International journal of health care quality assurance incorporating Leadership in health services最新文献

Purpose: The purpose of this article is to estimate the relationship between acute care consumers' satisfaction with hospital foodservices, foodservice characteristics, demographic and contextual variables. DDESIGN/METHODOLOGY/APPROACH: The acute care hospital foodservice patient satisfaction questionnaire was administered to 2347 patients in Queensland, Australia from 1996-2001. Regression analysis was conducted to measure the influence of 21 foodservice attributes and seven contextual/demographic items on overall foodservice satisfaction. FFINDINGS: Foodservice satisfaction was strongly associated with variety, flavour, meat texture, temperature, meal taste, and menu staff (p < 0.01). Consumers aged 70 years or more rated their overall satisfaction significantly lower than younger consumers (p < 0.01), but no statistically significant differences in overall ratings existed for other contextual or demographic groups.

Research limitations/implications: This new foodservice instrument and the methods of analysis may be generalisable, but application is likely to be context-specific. Further applications of the instrument are required to produce greater confidence in its validity and reliability across different foodservice settings.

Practical implications: Global statements often used in health service satisfaction surveys (e.g. a single rating of "food quality") provide insufficient information to allow managers to adapt foodservices to suit consumers' preferences.

Originality/value: Detailed information of the kind produced here is required for the formulation of managerial and sectoral policies to improve the quality of health and consumer nutrition care. The findings are noteworthy and, as far as the literature review showed, no previously published study has produced this level of detail on consumer preferences across foodservice attributes or their relationship to overall foodservice satisfaction.

Purpose: To bring to the attention of health care professionals a framework and set of ideas for conceptualising a typical patient's experience and ways to respond out of a subjective inner quality called personal excellence.

Design/methodology/approach: This paper essays the viewpoint of the author on a selection of his experiences as a patient over 19 hospital admissions during his lifetime. He integrates these findings with his understanding of personal construct psychology, the psychology of change and the Greek philosophical concept of "arete" or excellence.

Findings: The paper offers a theory that patients experience three kinds of emotions or anguish when admitted to hospitals called threat, fear and anxiety. These three ways of interpreting an experience of change are based on the diagnostic constructs of transition from the psychology of personal constructs or the psychology of change. The paper asserts that a holistic approach is more likely to be delivered by health care staff with a calling than those who are merely doing a job or pursuing a career.

Originality/value: This paper is significant in that it draws on authentic experiences of a patient that are conceptualised into a coherent framework and linked to a well-accepted theory within the science of psychology. Further it offers an alternative to essays on quality that are confined to objective features only. It offers a way, via the philosophical concept of "arete" to tap into the subjective attitudinal dimension of quality that is often the lever or more often the impediment to enabling quality improvement programmes to be effective.

Purpose: When a mission statement is introduced to enhance the quality of health care management, it is vital to assess the actual impact. This article aims to consider the effect of introducing a single mission statement into an association of 18 not-for-profit hospitals by investigating the views of different groups of employees.

Design/methodology/approach: The paper explores the impact a mission statement has had by examining questionnaire responses from different groups of staff including the designers of the mission statement and those at the delivery point of services.

Findings: The study's outcomes indicate the value of examining the views of staff that are not in senior management. The evaluation of the mission statement's impact by senior managers was at variance with that of other staff.

Originality/value: The findings highlight the inadequacy of only examining senior management's opinions when considering the benefits of having introduced a mission statement into an organisation. In this study we identify those who originated or contributed to the mission statement in the first place. Once launched, a mission statement can have an impact throughout all staff, and that information needs to be captured in any assessment. This is consistent with the high rating normally given to a mission statement being an aid to motivating all staff. An important dimension of this study is the impact of a single mission statement throughout a group of dissimilar hospitals.

Purpose: The purpose of this pilot project is to highlight how food intake, nutrition status and quality of life could be improved for long stay residents of a community nursing unit and demonstrate that assisted feeding can be a more dignified experience for them.

Design/methodology/approach: A good dining experience involves not just the food, but also its presentation and the environment in which it is served. A review of the literature identified projects with similar objectives but differing approaches. A survey of residents informed the planning phase. A home style dining room was created with a more traditional ambiance and decoration. The pace of dining was leisurely. Personal choice and independence in eating were supported. A schedule of dining activities was delivered by two staff facilitators.

Findings: Eight dining sessions facilitated 23 residents over three months. "Minced" meals were not served, help was given to cut up meat and cues or prompts offered to maximize independence and demonstrate the value of this approach to care staff.

Originality/value: The project illustrated the advantages of stepping outside the purely clinical framework in addressing issues around poor food intake. It highlighted and how small but valuable changes can be implemented even where resources and space is limited. Involvement with the project allowed staff to observe and reflect on the benefits of enhancing the social and aesthetic aspects of dining.

Purpose: To examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Egypt and Jordan evaluate quality of health care similarly or differently.

Design/methodology/approach: A conceptual model including behavioural dimensions of patient-physician relationships and patient satisfaction has been developed. As the empirical research setting, this study concerns three hospitals in Egypt and Jordan. The survey instrument in a questionnaire form was designed to achieve the research objectives. A total of 48 items (attributes) of the newly developed five quality dimensions were identified to be the most relevant. A total of 224 complete and usable questionnaires were received from the in-patients.

Findings: Hospital C has above-average total and dimensional qualities and patients are the most satisfied in accordance with all dimensions of services. Hospitals A and B have under-average total qualities as the majority of patients are not satisfied with services. Comparing hospitals A and B, in the majority of dimensions (with the exception of Q5), the quality in hospital B is higher than in hospital A. Patients' satisfaction with different service quality dimensions is correlated with their willingness to recommend the hospital to others. A cure to improve the quality for health-care services can be an application of total relationship management and the 5Qs model together with customer orientation strategy.

Practical implications: The result can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health-care quality strategies.

Originality/value: In this research a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented. This study argues that a patient's satisfaction is a cumulative construct, summing satisfaction with five different qualities (5Qs) of the hospital: quality of object, processes, infrastructure, interaction, and atmosphere.

Purpose: Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue.

Design/methodology/approach: Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year.

Findings: The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency.

Originality/value: Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

Purpose: With the number of prescriptions rising nationally each year, it is surprising that Web-based technology is not fully embraced in the pharmacy industry as an aid to quality-assuring prescribing processes. Traditional prescription handling is done in a manual fashion with physicians hand-writing prescriptions for the patients during an office visit, giving the patient the responsibility of taking the prescription to a pharmacy or mailing the prescription to a mail order company for fulfillment. Electronic prescribing (e-prescribing) has the ability not only to streamline the prescription writing process, but also to reduce the number of errors that may be incurred with hand-written prescriptions. The purpose of this paper is to investigate these phenomena in the U.S.A.

Design/methodology/approach: A number of hypotheses were tested using principal-components analysis (PCA) and factor analyses. As a result, a total of 55 fully employed, professional and semi-professional service management and internet users, representing a college-educated and knowledge-based sample derived from the metropolitan section of Pittsburgh, was selected.

Findings: The six major constructs generated from the factor loadings in descending order of importance were: profit and risk factors, shipping and handling, saving, customer relationship management (CRM) and ethics, age, and awareness. The dependent variable chosen to be regressed against these major independent factor-based constructs was willingness to purchase prescriptions online. The overall relationship was found to be statistically significant (F = 2.971, p = 0.015) in predicting willingness to use e-prescribing options based on the various independent constructs. However, when testing the various standardized beta coefficients in the linear model, only the factor score-based construct CRM and ethics was found to significantly contribute to predicting the willingness to purchase prescriptions online (t = -3.074, p = 0.003).

Research limitations/implications: Although this study appears to represent the e-prescribing process in the U.S.A., the sample size and region studied are only one slice of the general population. Practical implications - Unfortunately, the adoption of e-prescribing has been difficult to attain owing to numerous barriers throughout the industry. Such acceptance barriers include lack of technology trust, associated system costs, and risk of un-securing patient health and medical information.

Originality/value: This article documents that increasing numbers of pharmacies today are building their IT-infrastructures to accept electronic prescriptions and it may soon be the preferred method for physicians to write prescriptions. It is with great anticipation that this technology will also enhance the prescription-writing abilities of prescribing physicians globally, giving them