INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE最新文献

Purpose: The objective of this review is to provide a comprehensive analysis of risk management practices in the healthcare sector, with a particular focus on identifying challenges and strategies in Moroccan hospitals.

Design/methodology/approach: A literature search was carried out on several academic search engines using search terms reflecting the relationship between risk management and public hospitals in Morocco.

Findings: The Moroccan public hospital is confronted with several disjunctions, which can be sources of multiple risks. This influences the quality of care provided to patients and can sometimes threaten their vital prognosis. The risk management process can help health professionals, researchers and risk managers to be agile and identify and anticipate risks in order to avoid serious accidents that can affect the whole organization, especially after the pandemic lived experiences (COVID-19).

Originality/value: Protecting human life in an environment where risks are omnipresent is a dilemma that every hospital organization must confront. So, risk management in the hospital is not a simple process, given the interaction of several components and the sensitivity of the field. Risk management in this establishment must be rigorous because every error can cost human life. In this sense, the analysis of risk management processes in Moroccan hospitals, based on what really exists, enables the identification of shortcomings in order to master the risk management system and thus protect goods and services as well as human life, which is the ultimate goal of the hospital organization's existence.

Purpose: Family-centered rounds (FCR) are a multidisciplinary process in which patients and/or family members are present and actively participate in medical rounds. While research has shown that FCR may enhance collaborative information exchange and reduce family anxiety, the impact of the information exchange modality on the experience has been largely unexplored. Medical rounds are typically assumed to be carried out in person at the bedside. In this research, we challenge this perception. We ask whether FCR communication is best conducted at the bedside or if similar communication outcomes are obtained when family members choose the communication mode according to their preferences.

Design/methodology/approach: Using a field experiment in which participants choose the communication mode, we empirically analyze perceptions of the resulting communication in terms of information exchange. Three communication modes are available for participants to choose from (i.e. patients' families): face-to-face (FtF), phone and video conferencing. A questionnaire is distributed, and the responses of the patients' family members are analyzed. ANOVA tests are carried out to analyze the effect of communication mode on family perceptions.

Findings: Perceptions following video conferencing or FtF interaction were significantly higher than perceptions following the use of a phone. Thus, our results show clear superiority of video and FtF communication modes as facilitators of effective communication perceptions. There is also marginal evidence that FtF communication is perceived as superior than video conferencing in supporting the receipt of information and understanding but not in the ability to convey information and input to the care team. These results suggest that allowing family members to choose their communication preferences does not always support effective communication. A case can be made for motivating patient family members to use face-to-face or video communication rather than phone if possible.

Originality/value: The possible ramifications of allowing family members to choose communication mode with the care team have been largely unexplored. Medical rounds are typically assumed to be carried out in person at the bedside. In this research, we challenge this perception. We ask whether communication is best conducted at the bedside or whether similar communication outcomes are obtained when family members choose the communication mode according to their preferences.

Purpose: The purpose of this review is to identify how health professionals perceive participation in implementation of new technology in healthcare organizations.

Design/methodology/approach: A qualitative systematic review based on the PRISMA diagram, was conducted using qualitative synthesis. NVivo software was used for thematic analysis. The searches were performed in PubMed, CINAHL and Scopus.

Findings: A total of 15 articles were included in the review, four themes describing how participation of health professionals in digital transformation affects the outcomes were identified, and three themes describing the factors that are necessary to promote participation. The underlying latent theme of an unmet desire to participate in the digital transformation was also identified in the analysis.

Originality/value: The digital transformation of healthcare is complex and faces many obstacles if not managed correctly. Professional participation in the implementation seems to be essential for success. Focus on increased resources and planning during early stages, as well as teamwork and ethical reflection is important addressing the challenges that professionals face in digital transformation of healthcare.

Purpose: The main objective of this study was to understand why employees engage in time theft behavior and what is the behavioral consequence of this deviant behavior. To do this, the conservation of resources theory helps to examine the role of organizational cronyism behind employee time theft behavior and decreased proactive behavior.

Design/methodology/approach: A three-wave self-administered employee survey was used for data collection. The data were collected through an adopted questionnaire from nurses working in the public sector hospitals of Pakistan. Structural equation modeling (SEM) was used to analyze data collected from 256 respondents.

Findings: The results of this three-wave study supported the hypotheses which are: (1) Organizational cronyism positively predicts employee involvement in time theft behavior. (2) Employee time theft behavior negatively impacts their proactive behavior. (3) Organizational cronyism is detrimental to employee proactive behavior. (4) The relationship between organizational cronyism and proactive behavior is mediated by time theft.

Practical implications: In the presence of organizational cronyism, employees use time theft as a dysfunctional coping strategy to conserve their valued resources rather than allowing the organization to consume them. Organizational leaders of public sector hospitals must promote merit-based HRM practices to discourage time theft behavior as well as to improve the proactive performances of the nurses.

Originality/value: This study is one of the initial attempts to extend the scant literature on the antecedents and consequences of time theft behavior and its dimensions in the South Asian context.

Purpose: This study explores how Lean was deployed in several hospitals in the Apulia region in Italy over 3.5 years.

Design/methodology/approach: An exploratory qualitative design was drawn up based on semi-structured interviews.

Findings: The drivers of Lean in hospitals were to increase patient satisfaction and improve workplace well-being by eliminating non-value-add waste. The participants highlighted three key elements of the pivotal implementation stages of Lean: introduction, spontaneous and informal dissemination and strategic level implementation and highlighted critical success and failure factors that emerged for each of these stages. During the introduction, training and coaching from an external consultant were among the most impactful factors in the success of pilot projects, while time constraints and the adoption of process analysis tools were the main barriers to implementation. The experiences of the Lean teams strongly influence the process of spontaneous dissemination aided by the celebration of project results and the commitment of the departmental hospital heads.

Practical implications: Lean culture can spread to allow many projects be conducted spontaneously, but the Lean paradigm can struggle to be adopted strategically. Lean in healthcare can fail because of the lack of alignment of Lean with leadership in healthcare and with their strategic vision, a lack of employees' project management skills and crucially the absence of a Lean steering committee.

Originality/value: The absence of managerial expertise and a will to support Lean implementation do not allow for systemic adoption of Lean. This is one of the first and largest long-term case studies on a Lean cross-regional multi-hospital application in healthcare.

Purpose: The prime aim of this research is to examine the mediating effect of patient trust on the relationship between service quality and patient satisfaction in Amman, Jordan.

Design/methodology/approach: A convenience sample of patients visiting seven out of the 44 private hospitals in Amman was selected. In total, 385 questionnaires were distributed among patients, with a response rate of 91%. Of these, 35 were disregarded, and the data from the remaining 350 questionnaires were analyzed using SPSS.

Findings: The results showed that service quality has a statistically significant effect on patient satisfaction. Furthermore, service quality has a statistically significant effect on patient trust, while there is also a statistically significant effect of patient trust on patient satisfaction. The findings also revealed that patient satisfaction partially mediates the relationship between service quality and patient satisfaction.

Originality/value: Generating more insights in the areas of service quality, patient trust and patient satisfaction while also extending the findings of earlier studies. The prior studies in the literature that focus on customers are given a more advantageous perspective by using Jordanian hospitals as a population to test the model of this research. The majority of past research on service quality, patient satisfaction and patient trust in the healthcare sector has been conducted in western nations.

Purpose: This case study aims to demonstrate the strengths of the Lean Six Sigma (LSS) methodology to improve the acute ischemic stroke (AIS) treatment rates and reduce process lead time at Baruch Padeh Medical Center (BPMC), a rural hospital in the Galilee region of Northern Israel. The LSS project redefined the BPMC stroke care pathway and increased its efficacy.

Design/methodology/approach: The LSS methodology was implemented in September 2017 by integrating lean principles and the Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control). Existing procedures, field observation, ad hoc measurement and in-depth interviews were utilized, and the GEMBA method was implemented to identify root cause and improve actions optimizing the stroke pathway.

Findings: The presented case shows the usefulness of the LSS methodology in improving quality performance in a rural hospital. The intervention allowed the BPMC to improve the intravenous tissue plasminogen activator (IV-tPA) administration rate (+15.2%), reducing the process lead time. The lead time of door-to-computer tomography decreased from 52 to 26 min, and the door-to-needle time decreased from 94 to 75 min.

Originality/value: The present case study shows the implementation of the LSS methodology aimed to improve the IV-tPA administration rate and reduce the stroke pathway lead time in a rural hospital. The case demonstrates the potential for the LSS methodology to support the AIS pathway optimization and represents a guide for healthcare organizations located in rural areas.

Purpose: The purpose of this research is to examine the impact of perceived service quality (PSQ) on the behavioural intention (BI) of patients in Indian government hospitals. The underlying mechanism of trust and patient satisfaction (SAT) is examined as multiple mediating effect.

Design/methodology/approach: Data from 510 respondents were collected using structured questionnaires. Six government hospitals, namely, S.M.S. Hospital, J.L.N. Hospital, New Medical College Hospital, Maharana Bhupal Medical Hospital, Mathuradas Hospital and P.B.N. Hospital, were selected from the cities of Jaipur, Ajmer, Kota, Udaipur, Jodhpur and Bikaner, respectively. The data were collected from adult patients (>18 years old) who spent at least two nights in a government hospital between 1 October, 2020 and 30 December, 2020. PSQ formed as a reflective-formative model was analysed using the repeated indicator approach. Structural equation modelling (SEM) using SMART-PLS software was used to test the hypothesised model(s) derived deductively from literature.

Findings: The findings support the following conclusions: (1) the positive relationship between PSQ and BI is significant; (2) SAT mediates the PSQ and BI relationship; (3) trust mediates the PSQ and BI relationship; (4) the mediation effect of SAT is stronger than that of trust.

Practical implications: The results indicate that, in order to enhance the positive BI of patients towards government hospitals, it is necessary for the hospitals to work on strategies to enhance the service quality provided to patients. The outcome of this study will enable state government hospitals to get a better understanding of the different dimensions of service quality and will help in observing the factors that contribute to patients' satisfaction and trust in building long-term relationships by encouraging a positive BI.

Originality/value: There is a dearth of research in India that evaluates the relationships between the constructs PSQ, trust, BI and SAT in the context of healthcare service. This empirical study is an attempt to fill this gap by focussing on the government hospitals in India.