Pub Date : 2019-10-14DOI: 10.1108/IJHCQA-01-2019-0012
S. H. Galstyan, Hrant Z Kalenteryan, Arshak S Djerdjerian, Hovhannes S Ghazaryan, Naira T Gharakhanyan, Viktoria Y Kalenteryan
PURPOSE The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants. DESIGN/METHODOLOGY/APPROACH The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations. FINDINGS In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment. ORIGINALITY/VALUE Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure-process-outcomes approach as a theoretical basis.
{"title":"Cross-sectional study of the quality of neonatal care services in Armenia.","authors":"S. H. Galstyan, Hrant Z Kalenteryan, Arshak S Djerdjerian, Hovhannes S Ghazaryan, Naira T Gharakhanyan, Viktoria Y Kalenteryan","doi":"10.1108/IJHCQA-01-2019-0012","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2019-0012","url":null,"abstract":"PURPOSE\u0000The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations.\u0000\u0000\u0000FINDINGS\u0000In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure-process-outcomes approach as a theoretical basis.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-01-2019-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43712627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-14DOI: 10.1108/IJHCQA-02-2019-0043
A. Maher, A. Ayoubian, S. Rafiei, Donya Sheibani Tehrani, F. Mostofian, Pooneh Mazyar
PURPOSE Today, healthcare organizations focus mainly on development and implementation of patient safety strategic plan to improve quality and ensure safety of provided services. The purpose of this paper is to recommend potential strategies for successful implementation of patient safety program in Iranian hospitals based on a strengths, weaknesses, opportunities, threats (SWOT) analysis. DESIGN/METHODOLOGY/APPROACH In this qualitative study, key informant interviews and documentation review were done to identify strength and weakness points of Iranian hospitals in addition to opportunities and threats facing them in successful implementation of a patient safety program. Accordingly, the research team formulated main patient safety strategies and consequently prioritized them based on Quantitative Strategic Planning Matrix (QSPM) matrix. FINDINGS The study recommended some of the potential patient safety strategies including provision of education for employees, promoting a safety culture in hospitals, managerial support and accountability, creating a safe and high-quality delivery environment, developing national legislations for hospital staff to comply with patient safety standards and developing a continuous monitoring system for quality improvement and patient safety activities to ensure the achievement of predetermined goals. PRACTICAL IMPLICATIONS Developing a comprehensive and integrated strategic plan for patient safety based on accurate information about the health system's weaknesses, strengths, opportunities and threats and trying to implement the plan in accordance with patient safety principles can help hospitals achieve great success. ORIGINALITY/VALUE Ministry of Health and Medical Education (MOHME) conducted a national study to recommend potential strategies for successful implementation of patient safety in Iranian hospitals based on a SWOT analysis and QSPM matrix.
{"title":"Developing strategies for patient safety implementation: a national study in Iran.","authors":"A. Maher, A. Ayoubian, S. Rafiei, Donya Sheibani Tehrani, F. Mostofian, Pooneh Mazyar","doi":"10.1108/IJHCQA-02-2019-0043","DOIUrl":"https://doi.org/10.1108/IJHCQA-02-2019-0043","url":null,"abstract":"PURPOSE\u0000Today, healthcare organizations focus mainly on development and implementation of patient safety strategic plan to improve quality and ensure safety of provided services. The purpose of this paper is to recommend potential strategies for successful implementation of patient safety program in Iranian hospitals based on a strengths, weaknesses, opportunities, threats (SWOT) analysis.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000In this qualitative study, key informant interviews and documentation review were done to identify strength and weakness points of Iranian hospitals in addition to opportunities and threats facing them in successful implementation of a patient safety program. Accordingly, the research team formulated main patient safety strategies and consequently prioritized them based on Quantitative Strategic Planning Matrix (QSPM) matrix.\u0000\u0000\u0000FINDINGS\u0000The study recommended some of the potential patient safety strategies including provision of education for employees, promoting a safety culture in hospitals, managerial support and accountability, creating a safe and high-quality delivery environment, developing national legislations for hospital staff to comply with patient safety standards and developing a continuous monitoring system for quality improvement and patient safety activities to ensure the achievement of predetermined goals.\u0000\u0000\u0000PRACTICAL IMPLICATIONS\u0000Developing a comprehensive and integrated strategic plan for patient safety based on accurate information about the health system's weaknesses, strengths, opportunities and threats and trying to implement the plan in accordance with patient safety principles can help hospitals achieve great success.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000Ministry of Health and Medical Education (MOHME) conducted a national study to recommend potential strategies for successful implementation of patient safety in Iranian hospitals based on a SWOT analysis and QSPM matrix.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-02-2019-0043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41836940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-14DOI: 10.1108/IJHCQA-01-2019-0017
Therese Kahm, Pernilla Ingelsson
PURPOSE The purpose of this paper is to present the results from a study that investigates first-line healthcare managers' views on their role and the conditions that influence their ability to drive improvement work based on Lean. DESIGN/METHODOLOGY/APPROACH A questionnaire was sent to all first-line managers in a healthcare organization to investigate their views on their role, conditions and ability to create change according to Lean. The results from four of the questions are presented, which focus on how crucial they consider their role to be for managing improvement work based on Lean, what work tasks their time is spent on, what factors they consider to be important to their ability to drive change and what factors best describe what Lean provides. FINDINGS The results show that first-line managers claim that their role is crucial in improvement work, but when they defined their work tasks, the time spent on improvements was not frequently described. Time, support from coworkers, and a clear vision and clear goals were the three factors that they considered to be most important to their ability to drive improvement work. Considering their leadership, Lean contributed to the structure with tools and supportive methods. ORIGINALITY/VALUE The questions can be used separately or as part of the entire questionnaire before and along a Lean process to obtain a better understanding of how to create a sustainable Lean approach in healthcare. Understanding the factors that first-line managers consider supporting their ability in improvement work and what they consider Lean provides is important in creating a development force in Swedish healthcare.
{"title":"Creating a development force in Swedish healthcare.","authors":"Therese Kahm, Pernilla Ingelsson","doi":"10.1108/IJHCQA-01-2019-0017","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2019-0017","url":null,"abstract":"PURPOSE\u0000The purpose of this paper is to present the results from a study that investigates first-line healthcare managers' views on their role and the conditions that influence their ability to drive improvement work based on Lean.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000A questionnaire was sent to all first-line managers in a healthcare organization to investigate their views on their role, conditions and ability to create change according to Lean. The results from four of the questions are presented, which focus on how crucial they consider their role to be for managing improvement work based on Lean, what work tasks their time is spent on, what factors they consider to be important to their ability to drive change and what factors best describe what Lean provides.\u0000\u0000\u0000FINDINGS\u0000The results show that first-line managers claim that their role is crucial in improvement work, but when they defined their work tasks, the time spent on improvements was not frequently described. Time, support from coworkers, and a clear vision and clear goals were the three factors that they considered to be most important to their ability to drive improvement work. Considering their leadership, Lean contributed to the structure with tools and supportive methods.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000The questions can be used separately or as part of the entire questionnaire before and along a Lean process to obtain a better understanding of how to create a sustainable Lean approach in healthcare. Understanding the factors that first-line managers consider supporting their ability in improvement work and what they consider Lean provides is important in creating a development force in Swedish healthcare.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-01-2019-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44319519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-14DOI: 10.1108/IJHCQA-05-2019-0096
Nidhi Ghildayal
PURPOSE Hepatitis A is a prevalent disease that is largely preventable by vaccine usage. The vaccine for this illness is highly underused in most regions. In an attempt to find the strategies that are most beneficial in regard to quality-adjusted life years (QALYs) and cost in current environments, the purpose of this paper is to conduct cost-effectiveness analyses to investigate vaccination strategies in a more economically developed country (MEDC), generally known as a "developed" area: the USA, and a less economically developed country (LEDC), generally known as a "developing" area: the state of Rio de Janeiro, Brazil. DESIGN/METHODOLOGY/APPROACH This study used a dynamic transmission model for comparative effectiveness analyses. The model ran two different scenarios. The two regions studied have different policies and strategies for Hepatitis A vaccination currently, and also used different strategies in 2009. In the USA, a universal vaccination policy was modeled, along with a scenario in which it was removed. In Rio de Janeiro, a no vaccination policy was modeled, along with a scenario in which a universal vaccination policy was effected. FINDINGS The comparison of resulting incremental cost-effectiveness ratio values to accepted threshold values showed universal vaccination to be cost-effective in both the USA and Rio de Janeiro as compared to no vaccination. When episode and vaccination costs and vaccination efficacy were varied, this still remained true. Universal vaccination was found to result in lower incidence of Hepatitis A in both the USA and Rio de Janeiro. Over the twenty-year time horizon, universal vaccination is projected to prevent 506,945 cases of symptomatic Hepatitis A in the USA and 42,318 cases of Hepatitis A in Rio de Janeiro. Other benefits include a projected increase in cumulative QALYs through the use of universal vaccination. ORIGINALITY/VALUE This analysis showed universal vaccination to be cost-effective as compared to no vaccination, and portions of the study's approach had not previously been applied in tandem to investigate Hepatitis A interventions. The results may help foster higher compliance rates for Hepatitis A vaccination and even greater per-person economic benefits of universal vaccination, particularly in the USA. The purpose of this study is also to encourage elevated levels of surveillance on age of infection in developing regions and consistent reevaluation utilizing dynamic transmission models in both the USA and Brazil, as well as other rapidly developing regions, in order to prevent future epidemics and costs associated with the disease.
{"title":"Cost-effectiveness of Hepatitis A vaccination in a developed and developing country.","authors":"Nidhi Ghildayal","doi":"10.1108/IJHCQA-05-2019-0096","DOIUrl":"https://doi.org/10.1108/IJHCQA-05-2019-0096","url":null,"abstract":"PURPOSE\u0000Hepatitis A is a prevalent disease that is largely preventable by vaccine usage. The vaccine for this illness is highly underused in most regions. In an attempt to find the strategies that are most beneficial in regard to quality-adjusted life years (QALYs) and cost in current environments, the purpose of this paper is to conduct cost-effectiveness analyses to investigate vaccination strategies in a more economically developed country (MEDC), generally known as a \"developed\" area: the USA, and a less economically developed country (LEDC), generally known as a \"developing\" area: the state of Rio de Janeiro, Brazil.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000This study used a dynamic transmission model for comparative effectiveness analyses. The model ran two different scenarios. The two regions studied have different policies and strategies for Hepatitis A vaccination currently, and also used different strategies in 2009. In the USA, a universal vaccination policy was modeled, along with a scenario in which it was removed. In Rio de Janeiro, a no vaccination policy was modeled, along with a scenario in which a universal vaccination policy was effected.\u0000\u0000\u0000FINDINGS\u0000The comparison of resulting incremental cost-effectiveness ratio values to accepted threshold values showed universal vaccination to be cost-effective in both the USA and Rio de Janeiro as compared to no vaccination. When episode and vaccination costs and vaccination efficacy were varied, this still remained true. Universal vaccination was found to result in lower incidence of Hepatitis A in both the USA and Rio de Janeiro. Over the twenty-year time horizon, universal vaccination is projected to prevent 506,945 cases of symptomatic Hepatitis A in the USA and 42,318 cases of Hepatitis A in Rio de Janeiro. Other benefits include a projected increase in cumulative QALYs through the use of universal vaccination.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000This analysis showed universal vaccination to be cost-effective as compared to no vaccination, and portions of the study's approach had not previously been applied in tandem to investigate Hepatitis A interventions. The results may help foster higher compliance rates for Hepatitis A vaccination and even greater per-person economic benefits of universal vaccination, particularly in the USA. The purpose of this study is also to encourage elevated levels of surveillance on age of infection in developing regions and consistent reevaluation utilizing dynamic transmission models in both the USA and Brazil, as well as other rapidly developing regions, in order to prevent future epidemics and costs associated with the disease.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-05-2019-0096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48315196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-14DOI: 10.1108/IJHCQA-10-2018-0240
Reza Etemad-Sajadi, Gil Gomes Dos Santos
PURPOSE The objective of this paper is to focus on seniors' acceptance of the usage of connected healthcare technologies in their homes. The authors integrated into technology acceptance model (TAM) several latent variables such as social presence, trust and degree of intrusiveness perceived with the use of connected health technologies. DESIGN/METHODOLOGY/APPROACH The authors distributed the survey by post to 605 seniors. The authors targeted elderly people using connected health technologies (assistive alarm, telecare, sensors, etc.) at home and/or receiving healthcare at home. The authors received 213 questionnaires back. As The authors had several latent variables, the authors used partial least squares (PLS), a variance-based structural equation modeling method. FINDINGS The results show that the level of trust in these technologies impacts significantly the perception of usefulness and the degree of intrusiveness. In parallel, the degree of usefulness of these technologies impacts positively elderly people's intention to accept their usage. Finally, one can claim that the perception of the social presence with the use of these technologies impacts positively the degree of perceived usefulness, trust and intrusiveness. RESEARCH LIMITATIONS/IMPLICATIONS The sample covers a population benefiting from similar connected health technologies. It was difficult to distinguish and interpret the added value of each technology separately. As more and more elderly people use or are least familiarizing themselves with a range of connected technologies it would be interesting to identify which sets of connected technologies contribute the most to a positive feeling of social presence. SOCIAL IMPLICATIONS These results are particularly relevant to stakeholders in the health industry in their quest to improve their products/services. A better understanding of the relation that the elderly have with connected health technologies is an essential prerequisite to supporting the development of new solutions capable of meeting the specific needs of our seniors. ORIGINALITY/VALUE The authors want to apply the TAM to connected health technologies designed for elderly people and the authors also want to extend it by integrating the social presence, trust and degree of intrusiveness variables to our research model.
{"title":"Senior citizens' acceptance of connected health technologies in their homes.","authors":"Reza Etemad-Sajadi, Gil Gomes Dos Santos","doi":"10.1108/IJHCQA-10-2018-0240","DOIUrl":"https://doi.org/10.1108/IJHCQA-10-2018-0240","url":null,"abstract":"PURPOSE\u0000The objective of this paper is to focus on seniors' acceptance of the usage of connected healthcare technologies in their homes. The authors integrated into technology acceptance model (TAM) several latent variables such as social presence, trust and degree of intrusiveness perceived with the use of connected health technologies.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000The authors distributed the survey by post to 605 seniors. The authors targeted elderly people using connected health technologies (assistive alarm, telecare, sensors, etc.) at home and/or receiving healthcare at home. The authors received 213 questionnaires back. As The authors had several latent variables, the authors used partial least squares (PLS), a variance-based structural equation modeling method.\u0000\u0000\u0000FINDINGS\u0000The results show that the level of trust in these technologies impacts significantly the perception of usefulness and the degree of intrusiveness. In parallel, the degree of usefulness of these technologies impacts positively elderly people's intention to accept their usage. Finally, one can claim that the perception of the social presence with the use of these technologies impacts positively the degree of perceived usefulness, trust and intrusiveness.\u0000\u0000\u0000RESEARCH LIMITATIONS/IMPLICATIONS\u0000The sample covers a population benefiting from similar connected health technologies. It was difficult to distinguish and interpret the added value of each technology separately. As more and more elderly people use or are least familiarizing themselves with a range of connected technologies it would be interesting to identify which sets of connected technologies contribute the most to a positive feeling of social presence.\u0000\u0000\u0000SOCIAL IMPLICATIONS\u0000These results are particularly relevant to stakeholders in the health industry in their quest to improve their products/services. A better understanding of the relation that the elderly have with connected health technologies is an essential prerequisite to supporting the development of new solutions capable of meeting the specific needs of our seniors.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000The authors want to apply the TAM to connected health technologies designed for elderly people and the authors also want to extend it by integrating the social presence, trust and degree of intrusiveness variables to our research model.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-10-2018-0240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46904010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-12DOI: 10.1108/IJHCQA-07-2018-0164
Naif Alzahrani, Russell Jones, Amir Rizwan, Mohamed E Abdel-Latif
Purpose: The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments (EDs).
Design/methodology/approach: An electronic search was conducted of PsychINFO, ProQuest, MEDLINE, EMBASE, PubMed and CINAHL databases. The review included all studies that focussed on the safety attitudes of professional hospital staff employed in EDs.
Findings: Overall, the review revealed that the safety attitudes of ED health staff are generally low, especially on teamwork and management support and among nurses when compared to doctors. Conversely, two intervention studies showed the effectiveness of team building interventions on improving the safety attitudes of health staff employed in EDs.
Research limitations/implications: Six studies met the inclusion criteria, however, most of the studies demonstrated low to moderate methodological quality.
Originality/value: Teamwork, communication and management support are central to positive safety attitudes. Teamwork training can improve safety attitudes. Given that EDs are the "front-line" of hospital care and patients within EDs are especially vulnerable to medical errors, future research should focus on the safety attitudes of medical staff employed in EDs and its relationship to medical errors.
{"title":"Safety attitudes in hospital emergency departments: a systematic review.","authors":"Naif Alzahrani, Russell Jones, Amir Rizwan, Mohamed E Abdel-Latif","doi":"10.1108/IJHCQA-07-2018-0164","DOIUrl":"10.1108/IJHCQA-07-2018-0164","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments (EDs).</p><p><strong>Design/methodology/approach: </strong>An electronic search was conducted of PsychINFO, ProQuest, MEDLINE, EMBASE, PubMed and CINAHL databases. The review included all studies that focussed on the safety attitudes of professional hospital staff employed in EDs.</p><p><strong>Findings: </strong>Overall, the review revealed that the safety attitudes of ED health staff are generally low, especially on teamwork and management support and among nurses when compared to doctors. Conversely, two intervention studies showed the effectiveness of team building interventions on improving the safety attitudes of health staff employed in EDs.</p><p><strong>Research limitations/implications: </strong>Six studies met the inclusion criteria, however, most of the studies demonstrated low to moderate methodological quality.</p><p><strong>Originality/value: </strong>Teamwork, communication and management support are central to positive safety attitudes. Teamwork training can improve safety attitudes. Given that EDs are the \"front-line\" of hospital care and patients within EDs are especially vulnerable to medical errors, future research should focus on the safety attitudes of medical staff employed in EDs and its relationship to medical errors.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48069996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-12DOI: 10.1108/IJHCQA-02-2017-0033
Xiao Ping Xu, D. Ke, D. Deng, S. Houser, Xiao Ning Li, Qing Wang, Ng Chui Shan
PURPOSE The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients' and medical staff's perspectives. DESIGN/METHODOLOGY/APPROACH A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples. FINDINGS A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff. ORIGINALITY/VALUE There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients' consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.
{"title":"An innovative medical consultation model in mainland China.","authors":"Xiao Ping Xu, D. Ke, D. Deng, S. Houser, Xiao Ning Li, Qing Wang, Ng Chui Shan","doi":"10.1108/IJHCQA-02-2017-0033","DOIUrl":"https://doi.org/10.1108/IJHCQA-02-2017-0033","url":null,"abstract":"PURPOSE\u0000The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients' and medical staff's perspectives.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.\u0000\u0000\u0000FINDINGS\u0000A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients' consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-02-2017-0033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44186128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-12DOI: 10.1108/IJHCQA-09-2018-0229
Assia Boughaba, S. Aberkane, Y. Fourar, M. Djebabra
PURPOSE For many years, the concept of safety culture has attracted researchers from all over the world, and more particularly in the area of healthcare services. The purpose of this paper is to measure safety culture dimensions in order to improve and promote healthcare in Algeria. DESIGN/METHODOLOGY/APPROACH The used approach consists of getting a better understanding of healthcare safety culture (HSC) by measuring the perception of healthcare professionals in order to guide promotion actions. For this, the Hospital Survey on Patient Safety Culture questionnaire was used in a pilot hospital setting where it was distributed on a number of 114 health professionals chosen by stratified random sampling. FINDINGS The results showed that the identified priority areas for HSC improvement help in establishing a trust culture and a non-punitive environment based on the system and not on the individual. ORIGINALITY/VALUE Safety is recognized as a key aspect of service quality, thus measuring the HSC can help establish an improvement plan. In Algerian health facilities, this study is considered the first to examine perceptions in this particular area. The current results provide a baseline of strengths and opportunities for healthcare safety improvement, allowing the managers of this type of facilities to take steps that are more effective.
{"title":"Study of safety culture in healthcare institutions: case of an Algerian hospital.","authors":"Assia Boughaba, S. Aberkane, Y. Fourar, M. Djebabra","doi":"10.1108/IJHCQA-09-2018-0229","DOIUrl":"https://doi.org/10.1108/IJHCQA-09-2018-0229","url":null,"abstract":"PURPOSE\u0000For many years, the concept of safety culture has attracted researchers from all over the world, and more particularly in the area of healthcare services. The purpose of this paper is to measure safety culture dimensions in order to improve and promote healthcare in Algeria.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000The used approach consists of getting a better understanding of healthcare safety culture (HSC) by measuring the perception of healthcare professionals in order to guide promotion actions. For this, the Hospital Survey on Patient Safety Culture questionnaire was used in a pilot hospital setting where it was distributed on a number of 114 health professionals chosen by stratified random sampling.\u0000\u0000\u0000FINDINGS\u0000The results showed that the identified priority areas for HSC improvement help in establishing a trust culture and a non-punitive environment based on the system and not on the individual.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000Safety is recognized as a key aspect of service quality, thus measuring the HSC can help establish an improvement plan. In Algerian health facilities, this study is considered the first to examine perceptions in this particular area. The current results provide a baseline of strengths and opportunities for healthcare safety improvement, allowing the managers of this type of facilities to take steps that are more effective.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-09-2018-0229","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47430619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-12DOI: 10.1108/IJHCQA-04-2019-0084
Jitendra Singh, Brandi Sillerud, Marah Omar
PURPOSE The purpose of this paper is to explore and examine attitudes and perceptions of leaders on application of quality improvement (QI) strategies in a palliative and hospice care organization. DESIGN/METHODOLOGY/APPROACH This study employed qualitative research methodology where leaders working in a hospice and palliative care organization were invited to participate in 45-60-min-long semi-structured interview. Interviews were recorded and transcribed verbatim. Qualitative content analysis was utilized to analyze the data collected during participant interviews. FINDINGS Seven leaders participated in the interviews. Five themes were developed from data analysis: patient-centered care; continuous QI; leadership involvement and commitment; communication as a foundation for QI; and perceived barriers. Data analysis suggests that use of QI approach in palliative and hospice care enhances the quality of care provided for patients, and can help improve patient satisfaction. PRACTICAL IMPLICATIONS Because there is a paucity of research on implementation of QI strategies in hospice and palliative care settings, this research can have wide practical implications. This research can provide useful practical tips to leaders as they work on implementing QI projects in their organization. ORIGINALITY/VALUE This manuscript can be of value to leaders, administrators and academicians who are interested in applying QI principles to healthcare processes especially in palliative and hospice care settings. Ability to work with others, solid communication and involvement of employees from all levels can help in streamlining current systems of care.
{"title":"Quality improvement in hospice settings: perceptions of leaders.","authors":"Jitendra Singh, Brandi Sillerud, Marah Omar","doi":"10.1108/IJHCQA-04-2019-0084","DOIUrl":"https://doi.org/10.1108/IJHCQA-04-2019-0084","url":null,"abstract":"PURPOSE\u0000The purpose of this paper is to explore and examine attitudes and perceptions of leaders on application of quality improvement (QI) strategies in a palliative and hospice care organization.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000This study employed qualitative research methodology where leaders working in a hospice and palliative care organization were invited to participate in 45-60-min-long semi-structured interview. Interviews were recorded and transcribed verbatim. Qualitative content analysis was utilized to analyze the data collected during participant interviews.\u0000\u0000\u0000FINDINGS\u0000Seven leaders participated in the interviews. Five themes were developed from data analysis: patient-centered care; continuous QI; leadership involvement and commitment; communication as a foundation for QI; and perceived barriers. Data analysis suggests that use of QI approach in palliative and hospice care enhances the quality of care provided for patients, and can help improve patient satisfaction.\u0000\u0000\u0000PRACTICAL IMPLICATIONS\u0000Because there is a paucity of research on implementation of QI strategies in hospice and palliative care settings, this research can have wide practical implications. This research can provide useful practical tips to leaders as they work on implementing QI projects in their organization.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000This manuscript can be of value to leaders, administrators and academicians who are interested in applying QI principles to healthcare processes especially in palliative and hospice care settings. Ability to work with others, solid communication and involvement of employees from all levels can help in streamlining current systems of care.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-04-2019-0084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44781266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-12DOI: 10.1108/IJHCQA-09-2018-0233
Daniel Meehan, A. Balhareth, Madhumitha Gnanamoorthy, J. Burke, D. McNamara
PURPOSE The capacity available to deliver outpatient surgical services is outweighed by the demand. Although additional investment is sometimes needed, better aligning resources, increasing operational efficiency and considering new processes all have a role in improving delivering these services. The purpose of this paper is to evaluate the safety of a physician associate (PA) delivered virtual outpatient department (VOPD) consultation service that was established in a General and Colorectal Surgery Department at an Irish teaching hospital. DESIGN/METHODOLOGY/APPROACH A series of low-risk surgical patients were referred by senior surgeons to a PA delivered virtual clinic (VOPD). Medical records belonging to half the included patients were randomly selected for review by two doctors three months following discharge back to primary care to confirm appropriate standards of care and documentation and to audit any recorded adverse incidents or outcomes. FINDINGS In total, 191 patients had been reviewed by the PA in the VOPD with 159 discharged directly back to primary care. Among the 95 medical records that were reviewed by the NCHDs, there were no recorded adverse incidents after discharge. Medical record keeping was deficient in 1 out of 95 reviewed cases. PRACTICAL IMPLICATIONS Using a PA delivered VOPD consultation appears to have a role in following up patients who have undergone low-risk procedures irrespective of age or co-morbidity when selected appropriately. This may assist in reducing the demand on outpatient services by reducing unnecessary return visits, thereby increasing the capacity for new referrals. ORIGINALITY/VALUE While there are reported examples to date of virtual clinics, these relate to services delivered by registered medical practitioners. Here, the authors demonstrate the acceptability of this model of care in an Irish population as delivered by a PA.
{"title":"Efficacy of physician associate delivered virtual outpatient clinic.","authors":"Daniel Meehan, A. Balhareth, Madhumitha Gnanamoorthy, J. Burke, D. McNamara","doi":"10.1108/IJHCQA-09-2018-0233","DOIUrl":"https://doi.org/10.1108/IJHCQA-09-2018-0233","url":null,"abstract":"PURPOSE\u0000The capacity available to deliver outpatient surgical services is outweighed by the demand. Although additional investment is sometimes needed, better aligning resources, increasing operational efficiency and considering new processes all have a role in improving delivering these services. The purpose of this paper is to evaluate the safety of a physician associate (PA) delivered virtual outpatient department (VOPD) consultation service that was established in a General and Colorectal Surgery Department at an Irish teaching hospital.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000A series of low-risk surgical patients were referred by senior surgeons to a PA delivered virtual clinic (VOPD). Medical records belonging to half the included patients were randomly selected for review by two doctors three months following discharge back to primary care to confirm appropriate standards of care and documentation and to audit any recorded adverse incidents or outcomes.\u0000\u0000\u0000FINDINGS\u0000In total, 191 patients had been reviewed by the PA in the VOPD with 159 discharged directly back to primary care. Among the 95 medical records that were reviewed by the NCHDs, there were no recorded adverse incidents after discharge. Medical record keeping was deficient in 1 out of 95 reviewed cases.\u0000\u0000\u0000PRACTICAL IMPLICATIONS\u0000Using a PA delivered VOPD consultation appears to have a role in following up patients who have undergone low-risk procedures irrespective of age or co-morbidity when selected appropriately. This may assist in reducing the demand on outpatient services by reducing unnecessary return visits, thereby increasing the capacity for new referrals.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000While there are reported examples to date of virtual clinics, these relate to services delivered by registered medical practitioners. Here, the authors demonstrate the acceptability of this model of care in an Irish population as delivered by a PA.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-09-2018-0233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44885296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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