Purpose: The purpose of this paper is to confirm and examine organization-related factors that could affect quality management at the Thai national reference laboratory known as National Institute of Health.
Design/methodology/approach: The authors invited 340 laboratory staff members to complete a questionnaire that enquired about their skills, opinions, perceptions, leadership, work environment, organizational culture and organizational commitment in relation to quality management. Confirmatory factor analysis (CFA) and multiple linear regression were used to analyze the data.
Findings: In total, 65 percent of institute members responded to the questionnaire. CFA revealed that all factors were related to quality management. Three factors, leadership, organizational commitment and work environment, significantly affected quality management, but organizational culture did not.
Research limitations/implications: Other data types should be collected for an in-depth understanding, i.e. focus groups or in-depth interviews. A longitudinal study could also enhance quality management understanding to see how each variable changes over time.
Originality/value: Analyzing quality management through confirmatory factor and regression analysis showed that the four analyzed variables are statistically significant in relation to quality management at the laboratory. Managers could apply this information to revise the current policy.
Purpose: The purpose of this paper is to examine whether Bahraini individuals accept e-health system and the prominent factors affecting e-health system adoption in Bahrain.
Design/methodology/approach: The authors adopted a quantitative and qualitative approach, i.e., a self-administered questionnaire, unstructured and a semi-structured interview, which were used to collect the data. A questionnaire was distributed to Bahraini residents selected randomly. The framework was based on the technology acceptance model (TAM) and theory of reasoned action (TRA). Important variables from both the TAM model and TRA theory were extracted and jointly used to build the research model.
Findings: The findings indicated that the most factors affecting e-health adoption are trust, health literacy and attitude. Additionally, people in the private and government sectors understand e-health benefits.
Practical implications: If healthcare professionals understand the factors affecting e-health system adoption from an individual and organisational perspective, then nurses, pharmacists and others will be more conscious about e-health and its adoption status.
Originality/value: E-health system adoption has become increasingly important to governments, individuals, and researchers in recent years. A novel research framework, based on TAM and TRA, was used to produce a new integrated model.
Purpose: The purpose of this paper is to validate the Press Ganey Questionnaire (PGQ) (Bahasa Melayu version) using Hospital Universiti Sains Malaysia (HUSM) patients.
Design/methodology/approach: This cross-sectional study comprised 252 patients visiting HUSM. Patients were selected using the convenience sampling method. The PGQ (Bahasa Melayu version) had three main factors: during your visit; your care provider and overall assessment. Data were analyzed using the structural equation modeling.
Findings: The exploratory factor analysis resulted in item reduction from 21 to 17, which contained four factors with eigenvalues greater than 1. Meanwhile, confirmatory factor analysis results showed that data fitted the model: χ2/df at 1.764, comparative fit index at 0.952, Tucker-Lewis index at 0.941 and root mean square error of approximation at 0.073. The average variance extracted value for the four factors was greater than 0.50, which indicated that PGQ convergent validity was met. Overall, PGQ produced good reliability with composite reliability score equals to 0.966. Four factors were reclassified as "during your registration," "hospital staff attitude," "doctor's attitude" and "overall assessment."
Research limitations/implications: Patient satisfaction is an important and frequently used indicator for measuring healthcare quality; hence, a validated and reliable instrument is important for measuring patient satisfaction that leads to healthcare service quality assessment.
Practical implications: Validated PGQ provides some useful information for doctors, medical assistants, nurses and staff in the emergency department to help them become more prominent and efficient in their role as healthcare providers.
Social implications: Validated PGQ will help healthcare providers to deliver the best and exceptional care toward emergency patient, and thus improve their quality of work life. The findings in this study can be used as a guide or as baseline data for further research in this area.
Originality/value: The PQG (Bahasa Melayu version) was confirmed as a reliable and valid instrument for measuring patient satisfaction. This research is the first PGQ validation study in Southeast Asia, specifically focusing on Malaysian respondents.
Purpose: Risk identification plays a key role identifying patient safety risks. As previous research on risk identification practices, as applied to patient safety, and its association with safety culture is limited, the purpose of this paper is to evaluate current practice to address gaps and potential room for improvement.
Design/methodology/approach: The authors carry out interview-based questionnaires in one UK hospital to investigate real-world risk identification practices with eight healthcare staff, including managers, nurses and a medical consultant. Considering various aspects from both risk identification and safety culture practices, the authors investigate how these two are interrelated.
Findings: The interview-based questionnaires were helpful for evaluating current risk identification practices. While gaining significant insights into risk identification practices, such as experiences using current tools and methods, mainly retrospective ones, results also explicitly showed its link with the safety culture and highlighted the limitation in measuring the relationship.
Originality/value: The interviews addressed valuable challenges affecting success in the risk identification process, including limitations in safety culture practice, training, balancing financial and safety concerns, and integrating risk information from different tools and methods.
Purpose: This paper presents an interpretive data analysis from a superordinate study that aimed to determine foodservice satisfaction. The purpose of this paper is to determine inpatient hospital foodservice experiences.
Design/methodology/approach: The authors used secondary data obtained from 419 respondents: (225 (53.70 per cent) males, 178 (42.48 per cent) females and 16 (3.82 per cent) undisclosed) participants. A comparative, quantitative and cross-sectional approach was applied to provide insight into hospital foodservice experiences. The Wilcoxon-Mann-Whitney test, interpreted at 0.05 error rate, was used to compare male and female patient experiences.
Findings: Male patients had significantly higher rank-sum scores than female patients in almost all items (p<0.0001). The study revealed that hospital personnel, especially foodservice staff, had an unsatisfactory communication approach.
Originality/value: This is the first South African study that compares female and male inpatient foodservice perceptions. Hospital managers and stakeholders may need to consider patient's gender, as a significant factor that is associated with patient experiences, when embarking on improving foodservice systems.
Purpose: To respect the patients' physical privacy, they should be provided with proper clothing that prevents the exposure of unnecessary parts of the body. The purpose of this paper is to evaluate patient satisfaction upon wearing customized, high-coverage, procedure-specific dresses.
Design/methodology/approach: New designs of clothing adapted for different kinds of procedures, and offering a good coverage of the body and easy access to the required parts were compared with regular patient clothing. Patients from six different wards of a university hospital filled out a questionnaire inquiring about general and demographic variables, and patient satisfaction was evaluated based on six main features of the clothing design. p<0.005 was considered as the level of statistical significance.
Findings: Overall, 256 patients were entered into the regular-design and new-design groups (n=128 in each). In Group 1 (regular design), the rate of dissatisfaction was about 98, 84, 84, 78, 77 and 38 percent for ease of wearing, comfort, design, material, coverage level and size, respectively. In Group 2 (new design), the highest satisfaction rates were associated with ease of wearing, size, coverage level, material, design and comfort as 93.7, 91.4, 89.9, 87.1, 86, and 80.5 percent, respectively.
Originality/value: The present study is the first to investigate customized patient clothing and demonstrated that these clothes can improve the patients' satisfaction in terms of coverage, comfort, design and size.
Purpose: Residents collect information from the electronic health record (EHR) to present during rounds, but this crucial process is understudied. The purpose of this paper is to examine the feasibility of utilizing an EHR embedded time-tracking software to quantify resident pre-round EHR activity and how patient acuity impacts this activity.
Design/methodology/approach: This was a retrospective observational study that quantified resident EHR activities (total time spent, tasks performed and patient encounters accessed) during pre-rounds on their pediatric intensive care unit rotation between May 2016 and December 2016. Patient encounters were reviewed to determine resident ownership and critical care resources provided.
Findings: Allo 21 eligible participants were included. In total, 907 patient encounters were included to evaluate patient acuity impact. EHR usage per patient encounter (median in minutes (25th, 75th percentile)) was significantly affected by the critical care resources utilized. Total EHR time: both ventilator and vasoactive support (10.54 (6.68, 17.19)); neither ventilator nor vasoactive support (8.23 (5.07, 12.72)); invasive/noninvasive ventilator support (8.74 (5.69, 13.2)); and vasoactive support (10.37 (7.72, 11.65)), p<0.001. Chart review, order entry and documentation EHR times demonstrated similar trends.
Practical implications: Residents spend more time utilizing the EHR to collect data on patients who require significant critical care resources. This information can be useful to determine optimal resident to patient workload. Future research is required to assess this EHR tool's ability to contribute to physician workflow study.
Originality/value: EHR embedded time-tracking software can offer insights into resident workflow.
Purpose: The purpose of this paper is three-fold: first, to assess nurse satisfaction levels with working environment (known as favourability) in five Greek public hospitals using the practice environment scale (PES); second, to compare perceptions among nurses employed in surgical and medical departments; and third, to examine relationships between perceptions and nurse educational level and experience.
Design/methodology/approach: In total, 532 nurses from five major public hospitals in Greece completed the PES. Descriptive statistics, t-tests and Spearman correlations were employed to analyse the data.
Findings: Nurses perceived their work settings as unfavourable in all five hospitals, with collegial nurse-physician relations emerging as the only positive factor. Compared to medical wards, surgical departments emerged as slightly more positive working environments. Work department notwithstanding, in some cases, education and experience levels affected their perceptions on management, poor care quality, limited nurse involvement in hospital affairs and nursing shortage.
Practical implications: Hospital managers do not provide sufficient support for Greek nurses in their working environments.
Originality/value: The authors attempted to evaluate nursing practice environments in Greek hospitals, viewed from nurse perspectives. The authors identified insufficient support for nurses' working in these hospitals.
Purpose: Hospitals are complex and complicated organizations and are prone to the conflict. The purpose of this paper is to identify the intensity and type of conflict experienced by hospital managers and explore their conflict management strategies in hospitals affiliated with Tehran University of Medical Sciences.
Design/methodology/approach: This quantitative, descriptive and cross-sectional study was conducted in 2015. A self-administered questionnaire was used to collect data from top, middle and front line managers. In total, 563 managers from 14 hospitals responded to the questionnaires. Data were analyzed using SPSS software version 19.
Findings: Hospital managers reported average level of conflict (2.73 score out of 5). Organizational factors produced more conflict for managers than personal factors. High workload, resource shortage, bureaucracy and differences in managers' personality, knowledge, capabilities and skills were the main causes of organizational and personal conflict. Top managers experienced more conflict than middle and front line managers. Conflict was higher in specialized hospitals compared to general hospitals. Less conflict was observed in administrative and support departments than diagnostic and therapeutic departments. Conflict was meaningfully associated with management level, education, size of hospital, number of employees and willingness to leave the hospital. The dominant conflict management style of managers was collaborating. There were significant relationships between collaborating style and management level, manager's age, work experience and management experience.
Practical implications: The nature of hospitals requires that managers use collaborating, compromising and accommodating styles to interact better with different stakeholders. Managers by acquiring necessary training and using the right conflict resolution strategies should keep the conflict in a constructive level in hospitals.
Originality/value: This is the first study conducted in Iran examining the level of conflict, its types and identifying managers' dominant conflict resolution strategies at front line, middle and top management levels.