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

Purpose: Improved quality and safety in drug use is a public health goal of major importance. In Sweden, local drug and therapeutics committees (DTCs) have adopted the task of working for safe and rational drug use. This study aimed to explore how chairs conceived the role of the DTCs, to explore how information officers conceived their own role, and to determine whether the respondents included patients in their answers.

Design/methodology/approach: Data were collected using questionnaires and the answers were analysed according to phenomenographic method to identify conceptions. "Patient awareness" was studied by content analysis.

Findings: In both groups the prescribers were the focus of attention, and only a few respondents mentioned patients. A variation of four conceptions was found among chairs and three among information officers. It would be beneficial if DTCs used this knowledge in their development.

Originality/value: The importance of "patient awareness" within DTCs must be further explored.

Purpose: Aims to establish the critical score and screening accuracy of the CAGE Questionnaire in three treatment settings--primary health care, walk-in (triage) clinic and the emergency room.

Design/methodology/approach: Taguchi methods are applied to three screens of the CAGE questionnaire.

Findings: Analysis of the sensitivity and specificity data of three CAGE screens by leveling factor (p'), signal-to-noise ratios (S/N, SS/N) and their dependent relation resulted in critical CAGE scores of 1, 1 and 2; and high screening accuracy levels of 98.44, 97.20 and 94.92 percent, respectively. The illustrated method yielded excellent (> or = 95 percent) screening accuracy values for primary health care, emergency room and walk-in clinic patients.

Originality/value: To reduce misclassification rates of alcohol abuse, screening systems should concentrate first on developing ways to standardize protocols. Further work is needed to establish high screening accuracy in other clinical settings, and particularly in those at risk of alcohol abuse in the general population.

Purpose: This purpose of this research was to develop and establish psychometric properties of scales measuring individual leadership for health promotion.

Design/methodology/approach: Scales to measure leadership in health promotion were drafted based on capacity assessment instruments developed by other provinces involved in the Canadian Heart Health Initiative (CHHI), and on the literature. Content validity was established through a series of focus groups and expert opinion appraisals and pilot testing. Psychometric analyses provided empirical evidence of the construct validity and reliability of the leadership scales in the baseline survey (n = 144) of the Alberta Heart Health Project.

Findings: Principal component analysis verified the construct of the leadership scales of personal work-related practices and satisfaction with work-related practices. Each of the theoretically a prior determined scales factored into two scales each for a total of four final scales. Scale alpha coefficients (Cronbach's alpha) ranged between 0.71 and 0.78, thus establishing good scale internal consistencies.

Research limitations/implications: Limitations include the relatively small sample size used in determining psychometric properties. In addition, further qualitative work would enhance understanding of the complexity of leadership in health organizations. These measures can be used by both researchers and practitioners for the assessment leadership for health promotion and to tailor interventions to increase leadership for health promotion in health organizations.

Originality/value: Establishing the psychometric properties and quality of leadership measures is an innovative step toward achieving capacity assessment instruments which facilitate evaluation of key relationships in developing health sector capacity for health promotion.

Purpose: To provide a picture of the access and use of health services by Aboriginal British Columbians living in both reserve and off-reserve communities.

Design/methodology/approach: This project represents a collaborative effort between the University of British Columbia and multiple Aboriginal community partners. Between June and November 2003, 267 face-to-face interviews were conducted with Aboriginal persons in seven rural community organizations across the province.

Findings: This paper reports on the results of a survey of 267 Aboriginal clients. It was found that a substantial number of survey respondents accessed health services provided by an Aboriginal person. Although most respondents felt that services were available, they also identified a number of concerns. These revolved around the need to travel for services, as well as a lack of access to more specialized services. A number of self-reported barriers to service were also identified. These findings have several policy implications and will be useful to service planners.

Research limitations/implications: Several questions for additional research were identified including the need to establish an inventory of service problem areas and investigating service and benefit policy and community awareness issues.

Originality/value: This paper provides policy makers with knowledge on the rural Aboriginal population, a population that has faced long standing problems in accessing appropriate health services.

Purpose: This article aims to highlight the importance of a complete and accurate medical record as it pertains to potential risk exposure in the outpatient physical therapy profession.

Design/methodology/approach: Basic charting rules, correction and alteration recommendations, documentation of telephone conversations, informed consent, exculpatory release forms and incident reports are discussed. Basic risk management strategies are reviewed that may reduce outpatient physical therapy practitioners' malpractice exposure.

Findings: The authors contend that quality and thorough documentation is as important as the quality of the care that is delivered to patients, since medical records are legal documents and serve as valuable evidence as to what transpired between patients and the healthcare providers.

Originality/value: Practical documentation strategies are described in a manner that will inform physical therapists of their legal obligations relating to patient care.

Purpose: The main aim of the study is to provide an empirical analysis of quality management practice among Malaysian Ministry of Health hospital employees, ranging from medical specialists to health attendants.

Design/methodology/approach: Self-administered questionnaires collected data and cluster sampling used to select hospitals, while stratified random sampling selected employee respondents. The research was limited to peninsular Malaysian public health care.

Findings: A total of 23 public hospitals participated in the survey, including the National Referral Centre, which is based in Hospital Kuala Lumpur. Eight quality management practices were identified in Malaysian public hospitals: continuous improvement, strategic planning, quality assurance, teamwork, leadership and management commitment, employee involvement and training, management by fact, and supplier partnership. Support for quality management was found to be lowest among the physicians.

Originality/value: The article fills a lacuna in the health care quality management empirical research literature. The main recommendation is for the Malaysian Ministry of Health to gamer physicians' support in its quality endeavours.

Purpose: The purpose of this paper is to discuss the need for the service line management approach in health care. Service line management is increasingly utilized by US health care organizations as an innovative method for providing the needed stimulus to increase viability and profitability for the ailing health care sector.

Design/methodology/approach: Using current literature, this study describes a paradigm shift from traditional health care management approaches to focus on the importance of a service line management approach with its specific emphasis on competencies of leaders.

Research limitations/implications: Four essential competencies--conceptual, participation, interpersonal, and leadership--must be gained by leaders to bring about organizational growth.

Practical implications: Health care managers must understand and practice these four key competencies to become effective health care leaders.

Originality/value: This paper provides useful information on the need for the service line management approach in health care.

Purpose: Aims to describe the growing importance of information and its governance within public services. The paper starts by considering how scandals in three national public health systems have focused public attention on information issues. It describes a theoretical framework for improving information governance, and its practical implementation as a management tool. The paper concludes with a discussion of the benefits of the approach, and the consequences of not improving information governance.

Design/methodology/approach: The framework brings together a number of existing methodological approaches, principally the maturity model approach to process improvement, first described in the Software Engineering Institute's capability maturity model, and the novice-to-expert approach to competency.

Findings: The paper describes how these approaches can be synthesised into an integrated framework to manage organisational change and how that can be used to improve information governance within public sector organisations.

Research implications: The paper compares the framework and its practical implementation with existing solutions, arguing that existing solutions provide only partial solutions.

Originality/value: Considers how plans for future service improvements will be restricted unless information governance issues can be addressed.