisfaction; measuring service quality, including SERVQUAL; planning; experiences at Texas A& M University in cooperation with ARL (Association of Research Libraries) that resulted in LibQUAL+; and conceptual issues. (Contains 54…
Josep M. Blanch
Full Text Available New Public Management (NPM turns public hospital and university services into market enterprises. The aim of the paper is to analyze and describe the impact of this metamorphosis on the labor subjectivity of the staff employed in such services. Empirical studies in Spanish and Latin American hospitals and universities uncover a paradoxical experience: relative manifest satisfaction with material and technical conditions allowing them to work harder and better, but also latent discomfort with the task overload, and professional and ethical dilemmas posed by new organizational demands, in the face of which staff develop ways of coping ranging from manifest obedience to latent resistance. This supports the reasons for the redesign of these services based on a better balance between commercial and social demands, managerial and professional values, and between business efficiency and quality of working life.
Mohebifar, Rafat; Hasani, Hana; Barikani, Ameneh; Rafiei, Sima
Objectives Providing high service quality is one of the main functions of health systems. Measuring service quality is the basic prerequisite for improving quality. The aim of this study was to evaluate the quality of service in teaching hospitals using importance?performance analysis matrix. Methods A descriptive?analytic study was conducted through a cross-sectional method in six academic hospitals of Qazvin, Iran, in 2012. A total of 360 patients contributed to the study. The sampling tech...
Discusses serving library-patron needs in terms of customer service and quality control. Highlights include tools for measuring the quality of service (e.g., the SERVQUAL survey), advisory boards or focus groups, library "service statements," changing patron needs, new information formats, and justifying depository library services. (JAK)
Groene, Oliver; Arah, Onyebuchi A; Klazinga, Niek S; Wagner, Cordula; Bartels, Paul D; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa
n = 1,503, deliveries n = 2,088, stroke n = 1,566). Patients admitted for hip fracture and stroke had the lowest scores across the four patient-reported experience measures throughout. Patients admitted after acute myocardial infarction reported highest scores on patient experience and hospital recommendation; women after delivery reported highest scores for patient involvement and health care transition. We found no substantial associations between hospital-wide quality management strategies, patient involvement in quality management, or patient-centered care strategies with any of the patient-reported experience measures. This is the largest study so far to assess the complex relationship between quality management strategies and patient experience with care. Our findings suggest absence of and wide variations in the institutionalization of strategies to engage patients in quality management, or implement strategies to improve patient-centeredness of care. Seemingly counterintuitive inverse associations could be capturing a scenario where hospitals with poorer quality management were beginning to improve their patient experience. The former suggests that patient-centered care is not yet sufficiently integrated in quality management, while the latter warrants a nuanced assessment of the motivation and impact of involving patients in the design and assessment of services.
Full Text Available The paper analysis approaches to establishing a system of indicators for public transport service quality in Moscow using customers’ expectations and current characteristics of transportation service. The topic is relevant due to using a new model of transportation service in Moscow involving private transportation companies, which requires establishing uniform service quality standards. Object of research. Public transport service quality Objectives. Using modern marketing concepts and customer oriented approach to service quality assessment develop a comprehensive methodology of managing public transport service quality. Methods. The paper uses Russian and foreign research publications in service quality assessment as well as results of research project by a team of scientists from Plekhanov Russian University of Economics. Methods of comparative research, netnography and marketing research (focus groups and survey methods were used. Results. After analyzing the public transportation problems in the megapolis, current transportation policy and survey of foreign experience, transportation service standards of EC, USA and CIS, a structure and method of establishing a self-regulated system of improving transportation service quality was developed basing on a marketing approach. Conclusions/relevance. The developed methodology of establishing a self-regulating system of improving the transportation service quality is based on a marketing approach, and the structure of a system of indicators to assess the service quality, basic indicators of expected and perceived quality of transportation service.
Full Text Available Purpose. To investigate sleep quality of hospital staff nurses, both by subjective questionnaire and objective measures. Methods. Female staff nurses at a regional teaching hospital in Northern Taiwan were recruited. The Chinese version of the pittsburgh sleep quality index (C-PSQI was used to assess subjective sleep quality, and an electrocardiogram-based cardiopulmonary coupling (CPC technique was used to analyze objective sleep stability. Work stress was assessed using questionnaire on medical worker’s stress. Results. A total of 156 staff nurses completed the study. Among the staff nurses, 75.8% (117 had a PSQI score of ≥5 and 39.8% had an inadequate stable sleep ratio on subjective measures. Nurses with a high school or lower educational degree had a much higher risk of sleep disturbance when compared to nurses with a college or higher level degree. Conclusions. Both subjective and objective measures demonstrated that poor sleep quality is a common health problem among hospital staff nurses. More studies are warranted on this important issue to discover possible factors and therefore to develop a systemic strategy to cope with the problem.
Canavan, Maureen E; Brault, Marie A; Tatek, Dawit; Burssa, Daniel; Teshome, Ayele; Linnander, Erika; Bradley, Elizabeth H
Maternal and neonatal mortality remains high in low- and middle-income countries, with poor quality of intrapartum care as a barrier to further progress. We developed and tested a method of measuring the quality of maternal and neonatal care that could be embedded in a larger national performance management initiative. The tool used direct observations and medical record reviews to score quality in nine domains of intrapartum care. We piloted and evaluated the tool in visits to the 18 lead hospitals that have responsibility to promote and coordinate quality improvement efforts within a hospital cluster in Ethiopia. Between baseline and follow-up assessments, staff from a national quality collaborative alliance provided hospital-based training on labour and delivery services. Ethiopia has invested in hospital quality improvement for more than a decade and this tool was integrated into existing quality improvement mechanisms within lead hospitals, with the potential for scale-up to all government hospitals. Significant improvements in quality of intrapartum care were detected from baseline (June-July 2015) to follow-up (February-March 2016) in targeted hospitals. The overall mean quality score rose from 65.6 (standard deviation, SD: 10.5) to 91.2 (SD: 12.4) out of 110 items (P < 0.001). The method was feasible, requiring a total of 3 days and two to three trained data collectors per hospital visit. It produced data that detected substantial changes made during 8 months of national hospital quality improvement efforts. With additional replication studies, this tool may be useful in other low- and middle-income countries.
Qolipour, Mohammad; Torabipour, Amin; Faraji Khiavi, Farzad; Saki Malehi, Amal
Continuous quality improvement of the hospital services is a basic requirement of medical tourism industry. The different dimensions of hospital services quality are assessed constantly to improve the service of medical tourism. The aim of this study was to determine the services quality of medical tourism in private and public hospitals. In this cross-sectional study, the quality of hospital services were assessed in view of 250 Iraqi tourists referred to Ahvaz private and public hospitals in 2015. Data were collected using a valid medical tourism SERVQUAL questionnaire (MTSQ). This questionnaire includes 8 main dimensions with 31 items. Finally, Mann-Whitney, Kruskal-Wallis and Wilcoxon tests were used to analyze the data. The mean of age of patients was 39±2.2 yr. The mean of hospital length of stay was 3.87±1.36 days. The most patients were admitted to Orthopedics, Otorhinolaryngology, Obstetrics, and Gynecology departments, respectively. There was a negative gap in all of the dimensions of service quality in the studied hospitals ( P >0.001). The highest and lowest quality gap was seen in the "exchange and travel facilities" (-2.63) and the "tangibles" (-0.68) dimension, respectively. There was a negative gap in all of the dimensions of service quality in the studied hospitals. Therefore, the hospital services quality is improved to attract the foreign patients.
QOLIPOUR, Mohammad; TORABIPOUR, Amin; FARAJI KHIAVI, Farzad; SAKI MALEHI, Amal
Background: Continuous quality improvement of the hospital services is a basic requirement of medical tourism industry. The different dimensions of hospital services quality are assessed constantly to improve the service of medical tourism. The aim of this study was to determine the services quality of medical tourism in private and public hospitals. Methods: In this cross-sectional study, the quality of hospital services were assessed in view of 250 Iraqi tourists referred to Ahvaz private and public hospitals in 2015. Data were collected using a valid medical tourism SERVQUAL questionnaire (MTSQ). This questionnaire includes 8 main dimensions with 31 items. Finally, Mann-Whitney, Kruskal-Wallis and Wilcoxon tests were used to analyze the data. Results: The mean of age of patients was 39±2.2 yr. The mean of hospital length of stay was 3.87±1.36 days. The most patients were admitted to Orthopedics, Otorhinolaryngology, Obstetrics, and Gynecology departments, respectively. There was a negative gap in all of the dimensions of service quality in the studied hospitals (P>0.001). The highest and lowest quality gap was seen in the “exchange and travel facilities” (−2.63) and the “tangibles” (−0.68) dimension, respectively. Conclusion: There was a negative gap in all of the dimensions of service quality in the studied hospitals. Therefore, the hospital services quality is improved to attract the foreign patients.
Татьяна Анатольевна Оруч
Full Text Available The article presents data from a study of the market of cellular communication of the Samara region and assess the quality of customer service by mobile operators for the period 2010-2012.Providing quality customer service is one of the major factors of competitiveness, enterprise services rendered. In a market economy, the problem of quality of service is the most important factor in improving the standard of living, economic, social and environmental security.The main problem in providing quality customer service system is that the formal criteria and evaluation methods used in the production sphere, do not apply to service businesses due to immateriality as a process of production and sales of services, and the service itself.The findings of the study conclusions and generalizations can be used in practice management companies providing public services provider.DOI: http://dx.doi.org/10.12731/2218-7405-2013-9-85
Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals. Final rule.
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2017. Some of these changes will implement certain statutory provisions contained in the Pathway for Sustainable Growth Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Notice of Observation Treatment and Implications for Care Eligibility Act of 2015, and other legislation. We also are providing the estimated market basket update to apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2017. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2017. In addition, we are making changes relating to direct graduate medical education (GME) and indirect medical education payments; establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities), including related provisions for eligible hospitals and critical access hospitals (CAHs) participating in the Electronic Health Record Incentive Program; updating policies relating to the Hospital Value-Based Purchasing Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program; implementing statutory provisions that require hospitals and CAHs to furnish notification to Medicare beneficiaries, including Medicare Advantage enrollees, when the beneficiaries receive outpatient observation services for more than 24 hours; announcing the implementation of the Frontier Community Health Integration Project Demonstration; and
Flores, Glenn; Torres, Sylvia; Holmes, Linda Janet; Salas-Lopez, Debbie; Youdelman, Mara K; Tomany-Korman, Sandra C
We surveyed New Jersey (NJ) hospitals to assess current language services and identify policy recommendations on meeting limited English proficiency (LEP) patients' needs. Survey with 37 questions regarding hospital/patient features, interpreter services, and resources/policies needed to provide quality interpreter services. Sixty-seven hospitals responded (55% response rate). Most NJ hospitals have no interpreter services department, 80% provide no staff training on working with interpreters, 31% lack multilingual signs, and 19% offer no written translation services. Only 3% of hospitals have full-time interpreters, a ratio of 1 interpreter:240,748 LEP NJ residents. Most hospitals stated third-party reimbursement for interpreters would be beneficial, by reducing costs, adding interpreters, meeting population growth, and improving communication. Most NJ hospitals have no full-time interpreters, interpreter services department, or staff training on working with interpreters, and deficiencies exist in hospital signage and translation services. Most NJ hospitals stated third-party reimbursement for interpreter services would be beneficial.
Chen, Minya; Zheng, Konglin; Xia, Yong
This paper introduces the construction and application of the platform of client service center in the general hospital and discusses how to provide patients with an entire service including service before clinic, on clinic and after clinic. It can also provide references for a new service mode for clinic service.
Full Text Available Retail is a service activity, and services are something that makes the retail companies differ from production companies. Retailers are trying to differentiate the 'package' offer, build customer loyalty and make their position through the provision of high service quality. In addition, the services provided can be varied, such as exterior and interior design of retail stores, preparation of goods for sale, appearance and behavior of sales personnel, culture of communication with customers, and services provided after the sales process. Consumers require the service quality when making purchasing decision. For retail companies and retail stores it is important to continuously monitor the level of service quality. In order to measure the service quality, the method that found its application in the theory and practice is SERVQUAL. This model was created as a combination of theoretical and practical research and it looks at the quality of service as the content of the following dimensions: tangibles, reliability, sensitivity, security and empathy. As such, it is a function of the difference between perceptions and expectations (Q = P-E and is widely accepted to measure the service quality in traditional retail stores, public sector, higher education, real estate, hospitals, courts and so on. In addition, this model is widely used to measure service quality in e-retailing, e-banking, e-selling of travel packages and other services provided by electronic means. The main assumption is that services are a key factor in making purchasing decision. The aim of this paper is to, through theoretical and practical research with special emphasis on SERVQUAL method, test the initial hypothesis and recognize the level of service quality in retail chains in Southeast Serbia.
The purpose of this paper is to determine service quality dimensions as predictors of perceived service quality in retail environment. Recent studies emphasised the multidimensional nature of service quality and multidimensional service quality measurement models. Literature reveals that SERVQUAL (Parasuraman et al. 1988) and RSQS (Dabholkar et al. 1996) are the most common instruments used to measure service quality in retail. Considering different market environments neither SERVQUAL nor RS...
U.S. Department of Health & Human Services — Prospective Payment System (PPS)-Exempt Cancer Hospital Quality Reporting (PCHQR) Program currently uses one clinical effectiveness measureâExternal Beam...
Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising
Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan
Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates
Soutar, Geoffrey; McNeil, Margaret
Measures service quality from the viewpoint of customers (students at an Australian university), using the SERVQUAL model. Obtains evaluations of academic and administrative aspects of the educational service. Makes significant negative evaluations of administrative service quality (resulting from communication problems). Satisfaction with the…
Conclusion: It seems that it is better for this hospital to put its priorities on "understanding patients' key needs in a correct way", "changing in hospital services for patients' more benefits", "using patients' opinions in designing services", "hospital management and employees' flexibility in offering new services", "understanding patients' information precisely", and "making precise feedback system" regarding the limits in its resources and attempts to upgrading its service quality.
communicable diseases, in particular aspects of the organisation of services, and indirect indicators of patient care. Design. A postal survey of services for asthma, epilepsy, diabetes and hypertension at nine hospitals. Assessment over 1 week of ...
Takaki, Osamu; Takeuti, Izumi; Takahashi, Koichi; Izumi, Noriaki; Murata, Koichiro; Ikeda, Mitsuru; Hasida, Koiti
For recent years, it has grown importance to evaluate medical service qualities of medical staffs and/or hospitals by using quality indicators. This paper introduces a representation system QI-RS of quality indicators. By using QI-RS, one can define quality indicators that satisfy understandability and formality, where "understandability" means that one can understand the calculation formula of a quality indicator easily and correctly, while "formality" means that the formula can be calculated to obtain the values of the indicator based on databases in a coherent manner.
This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\
Dobrea Valentina Alina
Full Text Available The hospital is the most important organization in health field, so they have to improve the quality in all the activities deployed. A very suitable way to show the hospital’s preoccupation for quality of health services is the quality management system certificate according ISO 9001/2000. In understanding the architecture of the hospital quality management system is necessary to decompose this system in subsystems and analyze each separately: the managerial subsystem, the human subsystem, the social subsystem, thetechnical subsystem, the informative subsystem. The relationship between those subsystems leads to the continuous improvement of quality in health services.
Krüger, A J; Lossius, H M; Mikkelsen, S
All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence...
Zijlker-Jansen, Pauline Y.; Janssen, M. P.|info:eu-repo/dai/nl/304818208; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.
Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion
Maksimović Mlađan V.
Full Text Available Quality in the world is considered to be the most important phenomenon of our age, with a permanent and irreversible growing trend of its emphasis. Many companies have come to the conclusion that high quality of services can provide them with a potential competitive advantage, leading to superior sales results and profit making. The aim of this paper is to test the applicability of service SERVQUAL dimensions and measure the quality of services in the public transport of passengers. Based on the data obtained by researching the views of public transport users in Kragujevac using the SERVQUAL methodology and statistical analysis based on defined service quality dimensions, this research will show the level of quality of urban transport services in Kragujevac and based on this, make recommendations for improving the quality of service.
Levin, Timothy E; Irvine, Cynthia E; Spyropoulou, Evdoxia
The premise of Quality of Security Service is that system and network management functions can be more effective if variable levels of security services and requirements can be presented to users or network tasks...
This Services Catalog contains information about field supplies and analytical services available from the National Water Quality Laboratory in Denver, Colo., and field supplies available from the Quality Water Service Unit in Ocala, Fla., to members of the U.S. Geological Survey. To assist personnel in the selection of analytical services, this catalog lists sample volume, required containers, applicable concentration range, detection level, precision of analysis, and preservation requirements for samples.
This Services Catalog contains information about field supplies and analytical services available from the National Water Quality Laboratory in Denver, Colo., and field supplies available from the Quality Water Service Unit in Ocala, Fla., to members of the U.S. Geological Survey's Water Resources Division. To assist personnel in the selection of analytical services, this catalog lists sample volume, applicable concentration range, detection level, precision of analysis, and preservation requirements for samples. (USGS)
Tyagi, Rajesh K; Cook, Lori; Olson, John; Belohlav, James
Background Healthcare technology and quality improvement programs have been identified as a means to influence healthcare costs and healthcare quality in Canada. This study seeks to identify whether the ability to implement healthcare technology by a hospital was related to usage of quality improvement programs within the hospital and whether the culture within a hospital plays a role in the adoption of quality improvement programs. Methods A cross-sectional study of Canadian hospitals was co...
Bucks County Technical School, Fairless Hills, PA.
The outline describes the food services and hospitality course offered to senior high school students at the Bucks County Technical School. Specifically, the course seeks to provide students with a workable knowledge of food services and foster in them a sense of personal pride for quality workmanship. In addition to a statement of the philosophy…
Full Text Available In order to constantly improve the quality of service program, organizations in tourism industry, have to pay special attention to managing employees' behavior, especially those in the first line of service provision and their direct superiors. Encouraging the employees towards service-oriented behavior is greatly determined by the adequate and consistent implementation of human resources management instruments. The subject of this research is an empirical examination of relations between employees' behavior in the service providing process and service quality. This research was conducted during 2012, in a five-star hotel 'Izvor', situated in Arandjelovac.
The strategic importance of service excellence for service industries places the focus on service quality leadership, service quality management systems, service quality dimensions and the measurement of service quality. Many businesses such as private higher education institutions (PHEIs) regard service quality ...
Korst, Lisa M; Feldman, Daniele S; Bollman, D Lisa; Fridman, Moshe; El Haj Ibrahim, Samia; Fink, Arlene; Wyatt, Lacey; Gregory, Kimberly D
The objective of the study was to describe the resources and activities associated with childbirth services. We adapted models for assessing the quality of healthcare to generate a conceptual framework hypothesizing that childbirth hospital resources and activities contributed to maternal and neonatal outcomes. We used this framework to guide development of a survey, which we administered by telephone to hospital labor and delivery nurse managers in California. We describe the findings by hospital type (ie, integrated delivery system [IDS], teaching, and other [community] hospitals). Of 248 nonmilitary childbirth hospitals in California, 239 (96%)responded; 187 community, 27 teaching, and 25 IDS hospitals reported. The context of services varied across hospital types, with community hospitals more likely to have for-profit ownership, be in a rural or isolated location, and have fewer annual deliveries per hospital. Results included the findings of the following: (1) 24 hour anesthesia availability in 50% of community vs 100% of IDS and teaching hospitals (P Childbirth services varied widely across California hospitals. Cognizance of this variation and linkage of these data to childbirth outcomes should assist in the identification of key resources and activities that optimize the hospital environment for pregnant women and set the groundwork for identifying criteria for the provision of maternal risk-appropriate care. Copyright © 2015 Elsevier Inc. All rights reserved.
Branco, Daniel; Wicks, Angela M; Visich, John K
The authors identify the quality tools and methodologies most frequently used by quality-positioned hospitals versus nonquality hospitals. Northeastern U.S. hospitals in both groups received a brief, 12-question survey. The authors found that 93.75% of the quality hospitals and 81.25% of the nonquality hospitals used some form of process improvement methodologies. However, there were significant differences between the groups regarding the impact of quality improvement initiatives on patients. The findings indicate that in quality hospitals the use of quality improvement initiatives had a significantly greater positive impact on patient satisfaction and patient outcomes when compared to nonquality hospitals.
Zineldin, Mosad; Camgöz-Akdağ, Hatice; Vasicheva, Valiantsina
This paper aims to examine the major factors affecting cumulative summation, to empirically examine the major factors affecting satisfaction and to address the question whether patients in Kazakhstan evaluate healthcare similarly or differently from patients in Egypt and Jordan. A questionnaire, adapted from previous research, was distributed to Kazakhstan inpatients. The questionnaire contained 39 attributes about five newly-developed quality dimensions (5Qs), which were identified to be the most relevant attributes for hospitals. The questionnaire was translated into Russian to increase the response rate and improve data quality. Almost 200 usable questionnaires were returned. Frequency distribution, factor analysis and reliability checks were used to analyze the data. The three biggest concerns for Kazakhstan patients are: infrastructure; atmosphere; and interaction. Hospital staffs concern for patients' needs, parking facilities for visitors, waiting time and food temperature were all common specific attributes, which were perceived as concerns. These were shortcomings in all three countries. Improving health service quality by applying total relationship management and the 5Qs model together with a customer-orientation strategy is recommended. Results can be used by hospital staff to reengineer and redesign creatively their quality management processes and help move towards more effective healthcare quality strategies. Patients in three countries have similar concerns and quality perceptions. The paper describes a new instrument and method. The study assures relevance, validity and reliability, while being explicitly change-oriented. The authors argue that patient satisfaction is a cumulative construct, summing satisfaction as five different qualities (5Qs): object; processes; infrastructure; interaction and atmosphere.
Izadi, Azar; Jahani, Younes; Rafiei, Sima; Masoud, Ali; Vali, Leila
Purpose Measuring healthcare service quality provides an objective guide for managers and policy makers to improve their services and patient satisfaction. Consequently, the purpose of this paper is to measure service quality provided to surgical and medical inpatients at Kerman Medical Sciences University (KUMS) in 2015. Design/methodology/approach A descriptive-analytic study, using a cross-sectional method in the KUMS training hospitals, was implemented between October 2 and March 15, 2015. Using stratified random sampling, 268 patients were selected. Data were collected using an importance-performance analysis (IPA) questionnaire, which measures current performance and determines each item's importance from the patients' perspectives. These data indicate overall satisfaction and appropriate practical strategies for managers to plan accordingly. Findings Findings revealed a significant gap between service importance and performance. From the patients' viewpoint, tangibility was the highest priority (mean=3.54), while reliability was given the highest performance (mean=3.02). The least important and lowest performance level was social accountability (mean=1.91 and 1.98, respectively). Practical implications Healthcare managers should focus on patient viewpoints and apply patient comments to solve problems, improve service quality and patient satisfaction. Originality/value The authors applied an IPA questionnaire to measure service quality provided to surgical and medical ward patients. This method identifies and corrects service quality shortcomings and improving service recipient perceptions.
To mount a broad effort aimed at improving their competitive position for some service or group of services, hospitals have begun to pursue product line management techniques. A few hospitals have even reorganized completely under the product line framework. The benefits include focusing accountability for operations and results, facilitating coordination between departments and functions, stimulating market segmentation, and promoting rigorous examination of new and existing programs. As part of its strategic planning process, a suburban Baltimore hospital developed a product line management methodology with six basic steps: (1) define the service lines (which they did by grouping all existing diagnosis-related groups into 35 service lines), (2) determine the contribution of each service line to total inpatient volume, (3) determine trends in service line volumes (by comparing data over time), (4) derive a useful comparison group (competing hospitals or groups of hospitals with comparable size, scope of services, payer mix, and financial status), (5) review multiple time frames, and (6) summarize the long- and short-term performance of the hospital's service lines to focus further analysis. This type of systematic and disciplined analysis can become part of a permanent strategic intelligence program. When hospitals have such a program in place, their market research, planning, budgeting, and operations will be tied together in a true management decision support system.
Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid
To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC) and info...
Service quality management systems are concerned with optimizing the customer -supplier quality relationship to the benefit of both parties. That is...and (4) description of techniques and guidelines, which are intended to optimize the relationship between the supplier and the customer . Service
In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…
Thibodeau, Patricia L; Funk, Carla J
The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends.
Al-Doghaither, Abdulla H.
Abstract: Recent development and changes in health care services in Saudi Arabia have encouraged a search a search for comprehensive and established measurements of the quality of care. Patient satisfaction with nursing care in particular has ferquently been used as a sensitive and objective measure of quality of hosiptal services. Objectives: The objectives of this study are: (1) to assess the level of inpatient satisfaction with nursing care (PSWC) in the various wards of the hospital; (2) ...
Service quality and customer satisfaction are the growing concerns for business organizations throughout the world, and customer satisfaction studies have been proven to be essential tools in trying to optimize services provided to users. For transit agencies, as in other service industries, increase in customer satisfaction ...
Keshtkaran, Ali; Hashemi, Neda; Kharazmi, Erfan; Abbasi, Mehdi
Quality function deployment (QFD) is one of the most effective quality design tools. This study applies QFD technique to improve the quality of the burn unit services in Ghotbedin Hospital in Shiraz, Iran. First, the patients' expectations of burn unit services and their priorities were determined through Delphi method. Thereafter, burn unit service specifications were determined through Delphi method. Further, the relationships between the patients' expectations and service specifications and also the relationships between service specifications were determined through an expert group's opinion. Last, the final importance scores of service specifications were calculated through simple additive weighting method. The findings show that burn unit patients have 40 expectations in six different areas. These expectations are in 16 priority levels. Burn units also have 45 service specifications in six different areas. There are four-level relationships between the patients' expectations and service specifications and four-level relationships between service specifications. The most important burn unit service specifications have been identified in this study. The QFD model developed in the study can be a general guideline for QFD planners and executives.
Wiig, Siri; Aase, Karina; von Plessen, Christian; Burnett, Susan; Nunes, Francisco; Weggelaar, Anne Marie; Anderson-Gare, Boel; Calltorp, Johan; Fulop, Naomi
Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical micro systems (micro level) in a cross-national study. This cross-national multi-level case study combines analysis of national policy documents and regulations at the macro level with semi-structured interviews (383) and non-participant observation (803 hours) of key meetings and shadowing of staff at the meso and micro levels in ten purposively sampled European hospitals (England, the Netherlands, Portugal, Sweden, and Norway). Fieldwork at the meso and micro levels was undertaken over a 12-month period (2011-2012) and different types of micro systems were included (maternity, oncology, orthopaedics, elderly care, intensive care, and geriatrics). The three quality dimensions clinical effectiveness, patient safety, and patient experience were incorporated in macro level policies in all countries. Senior hospital managers adopted a similar conceptualization, but also included efficiency and costs in their conceptualization of quality. 'Quality' in the forms of measuring indicators and performance management were dominant among senior hospital managers (with clinical and non-clinical background). The differential emphasis on the three quality dimensions was strongly linked to professional roles, personal ideas, and beliefs at the micro level. Clinical effectiveness was dominant among physicians (evidence-based approach), while patient experience was dominant among nurses (patient
satisfaction with services provided. A satisfied patient is more likely to comply with the medical treatment prescribed, provider and continue using medical services. Patient satis-. In a study conducted in Gondar town, 78% of the outpatient visitors to Gondar teaching hospital reported dissatisfaction with services offered at the ...
Al-Zaidi, Asma Nasser Mohammed
Hospitality and tourism are important sectors of any economy. In the service sector, achieving a level of service quality that satisfies customers usually results in a competitive advantage in the market. The concept of service quality in hotels has been the subject of many research studies and there are numerous published works in the field. However, only a few studies have focused on the determinants of service quality for hotels using a set of comprehensive criteria. Thus, conceptualizing...
Kondasani, Rama Koteswara Rao; Panda, Rajeev Kumar
The purpose of this paper is to analyse how perceived service quality and customer satisfaction lead to loyalty towards healthcare service providers. In total, 475 hospital patients participated in a questionnaire survey in five Indian private hospitals. Descriptive statistics, factor analysis, regression and correlation statistics were employed to analyse customer perceived service quality and how it leads to loyalty towards service providers. Results indicate that the service seeker-service provider relationship, quality of facilities and the interaction with supporting staff have a positive effect on customer perception. Findings help healthcare managers to formulate effective strategies to ensure a better quality of services to the customers. This study helps healthcare managers to build customer loyalty towards healthcare services, thereby attracting and gaining more customers. This paper will help healthcare managers and service providers to analyse customer perceptions and their loyalty towards Indian private healthcare services.
Weech-Maldonado, Robert; Dreachslin, Janice L; Brown, Julie; Pradhan, Rohit; Rubin, Kelly L; Schiller, Cameron; Hays, Ron D
The U.S. national standards for culturally and linguistically appropriate services (CLAS) in health care provide guidelines on policies and practices aimed at developing culturally competent systems of care. The Cultural Competency Assessment Tool for Hospitals (CCATH) was developed as an organizational tool to assess adherence to the CLAS standards. First, we describe the development of the CCATH and estimate the reliability and validity of the CCATH measures. Second, we discuss the managerial implications of the CCATH as an organizational tool to assess cultural competency. We pilot tested an initial draft of the CCATH, revised it based on a focus group and cognitive interviews, and then administered it in a field test with a sample of California hospitals. The reliability and validity of the CCATH were evaluated using factor analysis, analysis of variance, and Cronbach's alphas. Exploratory and confirmatory factor analyses identified 12 CCATH composites: leadership and strategic planning, data collection on inpatient population, data collection on service area, performance management systems and quality improvement, human resources practices, diversity training, community representation, availability of interpreter services, interpreter services policies, quality of interpreter services, translation of written materials, and clinical cultural competency practices. All the CCATH scales had internal consistency reliability of .65 or above, and the reliability was .70 or above for 9 of the 12 scales. Analysis of variance results showed that not-for-profit hospitals have higher CCATH scores than for-profit hospitals in five CCATH scales and higher CCATH scores than government hospitals in two CCATH scales. The CCATH showed adequate psychometric properties. Managers and policy makers can use the CCATH as a tool to evaluate hospital performance in cultural competency and identify and target improvements in hospital policies and practices that undergird the provision
D'Mello, Demian Antony; Ananthanarayana, V. S.
A web service is an interface of the software component that can be accessed by standard Internet protocols. The web service technology enables an application to application communication and interoperability. The increasing number of web service providers throughout the globe have produced numerous web services providing the same or similar functionality. This necessitates the use of tools and techniques to search the suitable services available over the Web. UDDI (universal description, discovery and integration) is the first initiative to find the suitable web services based on the requester's functional demands. However, the requester's requirements may also include non-functional aspects like quality of service (QoS). In this paper, the authors define a QoS model for QoS aware and business driven web service publishing and selection. The authors propose a QoS requirement format for the requesters, to specify their complex demands on QoS for the web service selection. The authors define a tree structure called quality constraint tree (QCT) to represent the requester's variety of requirements on QoS properties having varied preferences. The paper proposes a QoS broker based architecture for web service selection, which facilitates the requesters to specify their QoS requirements to select qualitatively optimal web service. A web service selection algorithm is presented, which ranks the functionally similar web services based on the degree of satisfaction of the requester's QoS requirements and preferences. The paper defines web service provider qualities to distinguish qualitatively competitive web services. The paper also presents the modelling and selection mechanism for the requester's alternative constraints defined on the QoS. The authors implement the QoS broker based system to prove the correctness of the proposed web service selection mechanism.
Kriegel, Johannes; Jehle, Franziska; Dieck, Marcel; Mallory, Patricia
...: What are the developmental options to expand the current capabilities of the hospital contract logistics service providers on the basis of the priorities of the decision-makers in the German hospital sector...
Sahin, Alper A
Health services are one of the most important criteria for making a country function. Turkey has mobilized all of its resources to provide high-quality, easily accessible and patient-friendly services for its population. To achieve this aim, the Turkish health care system has been undergoing a significant transformation through its Health Transformation Programme begun in 2005. The reforms focus on the introduction of a general health insurance system, changing hospital health services, improvements in hospital management and transformational leadership skills. Firstly, all state-run hospitals in the country were merged under the same umbrella, giving millions of people covered by the national security agency access to all of these hospitals. Secondly, all drugs and medical equipment used by patients were made free of charge. Thanks to these developments, hospitals were modernized, and this modernization process in the health sector is still continuing swiftly. On the other hand, for Turkish hospitals to survive, they need to modernize further and become closer to European models, and produce new leaders with new paradigms. In this new and changing health system, hospital leaders and executive officers should be visionaries and strategists advising when to change direction. Following this doctrine, most Turkish hospitals are now run by two top executives: the hospital manager and the chief executive officer who is in charge of business functions. These executives should clearly be the leaders of high-quality, health care organizations.
... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals Q&A Recipes En Español Teachers - Looking for ...
Foran, Amie; Millar, Elisa; Dorstyn, Diana
Objective The aim of the present study was to develop and pilot a measure of patient satisfaction that encompasses themes, activities, settings and interactions specific to the neuropsychological assessment process. Methods A focus group of out-patients (n=15) was surveyed to identify the factors commonly associated with a satisfactory neuropsychological experience. Responses informed a purposely designed 14-item patient satisfaction scale (α=0.88) that was completed by 66 hospital out-patients with mild to moderate cognitive impairment. Results Satisfaction with the neuropsychological assessment process was generally reported, with the testing phase (85%) rated significantly more favourably than the pre-assessment (79%) and feedback (70%) phases. Commentaries provided by 32 respondents identified interpersonal facilitators to a satisfactory neuropsychological assessment experience, but also dissatisfaction with physical aspects of the testing environment in addition to service availability. Conclusions The patient satisfaction scale can be used as a quality assurance tool to evaluate neuropsychological service delivery. Large-scale research is needed to confirm the scale's psychometric properties. Further research may also include a broader perspective on the consumers' experience of neuropsychological services.
Groene, O.; Arah, O.A.; Klazinga, N.S.; Wagner, C.; Bartels, P.D.; Kristensen, S.; Saillour, F.; Thompson, C.A.; Pfaff, H.; DerSarkissian, M.; Suñol, R.
Objectives: Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes
Timian, Alex; Rupcic, Sonia; Kachnowski, Stan; Luisi, Paloma
With the growth of Facebook, public health researchers are exploring the platform's uses in health care. However, little research has examined the relationship between Facebook and traditional hospital quality measures. The authors conducted an exploratory quantitative analysis of hospitals' Facebook pages to assess whether Facebook "Likes" were associated with hospital quality and patient satisfaction. The 30-day mortality rates and patient recommendation rates were used to quantify hospital quality and patient satisfaction; these variables were correlated with Facebook data for 40 hospitals near New York, NY. The results showed that Facebook "Likes" have a strong negative association with 30-day mortality rates and are positively associated with patient recommendation. These exploratory findings suggest that the number of Facebook "Likes" for a hospital may serve as an indicator of hospital quality and patient satisfaction. These findings have implications for researchers and hospitals looking for a quick and widely available measure of these traditional indicators.
Tahreem Noor Khan
Full Text Available Customer perspectives and satisfaction level are considered important for analysing the performance of Islamic bank service quality. Sufficient researches has been done to explore customer perception and satisfaction level with Islamic banking service quality, however there is lack of data to compare and find the similarity in understanding the main determinant attributes needed for Islamic banking service quality. The purpose of this paper is to describe and integrate the results of existing wealth of research on service quality in Islamic banks. After weighing up all the views from existing research, common findings, concerns will be discussed. This research did not find much of information or studies indicating toward innovation in Islamic banking service quality. Thus based on review of the literature this paper suggests main key attributes of service for Islamic banks (RIBA Service IQ. This research strongly asserts that sincere motivation, truthful intention, dynamic and practical service innovation of quality approaches can uplift Islamic financial brandDOI: 10.15408/aiq.v8i2.3161
Ramessur, Vinaysing; Hurreeram, Dinesh Kumar; Maistry, Kaylasson
The purpose of this paper is to illustrate a service quality framework that enhances service delivery in clinical laboratories by gauging medical practitioner satisfaction and by providing avenues for continuous improvement. The case study method has been used for conducting the exploratory study, with focus on the Mauritian public clinical laboratory. A structured questionnaire based on the SERVQUAL service quality model was used for data collection, analysis and for the development of the service quality framework. The study confirms the pertinence of the following service quality dimensions within the context of clinical laboratories: tangibility, reliability, responsiveness, turnaround time, technology, test reports, communication and laboratory staff attitude and behaviour. The service quality framework developed, termed LabSERV, is vital for clinical laboratories in the search for improving service delivery to medical practitioners. This is a pioneering work carried out in the clinical laboratory sector in Mauritius. Medical practitioner expectations and perceptions have been simultaneously considered to generate a novel service quality framework for clinical laboratories.
Abdulsalam, Yousef; Schneller, Eugene
The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U.S. hospitals. We find supply expenses to make up 15% of total hospital expenses, on average, but as high as 30% or 40% in hospitals with a high case-mix index, such as surgery-intensive hospitals. Future research can use supply expense data to better understand hospital strategies that aim to manage costs, such as systemization, physician-hospital arrangements, and value-based purchasing.
Smith, Gareth; Smith, Alison; Clarke, Alison
Purpose: The purpose of the study is to report on an in-depth exploration of service quality in an Information Technology service department in a Higher Education Institute (HEI) and to evaluate the instrument used. Design/methodology/approach: The study surveys customers using the SERVQUAL instrument, which is one of the most widely used and…
Forster, D H; Krause, G; Gastmeier, P; Ebner, W; Rath, A; Wischnewski, N; Lacour, M; Rüden, H; Daschner, F D
It is a fundamental principle of continuous quality improvement (CQI) that processes should be the objects of quality improvement. The objective of this study was to improve process quality concerning the prevention of hospital-acquired infections in surgical departments and intensive care units by a continuous quality improvement (CQI) approach based mainly on quality circles. This approach was evaluated in a prospective controlled intervention study in medium-size acute care hospitals (four intervention and four control hospitals). During two intervention periods (each 10 months) four external physicians with training in hospital epidemiology and infection control introduced and supervised quality circles in the intervention hospitals. Process quality was assessed by interviewing senior staff members before the first and after the second intervention period using standardized questionnaires. The gold standard process quality was defined on the basis of the CDC/HICPAC-guidelines for the prevention of hospital-acquired infections. Most of the evaluated aspects of process quality belonged to the HICPAC-categories IA and IB respectively, the CDC category I. Fifty quality circle sessions were performed in the four intervention hospitals of which 28 were dealing directly with key subjects in infection control. In the intervention hospitals, 19.8% of evaluated aspects of process quality which concerned the prevention of hospital-acquired infections were improved compared to only 6.9% in the control hospitals (Pquality were initiated by the results of the quality circles. Our study demonstrates that a CQI approach based on infection control quality circles can lead to a substantial improvement of process quality regarding the prevention of hospital-acquired infections.
Ali Mohammad Mosadeghrad
Full Text Available Background: Patient satisfaction is an important indicator of healthcare quality and effectiveness. Quality management as an organizational strategy enhances the quality of hospital services through continuously improving hospital structures and processes. This study aimed to examine the impact of quality management on patient satisfaction. Methods: A participatory action research was conducted in respiratory intensive care unit, at Labafinejad hospital, Tehran, Iran, in 2013. A quality improvement team was established. Operational processes were improved using a quality management model. The quality improvement team standardized processes, identified quality goals for the processes and improved them until achieved quality goals. Patients’ satisfaction data was collected before and after the intervention using a valid and reliable questionnaire. Results: Patients’ satisfaction was 75 percent at the beginning of the study. Patients were mostly dissatisfied with the nutrition services, amenities, lack of attention to their personal needs and lack of involving them in their treatment processes. An action plan was developed for improving patient satisfaction. After the quality management intervention, patient satisfaction reached to 81 percent at the end of this study. The quality management model improved the quality of services by 54.5 percent and consequently increased patient satisfaction by 7.2 percent. Almost half of the patients at the beginning of this study were definitely willing to recommend the hospital to their friends and relatives. This figure increased to 76 percent. The rest of patients stated that they may recommend the hospital to others. Conclusion: Implementing an appropriate quality management model appropriately in a supportive environment helps improve the quality of services and enhance patient satisfaction and loyalty.
Sawik, Bartosz; Mikulik, Jerzy
Supporting services play an important role in health care institutions such as hospitals. This paper presents an application of operations research model for optimal allocation of workers among supporting services in a public hospital. The services include logistics, inventory management, financial management, operations management, medical analysis, etc. The optimality criterion of the problem is to minimize operations costs of supporting services subject to some specific constraints. The constraints represent specific conditions for resource allocation in a hospital. The overall problem is formulated as an integer program in the literature known as the assignment problem, where the decision variables represent the assignment of people to various jobs. The results of some computational experiments modeled on a real data from a selected Polish hospital are reported.
Andaleeb, Syed Saad; Kara, Ali
The objective of this study was to examine a complex service environment-hospitals-to suggest how service quality could be reframed and measured for multiple-encounter service situations more effectively. In this cross-sectional study, a sample of 371 patients completed the survey instrument. Service quality measures were guided by the literature but allowed to flow from the respondents at the preliminary stage. Confirmatory factor analysis, along with structural equation modeling, was used to test the hypothesized relationships among key actors' performance metrics (KAPMs). Patient satisfaction is significantly influenced by perceived service quality based on KAPMs. For multiple-encounter services, service quality dimensions and measures ought to be tied to KAPMs. Primary actors-ie, doctors-need knowledge and skills about patient psychology, negotiation, handling difficult patients, and, importantly, "putting the customer first." Sensitivity training on such matters should be provided. The secondary actors are the nurses who have more frequent contact with the patients. Nurses need to be perceived as "patient advocates." Effective advocacy begins with prompt and caring services to build trust. The tertiary actors in their support role also ought to be integrated into becoming vital part of the service provided.
Full Text Available Ecotourism forms the pillar of the country’s tourism industry. Ecotourists make up more than 10% of international tourists in Malaysia. When service quality is thought of as an important factor to the success of tourism service providers, the importance of estimating service quality provided to tourists becomes apparent. Estimating service quality provides tourism service providers with the necessary information needed to manage their marketing operations appropriately. Therefore, this estimation should be performed with the right measurement scales. Despite the high volume of research on service quality (SERVQUAL models in recent years, limited effort has been directed toward improving the tool for measuring service quality, particularly to apply to the ecotourism sector in developing countries. This article aims to improve a SERVQUAL model that is suitable for ecotourism areas in developing countries using five dimensions of the original model and one additional sustainability dimension. Based on a survey of 127 tourists in Tasik Kenyir, an exploratory factor analysis (EFA was conducted to discover the underlying dimension of ecotourism services and test for reliability and validity. Using EFA resulted in seven factors totaling 27 items. These factors are labeled as follows: tangible sustainability, sustainable practices, tangibility, reliability, responsiveness, assurance, and empathy. The results reveal that when SERVQUAL is applied within the ecotourism context, new dimensions of tangible sustainability and sustainable practices may emerge. The result implies the need to refine the SERVQUAL model when used in different contexts.
U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...
Eleuch, Amira ep Koubaa
This study aims to assess Japanese patients' healthcare service quality perceptions and to shed light on the most meaningful service features. It follows-up a study published in IJHCQA Vol. 21 No. 7. Through a non-linear approach, the study relied on the scatter model to detect healthcare service features' importance in forming overall quality judgment. Japanese patients perceive healthcare services through a linear compensatory process. Features related to technical quality and staff behavior compensate for each other to decide service quality. A limitation of the study is the limited sample size. Non-linear approaches could help researchers to better understand patients' healthcare service quality perceptions. The study highlights a need to adopt an evolution that enhances technical quality and medical practices in Japanese healthcare settings. The study relies on a non-linear approach to assess patient overall quality perceptions in order to enrich knowledge. Furthermore, the research is conducted in Japan where healthcare marketing studies are scarce owing to cultural and language barriers. Japanese culture and healthcare system characteristics are used to explain and interpret the results.
Giraldes, Maria Do Rosário
The main aim of this article is to evaluate the hospital expenditure by user in an efficiency perspective and to evaluate the quality of the health system using process indicators and outcome indicators. In an efficiency perspective the concept of technical efficiency has been chosen, and a correction has been made, as well, in what concerns a case-mix index (CMI). The indicators have been calculated by user in what concerns the main hospital activities (the expenditure in inpatient care by treated patient, in day hospital by treated patient, in outpatient care by consultation, etc), and as well the auxiliary sections of clinic support and the hotel support services. All the indicators have been corrected according to the case-mix index, in 2004, and have been weighted according to the relevance of its expenditure in total expenditure. In a quality perspective two types of indicators have been considered: process indicators and outcome indicators. Process indicators, as the percentage of surgeries in ambulatory care, the percentage of caesareans in total deliveries and the rate of autopsy. The outcome indicator number of episodes of inpatient care due to surgery infection in total days of inpatient care The composite indicator of efficiency, weighted by the inverse of the case-mix index presents the lower values in Tondela, Seia, and Fafe, while the Hospital of the Litoral Alentejano is, in this group, the most inefficient. The Agueda Hospital presents the better Composite Efficiency Indicator, in Group II, followed by the Barcelos and S. João da Madeira Hospitals, while the Figueira da Foz Hospital presents the worst situation. In hospitals from Group III the Hospitals of Vale de Sousa, EPE, and the Vila Franca de Xira Hospital present the better Composite Efficiency Indicator followed by the Barreiro Hospital, EPE. In Group IV it is the Hospital of S. Sebastião, EPE, that presents the lowest Composite Efficiency Indicator, followed by the Cascais Hospital, SPA
The purpose of this paper is to investigate a lean manufacturing metric called Takt time as a benchmark evaluation measure to evaluate a public hospital's service quality. Lean manufacturing is an established managerial philosophy with a proven track record in industry. A lean metric called Takt time is applied as a measure to compare the relative efficiency between two emergency departments (EDs) belonging to the same public hospital. Outcomes guide managers to improve patient services and increase hospital performances. The patient treatment lead time within the hospital's two EDs (one department serves male and the other female patients) are the study's focus. A lean metric called Takt time is used to find the service's relative efficiency. Findings show that the lean manufacturing metric called Takt time can be used as an effective way to measure service efficiency by analyzing relative efficiency and identifies bottlenecks in different departments providing the same services. The paper presents a new procedure to compare relative efficiency between two EDs. It can be applied to any healthcare facility.
Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank
A service dog is defined as “any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability...
Landman, Adam B.; Spatz, Erica S.; Cherlin, Emily J.; Krumholz, Harlan M.; Bradley, Elizabeth H.; Curry, Leslie A.
Objective Evidence suggests that active collaboration between hospitals and emergency medical services (EMS) is significantly associated with lower acute myocardial infarction (AMI) mortality rates; however, the nature of such collaborations is not well understood. We sought to characterize views of key hospital staff regarding collaboration with EMS in the care of patients hospitalized with AMI. Methods We performed an exploratory analysis of qualitative data previously collected from site visits and in-depth interviews with 11 US hospitals that ranked in the top or bottom 5% of performance on 30-day risk-standardized AMI mortality rates (RSMRs) using Centers for Medicare and Medicaid Services data from 2005–2007. We selected all codes from the first analysis in which EMS was most likely to have been discussed. A multidisciplinary team analyzed the data using the constant comparative method to generate recurrent themes. Results Both higher and lower performing hospitals reported that EMS is critical to the provision of timely care for patients with AMI. However, close, collaborative relationships with EMS were more apparent in the higher performing hospitals. Higher performing hospitals demonstrated specific investment in and attention to EMS through: 1) respect for EMS as valued professionals and colleagues; 2) strong communication and coordination with EMS; and 3) active engagement of EMS in hospital AMI quality improvement efforts. Conclusion Hospital staff from higher performing hospitals described broad, multifaceted strategies to support collaboration with EMS in providing AMI care. The association of these strategies with hospital performance should be tested quantitatively in a larger, representative study. PMID:23146627
Full Text Available Quality of life of soldiers is the ability to participate in professional activities during the military service in accordance with intrapsychic state. The aim of this study was to establish the categories of quality of life, which are important for soldiers' adjustment during the military service. The investigation was performed on the subjects of the two squads of soldiers of Yugoslav Armed Forces, divided into three groups according to the period of investigations: after the first month, after the basic training, and at the end of military service. The applied instruments of the investigation were sociodemografic questionnaire and Quality of Life Scale (QLS. Statistical analysis of the obtained data was made by t-test. Investigation results showed that quality of life of soldiers during the military service depended on intrapsychic state, interpersonal relations and solidiers’ adjustment to common objects and activities, and did not depend on their occupational role.
O enfermeiro no gerenciamento à qualidade em serviço hospitalar de emergência: revisão integrativa da literatura La enfermera en la gestión de la calidad en el servicio de urgencia en el hospital: revisión integradora de la literatura Quality management by nurses in hospitals' emergency services: integrative literature review
José Aparecido Bellucci Júnior
las enfermeras en la Acogida Clasificadora de Riesgo es una estrategia clave para la gestión de calidad en los servicios.This study aimed to analyze publications related to the activities of nurses managing the quality in the Emergency Services of Hospitals. An integrative literature review identified 4780 articles of which 8 were selected considering the criteria: full articles, published from 2000 to 2010; available in Portuguese; indexed in the databases of the Virtual Health Library. All the material was analyzed through Content Analysis. Two themes emerged: Working in the structuring of the nursing staff to the quality of care and Nursing actions managing the quality of care. The conclusion is that the promotion of the quality of care provided in Hospitals' Emergency Services is linked to the actions promoting the humanization of both care and caregivers, and that the role of the nurse in the User Reception with Risk Rating is a key strategy for managing quality in services.
Jenaro, C.; Vega, V.; Flores, N.; Cruz, M.
Background: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this…
Quality has become a strategic element of organisations’ management, as it is at the basis of product and services competitiveness domestically and internationally. Quality must be understood by the superlative of excellence, signifying the maximum possible satisfaction of the customer’s needs in a dynamic context. Services represent one of the sectors of modern economy that register significant dynamics. Achieving customer satisfaction is essential to developing or maintaining business. Thus...
Full Text Available This article deals with service quality and the methods for its measurement and improvements to reach the so called service excellence. Besides older methods such as SERVQUAL and SERPERF, there are also shortly described capability maturity models based on which the own methodology is developed and used for process maturity assessment in organizations providing technical services. This method is equally described and accompanied by examples on pictures. The verification of method functionality is explored on finding a correlation between service employee satisfaction and average process maturity in a service organization. The results seem to be quite promising and open an arena for further studies.
Navathe, Amol S; Volpp, Kevin G; Konetzka, R Tamara; Press, Matthew J; Zhu, Jingsan; Chen, Wei; Lindrooth, Richard C
Quality of care may be linked to the profitability of admissions in addition to level of reimbursement. Prior policy reforms reduced payments that differentially affected the average profitability of various admission types. The authors estimated a Cox competing risks model, controlling for the simultaneous risk of mortality post discharge, to determine whether the average profitability of hospital service lines to which a patient was admitted was associated with the likelihood of readmission within 30 days. The sample included 12,705,933 Medicare Fee for Service discharges from 2,438 general acute care hospitals during 1997, 2001, and 2005. There was no evidence of an association between changes in average service line profitability and changes in readmission risk, even when controlling for risk of mortality. These findings are reassuring in that the profitability of patients' admissions did not affect readmission rates, and together with other evidence may suggest that readmissions are not an unambiguous quality indicator for in-hospital care.
Johns, Nick; Edwards, John S A; Hartwell, Heather J
Meals served in prisons and hospitals are produced in similar ways and have similar characteristics, yet hospital patients are often at risk of being undernourished, while prisoners typically are not. This article examines field notes collected during nutritional studies of prison and hospital food service, which confirmed the difference in nutrient intake claimed by other authors. A comparison of food service processes and systems showed that the production of meals and the quality leaving the kitchen was similar in both types of institution. However, the delivery and service system was found to be much less coherent in hospital than in prison. Transport and service of hospital food were subject to delays and disruptions from a number of sources, including poor communication and the demands of medical professionals. These meant that meals reached hospital patients in a poorer, less appetising condition than those received by prisoners. The findings are discussed in the light of previous work and in terms of hospital food service practice. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
Berry, Ralph E.
The primary purpose of this article is to investigate whether or not economies of scale exist in the production of hospital services. In previous studies the results have implied the existence of economies of scale, but the question has not been satisfactorily resolved. The factor most responsible for clouding the issue is the overwhelming prevalence of product differences in the outputs of hospitals. In this study a method which avoids the problem of product differentiation is developed. The analysis strongly supports the conclusion that hospital services are produced subject to economies of scale. PMID:6054380
Riddle, Dorothy I.; Bezanson, M. Lynne
This workbook was created as a "do it yourself" tool for helping organizations and career counseling services develop policies and standards to enhance the quality of services. The process is aimed at helping articulate policies that are sensible for each organization and challenging and achievable by staff. It is intended to be a…
Leung, Man Huen Jenny
Studies on service quality are popular but specifically on service quality of mobile network services industry in Hong Kong are scarce. This paper aims at developing a service quality dimension for the mobile network services industry in Hong Kong. The study investigates the service quality of the six network operators in Hong Kong and explores the determinants of service quality in the industry. It studies the impact of service quality on both customer satisfaction and behavioral intentions....
Rocha Luiz Roberto Martins
Full Text Available Abstract Background The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. Methods We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson’s correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach’s alpha coefficient; the intraclass (ICC and Pearson’s correlation coefficients were used for test-retest reliability. Results One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson’s correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson’s correlation coefficient was 0.89 and ICC was 0.90. Conclusions The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality.
Rocha, Luiz Roberto Martins; Veiga, Daniela Francescato; e Oliveira, Paulo Rocha; Song, Elaine Horibe; Ferreira, Lydia Masako
The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson's correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach's alpha coefficient; the intraclass (ICC) and Pearson's correlation coefficients were used for test-retest reliability. One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson's correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson's correlation coefficient was 0.89 and ICC was 0.90. The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality.
Constanta Aurelia Chitiba
Full Text Available Quality became the management imperative in the last time and will continue to be the key to success in the future. We often see the words “quality first”, and demands for quality invade every sphere of activity, from the motor vehicles we drive, to the domestic appliances we use, the food we eat and, of course, the products and services we import and export. Quality represents the goal of every business and it is focused on the customer. Satisfying the requirements of the customer is a dynamic activity: both customers and their needs are changing continuous and the suppliers have to recognize this. When it comes to international trade, no exporting country can afford to compromise on quality. The current global economic climate calls for export marketing and promotion efforts with assurances of superior and consistent quality in products and services, rather associated with lower prices.
Renner, C; Palmer, E
Service firms manage variability using both demand-side tactics (levelling customer demand), and supply-side tactics (increasing available capacity). One popular way of increasing available capacity is the outsourcing of non-core services. This article uses a case study to examine the impact of an outsourced non-core service on a hospital's overall service system. Findings show that the outsourced service provides access to more sophisticated technology, increases in-house capacity and saves capital expenditure. However, the outsourcing also increases the scheduling problems that the hospital faces. These problems are largely due to communication delays from the involvement of more than one organisation. These delays decrease the response time available to match changes in demand for the outsourced service. Given the obvious benefits of such outsourcing, the article concludes that management should pay close attention to the communication pathways between organisations, in order to minimise the end effects identified in this study.
Levy, Fiona Howard; Brilli, Richard J; First, Lewis R; Hyman, Daniel; Kohrt, Alan E; Ludwig, Stephen; Miles, Paul V; Saffer, Marian
Children's hospitals and their affiliated departments of pediatrics often pursue separate programs in quality and safety; by integrating these programs, they can accelerate progress. Hospital executives and pediatric department chairs from 14 children's hospitals have been exploring practical approaches for integrating quality programs. Three components provide focus: (1) alignment of quality priorities and resources across the organizations; (2) education and training for physicians in the science of improvement; and (3) professional development and career progression for physicians in recognition of quality-improvement activities. Process and resource requirements are identified for each component, and specific, actionable steps are identified. The action steps are arrayed on a continuum from basic to advanced integration. The resulting matrix serves as an "integration framework," useful to a hospital and its pediatric academic department at any stage of integration for assessing its current state, plotting a path toward further integration, tracking its progress, and identifying potential collaborators and models of advanced integration. The framework contributes to health care's quality-improvement movement in multiple ways: it addresses a basic impediment to quality and safety improvement; it is an implementable model for integrating quality programs; it offers career-advancement potential for physicians interested in quality; it helps optimize investments in quality and safety; and it can be applied both within a single children's hospital and across multiple children's hospitals. Widespread adoption of the integration framework could have a transformative effect on the children's hospital sector, not the least of which is improved quality and safety on a large scale.
The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.
Arup Kumar Baksi
Full Text Available The dimensions of service quality and their relationship with the behavioral pattern of customers have received immense importance in the banking sector. The relational impact of service quality on customers’ propensity to switch from their banking service provider, is therefore, very much relevant. Empirical studies have revealed that there is a significant relationship between retention of customers and profitability. Therefore, to have an understanding of the behavioral pattern of the customers with respect to their intention to defect from their bank is financially justified. This paper investigates the relationship between service quality and switching behavior of customers in the context of the largest nationalized bank of India –State Bank of India (SBI for two of their branches in sub-urban West Bengal namely Bolpur and Santiniketan.
... computed the change in average case- mix for hospitals paid under the Medicare prospective payment system...-mix analysis. SUPPLEMENTARY INFORMATION: I. Background Section 1813 of the Social Security Act (the... applicable for services furnished in the following calendar year (CY). II. Computing the Inpatient Hospital...
Longo, Francesco; Siciliani, Luigi; Gravelle, Hugh; Santos, Rita
We investigate whether hospitals in the English National Health Service change their quality or efficiency in response to changes in quality or efficiency of neighbouring hospitals. We first provide a theoretical model that predicts that a hospital will not respond to changes in the efficiency of its rivals but may change its quality or efficiency in response to changes in the quality of rivals, though the direction of the response is ambiguous. We use data on eight quality measures (including mortality, emergency readmissions, patient reported outcome, and patient satisfaction) and six efficiency measures (including bed occupancy, cancelled operations, and costs) for public hospitals between 2010/11 and 2013/14 to estimate both spatial cross-sectional and spatial fixed- and random-effects panel data models. We find that although quality and efficiency measures are unconditionally spatially correlated, the spatial regression models suggest that a hospital's quality or efficiency does not respond to its rivals' quality or efficiency, except for a hospital's overall mortality that is positively associated with that of its rivals. The results are robust to allowing for spatially correlated covariates and errors and to instrumenting rivals' quality and efficiency. Copyright © 2017 John Wiley & Sons, Ltd.
Dong, Gang Nathan
Fiscal constraints faced by U.S. hospitals as a result of the recent economic downturn are leading to business practices that reduce costs and improve financial and operational efficiency in hospitals. There naturally arises the question of how this finance-driven management culture could affect the quality of care. This paper attempts to determine whether the process measures of treatment quality are correlated with hospital financial performance. Panel study of hospital care quality and financial condition between 2005 and 2010 for cardiovascular disease treatment at acute care hospitals in the United States. Process measures for condition-specific treatment of heart attack and heart failure and hospital-level financial condition ratios were collected from the CMS databases of Hospital Compare and Cost Reports. There is a statistically significant relationship between hospital financial performance and quality of care. Hospital profitability, financial leverage, asset liquidity, operating efficiency, and costs appear to be important factors of health care quality. In general, public hospitals provide lower quality care than their nonprofit counterparts, and urban hospitals report better quality score than those located in rural areas. Specifically, the first-difference regression results indicate that the quality of treatment for cardiovascular patients rises in the year following an increase in hospital profitability, financial leverage, and labor costs. The results suggest that, when a hospital made more profit, had the capacity to finance investment using debt, paid higher wages presumably to attract more skilled nurses, its quality of care would generally improve. While the pursuit of profit induces hospitals to enhance both quantity and quality of services they offer, the lack of financial strength may result in a lower standard of health care services, implying the importance of monitoring the quality of care among those hospitals with poor financial health.
Full Text Available BACKGROUND: Accurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre. METHODS: Two thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions. RESULTS: The correlation coefficient amounted to 0.73 (95%CI: 0.72; 0.76. The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Beta = -2.4; p = 0.02, ASA score (Beta = 76.3; p<0.001, RCI (Beta = 5.5; p<0.001, staffing level (Beta = 437.0; p<0.001 and intervention duration (Beta = -10.5; p<0.001. CONCLUSIONS: The ability of the current method to provide relevant information to managers, clinicians and payers is questionable. As in other European countries, a shift towards time-driven activity-based costing should be advocated.
Park, Arum; Chang, Hyejung; Lee, Kyoung Jun
Services based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals. Application of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases. During the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively. From an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital.
Messeder, Ana Márcia; Osorio-de-Castro, Claudia Garcia Serpa; Camacho, Luiz Antonio Bastos
This paper discusses the development of a methodological approach to classify hospital pharmacies according to their performance, measured by structure and process indicators. The method considers the influence exerted on performance by the level of care in the hospital and the interdependence among pharmaceutical activities. Algorithms for assessing performance of hospital pharmacies were constructed for each level of care. Different weights were used for core activities in the pharmacy and other specific activities, according to the level of care in the hospital where the respective service was provided. This methodology allowed classifying hospital pharmacies from best to worst, based on performance. Independently of level of care in the hospital, no hospital pharmacies were classified as high-performance, and more than 50% were classified as low-performance.
Full Text Available In conditions of increasing global competition, demands and needs of consumers, quality and quality management have become fundamental strategic factors of achieving profitability and competitiveness on the relentless tourism market. Any serious "top" hotel management, with a defined mission, vision and goals, must define a "special policy" of improving the quality of hotel services through "structural programs of quality improvement," which have become an important factor in the hotel business. With the design, introduction and control of a "special program" of quality improvement of hotel services, hotel management can have a positive impact on increasing satisfaction of customers and human resources, increasing competitiveness and market power of the hotel, the rationalization of operating costs and enhance the reputation and value of the hotel on the demanding tourist market.
This paper aims to examine the impact of service encounter quality on servicevalue evaluation within a higher education context, especially in classlearning process. Service encounter quality was approached with threedimensions, they are : instructor interaction competencies, instructor taskcompetencies and student interaction competencies. Service valueevaluation in this study was called as learning experience value. Somequstionares were distributed to 306 students in some classes. The data ...
Ho, Li-Hsing; Feng, Shu-Yun; Yen, Tieh-Min
The purpose of this paper is intended to create a model to measure quality of service, using fuzzy linguistics to analyze the quality of service of medical tourism in Taiwan so as to find the direction for improvement of service quality in medical tourism. The study developed fuzzy questionnaires based on the characteristics of medical tourism quality of service in Taiwan. Questionnaires were delivered and recovered from February to April 2014, using random sampling according to the proportion of medical tourism companies in each region, and 150 effective samples were obtained. The critical quality of service level is found through the fuzzy gap analysis using questionnaires examining expectations and perceptions of customers, as the direction for continuous improvement. From the study, the primary five critical service items that improve the quality of service for medical tourism in Taiwan include, in order: the capability of the service provider to provide committed medical tourism services reliably and accurately, facility service providers in conjunction with the services provided, the cordial and polite attitude of the service provider eliciting a sense of trust from the customer, professional ability of medical (nursing) personnel in hospital and reliability of service provider. The contribution of this study is to create a fuzzy gap analysis to assess the performance of medical tourism service quality, identify key quality characteristics and provide a direction for improvement and development for medical tourism service quality in Taiwan.
Smith, Robert B
A hospital that provides cardiovascular services and embraces a heart-hospital brand and strategy can achieve competitive advantage. Providers that want to compete aggressively for cardiovascular services are developing a specialty-based carve-out strategy. A heart-hospital initiative can cannibalize revenues from a hospital's other programs and services. A successful heart-hospital strategy requires physician buy-in. A heart hospital needs a brand that customers will value.
Bazzoli, Gloria J; Chen, Hsueh-Fen; Zhao, Mei; Lindrooth, Richard C
Concerns about deficiencies in the quality of care delivered in US hospitals grew during a time period when an increasing number of hospitals were experiencing financial problems. Our study examines a six-year longitudinal database of general acute care hospitals in 11 states to assess the relationship between hospital financial condition and quality of care. We evaluate two measures of financial performance: operating margin and a broader profitability measure that encompasses both operating and non-operating sources of income. Our model specification allows for gradual adjustments in quality-enhancing activities and recognizes that current realizations of patient quality may affect future financial performance. Empirical results suggest that there is a relationship between financial performance and quality of care, but not as strong as suggested in earlier research. Overall, our results suggest that deep financial problems that go beyond the patient care side of business may be important to prompting quality problems. Copyright (c) 2007 John Wiley & Sons, Ltd.
Han, Johann; Kairies-Schwarz, Nadja; Vomhof, Markus
On the basis of a Salop model with regulated prices, we investigate quality provision behaviour of competing hospitals before and after a merger. For this, we use a controlled laboratory experiment where subjects decided on the level of treatment quality as head of a hospital. We find that the post-merger average quality is significantly lower than the average pre-merger quality. However, for merger insiders and outsiders, average quality choices are significantly higher than predicted for pure profit-maximising hospitals. This upward deviation is potentially driven by altruistic behaviour towards patients. Furthermore, we find that in the case where sufficient cost synergies are realised by the merged hospitals, there is a significant increase in average quality choices compared to the scenario without synergies. Finally, we find that our results do not change when comparing individual decisions to team decisions. Copyright © 2017 John Wiley & Sons, Ltd.
Full Text Available Service quality plays an important role in health care systems since hospitals are responsible for people's lives. This study presents an effective approach for evaluating and comparing service qualities of four hospitals. Service quality consists of different attributes and many of them are intangible and difficult to measure. Therefore, we propose a fuzzy method to resolve the ambiguity of the concepts, which are associated with human judgments. SERVQUAL model is used to evaluate the respondents' judgments of service quality and multi attribute decision making approach is implemented for the comparison among hospitals. The paper use analytical hierarchy process (AHP for obtaining criteria weight and TOPSIS for ranking the cases.
Spagnol, Carla Aparecida; Fernandes, Marcia Simoni
This work aims at approaching some theoretical aspects related to organizational structure, focussing on the structure of the nursing service in the majority of hospitals. We found, through a literature, that some hospitals are adopting new management practices, changing rigid hierarchical structures to flexible and well coordinated ones. In this context of organizational changes, nursing needs to discuss its classical organizational structure and management still based on taylorist principles in order to fulfill actual demands and needs of clients and workers.
Sibbald, Bonnie; McDonald, Ruth; Roland, Martin
A key objective in many health-care systems is to shift specialist services from acute hospitals to the community and so bring care closer to home for patients. Our aim was to review published research into the effectiveness of strategies for achieving this objective. We conducted a 'scoping' review and qualitative data synthesis of four strategies: transfer of services from hospital to primary care; relocation of hospital services to primary care; joint working between primary and acute care; and interventions to alter the referral behaviour of primary care practitioners. One hundred and nineteen studies were identified and data systematically extracted. The findings suggest that transferring hospital services to primary care, and interventions that change the referral behaviour of primary care practitioners generally reduced outpatient activity but also risked reducing quality. Savings in cost were offset by increases in overall service volume and loss of economies of scale. Relocating specialists to primary care, and joint working between primary and acute care, improved access without jeopardizing quality. However, outpatient activity was rarely reduced and costs were generally increased due to loss of economies of scale. Our findings suggest that the policy may be effective in improving access to specialist care for patients and reducing demand on acute hospitals. There is a risk, however, that the quality of care may decline and costs may increase.
Tschurtz, Brette A; Koss, Richard G; Kupka, Nancy J; Williams, Scott C
Despite efforts to advance effective patient-provider communication, many patients' language needs continue to be unmet or inappropriately addressed by healthcare providers (Wielawski 2010; Patek et al. 2009; Wilson-Stronks and Galvez 2007). This study presents a picture of the language resources currently provided by hospitals and those resources practitioners actually use. Questionnaire data were collected from 14 hospitals in Florida's Palm Beach, St. Lucie, and Martin counties on availability, staff awareness, and staff use of linguistic resources and services. Inconsistencies were identified between the language tools, services, and resources hospitals provide and those staff use. In addition, a large majority of staff respondents still rely upon someone accompanying the patient for communication with patients who have limited English proficiency, despite evidence that this practice contributes to miscommunication and serious medical errors (Flores et al. 2003; Flores 2005; HHS OMH 2001; Patek et al. 2009). Hospitals that use bilingual staff as interpreters often do not test the competency of these staff, nor do they assess the utilization or effectiveness of the tools and resources they provide. Hospitals can improve the cultural and linguistic care they provide if they (1) address the practice of using ad hoc interpreters, (2) effectively disseminate information to hospital staff regarding how and when to access available resources, and (3) collect patient population data and use it to plan for and evaluate the language services they provide to their patients.
Adams, Marsha Howell; Crow, Carolyn S
The nurse case management service (NCMS) for rural hospitals is an entrepreneurial endeavor designed to provide rural patients with quality, cost-effective healthcare. This article describes the development of an NCMS. A detailed marketing and financial plan, a review of industry trends, and the legal structure and risks associated with the development of the venture are presented. The financial plan projects a minimum savings of 223,200 dollars for rural institutions annually. To improve quality and reduce cost for rural hospitals, the authors recommend implementation of an NCMS.
Gautam, Kanak S
A national agenda for health care quality is unfolding but there is concern about inadequate progress on improving quality in hospitals. The 2003 Institute of Medicine report calls for transformational leadership in health care organizations to change systems and processes underlying quality. The key question is: Who will provide leadership in hospitals? A natural choice is the board of trustees on account of its legal responsibility for quality and its authority over medical staff and administration. This article describes several barriers to board leadership on quality and suggests strategies by which boards can lead the campaign for quality. Barriers include trustee ignorance, trustee insecurity, board inattention, poor board-physician communication, fragmented information on quality, traditional medical staff structure, lack of professional management of quality, and lack of investment. Strategies for hospital board leadership should include preparing to lead, self-education, visible participation in quality activities, activism, role clarification, increased informal dialogue with physicians, medical staff reform, creation of a quality management department, instituting high-quality standards, and external quality audit. Boards face a historic opportunity to transform hospital quality backed by a strong legal mandate.
Canaway, Rachel; Bismark, Marie; Dunt, David; Kelaher, Margaret
Purpose The purpose of this paper is to understand the concerns and factors that impact on hospital quality and safety, particularly related to use of performance data, within a setting of devolved governance. Design/methodology/approach This qualitative study used thematic analysis of interviews with public hospital medical directors. For additional context, findings were framed by themes from a review of hospital safety and quality in the same jurisdiction. Findings Varying approaches and levels of complexity were described about what and how performance data are reviewed, prioritised, and quality improvements implemented. Although no consistent narrative emerged, facilitators of improvement were suggested relating to organisational culture, governance, resources, education, and technologies. These hospital-level perspectives articulate with and expand on the system-level themes in a state-wide review of hospital safety and quality. Research limitations/implications The findings are not generalisable, but point to an underlying absence of system-wide agreement on how to perceive, retrieve, analyse, prioritise and action hospital performance data. Practical implications Lack of electronic medical records and an inefficient incident reporting system limits the extent to which performance and incident data can be analysed, linked and shared, thus limiting hospital performance improvement, oversight and learning. Social implications Variable approaches to quality and safety, standards of care, and hospital record keeping and reporting, mean that healthcare consumers might expect inconsistency across Victorian hospitals. Originality/value The views of medical directors have been little researched. This work uses their voice to better understand contextual factors that situate and impact on hospital quality and safety towards understanding the mixed effectiveness of hospital quality improvement strategies.
Aij, Kjeld Harald; Aernoudts, René L M C; Joosten, Gepke
This paper aims to assess the impact of the leadership traits of chief executive officers (CEOs) on hospital performance in the USA. The effectiveness and efficiency of the CEO is of critical importance to the performance of any organization, including hospitals. Management systems and manager behaviours (traits) are of crucial importance to any organization because of their connection with organizational performance. To identify key factors associated with the quality of care delivered by hospitals, the authors gathered perceptions of manager traits from chief executive officers (CEOs) and followers in three groups of US hospitals delivering different levels of quality of care performance. Three high- and three low-performing hospitals were selected from the top and bottom 20th percentiles, respectively, using a national hospital ranking system based on standard quality of care performance measures. Three lean hospitals delivering intermediate performance were also selected. A survey was used to gather perceptions of manager traits (providing a modern or lean management system inclination) from CEOs and their followers in the three groups, which were compared. Four traits were found to be significantly different (alpha performing hospitals. The different perceptions between these two hospital groups were all held by followers in the low-performing hospitals and not the CEOs, and all had a modern management inclination. No differences were found between lean (intermediate-) and high-performing hospitals, or between high- and low-performing hospitals. These findings support a need for hospital managers to acquire appropriate traits to achieve lean transformation, support a benefit of measuring manager traits to assess progress towards lean transformation and lend weight to improved quality of care that can be delivered by hospitals adopting a lean system of management.
M. Nur Mustafa
Full Text Available Education as a profession requires a thorough commitment and sincerity among educators in guiding and shaping the patterns of learning toward forming identities and lead change in the students. As an adult with a lot of knowledge and experience, classroom becomes an important medium for the delivery and access to knowledge to the students in an instructional condition that effectively and efficiently. Therefore, all educators need to prepare themselves to face challenges to deal with children as a leader in charge in constructing a conducive and persuasive educational relationship. Important characteristics in this context is how to create a memorable delivery systems that meet the standard qualities and aligned with the education laws enforced. As a teacher who has received training from experts and civil servants thus all actions taken should be sincere, open, meet the service specification that gives attention to the self-esteem of the students with a good service, quality, and meet their needs. Therefore, this study will discuss the main factors that affect the quality of service to the students among the teachers namely motivation and professional competence. Selected samples in this study were 327 teachers from Secondary School in Pekanbaru. This study has shown a clear interest in improving the quality of motivation and the quality of service of teachers to the students. The aspects of the professional competence of teachers are still experiencing problems in applying the knowledge and skills to lead and manage the classroom inrealizing a conducive environment.
The purpose of this quality improvement initiative was to enhance service delivery and patient experience in a musculoskeletal out-patient setting. A cross-sectional survey, with 6 annual stages, evaluated the musculoskeletal outpatient physiotherapy service in a large National Health Service hospital in Southern England. The population comprised 1095 patients, referred by medical staff to the service from rheumatology, orthopaedics, pain clinic and occupational health departments. The individual clinician-initiated strategies for quality improvement included: cue cards; reminders; reflections and training. The systems-changes comprised revised documentation and booking systems. The primary outcome was patient experience, measured with the Chartered Society of Physiotherapy's standardised 'Patients feedback' questionnaire. Attendance data was a secondary outcome. This initiative showed that strategies to motivate individual clinicians to change their behaviour were unsuccessful, whereas system-changes resulted in 32/37 improvements (8 statistically significant) in patient experience. Furthermore, the revised systems resulted in a 6% decrease in wasted appointments. It is essential that clinical services are evaluated through the eyes of their users. This initiative demonstrates the value of service evaluations (alongside research) and the importance of patient feedback to show how it can drive change and positively impact upon health-care experiences. Furthermore, this work has shown that active implementation strategies with systems-level changes produced greater improvements in service quality and patient experience, than simply encouraging and supporting clinicians to change their behaviour. Copyright © 2012 Elsevier Ltd. All rights reserved.
Kelly, Patrick; Frosch, Emily
Identify the frequency with which pediatric care teams recognize delirium in patients referred for psychiatric consultation, whether their diagnosis is substantiated by the involved consultant, and whether this diagnosis is documented in the discharge problem list. A retrospective chart review was conducted on all inpatient children receiving consultation from the Child and Adolescent Psychiatry service between 2003 and 2011. Additionally, the problem lists of all inpatient pediatric discharges during that period were examined for the diagnosis of "delirium" or "encephalopathy". Six of the 515 children referred to psychiatry for any reason were diagnosed with delirium by the pediatric team. The diagnosis was confirmed by psychiatry in all cases. An additional 47 cases of delirium were diagnosed by psychiatry in this same cohort, a condition never mentioned in the pediatric chart. Only 8 of the total 53 patients (15.1%) diagnosed with delirium by pediatrics and/or psychiatry had this condition listed in the discharge problem list. Overall, diagnoses of delirium or encephalopathy were included in only 89 of the total 64,046 problem lists for any pediatric discharge. Delirium was not noted or mentioned in 88.7% of delirious patients referred for psychiatric consultation, potentially because it was never diagnosed by pediatrics. There is a low documentation rate of this condition on the discharge problem list, even in those children so diagnosed by pediatrics. These findings highlight the important role of the consultation psychiatrist as an educator as well as a diagnostician. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
Baza, Joseph A.; Cabana, Timothy E.
Approved for public release; distribution is unlimited The purpose of this project is to identify and analyze customer expectations and customer perceptions of service quality provided by the local contracting office supporting the Naval Postgraduate School (NPS). Our goal is to identify performance gaps using the SERVQUAL instrument for measuring customers’ expectations and perceptions along five quality dimensions (tangibles, reliability, responsiveness, assurance, empathy). The results ...
Melody K. Schiaffino
Full Text Available Background Hispanics comprise 17% of the total U.S. population, surpassing African-Americans as the largest minority group. Linguistically, almost 60 million people speak a language other than English. This language diversity can create barriers and additional burden and risk when seeking health services. Patients with Limited English Proficiency (LEP for example, have been shown to experience a disproportionate risk of poor health outcomes, making the provision of Language Services (LS in healthcare facilities critical. Research on the determinants of LS adoption has focused more on overall cultural competence and internal managerial decision-making than on measuring LS adoption as a process outcome influenced by contextual or external factors. The current investigation examines the relationship between state policy, service area factors, and hospital characteristics on hospital LS adoption. Methods We employ a cross-sectional analysis of survey data from a national sample of hospitals in the American Hospital Association (AHA database for 2011 (N= 4876 to analyze hospital characteristics and outcomes, augmented with additional population data from the American Community Survey (ACS to estimate language diversity in the hospital service area. Additional data from the National Health Law Program (NHeLP facilitated the state level Medicaid reimbursement factor. Results Only 64%of hospitals offered LS. Hospitals that adopted LS were more likely to be not-for-profit, in areas with higher than average language diversity, larger, and urban. Hospitals in above average language diverse counties had more than 2-fold greater odds of adopting LS than less language diverse areas [Adjusted Odds Ratio (AOR: 2.26, P< 0.01]. Further, hospitals with a strategic orientation toward diversity had nearly 2-fold greater odds of adopting LS (AOR: 1.90, P< 0.001. Conclusion Our findings support the importance of structural and contextual factors as they relate to
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation Requirements; Electronic Health Record (EHR) Incentive Programs; Payment to Nonexcepted Off-Campus Provider-Based Department of a Hospital; Hospital Value-Based Purchasing (VBP) Program; Establishment of Payment Rates Under the Medicare Physician Fee Schedule for Nonexcepted Items and Services Furnished by an Off-Campus Provider-Based Department of a Hospital. Final rule with comment period and interim final rule with comment period.
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, in this final rule with comment period, we are making changes to tolerance thresholds for clinical outcomes for solid organ transplant programs; to Organ Procurement Organizations (OPOs) definitions, outcome measures, and organ transport documentation; and to the Medicare and Medicaid Electronic Health Record Incentive Programs. We also are removing the HCAHPS Pain Management dimension from the Hospital Value-Based Purchasing (VBP) Program. In addition, we are implementing section 603 of the Bipartisan Budget Act of 2015 relating to payment for certain items and services furnished by certain off-campus provider-based departments of a provider. In this document, we also are issuing an interim final rule with comment period to establish the Medicare Physician Fee Schedule payment rates for the nonexcepted items and services billed by a nonexcepted off-campus provider-based department of a hospital in accordance with the provisions of section 603.
Cataloged from PDF version of article. Increased competition and Turkey's entrance to the Customs Union with the European Union has boosted a quality movement throughout all sectors. In the service sector, banks have been the leaders for grasping the importance of quality issues. This study attempts to measure customers' satisfaction and personnel's understanding and implementation of service quality in a commercial bank. The study innovates with respect to former studies...
Fan, Li-Hua; Gao, Lei; Liu, Xin; Zhao, Shi-Hong; Mu, Hui-Tong; Li, Zhe; Shi, Lei; Wang, Ling-Ling; Jia, Xiao-Li; Ha, Min; Lou, Feng-Ge
The doctor-patient relationship has been a major focus of society. Hospitals' efforts to improve the quality of their medical services have been to reduce the probability of doctor-patient conflicts. In this study, we aimed to determine the gap between expectations and perceptions of service quality according to patients to provide reference data for creating strategies to improve health care quality. Twenty-seven hospitals in 15 provinces (municipalities directly beneath the central government) were selected for our survey; we sent out 1,589 questionnaires, of which 1,520 were collected (response rate 95.65%) and 1,303 were valid (85.72% effective recovery rate). Paired t-tests were used to analyze whether there were significant differences between patients' expectations and perceived service quality. A binary logistic regression analysis was used to determine whether there were significant differences in the gap between expectation and perception of service quality according to patients' demographic characteristics. There was a significant difference between the expected and perceived service quality (p services. Furthermore, the service quality gap of each service dimension was negative. Specifically, the gaps in service quality were as follows: economy, responsiveness, empathy, assurance, reliability, and tangibles. Overall, we can conclude that patients' perceptions of service quality are lower than their expectations. According to the study results, the quality of health care services as perceived by patients was lower than expected. Hospitals should make adjustments according to the actual situation and should strive to constantly improve the quality of medical services for patients.
Hanford Analytical Services Quality Assurance Requirements Document (HASQARD) is issued by the Analytical Services, Program of the Waste Management Division, US Department of Energy (US DOE), Richland Operations Office (DOE-RL). The HASQARD establishes quality requirements in response to DOE Order 5700.6C (DOE 1991b). The HASQARD is designed to meet the needs of DOE-RL for maintaining a consistent level of quality for sampling and field and laboratory analytical services provided by contractor and commercial field and laboratory analytical operations. The HASQARD serves as the quality basis for all sampling and field/laboratory analytical services provided to DOE-RL through the Analytical Services Program of the Waste Management Division in support of Hanford Site environmental cleanup efforts. This includes work performed by contractor and commercial laboratories and covers radiological and nonradiological analyses. The HASQARD applies to field sampling, field analysis, and research and development activities that support work conducted under the Hanford Federal Facility Agreement and Consent Order Tri-Party Agreement and regulatory permit applications and applicable permit requirements described in subsections of this volume. The HASQARD applies to work done to support process chemistry analysis (e.g., ongoing site waste treatment and characterization operations) and research and development projects related to Hanford Site environmental cleanup activities. This ensures a uniform quality umbrella to analytical site activities predicated on the concepts contained in the HASQARD. Using HASQARD will ensure data of known quality and technical defensibility of the methods used to obtain that data. The HASQARD is made up of four volumes: Volume 1, Administrative Requirements; Volume 2, Sampling Technical Requirements; Volume 3, Field Analytical Technical Requirements; and Volume 4, Laboratory Technical Requirements. Volume 1 describes the administrative requirements
Donovan, Leigh A; Wakefield, Claire E; Russell, Vera; Cohn, Richard J
There has been a breadth of research on the grief experience of parents following the death of a child. However, the role and impact of hospital-based bereaved services remain unclear. To identify services offered to bereaved families in perinatal, neonatal, and pediatric hospital settings and summarize the psychosocial impact of these services and published recommendations for best practice hospital-based bereavement care. Systematic review of qualitative, quantitative, and mixed method studies guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and methodological quality appraised in accordance with the Mixed Method Appraisal Tool. MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health, and PsychINFO were searched to find studies describing hospital-based bereavement services/interventions for parents, siblings, and grandparents. In all, 14 qualitative, 6 quantitative, and 10 mixed method studies were identified. Nine descriptive articles were also included. Qualitatively, family members described feeling cared for and supported by staff, a reduction in sense of isolation, and improved coping and personal growth. Quantitatively, bereavement services have most effect for parents experiencing more complex mourning. It is recommended that bereavement services be theoretically driven and evidence based, offer continuity of care prior to and following the death of a child, and provide a range of interventions for the "whole family" and flexibility in service delivery. There is a role for transitional hospital-based services/interventions for families in the lead up to and following the death of a child. Further mixed method research is required to inform best practice bereavement care guidelines in the perinatal, neonatal, and pediatric hospital settings. © The Author(s) 2014.
Hassani, Sahar; Lindman, Anja Schou; Kristoffersen, Doris Tove; Tomic, Oliver; Helgeland, Jon
The Norwegian Knowledge Centre for the Health Services (NOKC) reports 30-day survival as a quality indicator for Norwegian hospitals. The indicators have been published annually since 2011 on the website of the Norwegian Directorate of Health (www.helsenorge.no), as part of the Norwegian Quality Indicator System authorized by the Ministry of Health. Openness regarding calculation of quality indicators is important, as it provides the opportunity to critically review and discuss the method. The purpose of this article is to describe the data collection, data pre-processing, and data analyses, as carried out by NOKC, for the calculation of 30-day risk-adjusted survival probability as a quality indicator. Three diagnosis-specific 30-day survival indicators (first time acute myocardial infarction (AMI), stroke and hip fracture) are estimated based on all-cause deaths, occurring in-hospital or out-of-hospital, within 30 days counting from the first day of hospitalization. Furthermore, a hospital-wide (i.e. overall) 30-day survival indicator is calculated. Patient administrative data from all Norwegian hospitals and information from the Norwegian Population Register are retrieved annually, and linked to datasets for previous years. The outcome (alive/death within 30 days) is attributed to every hospital by the fraction of time spent in each hospital. A logistic regression followed by a hierarchical Bayesian analysis is used for the estimation of risk-adjusted survival probabilities. A multiple testing procedure with a false discovery rate of 5% is used to identify hospitals, hospital trusts and regional health authorities with significantly higher/lower survival than the reference. In addition, estimated risk-adjusted survival probabilities are published per hospital, hospital trust and regional health authority. The variation in risk-adjusted survival probabilities across hospitals for AMI shows a decreasing trend over time: estimated survival probabilities for AMI in
Full Text Available The Norwegian Knowledge Centre for the Health Services (NOKC reports 30-day survival as a quality indicator for Norwegian hospitals. The indicators have been published annually since 2011 on the website of the Norwegian Directorate of Health (www.helsenorge.no, as part of the Norwegian Quality Indicator System authorized by the Ministry of Health. Openness regarding calculation of quality indicators is important, as it provides the opportunity to critically review and discuss the method. The purpose of this article is to describe the data collection, data pre-processing, and data analyses, as carried out by NOKC, for the calculation of 30-day risk-adjusted survival probability as a quality indicator.Three diagnosis-specific 30-day survival indicators (first time acute myocardial infarction (AMI, stroke and hip fracture are estimated based on all-cause deaths, occurring in-hospital or out-of-hospital, within 30 days counting from the first day of hospitalization. Furthermore, a hospital-wide (i.e. overall 30-day survival indicator is calculated. Patient administrative data from all Norwegian hospitals and information from the Norwegian Population Register are retrieved annually, and linked to datasets for previous years. The outcome (alive/death within 30 days is attributed to every hospital by the fraction of time spent in each hospital. A logistic regression followed by a hierarchical Bayesian analysis is used for the estimation of risk-adjusted survival probabilities. A multiple testing procedure with a false discovery rate of 5% is used to identify hospitals, hospital trusts and regional health authorities with significantly higher/lower survival than the reference. In addition, estimated risk-adjusted survival probabilities are published per hospital, hospital trust and regional health authority. The variation in risk-adjusted survival probabilities across hospitals for AMI shows a decreasing trend over time: estimated survival probabilities
Sanford, Kathleen D
To promote better customer service, clinical and finance leaders should work as partners to: Make customer service as important a goal as clinical quality. Educate staff on better communication with patients and families. Perform a root-cause analysis to identify problem trends.
Full Text Available Introduction: Installation service system at the Emergency Department (ED Soetomo Hospital is a coordinated and integrated system under one roof. Include emergency medical and emergency surgery in a very important component of health services at each hospital. The information published on the patient proﬁle and the usefulness of emergency care services indeveloping countries and developed countries is still very rare. This study aimed to describe the characteristic of patients attending the ED at Soetomo hospital Surabaya. Method: This study was a retrospective study. The proﬁle of patients visiting the ED for 1 year were recorded and presented descriptively. Result: The total number of patients visiting the hospital was 5,835, with a monthly average of 486 patients. The children at the age of 1–5 years presented the largest age group (33.6%. The main diagnosis was respiratory tract infection (31%, diarrhea (17.%, followed by seizure (12.4%. The overall mortality rate was 1.7%. Discussion: Respiratory tract infection in children at the age of 1–5 years still count as a major problem at Soetomo Hospital Surabaya.
Home; Journals; Resonance – Journal of Science Education; Volume 10; Issue 3. Quality of Service in the Internet. Prashant Bharadwaj. General Article Volume 10 Issue 3 March 2005 pp 57-70. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/010/03/0057-0070. Keywords.
This book explains why applications running on cloud might not deliver the same service reliability, availability, latency and overall quality to end users as they do when the applications are running on traditional (non-virtualized, non-cloud) configurations, and explains what can be done to mitigate that risk.
Full Text Available The cost of medical services is a concept which cannot be overlooked from the managerial strategy of hospitals, given the fact that it reflects the expenses incurred in order to make the medical act possible. It adds up the direct and indirect costs which are recorded under hospital departments, regarded as cost centres. The result of the calculation is materialized in Expenses Settlement drawn for every discharged patient. The cost thus determined underlies the calculation of efficiency, both at hospital level and at each department and helps at conducting comparative analyses between different health care institutions. In fact, hospital financing is based on average costs established per case, according to the diagnosis groups. The financing system allows monitoring the quality of services and increasing efficiency through cost control. The present study analyses the calculation of the cost of medical services and of the efficiency for average level hospitals from Romania.
“Yaba apa osi” (Yaba to the left side). Consequently, in the year 2000 the hospital stepped up its efforts on destigmatization through public enlightenment programmes and provision of commercial /social as well as general health care services in the institution that would bring or attract the citizenry to its facilities. We carried ...
Ricketts, Thomas C; Belsky, Daniel W
To quantify the correlates of variations of Medicare per beneficiary costs at the hospital service area level and determine whether physician supply and the specialty of physicians has a significant relationship with cost variation. The American Medical Association Masterfile data on physician and surgeon location, characteristics and specialty; Census derived sociodemographic data from 2006 ZIP code level Claritas PopFacts database; and Medicare per beneficiary costs from the Dartmouth Atlas of Health Care project. A correlational analysis using bivariate plots and fixed effects linear regression models controlling for hospital service area sociodemographics and the number and characteristics of the physician supply. Data were aggregated to the Dartmouth hospital service area level from ZIP code level files. We found that costs are strongly related to the sociodemographic character of the hospital service areas and the overall supply of physicians but a mixed correlation to the specialist supply depending on the interaction of the proportion of the physician supply who are international medical graduates. The ratio of general surgeons and surgical subspecialists to population are associated with lower costs in the models, again with difference depending on the influence of international medical graduates. There is a strong association between higher costs and the local proportion of physician supply made up of graduates of non-US or Canadian medical schools and female graduates. These results suggest that strategies to reduce overall costs by changing physician supply must consider more than just overall numbers.
dence of shivering9 and an improved sense of maternal well-being.lo. In summary, the study presented here shows that the analgesia service provided ro the labour ward at King. Edward VIII Hospital is at present grossly inadequate. In particular, a high proportion (76%) of mothers with a specific indication for epidural ...
van Ineveld, Martin; van Oostrum, Jeroen; Vermeulen, Roel; Steenhoek, Adri; van de Klundert, Joris
markdownabstractThis study addresses the productivity of Dutch hospitals since the start of the health systems reform in 2005. We consider DEA based measures, which include efficiency and quality for the complete set of Dutch hospitals and present cross-sectional and longitudinal analysis. In particular, we consider how hospital efficiency has developed. As the reform created an environment of regulated competition, we pay special attention to relative efficiency. Our results suggest that the...
Kruger, Andreas J; Lockey, David; Kurola, Jouni
have established a core data set for documenting and reporting in physician-staffed pre-hospital services. We believe that this template could facilitate future studies within the field and facilitate standardised reporting and future shared research efforts in advanced pre-hospital care.......ABSTRACT: BACKGROUND: Physician-staffed pre-hospital units are employed in many Western emergency medical systems (EMS). Although these services usually integrate well within their EMS, little is known about the quality of care delivered, the precision of dispatch, and whether the services deliver...... a higher quality of care to pre-hospital patients. There is no current data set collected to document the activity of physician pre-hospital activity which makes shared research efforts difficult. The aim of this study was to develop a core data set for routine documentation and reporting in physician...
Kennedy, Denise M; Nordrum, Jon T; Edwards, Frederick D; Caselli, Richard J; Berry, Leonard L
A framework for improving health care service quality was implemented at a 12-provider family medicine practice in 2010. A national patient satisfaction research vendor conducted weekly telephone surveys of 840 patients served by that practice: 280 patients served in 2009, and 560 served during 2010 and 2011. After the framework was implemented, the proportion of "excellent" ratings of provider service (the highest rating on a 5-point scale) increased by 5% to 9%, most notably thoroughness (P = .04), listening (P = .04), and explaining (P = .04). Other improvements included prompt test result notification and telephone staff courtesy (each by 10%, P = .02), as well as teamwork (by 8%, P = .04). Overall quality increased by 10% (P = .01), moving the practice from the 68th to the 91st percentile of medical practices in the research vendor's database. Improvements in patient satisfaction suggest that this framework may be useful in value-based payment models. © 2014 by the American College of Medical Quality.
Mosadeghrad, Ali Mohammad
The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.
Groene, Oliver; Arah, Onyebuchi A.; Klazinga, Niek S.; Wagner, Cordula; Bartels, Paul D.; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A.; Pfaff, Holger; Dersarkissian, Maral; Sunol, Rosa
Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for
B.M. van Ineveld (Martin); J.M. van Oostrum (Jeroen); R. Vermeulen (Roel); A. Steenhoek (Adri); J.J. van de Klundert (Joris)
markdownabstractThis study addresses the productivity of Dutch hospitals since the start of the health systems reform in 2005. We consider DEA based measures, which include efficiency and quality for the complete set of Dutch hospitals and present cross-sectional and longitudinal analysis. In
Davidson, Ehud; Sheiner, Eyal
Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. In this editorial we describe the path to leadership in quality of medical care, service and research.
The purpose of the study was to determine the service quality dimensions of mobile phone services-network performance, service reliability and service accessibility, and to ex-amine the service quality/customer satisfaction link within the context of mobile phone services. An exploratory research design using a quantitative ...
... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing and related services, medical social... services, medical social services; use of hospital or CAH facilities. (a) Except as provided in paragraph... facilities, and medical social services as inpatient hospital or inpatient CAH services only if those...
Full Text Available Objective: To tamp basic neonatal care, provide high quality nursing service, improve the quality of neonatal care, guarantee the safety of nursing care, achieve satisfactory project. Methods:Adjust the staff of the neonatal ward , optimize schedule; strengthen the training and knowledge; strengthen the supervision and ensure the basic nursing; the nursing quality management group work out the rate of incidence of high quality nursing service, the incidence rate of hospital infection of the newborn as well as the satisfaction of their families. Results: The different data between the control group and observation group was statistically significant ( P < 0.05 . Conclusion: Develop the neonatal ward of high quality nursing service, ensure the basic nursing implement, significantly improve the quality of nursing, reduce nursing adverse events and neonatal hospital infection incidence to" zero defects and zero tolerance", and that ensures nursing safety, and achieve the goal of " quality care demonstration project" --- patient satisfaction, social satisfaction, and government satisfaction.
Christoglou, Konstantinos; Vassiliadis, Chris; Sigalas, Ioakim
This article presents the results of a service quality study. After an introduction to the SERVQUAL and the Kano research techniques, a Kano analysis of 75 patients from the General Hospital of Katerini in Greece is presented. The service quality criterion used satisfaction and dissatisfaction indices. The Kano statistical analysis process results strengthened the hypothesis of previous research regarding the importance of personal knowledge, the courtesy of the hospital employees and their ability to convey trust and confidence (assurance dimension). Managerial suggestions are made regarding the best way of acting and approaching hospital patients based on the basic SERVQUAL model.
Palacio, Carlos; House, Jeffrey; Ibrahim, Saif; Touchan, Jean N; Mooradian, Ariana
Heart failure (HF) is a leading cause of hospitalization in the United States. With the population trend shifting to a higher volume of elderly adults, the efficient management of HF will become increasingly essential. The development and implementation of The Patient Protection and Affordable Care Act and subsequent changes in reimbursement practices have made 30-day readmission rates a topic of much interest and relevance. The aim of the study was to compare rates of readmission among teaching and nonteaching hospitals. The authors gathered retrospective data on HF quality measures and readmission rates between August 2011 and July 2012, extracted from the institution's managerial accounting database. These data were compared among teaching and nonteaching hospitals. Patient demographics, readmission rates, readmission diagnoses, severity of illness, patient disposition, medications prescribed, cost of services, and mortality were reviewed. Analysis of variance was used for continuous variables; χ(2) analysis was used for evaluating categorical variables. A higher proportion of patients on the cardiology teaching service were men than on either the medicine teaching service or the medicine nonteaching service. Length of stay, case costs, and care costs were lowest for the cardiology teaching service; however, patient illness severity was lower on this service than on the other two services. Overall, readmissions and mortality were similar among all groups, but readmission for the same diagnosis was more likely on the cardiology service than on the medicine teaching and nonteaching services. Studies comparing teaching and nonteaching providers for an HF diagnosis are needed. Hospital readmission and mortality rates were similar across services and compared favorably with national data. Opportunities that target cost reduction and length of stay may be leveraged.
Full Text Available The in-hospital mortality (MIH is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity, and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from Nador, 2% from Bouarfa, 4% from Taourirt and 2% from Jerrada. One might question about the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, .... The MIH is however an important indicator to consider as a tool to detect potential problems related to admission procedures and to suspect an area of "non-quality" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.
Darney, Blair G; Simancas-Mendoza, Willis; Edelman, Alison B; Guerra-Palacio, Camilo; Tolosa, Jorge E; Rodriguez, Maria I
Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with .99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services. Copyright © 2014. Published by Elsevier Inc.
Pritt, Jeffrey; Jones, Berwyn E.
PREFACE This catalog provides information about analytical services available from the National Water Quality Laboratory (NWQL) to support programs of the Water Resources Division of the U.S. Geological Survey. To assist personnel in the selection of analytical services, the catalog lists cost, sample volume, applicable concentration range, detection level, precision of analysis, and preservation techniques for samples to be submitted for analysis. Prices for services reflect operationa1 costs, the complexity of each analytical procedure, and the costs to ensure analytical quality control. The catalog consists of five parts. Part 1 is a glossary of terminology; Part 2 lists the bottles, containers, solutions, and other materials that are available through the NWQL; Part 3 describes the field processing of samples to be submitted for analysis; Part 4 describes analytical services that are available; and Part 5 contains indices of analytical methodology and Chemical Abstract Services (CAS) numbers. Nomenclature used in the catalog is consistent with WATSTORE and STORET. The user is provided with laboratory codes and schedules that consist of groupings of parameters which are measured together in the NWQL. In cases where more than one analytical range is offered for a single element or compound, different laboratory codes are given. Book 5 of the series 'Techniques of Water Resources Investigations of the U.S. Geological Survey' should be consulted for more information about the analytical procedures included in the tabulations. This catalog supersedes U.S. Geological Survey Open-File Report 86-232 '1986-87-88 National Water Quality Laboratory Services Catalog', October 1985.
Full Text Available Abstract Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals with those hospitals participating in a nation-wide, voluntary hospital performance initiative. We then compared sample distributions and explored associations between the 'maturity' of the hospitals' quality improvement system and a range of composite outcomes measures, such as adjusted hospital-wide mortality, -readmission, -complication and -length of stay indices. Statistical analysis includes bivariate correlations for parametrically and non-parametrically distributed data, multiple robust regression models and bootstrapping techniques to obtain confidence-intervals for the correlation and regression estimates. Results Overall, 43 hospitals were included. Compared to the original sample of 113, this sample was characterized by a higher representation of university hospitals. Maturity of the quality improvement system was similar, although the matched sample showed less variability. Analysis of associations between the quality improvement system and hospital-wide outcomes suggests significant correlations for the indicator adjusted hospital complications, borderline significance for adjusted hospital readmissions and non-significance for the adjusted hospital mortality and length of stay indicators. These results are confirmed by the bootstrap estimates of the robust regression model after adjusting for hospital characteristics. Conclusions We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more
Mohebifar, Rafat; Hasani, Hana; Barikani, Ameneh; Rafiei, Sima
Providing high service quality is one of the main functions of health systems. Measuring service quality is the basic prerequisite for improving quality. The aim of this study was to evaluate the quality of service in teaching hospitals using importance-performance analysis matrix. A descriptive-analytic study was conducted through a cross-sectional method in six academic hospitals of Qazvin, Iran, in 2012. A total of 360 patients contributed to the study. The sampling technique was stratified random sampling. Required data were collected based on a standard questionnaire (SERVQUAL). Data analysis was done through SPSS version 18 statistical software and importance-performance analysis matrix. The results showed a significant gap between importance and performance in all five dimensions of service quality (p quality gap and "responsiveness" had the lowest gap (1.97). Also, according to findings, reliability and assurance were in Quadrant (I), empathy was in Quadrant (II), and tangibles and responsiveness were in Quadrant (IV) of the importance-performance matrix. The negative gap in all dimensions of quality shows that quality improvement is necessary in all dimensions. Using quality and diagnosis measurement instruments such as importance-performance analysis will help hospital managers with planning of service quality improvement and achieving long-term goals.
Zardawi, I M; Bennett, G.; Jain, S; Brown, M.
AIM: To assess the role of a quality assurance programme in improving the service provided by a surgical pathology department. METHODS: A continuous internal quality assurance study of the activities of an anatomical pathology department in an Australian teaching hospital was undertaken over a five year period. This addressed all steps involved in the production of a surgical pathology report. These were addressed in an open forum which included technical, scientific, clerical, and medical st...
Measures taken to assure medical quality in hospital departments have focused on external quality control. Public health insurance organizations and the society of hospital holders in Germany have now agreed to carry out activities that aims not only at outcome but also at structural and procedural aspects of medical quality. The next step will be the introduction of quality management systems according to ISO 9000.
Chang, Ching-Sheng; Chen, Su-Yueh; Lan, Yi-Ting
No previous studies have addressed the integrated relationships among system quality, service quality, job satisfaction, and system performance; this study attempts to bridge such a gap with evidence-based practice study. The convenience sampling method was applied to the information system users of three hospitals in southern Taiwan. A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid, suggesting a valid response rate of 56.6%. SPSS 17.0 and AMOS 17.0 (structural equation modeling) statistical software packages were used for data analysis and processing. The findings are as follows: System quality has a positive influence on service quality (γ11= 0.55), job satisfaction (γ21= 0.32), and system performance (γ31= 0.47). Service quality (β31= 0.38) and job satisfaction (β32= 0.46) will positively influence system performance. It is thus recommended that the information office of hospitals and developers take enhancement of service quality and user satisfaction into consideration in addition to placing b on system quality and information quality when designing, developing, or purchasing an information system, in order to improve benefits and gain more achievements generated by hospital information systems.
Background No previous studies have addressed the integrated relationships among system quality, service quality, job satisfaction, and system performance; this study attempts to bridge such a gap with evidence-based practice study. Methods The convenience sampling method was applied to the information system users of three hospitals in southern Taiwan. A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid, suggesting a valid response rate of 56.6%. SPSS 17.0 and AMOS 17.0 (structural equation modeling) statistical software packages were used for data analysis and processing. Results The findings are as follows: System quality has a positive influence on service quality (γ11= 0.55), job satisfaction (γ21= 0.32), and system performance (γ31= 0.47). Service quality (β31= 0.38) and job satisfaction (β32= 0.46) will positively influence system performance. Conclusions It is thus recommended that the information office of hospitals and developers take enhancement of service quality and user satisfaction into consideration in addition to placing b on system quality and information quality when designing, developing, or purchasing an information system, in order to improve benefits and gain more achievements generated by hospital information systems. PMID:23171394
Purpose: The purpose of this paper is to provide an overview of the evolution of "folk" understandings of quality in higher hospitality education and the consequent implications of these understandings for current quality concerns in the field. Design/methodology/approach: The paper combines a historical survey of the stated topic…
Full Text Available The starting point for the considerations made in the article is to compare such categories as product quality and service quality. An essential part of analysis is devoted to the relation of quality of service and satisfaction with the service. In the article discusses the grounds of designing and preparing customer satisfaction survey of services.
Full Text Available This study aims to determine the descriptive overview of the quality of education services consisting. The location of this research was at the Economics Faculty of Semarang State University, and the object of the study was student at semester VII of the Economics Faculty. The population of this study was 620 students in the academic year of 2014/2015. Proportional cluster ranom sampling technique was utilized to get 186 samples. The method of collecting data using questionnaires, whereas method of data analysis using non-parametric statistics (descriptive percentages.The result shows that the quality of education services, which can be seen from the dimensions of relevance, efficiency, effectiveness, accountability, responsiveness, creativity, productivity, academic abilities, empathy, and appearance, are perceived well by students. However, this result has not optimal yet, especially on the dimensions of relevance, efficiency and effectiveness.
Zhao, Shi-hong; Mu, Hui-tong; Li, Zhe; Shi, Lei; Wang, Ling-ling; Jia, Xiao-li; Ha, Min; Lou, Feng-ge
Background and aim The doctor–patient relationship has been a major focus of society. Hospitals’ efforts to improve the quality of their medical services have been to reduce the probability of doctor–patient conflicts. In this study, we aimed to determine the gap between expectations and perceptions of service quality according to patients to provide reference data for creating strategies to improve health care quality. Methods Twenty–seven hospitals in 15 provinces (municipalities directly beneath the central government) were selected for our survey; we sent out 1,589 questionnaires, of which 1,520 were collected (response rate 95.65%) and 1,303 were valid (85.72% effective recovery rate). Paired t-tests were used to analyze whether there were significant differences between patients' expectations and perceived service quality. A binary logistic regression analysis was used to determine whether there were significant differences in the gap between expectation and perception of service quality according to patients' demographic characteristics. Results There was a significant difference between the expected and perceived service quality (p services. Furthermore, the service quality gap of each service dimension was negative. Specifically, the gaps in service quality were as follows: economy, responsiveness, empathy, assurance, reliability, and tangibles. Overall, we can conclude that patients’ perceptions of service quality are lower than their expectations. Conclusions According to the study results, the quality of health care services as perceived by patients was lower than expected. Hospitals should make adjustments according to the actual situation and should strive to constantly improve the quality of medical services for patients. PMID:29272312
OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users\\' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.
Al Fraihi, Khalid J; Latif, Shahid A
To investigate perceptions and expectations of patients regarding hospital outpatient services by using a service quality gap model and factors influencing such gaps. In this cross-sectional descriptive study conducted between October and November 2014 in the outpatient waiting areas of a hospital in the Eastern Province of Saudi Arabia, a sample of 306 patients was selected by convenience sampling technique. The data was collected through an Arabic version of the service quality (SERVQUAL) questionnaire consisting of 2 parts: patients' demographic characteristics, and 22 items scales of patients' expectations and perceptions of SERVQUAL. The data was analyzed by confirmatory factor analysis, independent, and paired t samples tests and one way analysis of variance test The results showed that the proposed model for service quality dimensions had a good fit by satisfying the recommended values. The patients' expectations exceeded perceptions in all service quality dimensions indicating statistically significant service quality gaps (t=26.3, p less than 0.000). Findings revealed that the empathy dimension contributed most patients' expectations (4.7 ± 0.5) and perceptions (3.7 ± 0.8) scores, and responsiveness contributed least to expectations (4.5 ± 0.6) and perceptions (3.2 ± 0.8) scores. Prompt services showed highest service quality gap, while observation of privacy showed the smallest service quality gap in the statements. The study showed a significant association between gender, age, education, multiple visits, and service quality dimensions. The proposed model is valid and reliable and significant service quality gaps of all 5 dimensions need to be prioritized and addressed by focused improvement efforts of hospital management.
Skyrocketing health care costs are forcing payers to demand delivery efficiencies that preserve and promote quality care while reducing costs. Hospitals are challenged to meet the pressure from payers to deliver value and outcome-based health care while preserving sufficient financial margins. The fee-for-service (FFS) model with its perverse incentives to incur high-volume services is no longer, if ever, sufficient to ensure quality, cost-efficient health care. In response, payers have sought to force the issue through accelerated efforts to bundle payments to providers. It is theorized that by tying together providers throughout the continuum or episode of care for a patient, efficiencies in delivery inclusive of cost reductions will be obtained. This article examines the bundled payment models and the financial considerations for hospital facility providers.
Pennington, S J; McClelland, D B; Murphy, W G
One of the objectives of the NHS reforms is to improve customer focus within the health service. In a study to assess the quality of customer service provided by the Edinburgh and South East Scotland Blood Transfusion Service a 19 item questionnaire survey of the main clinical users of the service was performed to ascertain their satisfaction, measured on a 5 point anchored scale, with important aspects of the service, including medical consultation, diagnostic services, blood and blood components or products and their delivery, and general satisfaction with the service. Of 122 clinicians in medical and surgical disciplines in five hospitals in Edinburgh, 72 (59%) replied. Fourteen (22%) indicated dissatisfaction with any aspect of the medical consultation service, owing to inadequate follow up of clinical contacts and unsatisfactory routing of incoming calls. Diagnostic services were criticised for the presentation, communication, and interpretation of results. The restricted availability of whole blood, the necessity to order platelets and plasma through the duty blood transfusion service doctor, and the use of a group and screen policy, attracted criticism from a small number of clinicians. Ten of 68 respondents expressed dissatisfaction with delivery of blood and components to the wards and theatres. The findings indicate that the clinicians served by this blood transfusion service are largely satisfied with the service. Changes are being implemented to improve reporting of laboratory results and measures taken to improve liaison with clinicians.
The aim of this research is to examine the relationship between service quality management dimensions (quality management and patient service quality) and their impact on performance of the healthcare organizations. The organizations that deliver service must broaden their examination of quality from the conventional ...
Najafi, Seyesvahid; Saati, Saber; Tavana, Madjid
Service quality is often conceptualized as the comparison between service expectations and the actual performance perceptions. It enhances customer satisfaction, decreases customer defection, and promotes customer loyalty. Substantial literature has examined the concept of service quality, its dimensions, and measurement methods. We introduce the perceived service quality index (PSQI) as a single measure for evaluating the multiple-item service quality construct based on the SERVQUAL model. A...
Rocha, Álvaro; Freixo, Jorge
Quality Management occupies a strategic role in organizations, and the adoption of computer tools within an aligned information architecture facilitates the challenge of making more with less, promoting the development of a competitive edge and sustainability. A formal Information Architecture (IA) lends organizations an enhanced knowledge but, above all, favours management. This simplifies the reinvention of processes, the reformulation of procedures, bridging and the cooperation amongst the multiple actors of an organization. In the present investigation work we planned the IA for the Quality Management System (QMS) of a Hospital, which allowed us to develop and implement the QUALITUS (QUALITUS, name of the computer application developed to support Quality Management in a Hospital Unit) computer application. This solution translated itself in significant gains for the Hospital Unit under study, accelerating the quality management process and reducing the tasks, the number of documents, the information to be filled in and information errors, amongst others.
White, Marilyn Domas; Abels, Eileen G.; Nitecki, Danuta
This project tested the appropriateness of SERVQUAL (i.e., an instrument widely used in the service industry for assessing service quality based on repeated service encounters rather than a particular service encounter) to measure service quality in special libraries and developed a modified version for special libraries. SERVQUAL is based on an…
Asst. Prof. S. Anthony Rahul Golden
Due to huge competition in the service sector, service providers have to focus on lots of aspects in connection with satisfying the customer. Especially, the providers need to focus on increasing the service quality to maintain their position in the competitive market. Subscribers’ satisfaction is one of the determinants of service quality and perception carried by subscribers plays an important role in choosing a mobile service provider. This paper presents a service quality analysis of mobi...
BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.
Melton, Gary B
Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Study Design : Descriptive study. Materials and Methods : This study was conducted between September 2005 and June 2006. Patients attending the eye clinic of Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India, and admitted as in-patients in this hospital were our study population. Randomly selected patients were interviewed by trained staff. Close-ended questionnaire was used to conduct these structured interviews. Their responses were grouped into one of five categories and evaluated to determine satisfaction for different components of eye care services. Results : Three hundred and twenty persons were interviewed. The satisfaction was of excellent grade among 77 (48.1% patients attending clinic and 156 (97.5% patients who were admitted in the hospital. The participants expressed dissatisfaction for the long waiting period in clinics, poor cleanliness, and insufficient toilet facilities. Those admitted in the hospital felt that food facilities were less than the expected quality. Child-friendly facilities received high satisfaction scores. Conclusion : Although eye care services both in clinics and in the wards were satisfactory according to the end-users, there are scopes for improvement. Patient satisfaction surveys should be encouraged in hospitals for better accountability and also for strengthening the quality of eye care services.
Ecole de Santé Publique Université Libre de Bruxelles Academic Year 2010-2011 Al-Awa, Bahjat Impact of Hospital Accreditation on Patients' Safety and Quality Indicators Dissertation Summary I. Introduction: There is increased interest around the world in the evaluation of healthcare, coming not only from governments, but also from providers and consumers . Therefore initiatives to address quality of health care have become worldwide phenomena . As quality is crucial fa...
Al-Damluji, Mohammed Salim; Dzara, Kristina; Hodshon, Beth; Punnanithinont, Natdanai; Krumholz, Harlan M; Chaudhry, Sarwat I; Horwitz, Leora I
Single-site studies have demonstrated inadequate quality of discharge summaries in timeliness, transmission, and content, potentially contributing to adverse outcomes. However, degree of hospital-level variation in discharge summary quality for patients hospitalized with heart failure (HF) is uncertain. We analyzed discharge summaries of patients enrolled in the Telemonitoring to Improve Heart Failure Outcomes (Tele-HF) study. We assessed hospital-level performance on timeliness (fraction of summaries completed on the day of discharge), documented transmission to the follow-up physician, and content (presence of components suggested by the Transitions of Care Consensus Conference). We obtained 1501 discharge summaries from 1640 (91.5%) patients discharged alive from 46 hospitals. Among hospitals contributing ≥ 10 summaries, the median hospital dictated 69.2% of discharge summaries on the day of discharge (range, 0.0%-98.0%; PHospital course was typically included (97.2%), but summaries were less likely to include discharge condition (30.7%), discharge volume status (16.0%), or discharge weight (15.7%). No discharge summary included all 7 Transitions of Care Consensus Conference-endorsed content elements, was dictated on the day of discharge, and was sent to a follow-up physician. Even at the highest performing hospital, discharge summary quality is insufficient in terms of timeliness, transmission, and content. Improvements in all aspects of discharge summary quality are necessary to enable the discharge summary to serve as an effective transitional care tool. © 2015 American Heart Association, Inc.
Qin, Hong; Prybutok, Victor; Prybutok, Gayle
Service quality and patient satisfaction are essential to health care organization success. Parasuraman, Zeithaml, and Berry introduced SERVQUAL, a prominent service quality measure not yet applied to urgent care. We develop an instrument to measure perceived service quality and identify the determinants of patient satisfaction/ behavioral intentions. We examine the relationships among perceived service quality, patient satisfaction and behavioral intentions, and demonstrate that urgent care service quality is not equivalent using measures of perceptions only, differences of expectations minus perceptions, ratio of perceptions to expectations, and the log of the ratio. Perceptions provide the best measure of urgent care service quality.
Murphy, M J; Dryburgh, F J; Shepherd, J
To ascertain the views of Scottish hospital laboratory users on aspects of regional and supraregional biochemical services offered by the Institute of Biochemistry at Glasgow Royal Infirmary. A questionnaire was circulated asking questions or inviting opinions under various headings, including current patterns of usage of the services provided, availability of information on specimen collection requirements and reference ranges, current arrangements for transport of specimens, turnaround times for delivery of reports, layout and content of request and report forms, quantity and quality of interpretive advice, potential changes in laboratory services, and overall impression of the services provided. Opportunities were provided for free text comment. The questionnaire was circulated in 1992 to heads of department in 23 Scottish hospital biochemistry laboratories. Twenty one replies were received. Services used widely included trace metals/vitamins (n = 20) and specialised endocrine tests (n = 19). Other services also used included specialised lipid tests (n = 13), toxicology (n = 12), thyroid function tests (n = nine), and tumour markers (n = eight). Fifteen laboratories used one or more of the services at least weekly. Most (n = 20) welcomed the idea of a handbook providing information on specimen collection and reference ranges. Nine identified loss of specimens as a problem. Other perceived problems included the absence of reference ranges from report forms, quantity and quality of interpretive advice, and turnaround times of some tests. Overall impressions of the service(s) offered were very good (n = 12); adequate (n = seven); poor (n = one). Useful information was obtained about patterns of use and transport arrangements. Areas identified as requiring follow up included provision of information, alternative ways of communicating reports, and improvement in quantity and quality of interpretive advice.
Judson, Katherine; Courtright, Paul; Ravilla, Thulsiraj; Khanna, Rohit; Bassett, Ken
This study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. The intervention involved eye care non-governmental organizations or high-performing eye hospitals acting as "mentors" to underperforming eye hospitals- "mentees" in 10 countries. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes. This is a before and after observational study of the impact of this multi-dimensional process on hospital and individual productivity and financial sustainability after 4 years. Mentee hospitals reported data monthly using a standardized template. Key indicators included cataract surgery volume, cataract operations per surgeon, the proportion of direct paying cataract surgical patients, intervention program costs per additional surgery and cost per mentor. By the end of the study period, the hospitals experienced a 69% average increase (range: -63% to 690%) in cataract surgical volume over baseline with 12 hospitals showing increases over 100%. Twenty-three hospitals experienced a 59% average increase in the number of cataract surgeries per surgeon with 10 hospitals showing increases over 100%. The proportion of paying patients increased in 8 of the 14 hospitals reporting this data. The average mentoring cost per additional surgery for these 25 hospitals was $5.39. An average of $36,489.99 was spent per mentor per year to support their work with mentees. The intervention resulted in proportionally similar increases in cataract surgical volume and productivity across diverse settings in three distinct geographic regions. Its wide applicability and moderate
Bardach, Naomi S; Vittinghoff, Eric; Asteria-Peñaloza, Renée; Edwards, Jeffrey D; Yazdany, Jinoos; Lee, Henry C; Boscardin, W John; Cabana, Michael D; Dudley, R Adams
To assess variation among hospitals on pediatric readmission and revisit rates and to determine the number of high- and low-performing hospitals. In a retrospective analysis using the State Inpatient and Emergency Department Databases from the Healthcare Cost and Utilization Project with revisit linkages available, we identified pediatric (ages 1-20 years) visits with 1 of 7 common inpatient pediatric conditions (asthma, dehydration, pneumonia, appendicitis, skin infections, mood disorders, and epilepsy). For each condition, we calculated rates of all-cause readmissions and rates of revisits (readmission or presentation to the emergency department) within 30 and 60 days of discharge. We used mixed logistic models to estimate hospital-level risk-standardized 30-day revisit rates and to identify hospitals that had performance statistically different from the group mean. Thirty-day readmission rates were low (1% of hospitals labeled as different from the mean on 30-day risk-standardized revisit rates was mood disorders (4.2% of hospitals [n = 15], range of hospital performance 6.3%-15.9%). We found that when comparing hospitals' performances to the average, few hospitals that care for children are identified as high- or low-performers for revisits, even for common pediatric diagnoses, likely due to low hospital volumes. This limits the usefulness of condition-specific readmission or revisit measures in pediatric quality measurement.
Gianino, Maria Michela; Raciti, Ida Marina; Galzerano, Mario; Villata, Eugenia; Fonte, Gianfranco; Rapellino, Marco; Fiandra, Umberto
The San Giovanni Battista Hospital in Turin validated a tool for evaluating the quality of hospital patient records. The tool defines the essential contents of patient records, indicators and weights as well as the standard score that must be reached. A pilot study was performed in 2007 to evaluate whether this tool adequately evaluates the quality of hospital patient records in both medical and surgical wards, and whether it can do so in a standardized and repeatable manner. A random sample of 206 medical charts of patients admitted to the San Giovanni Battista Hospital in 2007 was extracted and analysed. The instrument was found to adequately evaluate hospital patient records in a standardisd and repeatable manner.
and ART treatment;. Testing positive who delivered in a facility and were. 3. Utilization of PMTCT services at Juba Teaching. Hospital, South Sudan. Idyoro Joseph .... Alive. Yes. No. 297. 3. 99.0. 1.0. Educational level. None. Primary. Intermediate. Secondary. College/university. 14. 46. 11. 118. 111. 4.7. 15.3. 3.7. 39.3. 37.0.
Poole, LeJon; Davis, Jullet A; Gunby, Norris W
Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services. The purpose of this research was to assess the financial effectiveness of the niche strategy. We theorize that firm and market-level factors concomitantly with the strategy of the hospital-niche versus traditional-are associated with financial performance. This research used 2 data sources, the 2003 Medicare Cost Report and the 2003 Area Resource File. The sample was limited to only for-profit, urban, nongovernmental hospitals (n = 995). The data were analyzed using hierarchical least squares regression. Financial performance was operationalized using the hospital's return on assets. The principal finding of this project is that niche hospitals had significantly higher performance than traditional facilities. From the organizational perspective, the niche strategy leads to better financial performance. From a societal perspective, the niche strategy provides increased focus and efficiencies through repetition. Despite the limited focus of this strategy, patients who can access these providers may experience better outcomes than patients in more traditional hospitals.
Kuziemski, Arkadiusz; Czerniak, Beata; Frankowska, Krystyna; Gonia, Ewa; Salińska, Teresa; Motuk, Andrzej; Sobociński, Zbigniew
In 2006 the Board of the Jan Biziel Hospital in Bydgoszcz decided to include procedures of health services in the implementation process within the confines of ISO 9001:2000 certification. The hospital infection control team that has operated in the hospital since 1989 performed the analysis of the forms of activities to date and on that basis the team prepared original plan of quality management. In April 2007, this plan was successfully accepted by the certifying team. The aim of this study is to present the aforementioned plan which is the result of 18 years experience of the team. At the same time, I hope that this study will be very helpful for all professionals interested in hospital epidemiology, especially in the context of implementing quality management systems.
Ford, Eric W; Huerta, Timothy R; Diana, Mark L; Kazley, Abby Swanson; Menachemi, Nir
Hospitals and health systems are using web-based and social media tools to market themselves to consumers with increasingly sophisticated strategies. These efforts are designed to shape the consumers' expectations, influence their purchase decisions, and build a positive reputation in the marketplace. Little is known about how these web-based marketing efforts are taking form and if they have any relationship to consumers' satisfaction with the services they receive. The purpose of this study is to assess if a relationship exists between the quality of hospitals' public websites and their aggregated patient satisfaction ratings. Based on analyses of 1,952 U.S. hospitals, our results show that website quality is significantly and positively related to patients' overall rating of the hospital and their intention to recommend the facility to others. The potential for web-based information sources to influence consumer behavior has important implications for policymakers, third-party payers, health care providers, and consumers.
Nguyen, My H Ng; Gammeltoft, Tine; Rasch, Vibeke
Six months after a Comprehensive Abortion Care project was implemented in Phu-San Hospital, the main maternity hospital in Hai Phòng, northern Viet Nam, a study of quality of abortion services was carried out. The study explored the interaction between providers and women seeking abortion and how...
Jeevarathnam P. Govender
Full Text Available This paper evaluates service quality in the Durban freight transportation industry, in which a high degree of competition exists. Previous measurements of service quality in the industry have been casual gauges, rather than a formalised process. This paper makes a contribution by examining the level of service quality, specifically from a tangibles, reliability and responsiveness perspective, thereby identifying service quality gaps which need to be closed, with a view to raising service quality levels in the industry. The SERVQUAL instrument has been used to measure service quality levels administered to 500 of the industry’s active customers, i.e. organisations utilising the services of the freight transportation industry. The targeted respondents were managers responsible for logistics in their organisations. It was found that gaps existed between expectations and perceptions of service quality on 14 of the 15 measured items. Recommendations are made as to how the industry can improve its service quality levels.
Baernholdt, Marianne; Jennings, Bonnie Mowinski; Merwin, Elizabeth; Thornlow, Deirdre
This paper is a report of a study conducted to answer the question: 'How do rural nurses and their chief nursing officers define quality care?' Established indicators of quality care were developed primarily in urban hospitals. Rural hospitals and their environments differ from urban settings, suggesting that there might be differences in how quality care is defined. This has measurement implications. Focus groups with staff nurses and interviews with chief nursing officers were conducted in 2006 at four rural hospitals in the South-Eastern United States of America. Data were analysed using conventional content analysis. The staff nurse and chief nursing officer data were analysed separately and then compared, exposing two major themes: 'Patients are what matter most' and 'Community connectedness is both a help and a hindrance'. Along with conveying that patients were the utmost priority and all care was patient-focused, the first theme included established indicators of quality such as falls, pressure ulcers, infection rates, readmission rates, and lengths of stay. A new discovery in this theme was a need for an indicator relevant for rural settings: transfer time to larger hospitals. The second theme, Community Connectedness, is unique to rural settings, exemplifying the rural culture. The community and hospital converge into a family of sorts, creating expectations for quality care by both patients and staff that are not typically found in urban settings and larger hospitals. Established quality indicators are appropriate for rural hospitals, but additional indicators need to be developed. These must include transfer times to larger facilities and the culture of the community.
Marshall, Joanne Gard; Morgan, Jennifer Craft; Thompson, Cheryl A; Wells, Amber L
The purpose of this paper is to explore library and information service impact on patient care quality. A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. Electronic collections and services provided by the library and the librarian contribute to patient care quality.
Full Text Available Introduction: Quality of life (QOL of emergency medicine specialists can be effective in providing services to patients. The aim of the present study was evaluating the lifestyle of emergency medicine practitioners, understanding their problems, and addressing the solutions to enhance and improve their lifestyles, in teaching hospitals in Iran. Method: This descriptive cross-sectional study was conducted on emergency medicine physicians in 10 teaching hospitals of Iran in 2011. Emergency physicians with at least three years of experience who interested in the study, were enrolled in the project. All participants filled out the consent form and QOL questionnaires, then underwent physical examinations and some medical laboratory tests. Categorical variables were reported as percentages, while continuous variables expressed as means and standard deviations. p <0.05 was considered statistically significant. Results: Totally, 100 subjects participated in the study, of whom 48 were male. The mean and standard deviation of the physicians’ age were 38.7±5.1 years. 43% of physicians had an average QOL, while 37% good. 96% of studied physicians had a good condition regarding habitual history, while 93% of them had a poor condition in performing screening tests. Exercise program and personal health in individuals with normal BMI were correlated with higher levels of QOL. BMI was higher in 40-50 years old subjects than youngers. Hypertension was present in five cases (5%, hypercholesterolemia in six (6%, hypertriglyceridemia in six (6%, increased LDL in four (4%, low HDL in four (4%, and impaired FBS in 4 (4%. Conclusion: The findings showed that 63% of studied emergency physicians had an average level of QOL and other ones good. The majority of physicians had undesirable situation regarding the performance of screening tests.
Asgar Aghaei Hashjin
Full Text Available RESEARCH OBJECTIVE: This study examines the perspectives of a range of key hospital staff on the use, importance, scientific background, availability of data, feasibility of data collection, cost benefit aspects and availability of professional personnel for measurement of quality indicators among Iranian hospitals. The study aims to facilitate the use of quality indicators to improve quality of care in hospitals. STUDY DESIGN: A cross-sectional study was conducted over the period 2009 to 2010. Staff at Iranian hospitals completed a self-administered questionnaire eliciting their views on organizational, clinical process, and outcome (clinical effectiveness, patient safety and patient centeredness indicators. POPULATION STUDIED: 93 hospital frontline staff including hospital/nursing managers, medical doctors, nurses, and quality improvement/medical records officers in 48 general and specialized hospitals in Iran. PRINCIPAL FINDINGS: On average, only 69% of respondents reported using quality indicators in practice at their affiliated hospitals. Respondents varied significantly in their reported use of organizational, clinical process and outcome quality indicators. Overall, clinical process and effectiveness indicators were reported to be least used. The reported use of indicators corresponded with their perceived level of importance. Quality indicators were reported to be used among clinical staff significantly more than among managerial staff. In total, 74% of the respondents reported to use obligatory indicators, while this was 68% for voluntary indicators (p<0.05. CONCLUSIONS: There is a general awareness of the importance and usability of quality indicators among hospital staff in Iran, but their use is currently mostly directed towards external accountability purposes. To increase the formative use of quality indicators, creation of a common culture and feeling of shared ownership, alongside an increased uptake of clinical process and
Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael
Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.
Ferdosi, Masoud; Farahabadi, Ehsan; Mofid, Maryam; Rejalian, Farzaneh; Haghighat, Maryam; Naghdi, Parnaz
Hospitals need to focus on their core activities, thus outsourcing of services may be effective in some instances. However, monitoring and supervision is a vital mechanism to preserving and enhancing the quality of outsourced services, and to identify the benefits and losses occurred. The purpose of this study is evaluation of nursing services outsourced in a general hospital from different point of views. This is a descriptive and applied study done by case study (before and after) method. Outsourcing nursing services of clinical wards (ENT and Neurosurgery) of Kashani Hospital in 2011 has been studied. We extracted data from a handmade questionnaire about internal customer's satisfaction and semi-structured interviews with officials, and also survey of financial and administrative documents and records related to the topic. The findings indicate an increased number of graduated nurses per bed to fulfill the main objective of outsourcing in this case. But achieving this objective is accompanied with remarkable increased costs per bed after outsourcing. Besides, we noticed minor changes in internal customer satisfaction rate. While outsourcing should bring about staff and patients' satisfaction and increase the efficiency and effectiveness, outsourcing nursing workforce singly, leaded to a loss of efficiency. Therefore, the applied outsourcing has not met the productivity for the hospital.
Buja, Alessandra; Canavese, Daniel; Furlan, Patrizia; Lago, Laura; Saia, Mario; Baldo, Vincenzo
This population-level health service study aimed to address whether hospitals assure the same quality of care to people in equal need, i.e. to see if any associations exist between social determinants and adherence to four hospital process indicators clearly identified as being linked to better health outcomes for patients. This was a retrospective cohort study based on administrative data collected in the Veneto Region (northeast Italy). We included residents of the Veneto Region hospitalized for ST-segment elevation myocardial infarction (STEMI) or acute myocardial infarction (AMI), hip fracture, or cholecystitis, and women giving birth, who were discharged from any hospital operating under the Veneto Regional Health Service between January 2012 and December 2012. The following quality indicator rates were calculated: patients with STEMI-AMI treated with percutaneous coronary intervention, elderly patients with hip fractures who underwent surgery within 48 h of admission, laparoscopic cholecystectomies and women who underwent cesarean section. A multilevel, multivariable logistic regression analyses were conducted to test the association between age, gender, formal education or citizenship and the quality of hospital care processes. All the inpatient hospital care process quality indicators measured were associated with an undesirable number of disparities concerning the social determinants. Monitoring the evidence-based hospital health care process indicators reveals undesirable disparities. Administrative data sets are of considerable practical value in broad-based quality assessments and as a screening tool, also in the health disparities domain. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Crawford, Stephanie Y; Schumock, Glen T; Ursan, Iulia D; Ursan, Julia D; Walton, Surrey M; Donnelly, Andrew J
The results of a survey evaluating pharmacy services and technology use at critical access hospitals (CAHs) and other small and rural hospitals in Illinois are reported. A mail survey was sent to pharmacy directors at 86 CAHs and other rural and small hospitals in Illinois not designated as CAHs. Independent sample t tests and chi-square statistics were used to compare CAHs and non-CAHs in areas such as pharmacy services, staffing, use of technology, and sterile compounding practices. The survey response rate was 46.5%, with usable data received from 40 hospitals. Analysis of the survey data indicated that hospitals designated as CAHs were significantly less likely than non-CAHs to have automatic therapeutic interchange policies (p = 0.012) and more likely to conduct pharmacist-provided educational programs on medication costs for physicians and other health care personnel (p = 0.037). Relative to non-CAHs, CAHs were significantly less likely to have automated dispensing cabinets (p = 0.016) and to out-source the preparation of sterile products to offsite vendors (p = 0.012); pharmacy directors at CAHs were less likely to report the use of technology for remote medication order entry or review (p = 0.038). At both types of facilities, pharmacists typically have both distributive and clinical responsibilities, and patient-specific clinical pharmacy services (e.g., patient education or counseling, other drug therapy monitoring, medication reconciliation, pharmacokinetic consultations) are offered at similar frequencies. A survey of pharmacy departments at small and rural hospitals in Illinois determined that there were more similarities than differences between CAHs and non-CAHs. The survey indicated significant differences in dispensing processes, the use of technology and drug policy tools, and outsourcing of sterile product preparation.
Weng, Rhay-Hung; Chen, Wan-Ping; Huang, Ching-Yuan; Hung, Chiu-Hsia; Hsu, Ching-Tai
This study aimed to clarify how nurse innovation is related to customer perception of medical service quality and experience. Recently, many hospitals have put much emphasis upon the development of nurse innovation. A cross-sectional study was employed. This study adopted questionnaire survey method with nurses and customers of the inpatient wards from three Taiwanese hospitals as the research subjects. After pairing, there were 294 valid questionnaires. Hierarchical regression analysis was utilised to test the possible impact of nurse innovation on medical service quality and experience. In terms of the dimensions of nurse innovation, 'innovation behaviour' ranked the highest (3·24), followed by knowledge creation and innovation diffusion; in terms of the degree of the medical service quality, 'reliability' ranked the highest (4·35). As for the degree of the medical service experience, 'feel experience' ranked the highest (4·44). All dimensions of nurse innovation have no significant effects on medical service quality and experience. Of these three dimensions of nurse innovation, the level of innovation behaviour was perceived by the nurses as the highest. The study found that nurse innovation has no significant effects on customer perception of service quality and experience. Hospitals shall provide sufficient resources and budget for fostering innovation development and encourage their nurses to develop nursing innovation for patents. The education and training courses on 'patient-centred' shall be enhanced among hospital nurses. Healthcare managers shall also explore the difficulties about innovation diffusion and find the solutions for nurses. © 2016 John Wiley & Sons Ltd.
Smith, S M; Clark, M
The research confirms the coexistence of different images for hospitals, service centers within the same hospitals, and service programs offered by each of the service centers. The images of individual service centers are found not to be tied to the image of the host facility. Further, service centers and host facilities have differential rankings on the same service decision attributes. Managerial recommendations are offered for "image differentiation" between a hospital and its care centers.
Bronson Healthcare Group, a 343-bed not-for-profit health care system serving all of southwest Michigan and northern Indiana, has as its flagship Bronson Methodist Hospital, the recipient of the 2005 Malcolm Baldrige National Quality Award. The Baldrige criteria were used to formalize Bronson's approach to performance excellence. The strategic plan is condensed and communicated via a "Plan for Excellence" focused on three strategies: clinical excellence, customer and service excellence, and corporate effectiveness. Initiatives include clinical scene investigation (a system for reporting and investigating sentinel and atypical events), a strategy for educating staff in the Situation-Background-Assessment-Recommendations (SBAR) communication technique, and mandatory influenza immunization for health care staff (safety), patient health literacy needs and a health information center (patient centeredness); methods to reduce bloodstream and ventilator-acquired pneumonia infections (effectiveness); a physician portal for access to forms, test results, and patient information (efficiency); restaurant-style pagers for patients and families while waiting (timeliness); and community outreach (equity). Bronson's journey to excellence continues with more accountability for hand-off communication and teamwork, enhancing a non-punitive environment for patient safety reporting, and further incorporating patient and family involvement.
Kotlega, Dariusz; Nowacki, Przemysław; Lewiński, Dariusz; Chmurowicz, Ryszard; Ciećwiez, Sylwester
Outsourcing proves to be a useful tool in the difficult process of improving the financial result of hospitals. Outsourcing means separation of some functions and services in one entity and their transfer to another. The aim of this study was to analyze the use of outsourcing at the Second Independent Public University Hospital of the Pomeranian Medical University (SPSK 2 PUM) in Szczecin. We studied the transport and treatment of medical waste. Outsourcing of waste treatment services led to financial savings. The cost of treatment of one kilogram of waste by an external company was PLN 2.53. The same service provided by the hospital would cost approximately PLN 7 per kilogram. Appropriate attention should be paid to the quality of services. It seems useful to have appropriate tools for quality control and monitoring. SPSK 2 PUM can serve as a good example of effective use of outsourcing.
Oct 12, 2015 ... Abstract: Background: Neonatal survival bespeaks the quality of neonatal care services available and accessible to the population. Intensive care improves outcome of high-risk infants with serious illness. The tiered level of care is yet to be applied to newborn care in Nigeria. Classification of care is key to ...
Lima, Cássio de Almeida; Santos, Bruna Tatiane Prates dos; Andrade, Dina Luciana Batista; Barbosa, Francielle Alves; Costa, Fernanda Marques da; Carneiro, Jair Almeida
To evaluate the quality of emergency rooms and urgent care services according to the satisfaction of their users. A cross-sectional descriptive study with a quantitative approach. The sample comprised 136 users and was drawn at random. Data collection took place between October and November 2012 using a structured questionnaire. Participants were mostly male (64.7%) aged less than 30 years (55.8%), and the predominant level of education was high school (54.4%). Among the items evaluated, those that were statistically associated with levels of satisfaction with care were waiting time, confidence in the service, model of care, and the reason for seeking care related to acute complaints, cleanliness, and comfortable environment. Accessibility, hospitality, and infrastructure were considered more relevant factors for patient satisfaction than the cure itself.
... performs, on a centralized basis, one or more of the following services and only such services: data...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial...
Full Text Available Introduction: Nowadays, the trend of hospital visits in Mojokerto is declining. It can caused by man (nurses, such as the quality of nursing services hasn’t been conducted optimally. This study was aimed to analyze the quality of nursing services at hospitals’ ward at Mojokerto. Method: This was explanatory research with survey method and cross sectional approach. The population were nurses and patients who undergo hospitalization minimally in three days at RSU. Dr. Wahidin Sudiro Husodo and RS Reksa Waluyo Mojokerto. The data were collected by using questionnaire, and then will be analyzed by using regression statistical test. Result: 1 There was positive significance influence of nurses capability, hospital’s ethic, and leadership to the commitment of nurses; 2 There was significant influence of capability work (identification, significance, autonomy, and feedback to the improvement of nursing services quality; 3 There was significant influence of hospital’s ethics (communication, relatedness with industry, compulsion, and specification to the improvement of nursing services quality; 4 There was significant influence of leadership (challenger risk, socialization in vision and mission, supporter, guiding, and supporting to the improvement of nursing services quality; 5 There was significant influence of nurses’ commitment (sense of belonging, sense of linking, believable leader, and suitability of value to the improvement of nursing services quality. Discussion: It can be concluded that in order to improve the quality of nursing service, management of RSU Dr. Wahidin Sudiro Husodo and RS Rekso Waluyo Mojokerto should improve the ability of nurses, the enforcement of hospital ethics to all employees without exception, and develop hospital ethics that can represent various stakeholder interests, as well as maintain and improve leadership issue. Keywords: nurses, quality, services (tangibility, reliability, responsiveness, assurance
Moraes, Danielle Pedroni; Andrade, Claudia Regina Furquim de
This article proposes a panel of quality indicators for the management of swallowing rehabilitation (SR) therapy in a hospital setting. There were four stages in developing these indicators: identifying procedures to be managed; generating indicators and standardizing data collection; identifying the correlation among indicators; and formulating the panel of indicators. The following 12 quality indicators were developed: swallowing evaluation index; individual care index; speech-language pathologist (SLP) care index; number of assisted patients index; severity rate; swallowing diagnosis rate per hospital unit; swallowing rehabilitation demand index; time until first swallowing evaluation; SLP index per hospital bed; time until removal of feeding tube; time until reintroduction of oral feeding; and time until decannulation. The proposed indicators were designed to improve the management of dysphagia in a hospital setting. Measuring these indicators is essential to understanding the patient's needs and providing quality care. Managing care using these indicators will make it easier to track the patient's rehabilitation process, measure the effectiveness of new therapeutic processes and technologies, and evaluate the performance of hospital units relative to other providers in the area. The management of SR using quality indicators allows the effectiveness and efficiency of rehabilitation programs to be clearly evaluated.
Resnick, Sheilagh M; Griffiths, Mark D
The purpose of this paper is to evaluate service quality in a UK privately funded alcohol treatment clinic. Data were gathered via interviews with two groups of participants using the SERVQUAL questionnaire. The first group comprised 32 patients and the second 15 clinic staff. The SERVQUAL instrument measures service quality expectations and perceptions across five service dimensions and identifies gaps between service expectations and perceptions of what was delivered. Patients' service quality expectations were exceeded on four of five dimensions. However, staff members felt services fell below expectations on four of five dimensions with the "reliability" service dimension emerging as the common service element falling below expectations for both participant groups. It was concluded that achieving consistent service delivery and increasing empathy between staff and patients improves overall service quality perceptions. The paper relies on self-report methods from a relatively small number of individuals. There have been limited research studies measuring alcohol treatment service quality in the private sector.
K. K. Govender
Full Text Available This article reports the results of an empirical evaluation of a conceptual service encounter management model (Govender, 1999. The various hypotheses proposed to show a relationship between formal and informal socialisation strategies, and the bank employees' perception of the organisational climate and their role are empirically evaluated. Furthermore, the mediated effects of these socialization tactics on the bank customers perception of the service quality was also ascertained by matching a random sample of 210 bank employees with 1050 customers. Opsomming Hierdie artikel rapporteer die resultate van n empiriese evaluering van n konseptuele dienservaringsbestuursmodel (Govender, 1999. Verskeie hipoteses word voorgehou om n verband tussen formele en informele sosialise- ringstrategiee aan te toon, en die bankwerkers se persepsie van die organisatoriese klimaat en hulle rolle word empirics geevalueer.Verder word die modererende effek van hierdie sosialiseringstrategie op die bankkliente se persepsie van dienskwaliteit bepaal deur 'n ewekansige steekproefvan 210 bankwerkers met 1050 kliente af te paar.
Full Text Available Abstract Background: Iran is one of the countries with considerable road traffic injuries. Pre-hospital interventions have an important role in preventing mortalities and disabilities caused by traffic accidents.The present study aimed to explore the barriers of pre-hospital care in traffic injuries in Tehran, Iran. Methods: A qualitative content analysis approach was conducted based on 21 semi-structured interviews with 18 participants. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then data condensing, labeling, coding and defining categories were performed by qualitative content analysis. Results: Four main barriers including 4 main categories and 13 subcategories emerged; they included Barriers related to people, Barriers related to metropolitan infrastructure,Barriers related to the profession and Barriers related to managerial issues. Conclusion: Based on the findings of this study, pre-hospital service barriers in traffic accidents have many dimensions including cultural, structural and managerial domains. Policy makers in health system can use these findings to promote the quality of pre-hospital services, especially in the field of traffic injuries.
Currie, C J; Morgan, C L; Peters, J R; Kerr, M
To describe the patterns of inpatient and outpatient hospital care for patients with epilepsy in our health district. Routine hospital data for the health district of South Glamorgan (population 408,000) underwent record linkage to identify those records relating to the same patients and to flag those records for patients with epilepsy. This data was analyzed to determine inpatient and outpatient activity by specialty and compared with the nonepileptic population. We identified 2.267 patients representing a prevalence of 0.56%. The average age was 46 years in both male and female patients. This group, which constituted 1.5% of the hospital population, was responsible for 2.8% of all admissions but, because of increased length of stay, utilized 7.3% of all bed days. The total cost of care for this group lies between these two extreme values and is dependent on case severity. The patterns of associated diagnoses differed considerably in three arbitrary age groups (0-18, 19-55, >55 years). This study quantifies for the first time the level of demand that this subpopulation places on the service as a whole, and begins to illustrate that there may be evidence for cost containment by, for example, a reduction in multiple admissions. The demand for inpatient services is greater than we would have predicted.
Sanders, Richard B; Simpson, Kit N; Kazley, Abby S; Giarrizzi, Dana P
A critical shortage in the supply of physicians in the United States has necessitated innovative approaches to physician service delivery. Telemedicine is a viable service delivery model for a variety of physician and health services. Telemedicine is most effective when applied where physician resources are scarce, patient care is time sensitive, and service volume may be distributed across a network. Shortages in critical care and neurology specialists have led to the use of tele-intensive care unit and telestroke services in hospital settings. These hospital-based telemedicine services have gained acceptance and recommendation. Hospitalist staffing shortages may provide an opportunity to apply similar telemedicine models to hospitalist medicine. This study assesses the potential market for a nighttime telehospitalist service. An analysis of the Florida state hospital discharge dataset investigated the potential market for a new nighttime telehospitalist service. Admissions were filtered and stratified for common hospitalist metrics, time of day, and age of patients. Admissions were further expressed by hour of day and location. Nineteen percent of common hospitalist admissions occurred between 7:00 p.m. and 7:00 a.m., with a range of 17%-27% or 0.23-10.09 admissions per night per facility. Eighty percent of admissions occurred prior to midnight. Nonrural facilities averaged 6.69 hospitalist admissions per night, whereas rural facilities averaged 1.35 admissions per night. The low volume of nighttime admissions indicates an opportunity to leverage a telehospitalist physician service to deliver inpatient medical admission services across a network. Lower volumes of nighttime admissions in rural facilities may indicate a market for telehospitalist solutions to address the dilemma of hospitalist staffing shortages.
Hernon, Peter; Nitecki, Danuta A.; Altman, Ellen
Reviews the literature of library and information science to examine issues related to service quality and customer satisfaction in academic libraries. Discusses assessment, the application of a business model to higher education, a multiple constituency approach, decision areas regarding service quality, resistance to service quality, and future…
This study examined the characteristics of a good quality service as well as the methods used in controlling quality of service in the Nigerian Banking industry. It also identified and analysed the problems involved in producing good quality service and made practical suggestions to deal with the problems. The study which ...
Tan, Kay C.; Kek, Sei W.
Customer service and quality are driving forces in the business community. As higher educational institutions tussle for competitive advantage and high service quality, the evaluation of educational service quality is essential to provide motivation for and to give feedback on the effectiveness of educational plans and implementation. This…
Repositioning for quality service indicates a movement from the present level of quality service to a ... underpinning and literature review and model formulation are the focus of ... affecting a business unit's performance is the quality of its products and ... due to the heterogeneous nature of services, it is possible for the firm to.
Despite the interest in service quality, little research has been reported in South Africa on health and fitness service quality. The study adopted a conceptual framework for identifying factors that influence fitness service quality in commercial health and fitness centres in South Africa. A structured questionnaire containing 59 ...
Auras, Silke; de Cruppé, Werner; Blum, Karl; Geraedts, Max
Public reporting of hospital quality is to enable providers, patients and the public to make comparisons regarding the quality of care and thus contribute to informed decisions. It stimulates quality improvement activities in hospitals and thus positively impacts treatment results. Hospitals often use publicly reported data for further internal or external purposes.As of 2005, German hospitals are obliged to publish structured quality reports (QR) every two years. This gives them the opportunity to demonstrate their performance by number, type and quality in a transparent way. However, it constitutes a major burden to hospitals to generate and publish data required, and it is yet unknown if hospitals feel adequately represented and at the same time consider the effort appropriate.This study assesses hospital leaders' judgement about the capability of QR to put legally defined aims effectively and efficiently into practice. It also explores the additional purposes hospitals use their QR for. In a cross-sectional observational study, a representative random sample out of 2,064 German hospitals (N=748) was invited to assess QR via questionnaire; 333 hospitals participated. We recorded the suitability of QR for representing number, type and quality of services, the adequacy of cost and benefits (6-level Likert scales) and additional purposes QR are used for (free text question). For representation purposes, the net sample was weighted for hospital size and hospital ownership (direct standardization). Data was analyzed descriptively and using inferential statistics (chi-2 test) or for the purpose of generating hypotheses. German hospitals rated the QR as suitable to represent the number of services but less so for the type and quality of services. The cost-benefit ratio was seen as inadequate. There were no significant differences between hospitals of different size or ownership.Public hospitals additionally used their reports for mostly internal purposes (e
Leung, Peggy; Lo, Terence
This paper focuses on English language teaching for the hospitality industry in Hong Kong, presenting a brief statement on the concept of transfer and its relevance to teaching English as a Foreign Language (EFL) for the world of work. The observable changes in the nature of language in the world of work in a service-oriented economy are…
Full Text Available No abstract available. Article truncated at 150 words. The Annals of Internal Medicine posted a manuscript online today reporting that the growing trend of physician employment by hospitals does not improve quality (1. In 2003, approximately 29% of hospitals employed members of their physician workforce, a number that rose to 42% by 2012. The authors conducted a retrospective cohort study of U.S. acute care hospitals between 2003 and 2012 and examined mortality rates, 30-day readmission rates, length of stay, and patient satisfaction scores for common medical conditions for 803 hospitals that switched to the employment model compared with 2085 control hospitals that did not switch. Switching hospitals were more likely to be large (11.6% vs. 7.1% or major teaching hospitals (7.5% vs. 4.5% and less likely to be for-profit institutions (8.8% vs. 19.9% (all p values <0.001. The authors used Medicare Provider Analysis and Review File (MedPAR from 2002 to 2013 to calculate hospital-level risk-adjusted performance on mortality ...
Drinking water quality entering large buildings is generally adequately controlled by the water utility, but localized problems may occur within building or “premise” plumbing. Particular concerns are loss of disinfectant residual and temperature variability, which may enhance pathogen activity and metallic corrosion. Disinfection systems are available to building managers and are being installed in a variety of commercial buildings (hospitals, hotels, office buildings.) Yet our understanding of such additional treatment and of how to monitor end water quality at these buildings is limited. This class lecture will discuss challenges in maintaining acceptable water quality in hospitals, schools and other buildings. To give a lecture to a class of graduate students (ENVE 6054: Physical/Chemical Processes for Water Quality Control) at the University of Cincinnati, by presenting past research projects.
Esselink, P. (Priscilla)
In this report the concepts services, hospitality and experiences will be discussed. The goal of this report is to provide insight in what is written in literature about services, hospitality and experiences and to help defining the concept hospitality services for the Research Centre of the Saxion
Maya Rathore; Ugrasen Suman
Problem statement: With fast spreading of web services technology over the Internet, the quality aspects of a web service has received significant attention to the practitioners. The quality of web service includes both functional and nonfunctional details. In order to provide the correct and meaningful information to web service consumer, sometimes there is a need to compose existing web services in order to create new web service. Approach: We have proposed a Quality of ...
Regaira Martínez, E; Sola Iriarte, M; Goñi Viguria, R; Del Barrio Linares, M; Margall Coscojuela, M A; Asiain Erro, M C
The evaluation made by the patients on the quality of service received is important to introduce improvement strategies in the care quality. 1. To evaluate the care quality through the analysis of the differences obtained between expectations and perceptions, that the patients have of the service received in the ICU. 2. To analyze if there is any relationship between care quality evaluated by the patients and the sociodemographic variables. A total of 86 patients who were conscious and oriented during their stay in the ICU were studied prospectively. At 24h of the discharge from the ICU, the SERVQUAL (Service Quality) scale, adapted for the hospital setting by Babakus and Mangold (1992), was applied. This scale measures the care quality based on the difference in scores obtained between expectations and perceptions of the patients. The positive scores indicate that the perceptions of the patients exceed their expectations. The scale has 5 dimensions: Tangibility, Reliability, Responsiveness, Assurances and Empathy. It includes 15 items for perceptions and the same for expectations, with 5 grades of response (1 totally disagree - 5 totally agree). The mean score of perceptions 66.92) exceeded that of the expectations (62.30). The mean score of the difference between perceptions and expectations for the total of the SERVQUAL scale was 4.62. It was also positive for each one of the dimensions: Tangibility=1.44, Reliability=0.53, Responsiveness=0.95, Assurances=0.99, Empathy=0.71. No statistically significant associations were found between care quality evaluated by the patients and the sociodemographic variables. The care quality perceived by the patients in the ICU exceeds their expectations, and had no relationship with the sociodemographic characteristics. Copyright 2009 Elsevier España, S.L. y SEEIUC. All rights reserved.
Bilqis Bolanle AMOLE
Full Text Available This paper proposed the use of Analytic Hierarchy Process (AHP for the prioritization of factors influencing patients’ satisfaction with service quality dimensions of public teaching hospitals in Southwest Nigeria. To accomplish this purpose, data were collected from 326 respondents who were patients of public teaching hospitals in southwest Nigeria. The data were modeled and analysed with AHP excel software. The results show the rank of service quality dimensions criteria and the alternatives based on the respondents preferences for satisfaction. The finding revealed that empathy dimension criteria were given the highest preference while the waiting time dimension was the least preferred. In the global ranking of all the decision alternatives of the service quality dimensions of hospitals, the interaction of patients with hospital staff were given highest preference while the least preferred were the unpredictable time for treatment. This study recommends that there is need for healthcare managers to consider the perception of patients towards service quality dimensions alternatives on how they ranked those factors so as to improve their quality of service that would enhance patient satisfaction.
Cruz-Correia, Ricardo; Boldt, Isabel; Lapão, Luís; Santos-Pereira, Cátia; Rodrigues, Pedro Pereira; Ferreira, Ana Margarida; Freitas, Alberto
Audit Trails (AT) are fundamental to information security in order to guarantee access traceability but can also be used to improve Health information System's (HIS) quality namely to assess how they are used or misused. This paper aims at analysing the existence and quality of AT, describing scenarios in hospitals and making some recommendations to improve the quality of information. The responsibles of HIS for eight Portuguese hospitals were contacted in order to arrange an interview about the importance of AT and to collect audit trail data from their HIS. Five institutions agreed to participate in this study; four of them accepted to be interviewed, and four sent AT data. The interviews were performed in 2011 and audit trail data sent in 2011 and 2012. Each AT was evaluated and compared in relation to data quality standards, namely for completeness, comprehensibility, traceability among others. Only one of the AT had enough information for us to apply a consistency evaluation by modelling user behaviour. The interviewees in these hospitals only knew a few AT (average of 1 AT per hospital in an estimate of 21 existing HIS), although they all recognize some advantages of analysing AT. Four hospitals sent a total of 7 AT - 2 from Radiology Information System (RIS), 2 from Picture Archiving and Communication System (PACS), 3 from Patient Records. Three of the AT were understandable and three of the AT were complete. The AT from the patient records are better structured and more complete than the RIS/PACS. Existing AT do not have enough quality to guarantee traceability or be used in HIS improvement. Its quality reflects the importance given to them by the CIO of healthcare institutions. Existing standards (e.g. ASTM:E2147, ISO/TS 18308:2004, ISO/IEC 27001:2006) are still not broadly used in Portugal.
Somatunga L C
Full Text Available Abstract Health care systems are accountable to their patients and society to provide quality cost effective care and to seek ways to improve that care. By doing this positive patient outcomes are ensured. Those factors which affect the delivery of a good service have to be identified. It is important to determine whether the environment of an organization type of hospitals plays an important role in determining the implementation of quality improvement programmes Methodology This was a hospital-based descriptive cross-sectional survey carried out in selected hospitals in Sri Lanka. Sixteen Line Ministry Hospitals where Quality Management Units are already in place were selected for the study. Staff working in these hospitals including doctors nurses and allied health staff was included. The data was collected using a self-administered questionnaire. The questionnaire was repeated after three weeks. Findings A total of 378 participants responded in the study. This study identified top management commitment training teamwork physical structure and monitoring system as independent variables that influence the CQI implementation programme. All the participants rated lower for teamwork and felt that teamwork had little influence on CQI programme implementation. The type of hospital has not influenced the implementation of CQI programme.
Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh
Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals.
Spreuwel, P.C. van; Blok, H.; Langelaar, M.F.; Kullberg, B.J.; Mouton, J.W.; Natsch, S.S.
OBJECTIVES: To audit antibiotic use in a university hospital and to identify targets for quality improvement in a setting with low antibiotic use and resistance rates. METHODOLOGY: A point-prevalence survey (PPS), using a patient-based audit tool for antibiotic use, was executed in the Radboud
Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem
Objective: To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. Method: A search strategy was pet-formed on the Medline database for articles written in English published between 1992 and early 2006.
Saluvan, Mehmet; Ozonoff, Al
We aimed to determine availability of core Hospital Information Systems (HIS) functions implemented in Turkish hospitals and the perceived importance of these functions on quality and patient safety. We surveyed quality directors (QDs) at civilian hospitals in the nation of Turkey. Data were collected via web survey using an instrument with 50 items describing core functionality of HIS. We calculated mean availability of each function, mean and median values of perceived impact on quality, and we investigated the relationship between availability and perceived importance. We received responses from 31% of eligible institutions, representing all major geographic regions of Turkey. Mean availability of 50 HIS functions was 65.6%, ranging from 19.6% to 97.4%. Mean importance score was 7.87 (on a 9-point scale) ranging from 7.13 to 8.41. Functions related to result management (89.3%) and decision support systems (52.2%) had the highest and lowest reported availability respectively. Availability and perceived importance were moderately correlated (r = 0.52). QDs report high importance of the HIS functions surveyed as they relate to quality and patient safety. Availability and perceived importance of HIS functions are generally correlated, with some interesting exceptions. These findings may inform future investments and guide policy changes within the Turkish healthcare system. Financial incentives, regulations around certified HIS, revisions to accreditation manuals, and training interventions are all policies which will help integrate HIS functions to support quality and patient safety in Turkish hospitals.
Al-Doghaither, A H
Recent development and changes in health care services in Saudi Arabia have encouraged a search a search for comprehensive and established measurements of the quality of care. Patient satisfaction with nursing care in particular has ferquently been used as a sensitive and objective measure of quality of hosiptal services. THE OBJECTIVES OF THIS STUDY ARE: (1) to assess the level of inpatient satisfaction with nursing care (PSWC) in the various wards of the hospital; (2) to assess the socio-demographic determinants of PSWC in addition to the effects of duration of hospital stay and type of wards on the level of satisfaction. The sample consisted of randomly selected 450 inpatients with probability proportion to the size of the wards. The data was collected by personal interviews using a 21-item structured questionnaire pertaining to nursing services. The results revealed that the instrument of measurement was valid and reliable. The overall mean satisfaction score was 2.4 (77%) and the highest mean satisfaction was for items on skillfulness and the lowest score was for communication items. Multiple regression analysis indicated that sex, age, marital status and duration of stay are the most imortant predictors of PSWC; female, young, married and short duration of hospital stay have the highest satisfaction score. In conclusion, this study has highlighted the aspects of nursing care at King Khalid University Hospital (KKUH) which need re-examination by the management. The most importance findings have been that there is: (1) a shortage of nurses at the hospital; (2) limited communication between nurses and patients: most probably due to cultural and language barriers; (3) no proper oversight of patients personal hygiene; (4) dissatisfaction of male patients with most of the nursing care rendered. These results offer the hospial management the opportunity to work out stategies to connect the deficiencies highlighted.
Morishima, Toshitaka; Lee, Jason; Otsubo, Tetsuya; Ikai, Hiroshi; Imanaka, Yuichi
Quality of end-of-life (EOL) care is gaining increasing attention. However, the relationship between hospital case volume and performance of benchmark quality indicators is not well characterized. The aim of this study was to determine whether hospital case volume affects EOL care for terminal cancer patients. We conducted a retrospective cross-sectional study using claims data of patients who died of cancer at acute-care hospitals in Kyoto prefecture, Japan, between March 2009 and May 2010. Hospitals were grouped into tertiles based on the number of terminal cancer cases. We used multilevel logistic regression models to examine the association of the following quality indicators with the tertiles: opioid use during the last 2 months of life (indicating good quality of care), provision of intensive care unit (ICU) service or life-sustaining treatments during the last month of life (poor quality), and chemotherapy during the last month of life (poor quality). The final sample for analysis consisted of 3294 decedents from 88 hospitals. Significant associations between hospital case volume and quality of EOL care were identified after adjusting for patient and hospital characteristics. Small- and medium-volume hospitals were found to be less likely to administer opioids, and medium-volume hospitals were more likely to provide ICU service or life-sustaining treatments when compared with large-volume hospitals. No significant association between chemotherapy use and case volume was observed. The results showed that the case volume of terminally ill cancer patients was associated with several aspects of quality of EOL care.
Dantas, Rodrigo Assis Neves; Torres, Gilson de Vasconcelos; Salvetti, Marina de Góes; Dantas, Daniele Vieira; Mendonça, Ana Elza Oliveira de
To validate an instrument to assess quality of mobile emergency pre-hospital care. A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K> 0.80 and CVI ≥ 0.80. Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services.
Buciuniene, Ilona; Malciankina, Sonata; Lydeka, Zigmas; Kazlauskaite, Ruta
The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. QMSs are perceived to be successfully running in one
Full Text Available Abstract Background The regulations of the Quality Management System (QMS implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. Methods A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence. Results Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it. The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale. The most critical issues related to the QMS implementation include procedure development (5.5, lack of financial resources (5.4 and information (5.1, and development of work guidelines (4.6, while improved responsibility and power sharing (5.2, better service quality (5.1 and higher patient satisfaction (5.1 were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6. However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. Conclusion
Aktas, Demet; Terzioglu, Fusun
The purpose of the research was to determine the effect of home care service on the quality of life in patients with gynecological cancer. This randomized case control study was carried out in a womans hospital between September 2011 and February 2012. Women undergoing gynecological cancer treatment were separated into intervention and control groups, of 35 patients each. The intervention group was provided with nursing care service through hospital and home visits (1st, 12th weeks) within the framework of a specifically developed nursing care plan. The control group was monitored without any intervention through the hospital routine protocols (1st, 12th weeks). Data were collected using An Interview Form, Home Visit Monitoring Form and Quality of Life Scale/Cancer Survivors. Effects of home care service on the quality of life in gynecological cancer patients were investigated using chi-square tests, McNemar's test, independent t-test and ANOVA. This study found that the intervention group receiving home care service had a moderately high quality of life (average mean: 6.01±0.64), while the control group had comparatively lower quality (average mean: 4.35±0.79) within the 12 week post- discharge period (phome care services to be efficient in improving the quality of life in patients with gynecological cancer.
Ryu, Hyang Jin; Park, Eun Cheol; Sohn, Tae Yong; Yu, Seung Hum
Purpose The objectives of this study are to compare the hospital employees' and patients' recognition and attitudes toward the opening of the medical services market, to analyze the differences between hospital employees and patients on the factors in selecting a foreign hospital. Materials and Methods This study collected and analyzed data using systematic questionnaires that were self-administered by employees and outpatients to compare their recognition of the opening of the medical servic...
Mazzulla, Gabriella; Eboli, Laura
In this paper the importance of service quality attributes for public transport is estabilished by Importance Value calculation. Attribute weights (IV) are calculated by a specific empirical procedure in which a rate is assigned to each attribute according to the preferences of passengers. Finally, a Service Quality Index (SQI) for measuring the effectiveness of supplied services is calculated according to the main service quality attributes and their weights. This index can be us...
Bowers, John; Cheyne, Helen
UK health services are under pressure to make cost savings while maintaining quality of care. Typically reducing the length of time patients stay in hospital and increasing bed occupancy are advocated to achieve service efficiency. Around 800,000 women give birth in the UK each year making maternity care a high volume, high cost service. Although average length of stay on the postnatal ward has fallen substantially over the years there is pressure to make still further reductions. This paper explores and discusses the possible cost savings of further reductions in length of stay, the consequences for postnatal services in the community, and the impact on quality of care. We draw on a range of pre-existing data sources including, national level routinely collected data, workforce planning data and data from national surveys of women's experience. Simulation and a financial model were used to estimate excess demand, work intensity and bed occupancy to explore the quantitative, organisational consequences of reducing the length of stay. These data are discussed in relation to findings of national surveys to draw inferences about potential impacts on cost and quality of care. Reducing the length of time women spend in hospital after birth implies that staff and bed numbers can be reduced. However, the cost savings may be reduced if quality and access to services are maintained. Admission and discharge procedures are relatively fixed and involve high cost, trained staff time. Furthermore, it is important to retain a sufficient bed contingency capacity to ensure a reasonable level of service. If quality of care is maintained, staffing and bed capacity cannot be simply reduced proportionately: reducing average length of stay on a typical postnatal ward by six hours or 17% would reduce costs by just 8%. This might still be a significant saving over a high volume service however, earlier discharge results in more women and babies with significant care needs at home. Quality
White, Lesley; Klinner, Christiane
Although various instruments have been developed to measure customer satisfaction with community pharmacy services, there is limited research regarding pharmacy staffs' understanding of service quality and its determinants. This study aimed to explore the perceptions of pharmacy staff regarding the factors that constitute a high level of service quality using the service quality determinants proposed by the Conceptual Model of Service Quality. Structured interviews were conducted with 27 pharmacy assistants and 6 pharmacists in 3 community pharmacies in Sydney. The interview questions focused on the participants' perceptions of consumer expectations, the translation of these perceptions into service quality specifications, the actual service delivery, and the communication to customers. From the pharmacy staff perspective, service quality is significantly limited by insufficient internal communication and control processes that impede role clarity and the resolution of conflicting role expectations among customer service personnel. Participants indicated that these problems could be alleviated through the implementation of more transparent, realistic, measurable, and accepted quality specifications by pharmacy management. The study indicates that the extent to which pharmacy management sets, maintains, and communicates service quality specifications to staff directly affects role clarity, role conflict, and organizational commitment among customer service staff, which in turn directly influence the level of service quality provided to the customers. Copyright © 2012 Elsevier Inc. All rights reserved.
Abdellah, Amira E; Abdelrahman, Sirageldin M K
This study was conducted to analyze the quality of prescription writing of doctors in outpatient departments of paediatric teaching hospitals in Khartoum. This study is a descriptive cross- sectional, prospective, hospital based study. Nine hundred paediatric prescriptions collected from three paediatric teaching hospitals were analyzed. Three hundred prescriptions were also collected from doctors after giving them a case scenario for which they were asked to write appropriate prescriptions. These prescriptions were also analyzed for their completeness. Inadequate writing of the sex of the patient, weight, and height were notable regarding patient information. Generic names, concentration of the drug and treatment duration of the drug were poorly mentioned. Designation and identification of the prescriber were not adequately mentioned. In the case scenario 65.3 % of doctors wrote low quality prescriptions. Registrars wrote better prescriptions than medical officers who wrote better than house officers. Outpatient department prescriptions were unsatisfactory due to lack of necessary information for the ideal prescription. Also doctors, in response to case scenario, wrote low quality prescriptions. To improve prescription writing skills, we suggest that hospitals should provide standard prescription forms that contain the necessary fields for identification of both, patient and doctor.
Full Text Available Over 90% of outpatient care in China was delivered at public hospitals, making outpatient experience in this setting an important aspect of quality of care.To assess outpatient experience with different aspects of physician services at China's public hospitals and its association with overcrowding of the hospital outpatient departments.Retrospective analysis of a large survey of outpatient experience in Shanghai, China. We tested the hypotheses that patient experience was poorer with physician-patient communication, education, and shared decision-making and where and when there was greater overcrowding of the hospital outpatient departments. Ordered logistic models were estimated separately for general and specialty hospitals.7,147 outpatients at 40 public hospitals in Shanghai, China, in 2014.Patient experience with physician services were self-reported based on 12 questions as part of a validated instrument. Indicators of overcrowding included time of visit (morning vs. afternoon, Monday vs. rest of the week and hospital outpatient volume in the first half of 2014.Overall, patients reported very favorable experience with physician services. Two out of the 12 questions pertaining to both communication and shared decision-making consistently received lower ratings. Hospitals whose outpatient volumes were in the top two quartiles received lower patient ratings, but the relationship achieved statistical significance among specialty hospitals only.Inadequate physician-patient communication and shared decision-making and hospital overcrowding compromise outpatient experience with physician services at Chinese public hospitals. Effective diversion of patients with chronic and less complex conditions to community health centers will be critical to alleviate the extreme workloads at hospitals with high patient volumes and, in turn, improve patient experience.
Courtois, X; Baniachemi, J J; Carrier, D; Driencourt, J B; Fabretti, A M; Gaillat, J; Bissuel, J P
Emergency visits are one of the most common ways patients are admitted to hospitals. This study aims to characterise emergency visits in the Annecy District, in order to identify future actions for better management. Four studies were implemented: telephone surveys among 600 households and 130 physicians; and two observational studies of emergency visits to 80 physicians and to hospital emergency services. We observed that the hospital emergency service offers patients a good service, and therefore attracts many minor pathologies not requiring a hospital visit. Implementation of alternative structures, outside the hospital, to offer similar service must be considered. Co-operation among the different actors must be improved, and can benefit from new communication technology.
Chang, Ching-Sheng; Chen, Su-Yueh; Lan, Yi-Ting
Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be...
Pillay, Datuk Ir M S; Ghazali, Roslan Johari Dato Mohd; Manaf, Noor Hazilah Abd; Abdullah, Abu Hassan Asaari; Bakar, Azman Abu; Salikin, Faisal; Umapathy, Mathyvani; Ali, Roslinah; Bidin, Noriah; Ismail, Wan Ismefariana Wan
This is a national study which aims to determine the average waiting time in Malaysian public hospitals and to gauge the level of patient satisfaction with the waiting time. It also aims to identify factors perceived by healthcare providers which contribute to the waiting time problem. Self-administered questionnaires were the main method of data collection. Two sets of questionnaires were used. The first set solicited information from patients on their waiting time expereince. The second set elucidated information from hospital employees on the possible causes of lengthy waiting time. The questionnaires were administered in 21 public hospitals throughout all 13 states in Malaysia. A total of 13,000 responses were analysed for the patient survey and almost 3,000 were analysed for the employee survey. The findings indicate that on average, patients wait for more than two hours from registration to getting the prescription slip, while the contact time with medical personnel is only on average 15 minutes. Employee surveys on factors contributing to the lengthy waiting time indicate employee attitude and work process, heavy workload, management and supervision problems, and inadequate facilities to be among the contributory factors to the waiting time problem. Public healthcare in Malaysia is in a state of "excess demand", where demand for subsidised healthcare far outstrips supply, due to the large fee differential between public and private healthcare services. There is a need for hospital managers to reduce the boredom faced by patients while waiting, and to address the waiting time problem in a more scientific manner, as has been carried out in other countries through simulation and modelling techniques. Healthcare organisations are keen to address their waiting time problem. However, not much research has been carried out in this area. The study thus fills the lacuna in waiting time studies in healthcare organisations.
Canel, Cem; Kadipasaoglu, Sukran
In response to residents' reports of inefficiencies in the Veterans Administration (VA) system, a temporary task force of quality control circles was implemented at a VA hospital. A total of 25 internal medicine residents, on rotation at the VA, were subdivided into four groups. Each group was presented with a different problem, given the components and constraints of the problem, and asked to identify possible solutions. Program results were submitted to the hospital administration. Efforts are now being made to improve the working environment for medical residents.
Pipam, W; Penz, H; Janig, H; Plank, H; Gatternig, K; Likar, R
To determine objective and subjective indications of quality of life in hospitalized geriatric patients. Data were collected on 267 items using standardized interviews of 90 patients, including B-L and SF-36. In comparison to the control population, geriatric patients have worse SF-36 values; 91% have pain, and 63% depression and elevated B-L values. Pain therapy is usually with non-opiates and with warm/cold physical therapies. Pain therapy in the geriatric population surveyed does not reach the same standard as is usually offered to hospitalized medical and surgical patients.
Dascalaki, Elena G.; Gaglia, Athina G.; Balaras, Constantinos A. [Group Energy Conservation, Institute for Environmental Research and Sustainable Development, National Observatory of Athens, I. Metaxa and Vas. Pavlou, GR 152 36 P. Penteli (Greece); Lagoudi, Argyro [Terra Nova Ltd., Environmental Engineering Consultancy, Athens, Kaisareias 39, GR 115 27 Athens (Greece)
Indoor environmental quality (IEQ) in hospital operating rooms (ORs) constitutes a major challenge for the proper design and operation of an energy efficient hospital. A subjective assessment of the indoor environment along with a short monitoring campaign was performed during the audits of 18 ORs at nine major Hellenic hospitals. A total of 557 medical personnel participated in an occupational survey, providing data for a subjective assessment of IEQ in the audited ORs. The OR personnel reported work related health symptoms and an assessment of indoor conditions (thermal, visual and acoustical comfort, and air quality). Overall, personnel reported an average of 2.24 work-related symptoms each, and 67.2% of respondents reported at least one. Women suffer more health symptoms than men. Special dispositions, such as smoking and allergies, increase the number of reported symptoms for male and female personnel. Personnel that perceive satisfactory indoor comfort conditions (temperature, humidity, ventilation, light, and noise) average 1.18 symptoms per person, while for satisfactory indoor air quality the average complaints are 0.99. The perception of satisfactory IEQ (satisfactory comfort conditions and air quality) reduces the average number of health complaints to 0.64 symptoms per person and improves working conditions, even in a demanding OR environment. (author)
Background In the context of maternity service, the mother’s assessment of quality is central because emotional, cultural and respectful supports are vital during labour and the delivery process. This study compared client-perceived quality of maternity services between birth centres, public and private hospitals in a central hills district of Nepal. Methods A cohort of 701 pregnant women of 5 months or more gestational age were recruited and interviewed, followed by another interview within 45 days of delivery. Perception of quality was measured by a 20-item scale with three sub-scales: health facility, health care delivery, and interpersonal aspects. Perceived quality scores were analysed by ANOVA with post-hoc comparisons and multiple linear regression. Results Within the health facility sub-scale, birth centre was rated lowest on items ‘adequacy of medical equipment’, ‘health staff suited to women’s health’ and ‘adequacy of health staff’, whereas public hospital was rated the lowest with respect to ‘adequacy of room’, ‘adequacy of water’, ‘environment clean’, ‘privacy’ and ‘adequacy of information’. Mean scores of total quality and sub-scales health facility and health care delivery for women attending private hospital were higher (p < 0.001) than those using birth centre or public hospital. Mean score of the sub-scale interpersonal aspects for public hospital users was lower (p < 0.001) than those delivered at private hospital and birth centre. However, perception on interpersonal aspects by women using public hospital improved significantly after delivery (p < 0.001). Conclusions Overall, perception of quality differed significantly by types of health facility used for delivery. They rated lowest the supplies and equipment in birth centres and the amenities and interpersonal aspects in the public hospital. Accordingly, attention to these aspects is needed to improve the quality. PMID:24456544
Karkee, Rajendra; Lee, Andy H; Pokharel, Paras K
In the context of maternity service, the mother's assessment of quality is central because emotional, cultural and respectful supports are vital during labour and the delivery process. This study compared client-perceived quality of maternity services between birth centres, public and private hospitals in a central hills district of Nepal. A cohort of 701 pregnant women of 5 months or more gestational age were recruited and interviewed, followed by another interview within 45 days of delivery. Perception of quality was measured by a 20-item scale with three sub-scales: health facility, health care delivery, and interpersonal aspects. Perceived quality scores were analysed by ANOVA with post-hoc comparisons and multiple linear regression. Within the health facility sub-scale, birth centre was rated lowest on items 'adequacy of medical equipment', 'health staff suited to women's health' and 'adequacy of health staff', whereas public hospital was rated the lowest with respect to 'adequacy of room', 'adequacy of water', 'environment clean', 'privacy' and 'adequacy of information'. Mean scores of total quality and sub-scales health facility and health care delivery for women attending private hospital were higher (p < 0.001) than those using birth centre or public hospital. Mean score of the sub-scale interpersonal aspects for public hospital users was lower (p < 0.001) than those delivered at private hospital and birth centre. However, perception on interpersonal aspects by women using public hospital improved significantly after delivery (p < 0.001). Overall, perception of quality differed significantly by types of health facility used for delivery. They rated lowest the supplies and equipment in birth centres and the amenities and interpersonal aspects in the public hospital. Accordingly, attention to these aspects is needed to improve the quality.
Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem
To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. A search strategy was performed on the Medline database for articles written in English published between 1992 and early 2006. Using the thesaurus terms 'Total Quality Management' and 'Quality Assurance Health Care', combined with the term 'hospital' and 'implement*', we identified 533 publications. The screening process was based on empirical articles describing organization-wide QMS implementation. Fourteen empirical articles fulfilled the inclusion criteria and were reviewed in this paper. An organization culture emphasizing standards and values associated with affiliation, teamwork and innovation, assumption of change and risk taking, play as the key success factor in QMS implementation. This culture needs to be supported by sufficient technical competence to apply a scientific problem-solving approach. A clear distribution of QMS function within the organizational structure is more important than establishing a formal quality structure. In addition to management leadership, physician involvement also plays an important role in implementing QMS. Six supporting and limiting factors determining QMS implementation are identified in this review. These are the organization culture, design, leadership for quality, physician involvement, quality structure and technical competence.
Bates, Jason; Sharratt, Martin; King, John
This article examines the way that non-clinical support services are provided in healthcare settings through outsourcing partnerships. The integrated support services model and benefits to patient experience and safety as well as organizational efficiency and effectiveness are explored through an examination of services at a busy urban community hospital.
Gwo-Hshiung Tzeng; Hung-Fan Chang
As the global economy becomes a service oriented economy, food service accounts for over 20% of service revenue, with an annual growth rate of more than 3%. Compared to physical products, service features are invisible, and the production and sale occurs simultaneously. There is not easy to measure the performance of service. Therefore, the service quality of catering services is considered to be an important topic of service management. According Market Intelligence & Consulting Institute (M...
Chang Ching-Sheng; Chen Su-Yueh; Lan Yi-Ting
Abstract Background Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies...
Liu, Ying; Aungsuroch, Yupin
To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care. Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programs to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model. A cross-sectional survey. The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model. The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient-to-nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout. This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses' work conditions of work environment and patient-to-nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programs to improve quality nursing care. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Purpose: The purpose of this paper is to examine the performance of five alternative measures of service quality in the high education sector--service quality (SERVQUAL), importance-weighted SERVQUAL, service performance (SERVPERF), importance-weighted SERVPERF, and higher education performance (HEdPERF). Design/methodology/approach: Data were…
and Bateson, 2002). As a critical measure of organizational performance, service quality remains at the forefront of both the marketing literature generally and the services marketing literature specifically (Johnston, 1997). Practitioners and academics alike are keen on accurately measuring service quality in order to better ...
Decadt, Ine; Costermans, Els; Van de Poel, Maai; Kesteloot, Katrien; Devos, Timothy
Haemovigilance is the process of surveillance of blood transfusion procedures including unexpected hazards and reactions during the transfusion pathway in both donors and recipients. The haemovigilance team aims to increase blood transfusion safety and to decrease both morbidity and mortality in donors and recipients. The team collects data about transfusion reactions and incidents, instructs the involved health workers and assures the tracing of blood components. The haemovigilance team at the University Hospitals Leuven has played a pioneering role in the development of haemovigilance in Belgium Although the literature about safety and quality improvements by haemovigilance systems is abundant, there are no published data available measuring their financial impact in a hospital. Therefore, we studied the costs and returns of the haemovigilance team at the University Hospitals Leuven. This study has a descriptive explorative design. Research of the current costs and returns of the haemovigilance team were based upon data from the Medical Administration of the hospital. Data were analyzed descriptively. The haemovigilance team of the University Hospitals Leuven is financially viable: the direct costs are covered by the annual financial support of the National Public Health Service. The indirect returns come from two important tasks of the haemovigilance team itself: correction of the electronic registration of administered blood component and improvement of the return of conform preserved blood components to the blood bank. Besides safety and quality improvement, which are obviously their main goals, the haemovigilance team also implies a financial benefit for the hospital. Copyright © 2016 Elsevier Ltd. All rights reserved.
Chougrani, Saada; Ali, Abdessamed Dali
Created in 2003 as a profit organization, the University Hospital of Oran (Etablissement Hospitalier Universitaire d'Oran-EHUO) is currently in the process of developing a 'Quality' project aimed at assessing staff perception of quality. 20% of staff members representing the various professional categories working at EHUO (medical, nursing and administrative staff) were selected using quota sampling. Face-to-face interviews were conducted in March 2009 with 117 staff members from 25 medical and 5 non-medical units. The average length of service among medical and administrative staff was higher than the average length of service of nursing staff (8.3 vs 5.8 years; p = 0.9 Kruskal-Wallis H test). In discussing the question of quality, it was found that all categories of staff emphasized their specific professional experiences, standards and frames of reference. All staff members showed a greater preference for the various dimensions of the "are process" (mostly physicians and nurses rather than administrative staff (p=0.01)) than for the "structure" or "organization" components of the quality plan. In this sense, there appears to be a greater focus on technical rather than management aspects, as shown by the fact that two thirds of staff members were ill-informed about the hospital's quality assurance program (quality management, blood safety, complaints management...). While they appeared to be fully supportive of audit and certification procedures, 50% of health staff members were reluctant to support patient involvement in the management of the 'Quality' project. Finally, there appears to be a lack of awareness of quality concepts, standards and methodologies among hospital staff. This study suggests that there is a need for greater awareness, further training, and greater monitoring of practices based on concrete actions.
Sumaedi, Sik; Bakti, Gede Mahatma Yuda; Metasari, Nur
Purpose: This paper aims to identify: university students' perceived service quality dimensions; the dimensions contributing most towards overall students' perceived service quality; and whether there is a difference in perceived quality level of each dimension based on students' year of study and gender in the context of undergraduate students of…
Full Text Available BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS, cost per day (CPD, inpatient mortality rate (IMR, and length of stay (LOS, using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001, from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role
Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul
With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.
Krüger Andreas J
Full Text Available Abstract Background Physician-staffed pre-hospital units are employed in many Western emergency medical services (EMS systems. Although these services usually integrate well within their EMS, little is known about the quality of care delivered, the precision of dispatch, and whether the services deliver a higher quality of care to pre-hospital patients. There is no common data set collected to document the activity of physician pre-hospital activity which makes shared research efforts difficult. The aim of this study was to develop a core data set for routine documentation and reporting in physician-staffed pre-hospital services in Europe. Methods Using predefined criteria, we recruited sixteen European experts in the field of pre-hospital care. These experts were guided through a four-step modified nominal group technique. The process was carried out using both e-mail-based communication and a plenary meeting in Stavanger, Norway. Results The core data set was divided into 5 sections: "fixed system variables", "event operational descriptors", " patient descriptors", "process mapping", and "outcome measures and quality indicators". After the initial round, a total of 361 variables were proposed by the experts. Subsequent rounds reduced the number of core variables to 45. These constituted the final core data set. Emphasis was placed on the standardisation of reporting time variables, chief complaints and diagnostic and therapeutic procedures. Conclusions Using a modified nominal group technique, we have established a core data set for documenting and reporting in physician-staffed pre-hospital services. We believe that this template could facilitate future studies within the field and facilitate standardised reporting and future shared research efforts in advanced pre-hospital care.
Léon Navarro, Josefa; Gómez García, Carmen Isabel; Carrillo García, César
This paper analyzes, by a descriptive study, the closing of the Basic Hospital of the Defence the restructuration of the Santa María del Rosell University Hospital, and the moving of both to a new hospital: the Santa Lucía University Hospital. This process was carried out in coordination with a coincident objective: the creation of an only management staff for the area. The aim is the analysis of the opening of a hospital complex that coincided with the restructuration of the health area. This paper analyzes the actions in relation to the scheduling, training and moving, that concerned above 600 hospital beds and 275.000 inhabitants. Analyzes the intervention in infrastructures, logistics and training. The whole process is seen from de nursery point of view, as a professional stratus that knows the roles of the hospital and personnel. The period of the study comprises since October2010, beginning of the activity in the new hospital, to November 2011, moment of the effective culmination of the move. The result of the works carried out was the transfer of people and roles in a very short time (eleven months). All the patients were moved without any event. During the whole process healthcare continuity was obtained, whit the less economic impact, as in patients and professionals. From the point of view of future and practical implications, the basis for a modern and qualified provision of services have been established; and best results from means provided have been obtained in relation to health care quality.
Diez-Garcia, Rosa Wanda; Padilha, Marina; Sanches, Maísa
The scope of this paper is to validate proposals used to qualify hospital food by the Brazilian scientific community. An electronic questionnaire was applied to clinical nutrition professionals registered on the Lattes Platform (Brazilian database of institutions and researchers' curricula in the areas of Science and Technology). The questionnaire incorporated a Likert scale and had spaces for comments. The themes dealt with patient participation, the nutritional and sensory quality of hospital diets, and planning and goals of the Hospital Food and Nutrition Service (HFNS). The questionnaire also asked for the top five priorities for a HFNS. Proposals with total or partial adherence equal to or greater than 70% were considered to be approved. All proposals had total adherence equal to or greater than 70%. The proposal that had minimal adherence (70%) was the one that proposed that nutritional intervention must be arranged by mutual agreement with the patient. The proposal that had maximal adherence (93%) was the one advocating that there must be statistical control on diets prescribed by the HFNS. The most cited priorities referred to infrastructure and training of human resources (40%), the quality of hospital food (27%) and the nutritional status of the patient.
Parkum, K H
Surveys a stratified sample of patients in six different hospitals and compares their perceptions of hospital chaplaincy and other pastoral care efforts with related hospital services. Reports the presence of a strong impact of pastoral care services and discusses these findings from the perspective of a theory of expressive and instrumental social orientations as explicated by the sociologist Talcott Parsons.
Horwitz, Jill R; Nichols, Austin
To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File, and primary data collection for geographic coordinates. The sample includes all nonfederal, general medical, and surgical hospitals located outside of metropolitan statistical areas and within the continental United States from 1988 to 2005. We estimate multivariate regression models to examine the effects of (1) hospital ownership and (2) hospital ownership mix within rural hospital markets on profitable versus unprofitable medical service offerings. Rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors. Rural hospital ownership affects medical service provision at the hospital and market levels. Nonprofit hospital regulation should reflect both the direct and spillover effects of ownership. © Health Research and Educational Trust.
... medical services and inpatient hospital care. 17.49 Section 17.49 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.49 Priorities for outpatient medical services and inpatient hospital care. In scheduling appointments for outpatient medical...
Full Text Available Purpose: E-Government, as a new bond linking the government and the public, has gradually become the focus of innovation in government services. The paper focuses on the e-Government service quality issues from the perspective of users. Design/methodology/approach: From the aspects of online service quality perception and offline service quality perception, based on IS Success model and SERQUAL model, e-Government Services Quality model has been set up with information quality, system quality and service quality as key factors. Then, the survey method was applied to collect data and then to test the model. Findings: It was found that users’ perception of offline service quality has a significant effect on improving their perception of online service quality, and online service quality perception has a significant effect on public satisfaction of e-Government services; information clarity, system security and stability, interactive services and “one-stop” services all have a significant effect on public satisfaction of e-Government services. However, offline service quality perception has certain positive effect on public satisfaction of e-Government services but not dramatically. Research limitations/implications: Mobile e-Government as an important direction of the development of e-Government, in the future, we will study more about mobile e-Government services channels. Originality/value: This study further develops the theory of information system service quality, and also provides a theoretical reference for government departments. On the one hand, based on the characteristics of e-government system, information quality, system quality and service quality in the previous system service model are further discussed; on the other hand, both online and offline services are taken into consideration in the information system service model, thus establishing the e-government services quality model and making an in-depth study of the
As the UK population lives to older ages, with more complex health and social care needs, there comes a time when going to live in a care home might be essential for a frail, older person. Residents and their families expect high-quality care in return for the costs of their placements, but often find this is not the case ( Help the Aged, 2006 ). In order to improve quality in care homes, the Lincolnshire Community Health Services NHS Trust are piloting a care home support team. The new service aims to provide education and training to an unpredictable workforce, with the addition of regular ward rounds in care homes to ensure more proactive care for residents, in order to reduce unnecessary hospital admissions and improve the quality of care offered. This article looks at the literature relating to education and training for staff in care homes to support this service. It also aims to use the reviewed articles to identify specific training and education needed to improve quality of care for residents and reduce avoidable hospital admissions.
Ota, Yoshitaka; Ide, Hiroaki; Tsukamoto, Takahisa; Koga, Masahisa; Higaki, Koichi; Takano, Hisayo
St. Mary's Hospital Medical Inspecting Center acquired ISO 15189 authorization in December, 2007. In the process of authorization acquisition, measures were taken to improve various quality issues, and a marked effect was seen in patient services and medical safety control. Furthermore, we tried to improve ward nursing management using ISO, drew up standard operating procedures through detailed job analysis, and enabled ward operation standardization. In this paper, while describing the effect of ISO 15189 on clinical examinations, we refer to the significance of improving quality of hospital management which our clinical laboratory lead to.
Buchko, Barbara L; Gutshall, Connie H; Jordan, Elizabeth T
The purpose of this study was to investigate the implementation of an evidence-based, streamlined, education process (comprehensive education booklet, individualized education plan, and integration of education into the clinical pathway) and nurse education to improve the quality and efficiency of postpartum education during hospitalization. A one-group pretest-posttest design was used to measure the quality of discharge teaching for new mothers and efficiency of the education process for registered nurses before and after implementation of an intervention. Results indicated that a comprehensive educational booklet and enhanced documentation can improve efficiency in the patient education process for nurses.
BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.
The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.
Tilahun, Binyam; Fritz, Fleur
With the increasing implementation of different health information systems in developing countries, there is a growing need to measure the main determinants of their success. The results of this evaluation study on the determinants of HIS success in five low resource setting hospitals show that service quality is the main determinant factor for information system success in those kind of settings.
Full Text Available Introduction: Efforts to improve the quality of hospital services should be along with the efforts to improve the quality of nursing services. Quality of service is influenced by the organizational culture. The main objective of this study was to explain the effect of organizational culture and quality of nurses work life (QNWL on nurses performance and job satisfaction in Dr. Soetomo Hospital, Surabaya. Methods: This study used explanatory survey research design with cross sectional approach. The study population was all Civil Servants nurses working at Surgical Wards, Dr. Soetomo Hospital. The study sample comprised 95 nurses selected with cluster sampling. Data were analyzed using partial least square. Results: The results showed that there was influence of objective factors on organizational culture. Individual factors had no influence on QNWL. Social and environmental factors affected QNWL. Operational factors influenced QNWL. Administrative factors affected QNWL. Organizational culture influenced QNWL. QNWL affected nurses performance. QNWL significantly affected nurses job satisfaction. Nurses job satisfaction affected nurses performance. Discussion: Strong organizational culture, which can create good quality of work life for nurses, can improve the performance and job satisfaction of nurses in Dr. Soetomo Hospital. Further studies needs to be done to analyze the effect of empowerment and job involvement on the quality of nurses work life. Keywords: cultural organization, quality of nursing work life, performance and job satisfaction, nurse
Diongue, K; Badiane, A S; Seck, M C; Ndiaye, M; Diallo, M A; Diallo, S; Sy, O; Ndiaye, J L; Faye, B; Ndir, O; Ndiaye, D
In hospitals, the quality control of the air is a key element. Indeed airborne fungi constitute a real danger for patients hospitalized in wards at risk of nosocomial infections especially when they are immunocompromised. The objective was to determine the qualitative fungal flora composition of wards at risk of nosocomial infections at Le Dantec teaching hospital. Between April and May 2013, 73 samples were collected from 45 compartments within seven services at risk of nosocomial infection at Aristide Le Dantec teaching Hospital (Dakar). Samples were made once by sedimentation method and the percentage of positive cultures was 100%. The most represented species were Cladosporium spp. (91.1%), Aspergillus spp. (86.6%), Penicillium spp. 71.1% and Candida spp. (57.7%). Candida albicans and Aspergillus fumigatus were isolated respectively at 15.5% and 11.1%. Wards have been classified according to the number of species isolated; 11 species in pediatric oncology, 10 species in pediatric surgery/neonatal and intensive care, nine species for oncology, eight species in general surgery and dermatology, and four species in internal medicine. This study shows that fungi causing nosocomial infections are present in hospital and their monitoring should be included in the program of Nosocomial Infections Prevention Committees (CLIN). Copyright © 2014 Elsevier Masson SAS. All rights reserved.
White, Marilyn Domas; Abels, Eileen G.
Surveys the service marketing literature for models and data-gathering instruments measuring service quality, particularly the instruments SERVQUAL and SERVPERF, and assesses their applicability to special libraries and information centers. Topics include service characteristics and definitions of service; performance-minus-expectations and…
Worm, D.T.H.; Živković, M.; Berg, J.L. van den; Mei, R. van der
Service composition is one of the major approaches in service oriented architecture (SOA) based systems. Due to the inherent stochastic nature of services execution environment the issue of composite service quality assurance within SOA is a very challenging one. Such heterogeneous environment
D. Worm; M. Zivkovic; J.L. van den Berg (Hans); R.D. van der Mei (Rob)
htmlabstractService composition is one of the major approaches in service oriented architecture (SOA) based systems. Due to the inherent stochastic nature of services execution environment the issue of composite service quality assurance within SOA is a very challenging one. Such heterogeneous
Murphy, Sarah Anne
Summarizing specific tools for measuring service quality alongside tips for using these tools most effectively, this book helps libraries of all kinds take a programmatic approach to measuring, analyzing, and improving library services.