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Publisher: Emerald   (Total: 335 journals)

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Showing 1 - 200 of 335 Journals sorted alphabetically
A Life in the Day     Hybrid Journal   (Followers: 9)
Academia Revista Latinoamericana de Administración     Open Access   (Followers: 2, SJR: 0.144, h-index: 4)
Accounting Auditing & Accountability J.     Hybrid Journal   (Followers: 28)
Accounting Research J.     Hybrid Journal   (Followers: 25, SJR: 0.26, h-index: 7)
Accounting, Auditing and Accountability J.     Hybrid Journal   (Followers: 18, SJR: 0.88, h-index: 40)
Advances in Accounting Education     Hybrid Journal   (Followers: 13, SJR: 0.514, h-index: 5)
Advances in Appreciative Inquiry     Hybrid Journal   (SJR: 0.124, h-index: 5)
Advances in Autism     Hybrid Journal   (Followers: 3)
Advances in Dual Diagnosis     Hybrid Journal   (Followers: 47, SJR: 0.228, h-index: 2)
Advances in Gender Research     Full-text available via subscription   (Followers: 1, SJR: 0.229, h-index: 7)
Advances in Intl. Marketing     Full-text available via subscription   (Followers: 3, SJR: 0.123, h-index: 11)
Advances in Mental Health and Intellectual Disabilities     Hybrid Journal   (Followers: 58, SJR: 0.29, h-index: 5)
Advances in Mental Health and Learning Disabilities     Hybrid Journal   (Followers: 27)
African J. of Economic and Management Studies     Hybrid Journal   (Followers: 11, SJR: 0.125, h-index: 2)
Agricultural Finance Review     Hybrid Journal  
Aircraft Engineering and Aerospace Technology     Hybrid Journal   (Followers: 165, SJR: 0.391, h-index: 18)
American J. of Business     Hybrid Journal   (Followers: 15)
Annals in Social Responsibility     Full-text available via subscription  
Anti-Corrosion Methods and Materials     Hybrid Journal   (Followers: 8, SJR: 0.215, h-index: 25)
Arts and the Market     Hybrid Journal   (Followers: 9)
Asia Pacific J. of Marketing and Logistics     Hybrid Journal   (Followers: 7, SJR: 0.244, h-index: 15)
Asia-Pacific J. of Business Administration     Hybrid Journal   (Followers: 3, SJR: 0.182, h-index: 7)
Asian Association of Open Universities J.     Open Access  
Asian Education and Development Studies     Hybrid Journal   (Followers: 5)
Asian J. on Quality     Hybrid Journal   (Followers: 1)
Asian Review of Accounting     Hybrid Journal   (Followers: 2, SJR: 0.29, h-index: 7)
Aslib J. of Information Management     Hybrid Journal   (Followers: 21, SJR: 0.65, h-index: 29)
Aslib Proceedings     Hybrid Journal   (Followers: 228)
Assembly Automation     Hybrid Journal   (Followers: 2, SJR: 0.657, h-index: 26)
Baltic J. of Management     Hybrid Journal   (Followers: 3, SJR: 0.354, h-index: 14)
Benchmarking : An Intl. J.     Hybrid Journal   (Followers: 11, SJR: 0.556, h-index: 38)
British Food J.     Hybrid Journal   (Followers: 13, SJR: 0.329, h-index: 35)
Built Environment Project and Asset Management     Hybrid Journal   (Followers: 15, SJR: 0.232, h-index: 4)
Business Process Re-engineering & Management J.     Hybrid Journal   (Followers: 8, SJR: 0.614, h-index: 42)
Business Strategy Series     Hybrid Journal   (Followers: 6, SJR: 0.201, h-index: 6)
Career Development Intl.     Hybrid Journal   (Followers: 15, SJR: 0.686, h-index: 32)
China Agricultural Economic Review     Hybrid Journal   (Followers: 1, SJR: 0.238, h-index: 10)
China Finance Review Intl.     Hybrid Journal   (Followers: 5)
Chinese Management Studies     Hybrid Journal   (Followers: 4, SJR: 0.216, h-index: 12)
Circuit World     Hybrid Journal   (Followers: 15, SJR: 0.346, h-index: 17)
Collection Building     Hybrid Journal   (Followers: 12, SJR: 0.829, h-index: 10)
COMPEL: The Intl. J. for Computation and Mathematics in Electrical and Electronic Engineering     Hybrid Journal   (Followers: 3, SJR: 0.269, h-index: 22)
Competitiveness Review : An Intl. Business J. incorporating J. of Global Competitiveness     Hybrid Journal   (Followers: 5)
Construction Innovation: Information, Process, Management     Hybrid Journal   (Followers: 14, SJR: 0.508, h-index: 8)
Corporate Communications An Intl. J.     Hybrid Journal   (Followers: 5, SJR: 0.703, h-index: 26)
Corporate Governance Intl. J. of Business in Society     Hybrid Journal   (Followers: 7, SJR: 0.309, h-index: 29)
Critical Perspectives on Intl. Business     Hybrid Journal   (SJR: 0.32, h-index: 15)
Cross Cultural & Strategic Management     Hybrid Journal   (Followers: 7, SJR: 0.356, h-index: 13)
Development and Learning in Organizations     Hybrid Journal   (Followers: 7, SJR: 0.138, h-index: 8)
Digital Library Perspectives     Hybrid Journal   (Followers: 11)
Direct Marketing An Intl. J.     Hybrid Journal   (Followers: 6)
Disaster Prevention and Management     Hybrid Journal   (Followers: 20, SJR: 0.533, h-index: 32)
Drugs and Alcohol Today     Hybrid Journal   (Followers: 114, SJR: 0.241, h-index: 4)
Education + Training     Hybrid Journal   (Followers: 20, SJR: 0.532, h-index: 30)
Education, Business and Society : Contemporary Middle Eastern Issues     Hybrid Journal   (SJR: 0.141, h-index: 10)
Emerald Emerging Markets Case Studies     Hybrid Journal   (Followers: 1)
Employee Relations     Hybrid Journal   (Followers: 6, SJR: 0.435, h-index: 22)
Engineering Computations     Hybrid Journal   (Followers: 3, SJR: 0.387, h-index: 39)
Engineering, Construction and Architectural Management     Hybrid Journal   (Followers: 13, SJR: 0.541, h-index: 28)
Equal Opportunities Intl.     Hybrid Journal   (Followers: 3)
Equality, Diversity and Inclusion : An Intl. J.     Hybrid Journal   (Followers: 14, SJR: 0.239, h-index: 9)
EuroMed J. of Business     Hybrid Journal   (Followers: 1, SJR: 0.145, h-index: 9)
European Business Review     Hybrid Journal   (Followers: 7, SJR: 0.481, h-index: 21)
European J. of Innovation Management     Hybrid Journal   (Followers: 22, SJR: 0.596, h-index: 30)
European J. of Marketing     Hybrid Journal   (Followers: 20, SJR: 0.933, h-index: 55)
European J. of Training and Development     Hybrid Journal   (Followers: 9, SJR: 0.489, h-index: 23)
Evidence-based HRM     Hybrid Journal   (Followers: 6)
Facilities     Hybrid Journal   (Followers: 2, SJR: 0.371, h-index: 18)
Foresight     Hybrid Journal   (Followers: 10, SJR: 0.486, h-index: 20)
Gender in Management : An Intl. J.     Hybrid Journal   (Followers: 15, SJR: 0.359, h-index: 22)
Grey Systems : Theory and Application     Hybrid Journal   (Followers: 1)
Health Education     Hybrid Journal   (Followers: 3, SJR: 0.383, h-index: 17)
Higher Education, Skills and Work-based Learning     Hybrid Journal   (Followers: 41, SJR: 0.172, h-index: 4)
History of Education Review     Hybrid Journal   (Followers: 12, SJR: 0.141, h-index: 2)
Housing, Care and Support     Hybrid Journal   (Followers: 8, SJR: 0.174, h-index: 4)
Human Resource Management Intl. Digest     Hybrid Journal   (Followers: 15, SJR: 0.121, h-index: 6)
Humanomics     Hybrid Journal   (Followers: 2, SJR: 0.14, h-index: 4)
IMP J.     Hybrid Journal  
Indian Growth and Development Review     Hybrid Journal   (SJR: 0.163, h-index: 4)
Industrial and Commercial Training     Hybrid Journal   (Followers: 5, SJR: 0.217, h-index: 14)
Industrial Lubrication and Tribology     Hybrid Journal   (Followers: 6, SJR: 0.322, h-index: 19)
Industrial Management & Data Systems     Hybrid Journal   (Followers: 6, SJR: 0.63, h-index: 69)
Industrial Robot An Intl. J.     Hybrid Journal   (Followers: 3, SJR: 0.375, h-index: 32)
Info     Hybrid Journal   (Followers: 1, SJR: 0.25, h-index: 21)
Information and Computer Security     Hybrid Journal   (Followers: 22)
Information Technology & People     Hybrid Journal   (Followers: 45, SJR: 0.576, h-index: 28)
Interactive Technology and Smart Education     Hybrid Journal   (Followers: 14, SJR: 0.112, h-index: 1)
Interlending & Document Supply     Hybrid Journal   (Followers: 63, SJR: 0.48, h-index: 13)
Internet Research     Hybrid Journal   (Followers: 43, SJR: 1.746, h-index: 57)
Intl. J. for Lesson and Learning Studies     Hybrid Journal   (Followers: 1)
Intl. J. for Researcher Development     Hybrid Journal   (Followers: 9)
Intl. J. of Accounting and Information Management     Hybrid Journal   (Followers: 7, SJR: 0.304, h-index: 7)
Intl. J. of Bank Marketing     Hybrid Journal   (Followers: 7, SJR: 0.515, h-index: 38)
Intl. J. of Climate Change Strategies and Management     Hybrid Journal   (Followers: 14, SJR: 0.416, h-index: 7)
Intl. J. of Clothing Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.279, h-index: 25)
Intl. J. of Commerce and Management     Hybrid Journal   (Followers: 1)
Intl. J. of Conflict Management     Hybrid Journal   (Followers: 13, SJR: 0.763, h-index: 38)
Intl. J. of Contemporary Hospitality Management     Hybrid Journal   (Followers: 12, SJR: 1.329, h-index: 35)
Intl. J. of Culture Tourism and Hospitality Research     Hybrid Journal   (Followers: 15, SJR: 0.399, h-index: 5)
Intl. J. of Development Issues     Hybrid Journal   (Followers: 9)
Intl. J. of Disaster Resilience in the Built Environment     Hybrid Journal   (Followers: 7, SJR: 0.225, h-index: 7)
Intl. J. of Educational Management     Hybrid Journal   (Followers: 4, SJR: 0.424, h-index: 32)
Intl. J. of Emergency Services     Hybrid Journal   (Followers: 4, SJR: 0.179, h-index: 1)
Intl. J. of Emerging Markets     Hybrid Journal   (Followers: 3, SJR: 0.199, h-index: 5)
Intl. J. of Energy Sector Management     Hybrid Journal   (Followers: 3, SJR: 0.25, h-index: 12)
Intl. J. of Entrepreneurial Behaviour & Research     Hybrid Journal   (Followers: 5, SJR: 0.694, h-index: 28)
Intl. J. of Event and Festival Management     Hybrid Journal   (Followers: 6, SJR: 0.32, h-index: 8)
Intl. J. of Gender and Entrepreneurship     Hybrid Journal   (Followers: 5, SJR: 0.638, h-index: 6)
Intl. J. of Health Care Quality Assurance     Hybrid Journal   (Followers: 7, SJR: 0.352, h-index: 32)
Intl. J. of Health Governance     Hybrid Journal   (Followers: 26, SJR: 0.277, h-index: 15)
Intl. J. of Housing Markets and Analysis     Hybrid Journal   (Followers: 8, SJR: 0.201, h-index: 5)
Intl. J. of Human Rights in Healthcare     Hybrid Journal   (Followers: 9, SJR: 0.13, h-index: 2)
Intl. J. of Information and Learning Technology     Hybrid Journal   (Followers: 7)
Intl. J. of Innovation Science     Hybrid Journal   (Followers: 9, SJR: 0.173, h-index: 5)
Intl. J. of Intelligent Computing and Cybernetics     Hybrid Journal   (Followers: 1, SJR: 0.258, h-index: 10)
Intl. J. of Intelligent Unmanned Systems     Hybrid Journal   (Followers: 4, SJR: 0.145, h-index: 2)
Intl. J. of Islamic and Middle Eastern Finance and Management     Hybrid Journal   (Followers: 8)
Intl. J. of Law and Management     Hybrid Journal   (Followers: 2, SJR: 0.107, h-index: 2)
Intl. J. of Law in the Built Environment     Hybrid Journal   (Followers: 4, SJR: 0.111, h-index: 2)
Intl. J. of Leadership in Public Services     Hybrid Journal   (Followers: 11)
Intl. J. of Lean Six Sigma     Hybrid Journal   (Followers: 7, SJR: 0.562, h-index: 15)
Intl. J. of Logistics Management     Hybrid Journal   (Followers: 10, SJR: 0.998, h-index: 15)
Intl. J. of Managerial Finance     Hybrid Journal   (Followers: 6, SJR: 0.212, h-index: 11)
Intl. J. of Managing Projects in Business     Hybrid Journal   (Followers: 2)
Intl. J. of Manpower     Hybrid Journal   (Followers: 2, SJR: 0.354, h-index: 37)
Intl. J. of Mentoring and Coaching in Education     Hybrid Journal   (Followers: 19)
Intl. J. of Migration, Health and Social Care     Hybrid Journal   (Followers: 9, SJR: 0.261, h-index: 5)
Intl. J. of Numerical Methods for Heat & Fluid Flow     Hybrid Journal   (Followers: 10, SJR: 0.594, h-index: 32)
Intl. J. of Operations & Production Management     Hybrid Journal   (Followers: 16, SJR: 2.198, h-index: 94)
Intl. J. of Organizational Analysis     Hybrid Journal   (Followers: 3, SJR: 0.222, h-index: 11)
Intl. J. of Pervasive Computing and Communications     Hybrid Journal   (Followers: 3, SJR: 0.165, h-index: 9)
Intl. J. of Pharmaceutical and Healthcare Marketing     Hybrid Journal   (Followers: 4, SJR: 0.304, h-index: 12)
Intl. J. of Physical Distribution & Logistics Management     Hybrid Journal   (Followers: 10, SJR: 1.694, h-index: 66)
Intl. J. of Prisoner Health     Hybrid Journal   (Followers: 10, SJR: 0.254, h-index: 10)
Intl. J. of Productivity and Performance Management     Hybrid Journal   (Followers: 6, SJR: 0.785, h-index: 31)
Intl. J. of Public Sector Management     Hybrid Journal   (Followers: 20, SJR: 0.272, h-index: 37)
Intl. J. of Quality & Reliability Management     Hybrid Journal   (Followers: 8, SJR: 0.544, h-index: 63)
Intl. J. of Quality and Service Sciences     Hybrid Journal   (Followers: 2, SJR: 0.133, h-index: 1)
Intl. J. of Retail & Distribution Management     Hybrid Journal   (Followers: 6, SJR: 0.543, h-index: 36)
Intl. J. of Service Industry Management     Hybrid Journal   (Followers: 2)
Intl. J. of Social Economics     Hybrid Journal   (Followers: 9, SJR: 0.227, h-index: 25)
Intl. J. of Sociology and Social Policy     Hybrid Journal   (Followers: 48, SJR: 0.361, h-index: 5)
Intl. J. of Sports Marketing and Sponsorship     Hybrid Journal  
Intl. J. of Structural Integrity     Hybrid Journal   (Followers: 2, SJR: 0.325, h-index: 8)
Intl. J. of Sustainability in Higher Education     Hybrid Journal   (Followers: 12, SJR: 0.616, h-index: 29)
Intl. J. of Tourism Cities     Hybrid Journal   (Followers: 2)
Intl. J. of Web Information Systems     Hybrid Journal   (Followers: 5, SJR: 0.208, h-index: 13)
Intl. J. of Wine Business Research     Hybrid Journal   (Followers: 6, SJR: 0.196, h-index: 12)
Intl. J. of Workplace Health Management     Hybrid Journal   (Followers: 11, SJR: 0.358, h-index: 8)
Intl. Marketing Review     Hybrid Journal   (Followers: 14, SJR: 1.076, h-index: 57)
J. for Multicultural Education     Hybrid Journal   (Followers: 3, SJR: 0.124, h-index: 11)
J. of Accounting & Organizational Change     Hybrid Journal   (Followers: 5, SJR: 0.346, h-index: 7)
J. of Accounting in Emerging Economies     Hybrid Journal   (Followers: 7)
J. of Adult Protection, The     Hybrid Journal   (Followers: 15, SJR: 0.291, h-index: 7)
J. of Advances in Management Research     Hybrid Journal   (Followers: 2)
J. of Aggression, Conflict and Peace Research     Hybrid Journal   (Followers: 46, SJR: 0.177, h-index: 9)
J. of Agribusiness in Developing and Emerging Economies     Hybrid Journal   (Followers: 1)
J. of Applied Accounting Research     Hybrid Journal   (Followers: 14, SJR: 0.22, h-index: 5)
J. of Applied Research in Higher Education     Hybrid Journal   (Followers: 48)
J. of Asia Business Studies     Hybrid Journal   (Followers: 3, SJR: 0.115, h-index: 1)
J. of Assistive Technologies     Hybrid Journal   (Followers: 18, SJR: 0.215, h-index: 6)
J. of Business & Industrial Marketing     Hybrid Journal   (Followers: 8, SJR: 0.664, h-index: 48)
J. of Business Strategy     Hybrid Journal   (Followers: 12, SJR: 0.381, h-index: 17)
J. of Centrum Cathedra     Open Access  
J. of Children's Services     Hybrid Journal   (Followers: 5, SJR: 0.167, h-index: 9)
J. of Chinese Economic and Foreign Trade Studies     Hybrid Journal   (Followers: 1, SJR: 0.188, h-index: 4)
J. of Chinese Entrepreneurship     Hybrid Journal   (Followers: 3)
J. of Chinese Human Resource Management     Hybrid Journal   (Followers: 6, SJR: 0.112, h-index: 3)
J. of Communication Management     Hybrid Journal   (Followers: 7, SJR: 0.735, h-index: 6)
J. of Consumer Marketing     Hybrid Journal   (Followers: 17, SJR: 0.613, h-index: 62)
J. of Corporate Real Estate     Hybrid Journal   (Followers: 2, SJR: 0.633, h-index: 5)
J. of Criminal Psychology     Hybrid Journal   (Followers: 112, SJR: 0.13, h-index: 1)
J. of Criminological Research, Policy and Practice     Hybrid Journal   (Followers: 52)
J. of Cultural Heritage Management and Sustainable Development     Hybrid Journal   (Followers: 9, SJR: 0.109, h-index: 5)
J. of Documentation     Hybrid Journal   (Followers: 180, SJR: 0.936, h-index: 50)
J. of Economic and Administrative Sciences     Hybrid Journal   (Followers: 3)
J. of Economic Studies     Hybrid Journal   (Followers: 10, SJR: 0.498, h-index: 26)
J. of Educational Administration     Hybrid Journal   (Followers: 5, SJR: 0.848, h-index: 36)
J. of Engineering, Design and Technology     Hybrid Journal   (Followers: 17, SJR: 0.173, h-index: 10)
J. of Enterprise Information Management     Hybrid Journal   (Followers: 4, SJR: 0.433, h-index: 38)
J. of Enterprising Communities People and Places in the Global Economy     Hybrid Journal   (Followers: 1, SJR: 0.212, h-index: 8)
J. of Entrepreneurship and Public Policy     Hybrid Journal   (Followers: 9)
J. of European Industrial Training     Hybrid Journal   (Followers: 2)
J. of European Real Estate Research     Hybrid Journal   (Followers: 3, SJR: 0.52, h-index: 7)
J. of Facilities Management     Hybrid Journal   (Followers: 3)
J. of Family Business Management     Hybrid Journal   (Followers: 5)
J. of Fashion Marketing and Management     Hybrid Journal   (Followers: 12, SJR: 0.529, h-index: 30)
J. of Financial Crime     Hybrid Journal   (Followers: 336, SJR: 0.158, h-index: 5)
J. of Financial Economic Policy     Hybrid Journal  
J. of Financial Management of Property and Construction     Hybrid Journal   (Followers: 8, SJR: 0.234, h-index: 1)
J. of Financial Regulation and Compliance     Hybrid Journal   (Followers: 8)
J. of Financial Reporting and Accounting     Hybrid Journal   (Followers: 11)
J. of Forensic Practice     Hybrid Journal   (Followers: 41, SJR: 0.225, h-index: 8)
J. of Global Mobility     Hybrid Journal   (Followers: 1)
J. of Global Responsibility     Hybrid Journal   (Followers: 4)
J. of Health Organisation and Management     Hybrid Journal   (Followers: 19, SJR: 0.67, h-index: 27)
J. of Historical Research in Marketing     Hybrid Journal   (Followers: 3, SJR: 0.376, h-index: 8)
J. of Hospitality and Tourism Technology     Hybrid Journal   (Followers: 4, SJR: 0.672, h-index: 10)
J. of Human Resource Costing & Accounting     Hybrid Journal   (Followers: 5)
J. of Humanitarian Logistics and Supply Chain Management     Hybrid Journal   (Followers: 12)

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Journal Cover International Journal of Health Care Quality Assurance
  [SJR: 0.352]   [H-I: 32]   [7 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0952-6862
   Published by Emerald Homepage  [335 journals]
  • Healthcare quality improvement work: a professional employee perspective
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose To describe and analyse conditions that influence how employees engage in healthcare quality improvement (QI) work. Design/methodology/approach Qualitative case study based on interviews (n=27) and observations (n=10). Findings The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute. Practical implications Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed. Originality/value Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:32Z
      DOI: 10.1108/IJHCQA-02-2016-0013
       
  • Volume-outcome relationship for colorectal cancer in primary care: a
           prospective cohort study
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known whether such volume-outcome relationship exist in primary care settings. This study examined general practitioner (GP) CRC-specific caseload for possible associations with referral pathways, disease stage and CRC patients’ overall survival (OS). Design/methodology/approach Retrospectively analysing a prospectively maintained CRC database for 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services. Findings Of 1,145 CRC patients, 937 (81.8%) were diagnosed as symptomatic cancers. Two hundred and ten GPs from 44 practices were stratified according to their CRC caseload over the study period into low-volume (LV, 1-4); medium-volume (MV, 5-7); and high-volume (HV, 8-21 cases). Emergency presentation (LV:49/287 [17.1%]; MV:75/264 [28.4%]; HV:105/386 [27.2%]; p=0.007) and advanced disease at presentation (LV:84/287 [29.3%]; MV:94/264[35.6%]; HV:144/386 [37.3%]; p=0.034) was more common amongst HV GPs. Three-year mortality risk was significantly higher for HV GPs (MV: Hazard Ratio HR 1.185 [confidence interval CI=0.897-1.566], p=0.231, and HV: HR 1.366 [CI=1.061-1.759], p=0.016), but adjustment for emergency presentation and advanced disease largely accounted for this difference. There was some evidence that HV GPs used elective cancer pathways less frequently (LV:166/287 [57.8%]; MV:130/264 [49.2%]; HV:182/386 [47.2%]; p=0.007) and more selectively (CRC/referrals: LV:166/2,743[6.1%]; MV:130/2,321 [5.6%]; HV:182/2,508 [7.3%]; p=0.048). Originality/value Higher GP CRC caseload in primary care may be associated with advanced disease and poorer survival; more work is required to determine the reasons and to develop targeted intervention at local level to improve elective referral rates.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:26Z
      DOI: 10.1108/IJHCQA-01-2016-0001
       
  • Improving ICU risk management and patient safety.
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose This study aimed to: (i) develop and validate an assessment method for the International Electrotechnical Commission (IEC) 80001-1 (IEC, 2010) standard (the Standard); (ii) raise awareness; (iii) improve medical IT-network project risk management processes; and (iv) improve intensive care unit (ICU) patient safety. Design/methodology/approach An assessment method was developed and piloted. A healthcare IT-network project was undertaken using a semi-structured group interview with risk management stakeholders. Participants provided feedback via a questionnaire. Descriptive statistics and thematic analysis was undertaken. Findings The assessment method was validated as fit for purpose. Participants agreed (63%, n = 7) that assessment questions were clear and easy to understand, and participants agreed (82%, n = 9) that the assessment method was appropriate. Participant’s knowledge of the Standard increased. Non-compliance was identified. Medical IT-network project strengths, weaknesses, opportunities and threats in the risk management processes were identified. Practical implications The study raised awareness of the Standard and enhanced risk management processes that led to improved patient safety. Study participants confirmed they would use the assessment method in future projects. Originality/value Findings add to knowledge relating to IEC 80001-1 implementation.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:19Z
      DOI: 10.1108/IJHCQA-05-2016-0074
       
  • Using flow diagrams to improve tobacco cessation programs
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose To understand how the Wyoming Quit Tobacco Program (WQTP) is used by its subscribers and to better understand how WQTP might be connected to WQTP outcomes. Design/methodology/approach Provider intake and program use data corresponding to the May 2010 to March 2012 enrollment period (N=6,168) were used. All program flows were constructed using frequencies and crosstabs, based on an initial theoretical model prepared by the program provider. Data were adjusted based on analysis that explored all possible uses beyond those specified by the provider’s theoretical model.. Findings Although we could replicate the structure - the theoretical model constructed by the provider - we were not able to replicate all relationships between program components. We also found that most individuals signed up and used web-based services. Only a few individuals finished their treatment regimens in the way they were designed to be used by the program. Originality/value This is the first case study to use a program flow method to investigate an entire comprehensive tobacco cessation program structure and delivery.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:12Z
      DOI: 10.1108/IJHCQA-05-2016-0072
       
  • Developing a training package - lessons in partnership-working between
           health professionals, service users and carers.
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose This article outlines a training package for service users and carers with an interest in NHS health and social care research. It demonstrates how training package developers used their unique experience and expertise as service users and carers to inform their work. Design/methodology/approach Service users and carers, NHS Research and Development Forum working group members, supported by health professionals, identified a need for research training that was tailored to other service user and carer needs. After reviewing existing provision and drawing on their training and support experience, they developed a training package. Sessions from the training package were piloted, which evaluated positively. In trying to achieve programme accreditation and training roll-out beyond the pilots, the group encountered several challenges. Findings The training package development group formed good working relationships and a co-production model that proved sustainable. However, challenges were difficult to overcome owing to external factors and financial constraints. Practical implications Lessons learnt by the team are useful for other service user and carer groups working with health service professionals. Training for service users and carers should be designed to meet their needs; quality and consistency are also important. The relationships between service user and carer groups, and professionals are important to understanding joint working. Recognising and addressing challenges at the outset can help develop strategies to overcome challenges and ensure project success. Originality/value The training package was developed by service users and carers for other service users and carers. Their unique health research experience underpinned the group’s values and training development.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:06Z
      DOI: 10.1108/IJHCQA-06-2016-0084
       
  • Continuous improvement projects: an authorship bibliometric analysis
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose This article describes the current research on hospital continuous improvement projects (CIPs) from an author characteristic perspective. This work addresses the following questions: Who are the predominant research authors on hospital CIPs? To what extent are there research communities collaborating in distinct research groups? How internationalized has hospital CIPs research become with respect to author location? Design/methodology/approach A systematic literature review was conducted, identifying 302 academic publications related to hospital CIPs. Publications were analyzed using: author; quantity; diversity; collaboration; and impact. Findings Hospital CIPs are increasingly attracting new scholars each year. Based on our analysis, authors publishing in this area can be described as a relatively new international community given the countries represented. Originality/value This article describes current hospital CIP research by assessing author characteristics. Future work should examine additional attributes to characterize maturity, such as how new knowledge is being created and to what extent new knowledge is being disseminated to practitioners.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:12:59Z
      DOI: 10.1108/IJHCQA-07-2016-0105
       
  • Service quality, patient satisfaction and loyalty in the Bangladesh
           healthcare sector
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose This study investigates service quality, patient satisfaction and loyalty in Bangladesh’s healthcare sector. It identifies healthcare quality conformance, patient satisfaction and loyalty based on demographics such as gender, age and marital status. It examines the differences between public and private healthcare sectors regarding service quality, patient satisfaction and loyalty. Design/methodology/approach We distributed 450 self-administered questionnaires to hospital patients resulting in 204 useful responses (45.3% response rate). Data were analysed based on reliability analysis, exploratory factor analysis (EFA), independent samples t-tests, ANOVA and discriminant analysis using SPSS version 23. Findings Findings indicate that single patients perceive tangibles, reliability, empathy and loyalty higher compared to married patients. Young patients (<=20 years) have a higher tangibles, empathy and loyalty scores compared to other age groups. We observed that private hospital patients perceive healthcare service quality performance higher compared to patients in public hospitals. Research limitations/implications We focused solely on the Bangladesh health sector, so the results might not be applicable to other countries. Originality/value Our findings provide guidelines for enhancing service quality, patient satisfaction and loyalty in the Bangladesh healthcare sector and other countries.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:12:53Z
      DOI: 10.1108/IJHCQA-01-2017-0004
       
  • Quality improvement in physiotherapy services
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose To evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes. Design/methodology/approach Multiple case study: information was gathered from eight physiotherapy teams over 24 months. Findings The process change was successfully implemented in six teams. It had a clear, positive effect on service quality provided to patients in three teams. Whilst quality also improved in three other teams, other issues make changes difficult to assess. Factors that enabled process change to be effective are suggested. Research limitations/implications Findings are based on results achieved by only eight English teams. Practical implications This process change may be appropriate for other teams providing therapy services if attention is paid to potential enabling factors, and a learning approach is adopted to designing and introducing the change. Originality/value To the best of our knowledge, no other longitudinal process change study in therapy services has been published.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:12:45Z
      DOI: 10.1108/IJHCQA-05-2016-0066
       
  • What is the function of a journal?
    • First page: 302
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-25T12:05:35Z
      DOI: 10.1108/IJHCQA-01-2017-0015
       
  • Standardized ICU to OR handoff increases communication without delaying
           surgery
    • First page: 304
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.
      Purpose No studies have examined preoperative handoffs from the ICU to OR. Given the risk of patient harm, we developed a standardized ICU to OR handoff using a previously published handoff model. Primary aims were to determine whether a standardized ICU to OR handoff process would increase the number of team handoffs and improve patient transport readiness. Design/methodology/approach The intervention consisted of designing a multidisciplinary, face-to-face handoff between sending ICU providers and receiving anesthesiologist and OR nurse, verbally presented in the I-PASS format. Anticipatory calls from the OR nurse to the ICU nurse were made to prepare the patient for transport. Data collected included frequency of handoff, patient transport readiness, turnover time between OR cases, and anesthesia provider satisfaction. Findings Fifty-seven audits were completed. The frequency of handoffs increased from 25% to 86% (p<.0001) and the frequency of patient readiness increased from 61% to 97% (p=.001). There were no changes in timeliness of first start cases and no significant change in turnover times between cases. Anesthesia provider satisfaction scores increased significantly. Practical implications A standardized, team based ICU to OR handoff increased the frequency of face-to-face handoffs, patient readiness and anesthesia provider satisfaction within increasing turnover between cases. Originality/value Although studies have identified the transition of patients from the ICU to the OR as a period of increased harm, the development of a preoperative ICU to OR handoff had not been described. This intervention may be used in other institutions to design ICU to OR transitions of care.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-25T12:05:36Z
      DOI: 10.1108/IJHCQA-02-2016-0015
       
  • A decade of health assessments in Appalachia—Hospital Quality Alliance
           (HQA) data from Roane Medical Center, 2005 vs. 2015
    • First page: 312
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.
      Purpose To describe standardized clinical process of care and quality performance metrics at Roane Medical Center (RMC) and compare data from 2005 to 2015. Design/methodology/approach Information was extracted from a nationwide sample of short-term acute care hospitals using the Hospital Quality Alliance (HQA) database, evaluating multiple parameters measured at RMC. HQA data from RMC were matched against state and national benchmarks; findings were also compared with similar reports from the same facility in 2005. Findings Information collected by HQA expanded substantially in ten years and queried different parameters over time, thus exact comparisons between 2005 vs. 2015 cannot be easily calculated. Nevertheless, analysis of process of care data for 2015 placed RMC at or above state- and national-average performance in 64.9% (24/37) and 56.5% (26/46) categories, respectively. RMC registered superior process of care scores in heart failure care, pneumonia care, thrombus prevention & care, as well as stroke care. While RMC continues to perform favorably against state and national reference groups, the differences between RMC vs. state and RMC vs. national averages using current reporting metrics were both statistically smaller in 2015 compared to 2005 (p<0.05). Research limitations/implications Perhaps the most significant interval health event for the RMC service area since 2005 was a coal ash spill at the nearby Tennessee Valley Authority facility in December 2008. Although reports on environmental and health effects following one of the largest domestic industrial toxin releases reached a number of important conclusions, the consequences for RMC in terms of potential added clinical burden on emergency services and impact on chronic health conditions have not been specifically studied. This could explain data reported on emergency department services at RMC but additional research will be needed to establish causality. Practical implications While tracking of care processes at all U.S. hospitals will be facilitated by refinements in HQA tools, longitudinal evaluations for any specific unit will be more meaningful if the assessment instrument undergoes limited change over time. Originality/value As a follow-up study to track potential changes which have been registered in the decade 2005-2015, this is the first report to provide original, longitudinal analysis on RMC, an institution operating in a rural and underserved area.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-25T12:05:30Z
      DOI: 10.1108/IJHCQA-05-2016-0064
       
  • Impact of Centor scores on determining antibiotic prescribing in children
    • First page: 319
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.
      Purpose To establish the effect of incorporating Centor scoring into antibiotic prescribing in primary care in London, UK, before and after the introduction of an educational package and prescribing software tool. Design/methodology/approach A quality improvement project with analysis of all sore throat presentations in patients 3-14 years, in two phases. Phase 1 (retrospective): January 1st-December 31st 2013, followed by an intervention (software tool/education package). Phase 2 (prospective): March 1st 2014–February 28th 2015. Findings In the initial analysis 162/202 (80.2%) patients were prescribed antibiotics. Following the educational/software intervention, 191/231 (82.7%) patients were prescribed antibiotics (p=0.56, Chi-squared test). The mean Centor score decreased significantly following the education/software intervention (3.1 vs 2.7, p<0.001, Chi-squared test). 100% of patients with tonsillar exudate were prescribed antibiotics in both phases. The apparent order of importance for predictive signs/symptoms given by the prescribers in both phases of the study was tonsillar exudate > lymphadenopathy > fever > absence of cough. Originality/value This is the first time a differential importance given by practitioners on individual Centor criteria has been described. With a low probability of bacterial infection, children with exudate or anterior lymphadenopathy almost always received antibiotics. This is interesting, since studies have previously found that the presence of tonsillar exudate had no significant association with culture-confirmed streptococcal tonsillitis.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-27T12:26:53Z
      DOI: 10.1108/IJHCQA-08-2016-0114
       
  • Value-based HR practices, i-deals and clinical error control with CSR as a
           moderator
    • First page: 327
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.
      Purpose Notwithstanding the rising magnitude of system factors in patient safety improvement, “human factors” such as idiosyncratic deals (i-deals) which also contribute to the adjustment of system deficiencies should not be neglected. The research aims are therefore to investigate the role of value-based HR practices in catalyzing i-deals, which then influence clinical error control. The research further examines the moderating role of corporate social responsibility (CSR) on the effect of value-based HR practices on i-deals. Design/methodology/approach The data was collected from middle level clinicians from hospitals in Vietnam context. Findings The research results confirmed the effect chain from value-based HR practices through i-deals to clinical error control with CSR as a moderator. Originality/value The HRM literature is expanded through enlisting i-deals and clinical error control as the outcomes of HR practices.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-25T12:05:33Z
      DOI: 10.1108/IJHCQA-05-2016-0071
       
  • Waste in health information systems: a systematic review
    • First page: 341
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.
      Purpose To discuss a systematic review on waste identification related to Health Information Systems in Lean Transformation Design/methodology/approach A systematic review was conducted on nineteen studies to evaluate Lean transformation and tools used to remove waste related to HIS in clinical settings. Findings Ten waste categories were identified, along with their relationships and applications of Lean tool types related to HIS. Different Lean tools were used at the early and final stages of Lean transformation; the tool selection depended on the waste characteristic. Nine studies reported a positive impact from Lean transformation in improving daily work processes. The selection of Lean tools should be made based on the timing, purpose and characteristics of waste to be removed. Research limitations/implications Overview of waste and its category within HIS and its analysis from socio-technical perspectives enabled the identification of its root cause in a holistic and rigorous manner. Practical implications Understanding waste types, their root cause and review of Lean tools could subsequently lead to the identification of mitigation approach to prevent future error occurrence. Originality/value Specific waste models for HIS settings are yet to be developed. Hence, the identification of the waste categories could guide future implementation of Lean transformations in HIS settings.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-25T12:05:34Z
      DOI: 10.1108/IJHCQA-06-2016-0082
       
  • Implementation strategies for guidelines at ICUs: a systematic review
    • First page: 358
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.
      Purpose To critically analyse empirical studies related to the implementation strategies for clinical practice guidelines in intensive care units. Design/methodology/approach A systematic review with a narrative synthesis adapted from Popay et al.’s method for a narrative synthesis was conducted. A search using CINAHL, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials, MEDLINE via PUBMED and grey literature was conducted in 2014 and updated in 2016 (August). After reading the abstracts, titles and full-text articles, eleven (N=11) research studies met the inclusion criteria. Findings After critical appraisal, using the Joana Briggs Critical Appraisal Tools, eight RCTs conducted in adult and neonatal intensive care units using implementation strategies remained. Popay et al.’s method for narrative synthesis was adapted and used to analyse and synthesise the data and formulate concluding statements. Included studies found that multi-faceted strategies appear to be more effective that single strategies. Strategies mostly used were printed educational materials; information/ sessions; audit, feedback, use of champion leaders, educational outreach visits, and computer or internet usage. Practical training; monitoring visits and grand rounds were less used. Practical implications Findings can be used by clinicians to implement the best combination of multi-faceted implementation strategies in the intensive care units in order to enhance the optimal use of clinical practice guidelines. Originality/value No systematic review was previously done on the implementation strategies that should be used best for optimal clinical practice guideline implementation in the intensive care unit.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-25T12:05:30Z
      DOI: 10.1108/IJHCQA-08-2016-0119
       
  • Reducing patients’ falls rate in an Academic Medical Center (AMC) using
           six sigma ‘DMAIC’ approach
    • First page: 373
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.
      Purpose The purpose of this study is to evaluate the impact of adopting the six sigma ‘DMAIC’ approach in reducing patients fall rate in an AMC, Saudi Arabia. Design/methodology/approach A prospective study design was adopted and this study was conducted at King Fahd Hospital of the University (KFHU) during the year 2014. Based on the historical data of the patients’ falls reported at KFHU during the year 2013, the goal was fixed to reduce the falls rate from 7.18 to < 3 (over 60% reduction) by the end of December 2014. This study was conducted through the five phases of ‘DMAIC’ approach using various quality tools. Three time periods were identified viz. (i) Pre intervention phase; (ii) Intervention phase and; (iii) Post intervention phase. Appropriate strategies were identified through the process of brainstorming and were implemented to study the potential causes leading to the occurrence of falls. Findings The pre intervention falls rate was reported as 6.57 whereas the post intervention falls rate was measured as 1.91 (demonstrating a 70.93% reduction) after the implementation of improvement strategies. The adherence rate towards the practice of carrying falls risk assessment and hourly rounding was observed to be high where 88% of nurses are regularly practicing it. A control plan was also executed to sustain the improvements obtained. Originality/value The Six sigma ‘DMAIC’ approach improves the processes related to the prevention of falls. A greater reduction in patients falls rate (over 70%) was observed after the implementation of the improvement strategy.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-25T12:05:32Z
      DOI: 10.1108/IJHCQA-03-2016-0030
       
  • Exploring the advantages of using social network sites (SNSs) in dental
           medicine organizations
    • First page: 385
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.
      Purpose This study aims to deepen and contribute to knowledge of the use of Social Network Sites (SNSs) in organizations, and more precisely, identify the advantages. Design/methodology/approach To reach this objective, a cross-section study was adopted based on application of a questionnaire, the final sample consisting of 78 dental medicine organizations in Portugal. Findings The results obtained lead to the conclusion that a great number of the organizations studied are connected to SNSs, particularly Facebook. The advantages associated with marketing tools and breaking down barriers between the organization and the world are those highlighted most in this study. According to the empirical evidence obtained, organizations are also found to use these sites for other purposes, such as communicating with clients/patients and receiving feedback on the service provided to increase satisfaction and improve the quality of services. Practical implications According to the empirical evidence obtained, organizations are found to use these sites for other purposes, such as communicating with clients/patients and receiving feedback on the service provided to increase satisfaction and improve the quality of services. Originality/value Our study contributes to advancing theory in the field of internet research strategic. More precisely, this study is associated with the creation of a theoretical framework that shows the advantages of using SNSs in an innovative context: Dental Medicine Organizations. A categorization of these advantages and some implications for theory and practice are also some contributions of this study.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-25T12:05:31Z
      DOI: 10.1108/IJHCQA-09-2016-0142
       
  • Hospital staff to death ratios – a sound performance measure?
    • First page: 206
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:34Z
      DOI: 10.1108/IJHCQA-01-2017-0011
       
  • Failure mode and effect analysis: improving intensive care unit risk
           management processes
    • First page: 208
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. This study aimed to apply FMEA technique to examine the hazards associated with the process of service delivery in Intensive Care Unit of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 to December 2014. By forming a FMEA team, all potential hazards associated with ICU services - their frequency and severity - were identified. Then risk priority number (RPN) was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in Intensive Care Units proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:39Z
      DOI: 10.1108/IJHCQA-04-2016-0053
       
  • Embedding learning from adverse incidents: a UK case study
    • First page: 216
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose This paper reports on a regionally based UK study uncovering what has worked well in learning from adverse incidents in hospitals. It reviews the incident investigation methodology used, identifying strengths or weaknesses and explores the use of a database as a tool to embed learning Design/methodology/approach Documentary examination was conducted of all adverse incidents reported between 1st June 2011 and 30th June 2012 by three UK National Health Service hospitals. One Root Cause Analysis report per adverse incident for each individual hospital was sent an advisory group for review. Using terms of reference supplied, the advisory group feedback was analysed using an inductive thematic approach. The emergent themes led to the generation of questions which informed seven in-depth semi-structured interviews Findings ‘Time’ and ‘Work Pressures’ were identified as barriers to using adverse incident investigations as tools for quality enhancement. Methodologically, a weakness in approach was that no criteria influenced the techniques which were used in investigating adverse incidents. Regarding the sharing of learning, the use of a database as a tool to embed learning across the region was not supported Practical implications Softer intelligence from adverse incident investigations could be usefully shared between hospitals through a regional forum Originality/value The use of a database as a tool to facilitate the sharing of learning from adverse incidents across the health economy is not supported
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:26Z
      DOI: 10.1108/IJHCQA-05-2016-0060
       
  • Improving throughput in a youth mental health service
    • First page: 224
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose The discrepancy between increasing demand and limited resources in public mental health is putting pressure on services to continuously review their practices and develop innovative models of care that redress this discrepancy. To ensure the service models continue to meet the needs of all stakeholders, Children and Young People’s Mental Health (CYPMH) conducts regular reviews of its service models. Accordingly, the Youth Mental Health (YMH) model at CYPMH has evolved significantly over time in response to the needs of young people and service demand. This paper outlines the findings of a recent review of the YMH service, and the subsequent changes to the service model. Design/methodology/approach Informed by a participatory action philosophy, feedback was sought from staff on the service model through a range of methods including a questionnaire, staff consultations through a working party and interviews. This feedback was used to redesign the model, which was then evaluated again. Findings Staff identified a number of challenges with the service model and a range of service improvement solutions. The key issues included exceedingly high caseloads, workplace tensions, and fragmentation of the client journey. This paper outlines the primary solution to these key concerns, namely the introduction of brief intervention as the entry point to the service. Originality/value Brief intervention approaches provide a solution to overly high caseloads as the direct and focussed approach of brief intervention generally reduces the number of sessions people need. Brief intervention is an important addition to other treatment options and should be seen as a valid component of the continuum of mental health care.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:25Z
      DOI: 10.1108/IJHCQA-05-2016-0062
       
  • Nurse staffing levels and outcomes - mining the UK national datasets for
           insight.
    • First page: 235
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose Purpose of this paper Despite the generation of mass data by the nursing workforce, determining the impact of the contribution to patient safety remains challenging. Several cross sectional studies have indicated a relationship between staffing and safety. The aim of this paper was to uncover possible associations and explore if a deeper understanding of relationships between staffing and other factors such as safety could be revealed within nationally routinely collected datasets. Design/methodology/approach Methods Two longitudinal routinely collected datasets consisting of thirty years of UK nurse staffing data and seven years of National Health Service benchmark data such as survey results, safety and other indicators were used. A correlation matrix was built and a linear correlation operation was applied (Pearson Product moment Correlation coefficient). Findings Findings A number of associations were revealed within both the UK Staffing dataset and the NHS benchmarking dataset. However the challenges of using these datasets soon became apparent. Practical implications Practical implications Staff time and effort is required to collect these data. The limitations of these datasets include inconsistent data collection & quality. The mode of data collection and the itemset collected should be reviewed to generate a dataset with robust clinical application. Originality/value What this paper adds This paper revealed that relationships are likely to be complex & non-linear however the main contribution of the paper is the identification of the limitations of routinely collected data. Much time and effort is expended collecting this data however its validity, usefulness & method of routine national data collection appear to require re-examination.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:29Z
      DOI: 10.1108/IJHCQA-08-2016-0118
       
  • Healthcare seeking behaviour among Chinese elderly
    • First page: 248
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose The Chinese population is rapidly ageing before they are rich. This study aimed to describe healthcare seeking behaviour and the critical factors associated with healthcare seeking behaviour. Design/methodology/approach Using a purposive sampling method, we recruited 44 adults age 60 years or older from three provinces, representing the developed (Shanghai), undeveloped (Ningxia) regions and the regions between (Hubei). From July to September 2008, using a semi-structured guide, we interviewed participants in focus group discussions. Findings The healthcare needs for chronic and catastrophic diseases were high; however, the healthcare demands were low and healthcare utilizations were even lower owing to the limited accessibility to healthcare services, particularly, in underdeveloped rural areas. “Too expensive to see a doctor” was a prime complaint, explaining substantial discrepancies between healthcare needs, demands and use. Care seeking behaviour varied, depending on insurance availability, perceived performance - particularly hospital services and prescription medications. Participants consistently rated increasing the healthcare accessibility as a high priority, including offering financial aid, and improving service convenience. Improving social security fairness was as the first on the elderly’s wish list. Originality/value Healthcare demand and use were lower than needs, and influenced by multiple factors, primarily, service affordability and efficiency, perceived performance and hospital service quality.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:36Z
      DOI: 10.1108/IJHCQA-10-2015-0132
       
  • The NICE alcohol misuse standard – evaluating its impact
    • Pages: 260 - 273
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, Page 260-273, April 2017.
      Purpose The purpose of this paper is to explore factors affecting implementing the National Institute for Health and Care Excellence (NICE) quality standard on alcohol misuse (QS11) and barriers and facilitators to its implementation. Design/methodology/approach Qualitative interview study analysed using directed and conventional content analyses. Participants were 38 individuals with experience of commissioning, delivering or using alcohol healthcare services in Southwark, Lambeth and Lewisham. Findings QS11 implementation ranged from no implementation to full implementation across the 13 statements. Implementation quality was also reported to vary widely across different settings. The analyses also uncovered numerous barriers and facilitators to implementing each statement. Overarching barriers to implementation included: inherent differences between specialist vs generalist settings; poor communication between healthcare settings; generic barriers to implementation; and poor governance structures and leadership. Research limitations/implications QS11 was created to summarise alcohol-related NICE guidance. The aim was to simplify guidance and enhance local implementation. However, in practice the standard requires complex actions by professionals. There was considerable variation in local alcohol commissioning models, which was associated with variation in implementation. These models warrant further evaluation to identify best practice. Originality/value Little evidence exists on the implementing quality standards, as distinct from clinical practice guidelines. The authors present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-28T01:22:55Z
      DOI: 10.1108/IJHCQA-03-2016-0025
       
  • Patient non-adherence: an interpretative phenomenological analysis
    • First page: 274
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose While Interpretative Phenomenological Analysis (IPA) has been employed in health psychology research, it has so far not been applied to seek deeper insights into the patients’ experiences about treatment. This paper addresses this gap by employing Interpretative Phenomenological Analysis to understand patient non-adherence. Design/methodology/approach Eighteen patients with chronic conditions seeking health care services in Goa and Karnataka, India, were selected by employing snowball sampling method. In-depth interviews were conducted face to face. Semi-structured questionnaire developed by the researchers was used to collect the data. Interpretative Phenomenological Analysis was employed to explore the themes to predict patient non-adherence. Findings The study results indicate that economic factors, health system related factors, social factors and psychological factors impact patient non-adherence. Patient non-adherence includes medication non-adherence and lifestyle modification non-adherence. Research limitations/implications Being cross sectional in design, the results may not be as appropriate as the results derived from a longitudinal study given that non-adherence occurs over time. Practical implications Patient non-adherence is a global health issue. Multidisciplinary approach to enhance patient adherence to treatment should form the part of public health care policy. Originality/value Although there is extensive quantitative research on the prevalence of non-adherence, qualitative research is limited. This paper addresses this gap by employing Interpretative Phenomenological Analysis to understand patient non adherence and its factors and dimensions.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:31Z
      DOI: 10.1108/IJHCQA-03-2016-0033
       
  • Potential facilitators and barriers to adopting standard treatment
           guidelines in clinical practice: an Indian context
    • First page: 285
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose To assess medicines information sources accessed by clinicians if sources differed in theory and practice and to find out barriers and facilitators to effective guideline adoption. Design/methodology/approach One hundred and eighty-three doctors were surveyed.Barriers and facilitators were classified as: communication; potential adopters: innovation; organization characteristics and environmental/social/economic context Findings Most accessed multiple information sources including standard treatment guidelines (STGs), but consulted seniors/colleagues in practice. Top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in following areas: concerns about flexibility offered by the guideline; denying patients’ individuality; professional autonomy; insights into gaps in current practice and evidence based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance company) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors’ control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value This survey among clinicians, despite limitations, gives helpful insights. While favorable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:32Z
      DOI: 10.1108/IJHCQA-10-2016-0148
       
 
 
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