INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE最新文献

Purpose: The purpose of this research is to investigate the indirect effect of innovative culture (INVC) on the association between total quality management (TQM) and corporate sustainability (CS) in public hospitals in eastern Ethiopia.

Design/methodology/approach: The study is cross-sectional, and data were collected from 252 doctors and nurses of selected public hospitals in eastern Ethiopia using convenience sampling. The data was analyzed using Smart-PLS 4.

Findings: The findings indicate that innovative culture partially mediates the relationship between TQM and CS. Furthermore, TQM has a positive and significant influence on CS and INVC. The findings offer practical recommendations for implementing TQM principles in healthcare systems within emerging economies.

Practical implications: This study has substantial managerial implications for hospital administrators who may desire to evaluate and use the findings described in this paper when establishing strategic goals, policies and decision-making. Furthermore, the findings of this research add knowledge to the body of literature regarding the mediating role of INVC in the relationship between TQM and CS.

Originality/value: The novelty of the study lies in examining the impact of innovative culture as a mediator in the association between TQM and CS in public hospitals.

Purpose: This study aims to investigate the determinants of pandemic and epidemic preparedness in the least developed African countries by applying a multidimensional framework that incorporates governance, health infrastructure, socioeconomic vulnerability and institutional capacity. It addresses the lack of integrated empirical analyses tailored to Africa's complex socio-political and environmental context.

Design/methodology/approach: The study adopts a quantitative approach using cross-sectional data from 29 least developed African countries. The determinants are constructed across five dimensions: governance, institutional capacity, health infrastructure, socioeconomic conditions and social resilience. The robust weighted least squares method, using the Welsch loss function, is employed to address outlier sensitivity and provide stable parameter estimates for small sized samples.

Findings: Results show that higher immunization coverage and literacy significantly enhance pandemic preparedness, emphasizing the critical role of preventative health and education. Well-integrated social protection systems and effective governance are also strong positive contributors. In contrast, poorly supported community health workers, high poverty, informal employment and urban slums negatively affect preparedness. Environmental stressors such as air pollution and high population density further undermine resilience. Notably, nurses have a more positive impact on preparedness than physicians, highlighting the importance of strategic health workforce deployment over sheer numbers.

Originality/value: This study is the first to empirically assess pandemic preparedness in the least developed African countries using an integrated, multidimensional framework and robust estimation techniques. It fills a significant research gap by localizing global theoretical models to the African context.

Purpose: This study examines why health and sanitation projects in Uganda struggle to achieve sustainability despite substantial investments, supportive policies, and global commitments.

Design/methodology/approach: Guided by Institutional Theory, the study adopts a qualitative design involving 21 semi-structured interviews with project managers, government officials, NGO staff, health inspectors, and community mobilizers. Data were thematically analyzed using Nvivo.

Findings: Results show that fragmented governance, weak policy coherence, and short-term donor cycles constrain institutional alignment. Low community ownership, weak feedback systems, and donor-local power imbalances undermine accountability, while leadership gaps, corruption, and limited technical capacity further weaken resilience. Together, these factors explain why sustainability remains difficult to institutionalize in Uganda's health and sanitation sector.

Practical implications: The study calls for integrating interventions within national institutional frameworks, strengthening local accountability, and enhancing ethical and technical leadership. Donors and policymakers should support long-term learning, participatory design, and sustainable local financing.

Originality/value: This study provides one of the few empirical analyses of sustainability challenges in Uganda's health and sanitation projects. By applying Institutional Theory, it offers a systemic view of how governance, leadership, and community legitimacy shape project continuity and resilience.

Purpose: This study aims to identify the demographic, professional and regional determinants of financial management behavior among Brazilian physicians and discuss the implications for medical education and policy.

Design/methodology/approach: A cross-sectional online survey (n = 422) was conducted using an adapted 15-item Financial Management Behavior Scale (FMBS). The internal consistency was satisfactory (Cronbach's α = 0.758; McDonald's ω = 0.783). Group differences across FMBS terciles were assessed with chi-square/Fisher and Kruskal-Wallis tests; associations were examined via logistic regressions contrasting middle and upper terciles with the lower terciles (reference).

Findings: Positive behaviors were more frequent among men, older physicians and those practicing in the Southeast. In multivariable models, women had lower odds of being in the high-performing tercile (OR˜0.53, 95% CI 0.31-0.91); physicians aged = 50 years had markedly higher odds (OR˜27.3, 2.36-315.8); practice in the Southeast was associated with ˜three three-fold higher odds versus Central West. The FMBS subscales increased monotonically across terciles, especially Savings/Investments and Insurance (p < 0.001).

Research limitations/implications: This study is limited by its cross-sectional design, which prevents causal inference, and by the reliance on self-reported data, which may introduce response bias. The exclusion of incomplete surveys might also have reduced representativeness. Future research should employ longitudinal designs and intervention-based studies to assess the long-term impact of financial education programs on physicians' financial behavior.

Practical implications: The findings support targeted financial counseling for early careers and female physicians and the curricular integration of personal finance in medical training.

Social implications: Aligning physician-focused initiatives with national financial education efforts may reduce the gender and regional gaps.

Originality/value: The first nationwide analysis of Brazilian physicians' financial management behaviors used a culturally adapted FMBS and linked regional disparities to actionable education and policy levers.

Purpose: This study aims to assess the current state of awareness and preparedness for Mass Casualty Incidents (MCIs) among hospital pharmacies in Egypt, focusing on the availability of disaster plans either for pharmacy or for a hospital as a whole, participation in drills and the perceived adequacy of essential medication stocks.

Design/methodology/approach: A descriptive, cross-sectional study was conducted using a validated, self-administered questionnaire distributed to licensed pharmacists across various public, private, and university teaching hospitals, across different governorates in Egypt.

Findings: Our findings show significant gaps in preparedness and awareness of many aspects of the mass causality events' handling. While just over half of participants reported that they have a pharmacy-specific disaster plan, over a third (36.6%) were unaware of their hospital's overall disaster plan. A striking 75% of pharmacists had never participated in a disaster drill. Confidence in medication stocks was high for common drugs like analgesics (70.3% agreed adequate). 65.4% of pharmacists reporting that chemical weapon antidote stocks were insufficient. Larger, better-resourced hospitals were significantly more likely to have a formal disaster plan.

Originality/value: This research is the first focused examination of hospital pharmacy preparedness for MCIs in Egypt, which fills a significant gap in the national and regional literature. The findings provide novel, practical evidence that goes beyond intuitive opinion to identify specific readiness gaps, offering a critical foundation for stakeholders to build on.

Purpose: This study examined the reliability and validity of the Sickness Presenteeism Scale-Nurse (SPS-N) among Indian nurses.

Design/methodology/approach: Three independent studies were conducted to validate the SPS-N in the Indian context. The first study evaluated the factorial structure of the scale using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The second study explored reliability and validity with the help of Cronbach's alpha, McDonald's omega and the Fornell and Larcker testing system. Besides, convergent and criterion validities were also assessed by examining the correlation between SPS-N, Stanford presenteeism and perceived stress scores. Lastly, test-retest reliability was evaluated in the third study.

Findings: EFA yielded a four-factor solution that explains 59.17% of the total variance. However, the two statements were part of different dimensions of the scale in comparison to the original SPS-N scale. CFA confirmed the factorial structure among Indian nurses. Also, acceptable values of Cronbach's alpha and McDonald's omega established the scale's reliability. Besides, a significant positive association of the SPS-N scores with Stanford presenteeism and perceived stress scores confirmed the scale's convergent and criterion validities.

Originality/value: The SPS-N exhibited acceptable reliability and validity, with minor modifications. The scale could be used to investigate the impact of presenteeism among Indian nurses.

Purpose: Process improvement methodologies such as Lean Six Sigma are increasingly being deployed to address inefficiencies in healthcare. Simultaneously, global policy and strategy development stress the value of person-centredness in healthcare. This paper examines the application of a Person-Centred Lean Six Sigma Model (PCLSSM) to improve processes in a paediatric eye care clinic, specifically focusing on streamlining the referral system and optimising the clinic environment.

Design/methodology/approach: A quasi-experimental, single-site, pretest-posttest study was conducted over nine months using the Lean Six Sigma define, measure, analyse, improve and control (DMAIC) framework. Data were gathered through Voice of the Customer (VOC) sessions, Gemba observations, process mapping and referral letter audits. Key stakeholders, including clinicians, administrative staff and parents, co-designed the interventions to enhance efficiency and patient experience.

Findings: The application of the PCLSSM resulted in a 46% increase in right-first-time referral accuracy, a 20% reduction in referral processing time, a 13% increase in staff confidence in the referral system, a 158% improvement in staff satisfaction with workload and a 104% rise in child and parent satisfaction with their clinic experience. The implementation of an electronic referral system and an improved clinic environment contributed to these improvements.

Originality/value: This study is the first to integrate a person-centred approach with Lean Six Sigma in paediatric ophthalmology. The findings demonstrate the potential of combining process improvement methodologies with person-centred principles to enhance operational efficiency and stakeholder satisfaction. This approach can serve as a model for similar outpatient settings seeking to improve service delivery and patient experience.