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Internet Research     Hybrid Journal   (Followers: 45, SJR: 0.846, h-index: 44)
Intl. J. for Lesson and Learning Studies     Hybrid Journal   (Followers: 1)
Intl. J. for Researcher Development     Hybrid Journal   (Followers: 8)
Intl. J. of Accounting and Information Management     Hybrid Journal   (Followers: 6, SJR: 0.265, h-index: 4)
Intl. J. of Bank Marketing     Hybrid Journal   (Followers: 4, SJR: 0.672, h-index: 26)
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Intl. J. of Contemporary Hospitality Management     Hybrid Journal   (Followers: 11, SJR: 1.2, h-index: 24)
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Intl. J. of Disaster Resilience in the Built Environment     Hybrid Journal   (Followers: 7, SJR: 0.181, h-index: 5)
Intl. J. of Educational Management     Hybrid Journal   (Followers: 3, SJR: 0.508, h-index: 16)
Intl. J. of Emergency Services     Hybrid Journal   (Followers: 2)
Intl. J. of Emerging Markets     Hybrid Journal   (Followers: 3)

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Journal Cover International Journal of Health Care Quality Assurance
  [SJR: 0.357]   [H-I: 25]   [7 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0952-6862
   Published by Emerald Homepage  [312 journals]
  • Lean and Six Sigma in acute care: a systematic review of reviews
    • Authors: Simon Deblois, Luigi Lepanto
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.
      Purpose To present a systematic review of literature reviews, summarizing how Lean and Six Sigma management techniques have been implemented in acute care settings to date, and assessing their impact. To aid decision makers who wish to use these techniques by identifying the sectors of activity most often targeted, the main results of the interventions, as well as barriers and facilitators involved. Identify areas of future research. Design/methodology/approach A literature search was conducted, using eight databases. The methodological quality of the selected reviews was appraised with AMSTAR. A narrative synthesis was performed according to the guidelines proposed by Popay et al (2006). Data was reported according to PRISMA. Findings The literature search identified 149 publications published from 1999 to January 2015. Seven literature reviews were included into the systematic review, upon appraisal. The overall quality of the evidence was poor to fair. The clinical settings most described were specialized health care services, including operating suites, intensive care units and emergency departments. The outcomes most often appraised related to processes and quality. The evidence suggests that Lean and Six Sigma are better adapted to settings where processes involve a linear sequence of events. Research limitations/implications There is a need for more studies of high methodological quality to better understand the effects of these approaches as well as the factors of success and barriers to their implementation. Field studies comparing the effects of Lean and Six Sigma to those of other process redesign or quality improvement efforts would bring a significant contribution to the body of knowledge. Practical implications Lean and Six Sigma can be considered valuable process optimization approaches in acute health care settings. The success of their implementation requires significant participation of clinical personnel from the frontline as well as clinical leaders and managers. More research is needed to better understand the factors of success and the barriers to their implementation, as well as their long term impact. Originality/value This is the first broad systematic review of reviews, synthesizing data pertaining to implementation issues and results in acute care settings, to be published. It will benefit health care managers assessing the potential of these approaches and the potential drawbacks associated with their implementation. Moreover, it identifies directions for future research.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:38:18Z
      DOI: 10.1108/IJHCQA-05-2014-0058
  • Advancing the big five of user-oriented care and accounting for its
    • Authors: Petri Kajonius, Ali Kazemi
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.
      Purpose Care process quality (i.e., how care is enacted by a care worker toward a client at the interpersonal level) is a strong predictor of satisfaction in a wide range of health care services. The present research aims at describing the basic elements of care process quality as user-oriented care. Specifically, the questions of how and why quality in user-oriented care varies were investigated in the context of elderly care. Design/methodology/approach Two municipalities were selected for in-depth field studies. First, in each municipality, we interviewed and observed care workers’ interactions with the older persons in both home care and nursing homes during two weeks (Study 1). Second, in an attempt to gain a deeper understanding of why process quality in terms of user-oriented care varies, we conducted interviews with care workers and care unit managers (Study 2). Findings A new taxonomy for categorising process quality variation, the Big Five of user-oriented care (Task-focus, Person-focus, Affect, Cooperation, and Time-use), is proposed. In addition, the perceived reasons for process quality variation are reported in our own developed Quality Agents Model, suggesting that variations in care process evaluations may be explained from different perspectives at multiple levels (i.e., older person, care worker-, unit-, department-, and municipality-level). Originality/value The proposed taxonomy and model are useful for describing user-oriented care quality and the reasons for its variations. These findings are of relevance for future quality developments of elderly care services, but also may be adapted to applications in any other enterprise employing a user-oriented approach.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:38:17Z
      DOI: 10.1108/IJHCQA-03-2015-0040
  • Five focus strategies to organize health care delivery
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.
      Purpose The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. This article discusses strategic options to focus health care operations. Design/methodology/approach First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies. Findings The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: 1) population, 2) urgency and severity, 3) illnesses and symptoms, 4) care practices and processes, and 5) care outcomes. Research limitations/implications Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination. Practical implications Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization’s strategy and key performance indicators. Originality/value Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:38:16Z
      DOI: 10.1108/IJHCQA-05-2015-0065
  • How strange the change, from major to minor, with apologies to Ella
    • Authors: Ian Callanan
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:38:15Z
      DOI: 10.1108/IJHCQA-01-2016-0002
  • Management of surgical instruments with radio frequency identification
           tags: a 27-month in hospital trial
    • Authors: Kaori Kusuda, Kazuhiko Yamashita, Akiko Ohnishi, Kiyohito Tanaka, Masaru Komino, Hiroshi Honda, Shinichi Tanaka, Takashi Okubo, Julien Tripette, Yuji Ohta
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.
      Purpose To prevent malpractices, medical staff has adopted inventory time-outs and/or checklists. Accurate inventory and maintenance of surgical instruments decreases the risk of operating room miscounting and malfunction. In our previous study, an individual management of surgical instruments was accomplished using Radio Frequency Identification (RFID) tags. In this study, a new management method of RFID-tagged instruments was evaluated. Design/methodology/approach The management system of RFID-tagged surgical instruments was used for 27 months in clinical areas. Thirteen study participants assembled surgical trays in the central sterile supply department. Findings While using the management system, trays were assembled 94 times. During this period, no assembly errors occurred. An instrument malfunction had occurred after the 19th, 56th, and 73th uses, no malfunction caused by the RFID tags, and usage history had been recorded. Additionally, the time it took to assemble surgical trays was recorded, and the long-term usability of the management system was evaluated. Originality/value The system could record the number of uses and the defective history of each surgical instrument. In addition, the history of the frequency of instruments being transferred from one tray to another was recorded. The results suggest that our system can be used to manage instruments safely. Additionally, the management system was acquired of the learning effect and the usability on daily maintenance. This finding suggests that the management system examined here ensures surgical instrument and tray assembly quality.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:38:14Z
      DOI: 10.1108/IJHCQA-03-2015-0034
  • The impact of person-organization fit on innovative work behavior: the
           mediating effect of knowledge sharing behavior
    • Authors: Bilal Afsar
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.
      Purpose The direct relationship between person-organization fit and employee’s positive work attitudes and behaviours have been well researched. However, there has been no study on the impact of person-organization fit on innovative work behaviour of the nurses. The current study aims to fill this gap in the literature. In order to give a complete understanding of the psychology surrounding person-organization fit, this study has longitudinally analyzed the relationship between person-organization fit and innovative work behaviour along with the impact of a potential mediator i.e. knowledge sharing behaviour on this relationship. Design/methodology/approach A total of 357 nurses and 71 doctors from three government hospitals of Thailand filled out the questionnaires. Structural equation modeling was used to analyze the relationships. Findings Results of the study indicate that a nurse’s person-organization fit is positively associated with both self and doctor ratings of innovative behaviours; and knowledge sharing behaviour acts as a partial mediator between person-organization fit and innovative work behaviour at both Time 1 and Time 2. These results imply that a nurse’s perceived fit in the hospital impacts his/her engagement into innovative work behaviour. As nurses share knowledge with their co-workers frequently, it tends to strengthen the relationship between person-organization fit and innovative work behaviour. Originality/value Study findings begin to explain how person-organization fit impacts innovative work behavior of nurses. Specifically, we find that knowledge sharing behavior explains the relationship between person-organization fit and innovative work behaviour.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:38:12Z
      DOI: 10.1108/IJHCQA-01-2015-0017
  • Performance management of the public healthcare services in Ireland: a
    • Authors: Mohammed Mesabbah, Amr Arisha
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.
      Purpose Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services. Design/methodology/approach An extensive review of relevant HSE’s publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented. Findings PM and Performance Measurement (PME) systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g., feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals’ management systems. Research limitations/implications The HSE delivers several services such as Mental Health, Social Inclusion, etc. This study focuses on the HSE’s PM framework, with a particular interest in Acute Hospitals and Emergency Services. Originality/value This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:37:39Z
      DOI: 10.1108/IJHCQA-07-2014-0079
  • Improving healthcare practice behaviors: an exploratory study identifying
           effective and ineffective behaviors in healthcare
    • Authors: David D. Van Fleet, Tim O Peterson
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.
      Purpose This article presents the results of exploratory research designed to develop an awareness of healthcare behaviors, with a view toward improving the customer satisfaction with healthcare services. It examines the relationship between healthcare providers and their consumers/patients/clients. Design/methodology/approach The study uses a critical incident methodology, with both effective and ineffective behavioral specimens examined across different provider groups. Findings The effects of these different behaviors on what Berry (1999) identified as the common core values of service organizations are examined, as those values are required to build a lasting service relationship. Also examined are categories of healthcare practice based on the National Quality Strategy priorities. Research limitations/implications The most obvious is the retrospective nature of the method used. How accurate are patient or consumer memories? Are they capable of making valid judgments of healthcare experiences (Berry and Bendapudi, 2003)? While an obvious limitation, such recollections are clearly important as they may be paramount in following the healthcare practitioners’ instructions, loyalty for repeat business, making recommendations to others and the like. Further, studies have shown retrospective reports to be accurate and useful (Miller et al., 1985) Practical implications With this information, healthcare educators should be in a better position to improve the training offered in their programs and practitioners to better serve their customers. Originality/value Berry (1999) has argued that the overriding importance in building a lasting service business is human values. This exploratory study has shown how critical incident analysis can be used to determine both effective and ineffective practices of different medical providers. It also provides guidelines as to what are effective and ineffective behaviors in healthcare.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:37:38Z
      DOI: 10.1108/IJHCQA-07-2015-0089
  • Combined quality function deployment and the logical framework approach to
           improve quality of emergency care in Malta
    • Authors: Sandra Catherine Buttigieg, Prasanta Kumar Dey, Mary Rose Cassar
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.
      Purpose This paper aims to develop an integrated patient focused analytical framework to improve quality of care in Accident and Emergency (A&E) unit of a Maltese hospital. Design/methodology/approach The study adopts a case study approach. Firstly, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Secondly, a healthcare quality management framework is developed using combined Quality Function Deployment (QFD) and Logical Framework Approach (LFA). Thirdly, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A&E unit of the hospital. Findings The major and related problems being faced by the hospital under study were overcrowding at A&E and shortage of beds respectively. The combined framework ensures better A&E services and patient flow. QFD identifies and analyses the issues and challenges of A&E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage, and shorter waiting times at the A&E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A&E unit. Practical implications The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of six sigma and other quality initiatives. Originality/value Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A&E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-02-02T12:37:27Z
      DOI: 10.1108/IJHCQA-04-2014-0040
  • Corrigendum
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-01-14T11:35:40Z
      DOI: 10.1108/IJHCQA-02-2016-145
  • Editorial: Using QA methods to eliminate waste in healthcare services.
    • Authors: Keith Hurst
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:34Z
      DOI: 10.1108/IJHCQA-09-2015-0112
  • Factors influencing change in clinical practice: a qualitative evaluation
           of the implementation of the Quality Improvement in Colonoscopy study
    • Authors: Praveen T Rajasekhar, Colin J Rees, Catherine Nixon, James E East, Sally Brown
      First page: 5
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.
      Purpose The Quality Improvement in Colonoscopy study was a region wide service improvement study to improve adenoma detection rate at colonoscopy by implementing evidence into routine colonoscopy practice. Implementing evidence into clinical practice can be challenging. A qualitative interview study was performed to evaluate factors that influenced implementation within the study. Design/methodology/approach Semi-structured interviews were conducted with staff in endoscopy units taking part in the Quality Improvement in Colonoscopy study, after study completion. Units and interviewees were purposefully sampled to ensure a range of experiences was represented. Interviews were conducted with 11 participants. Findings Key themes influencing uptake of the Quality Improvement in Colonoscopy evidence bundle included time, study promotion, training, engagement, positive outcomes and modifications. Areas within themes were increased awareness of quality in colonoscopy, emphasis on withdrawal time and empowerment of endoscopy nurses to encourage the use of quality measures were positive outcomes of the study. The simple, visible study posters were reported as useful in aiding study promotion. Feedback sessions improved engagement. Challenges included difficulty arranging set up meetings and engaging certain speciality groups. Originality/value This evaluation suggests that methods to implement evidence into clinical practice should include identification and empowerment of team members who can positively influence engagement, simple, visible reminders and feedback. Emphasis on timing of meetings and strategies to engage speciality groups should also be given consideration. Qualitative evaluations can provide important insights into why quality improvement initiatives are successful or not, across different sites.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:31Z
      DOI: 10.1108/IJHCQA-09-2014-0093
  • Applying Lean Six Sigma to improve medication management
    • Authors: Preethy Nayar, Diptee Ojha, Ann Fetrick, Anh T Nguyen
      First page: 16
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.
      Purpose A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the United States, we used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care Veteran patients. The aims of this project were to: assess compliance with the VHA’s policy; collect data and describe the current process for co-management of dual care veterans’ medications; and draft recommendations to improve the current process for medications co-management. Design/methodology/approach Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. Findings A key bottleneck in the process that was identified was the receipt of the non-VA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: Documentation of Dual Care; Veteran Education; Process Redesign and Outreach to Community Providers. Research limitations/implications This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs medical center in the mid-Western United States to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. Practical implications The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care Veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care Veteran patients. Originality/value The findings of this project will be of value to VA providers and policy makers and health care managers who plan to apply Lean Six Sigma techniques in their organizations to improve the quality of care for their patients.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:42Z
      DOI: 10.1108/IJHCQA-02-2015-0020
  • Discharge against medical advice from a Tehran emergency department
    • Authors: Azar Hadadi, Patricia Khashayar, Mojgan Karbakhsh, Ali Vasheghani Farahani
      First page: 24
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.
      Purpose The aim of this study was to identify the main reasons for DAMA in the emergency department of a teaching hospital in Tehran, Iran Design/methodology/approach This Cross-sectional study was conducted on all the patients who left the Eemergency Department of a referral teaching Hospital against medical advice in 2008. A questionnaire was filled out for each patient to determine the reasons behind patient leaving against medical advice. Findings 12.8% of the patients left the hospital against medical advice. Dissatisfaction with being observed in the Emergency Department, having a feeling of recovery and hospital personnel encouraging patients to leave the hospital were the main reasons for leaving the hospital against medical advice. Practical implications Like many other centers, our results showed that poor communication skill and work overload were the main contributing factors to DAMA. Our center managed to improve patient satisfaction and thus lowered DAMA rates following this study. Considering the similarities reported in our reports and that of other studies, it could be concluded that policy makers in other centers can also benefit from our results to adopt effective approaches to reduce DAMA rate. Originality/value To our knowledge no study has evaluated the rate and the reasons behind DAMA in the Iranian Emergency Departments.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:39Z
      DOI: 10.1108/IJHCQA-03-2015-0030
  • Measuring family satisfaction with inpatient rehabilitation care.
    • Authors: Elisabetta Angelino, Andrea Gragnano, Massimo Miglioretti
      First page: 33
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.
      Purpose To investigate the psychometric characteristics of the Questionnaire of Family members’ Satisfaction about the Rehabilitation (QFSR), a new questionnaire assessing the satisfaction of patients’ families with the in-hospital rehabilitation service, i.e. the organizational procedure, medical treatment, relationship with nurses/other health workers, and outcome. Design/methodology/approach The QFSR (13 items) was administered to 1226 (F=60.4%; mean age=57.4 SD 15 years) family members of patients admitted to two units for inpatient rehabilitation, i.e. cardiovascular and neuromotor. Findings Confirmatory factor analysis (CFA) confirmed the theoretical 4-factor structure of the questionnaire in a subsample of 308 respondents randomly selected from the sample (SBχ² (61) = 57.4, p = .61; RMSEA = .0; 90% CI [.0, .031], CFI = 1.00). The remaining 708 respondents (393 relatives of cardiovascular unit inpatients and 315 relatives of neuromotor unit inpatients) were used to test measurement invariance between the groups of family members with patients in the two units. The configurial, scalar and strict factorial invariance provided a good fit to the data. Originality/value The QFSR, specifically developed to measure the satisfaction of family members of patients undergoing rehabilitation, appears to be a promising brief questionnaire that can provide important indications for continuous improvement in the delivery of healthcare.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:40Z
      DOI: 10.1108/IJHCQA-03-2015-0036
  • Two dimensions of trust in physicians in OECD-countries
    • First page: 48
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.
      Purpose This comparative study’s purpose is to analyse citizens’ trust in physicians in 22 OECD-countries. Design/methodology/approach We measure trust in physicians using items on generalised and particularised trust. Individual level data are received from the International Social Survey Program (ISSP), 2011. We also utilise macro variables drawn from different data banks. Data were analysed using descriptive statistics and xtlogit regression models. The main micro-level hypothesis is that low self-reported health is strongly associated with lower trust in physicians. Our second micro-level hypothesis is that frequent meetings with physicians result in higher trust. The third micro-level hypothesis assumes that males, and older and better educated respondents, express higher trust compared to others. The first macro-level hypothesis is that lower income inequality leads to higher the trust in physicians. The second macro-level hypothesis is that greater physician density leads to higher trust in physicians. Findings We found that the influence of individual and macro level characteristics varies between trust types. Results indicate that both trust types are clearly associated with individual level determinants. However, only general trust in physicians has weak associations with macro level indicators (mainly physician density) and therefore on institutional cross-country differences. It seems that particularised trust in a physician’s skills is more restricted to the individuals’ health and their own experiences meeting doctors, whereas general trust likely reflects attitudes towards the prevalent profession in the country. Originality/value Our findings hold significance for healthcare systems research and for research concerning social trust generally.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:37Z
      DOI: 10.1108/IJHCQA-04-2015-0041
  • Hospital menu interventions: a systematic review of research
    • Authors: Ella Ottrey, Judi Porter
      First page: 62
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.
      Purpose Most patients in developed countries solely depend on the hospital menu to order their food. The provision of menu choices to patients differs between facilities. This review aimed to determine which strategies that provide menu choices to patients are effective in improving clinical and non-clinical outcomes in hospital. Design/methodology/approach Five databases were searched to identify relevant publications. Prospective research published in English with the menu as the primary intervention was included. Study eligibility was determined and risk of bias assessed. Outcome data were combined narratively due to absence of homogeneous study design and outcomes. Findings Of the 2201 records screened, six studies met inclusion criteria. Standardised menu formatting and the spoken menu system were found to improve meal tray accuracy. The spoken menu and computerised interactive menu selector system enhanced aspects of patient satisfaction without cost increases. Descriptive menus may increase food consumption. Branding food items was not well supported by patients. One study rated positively for study quality with the remaining five studies receiving neutral quality ratings. Research limitations/implications The small number of studies conducted on each intervention and the quality of the evidence made it difficult to establish a solid evidence base around providing menu choices to patients. Further research is needed on menu ordering systems, including spoken and visual menus, to determine their impact on outcomes in hospital. Originality/value This review is first to examine the effectiveness of menu interventions in hospital. Hospital foodservice departments should consider these findings when reviewing local systems.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:43Z
      DOI: 10.1108/IJHCQA-04-2015-0051
  • Trans-disciplinary community groups: an initiative for improving
    • Authors: James Demetri Sideras
      First page: 75
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.
      Purpose In the context of budget constraints and the current quality crisis facing UK healthcare, the aim of this paper is to examine the use of Trans-disciplinary Community Groups (TCG) – an innovative and inexpensive initiative for improving patient care. Design/methodology/approach Using an action research study, TCG was implemented within a private healthcare firm for vulnerable adults. Qualitative data were gathered over twelve months from 33 participants using depth interviews and focus groups. Findings TCG led to improved patient activities and increased patient decision-making and confidence in self-advocacy. Key prerequisites were top management commitment, democratic leadership and employee empowerment. However, staff nurses resisted TCG because they were inclined to using managerial control and their own independent clinical judgments. Research limitations/implications Whilst the findings from this study should not be generalized across all healthcare sectors, its results could be replicated in contexts where there is wide commitment to TCG and where managers adopt a democratic style of leadership. Researchers could take this study further by exploring the applicability of TCG in public healthcare organizations or other multi-disciplinary service contexts. Practical implications The findings of this research paper provide policy makers and healthcare managers with practical insights on TCG and the factors that are likely to obstruct and facilitate its implementation. Originality/value Adopting TCG could enable healthcare managers to ameliorate their services with little or no extra cost, which is especially important in a budget constraint context and the current quality crisis facing UK healthcare.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:36Z
      DOI: 10.1108/IJHCQA-05-2015-0054
  • Maternity-care: measuring women’s perceptions
    • Authors: Kim Clark, Shelley Beatty, Tracy Reibel
      First page: 89
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 1, February 2016.
      Purpose Achieving maternity-care outcomes that align with women’s needs, preferences and expectations is important but theoretically-driven measures of women’s satisfaction with their entire maternity-care experience do not appear to exist. This paper outlines the development of an instrument to assess women’s perception of their entire maternity-care experience. Design/methodology/approach A questionnaire was developed on the basis of previous research and informed by a framework of standard service quality categories covering the spectrum of typical consumer concerns. A pilot survey with a sample of 195 women who had recent experience of birth was undertaken to establish valid and reliable scales pertaining to different stages of maternity care. Exploratory Factor Analysis was used to interpret scales and convergent validity was assessed using a modified version of the Client Satisfaction Questionnaire. Findings Nine theoretically-informed, reliable and valid stand-alone scales measuring the achievement of different dimensions of women’s expectancies of public maternity care were developed. The study scales are intended for use in identifying some potential areas of focus for quality improvement in the delivery of maternity care. Research limitations/implications Reliable and valid tools for monitoring the extent to which services respond to women’s expectations of their entire maternity care form part of the broader toolkit required to adequately manage healthcare quality. This study offers guidance on the make-up of such tools. Originality/value The scales produced from this research offer a means to assess maternity care across the full continuum of care and are brief and easy to use.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2015-12-19T12:18:32Z
      DOI: 10.1108/IJHCQA-06-2015-0078
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