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Publisher: Emerald   (Total: 312 journals)

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Showing 1 - 200 of 312 Journals sorted alphabetically
A Life in the Day     Hybrid Journal   (Followers: 9)
Accounting Auditing & Accountability J.     Hybrid Journal   (Followers: 20)
Accounting Research J.     Hybrid Journal   (Followers: 20, SJR: 0.148, h-index: 3)
Accounting, Auditing and Accountability J.     Hybrid Journal   (Followers: 9, SJR: 0.972, h-index: 30)
Advances in Accounting Education     Hybrid Journal   (Followers: 12)
Advances in Appreciative Inquiry     Hybrid Journal   (SJR: 0.107, h-index: 4)
Advances in Dual Diagnosis     Hybrid Journal   (Followers: 45)
Advances in Gender Research     Full-text available via subscription   (Followers: 1)
Advances in Intl. Marketing     Full-text available via subscription  
Advances in Mental Health and Intellectual Disabilities     Hybrid Journal   (Followers: 50, SJR: 0.211, h-index: 3)
Advances in Mental Health and Learning Disabilities     Hybrid Journal   (Followers: 22)
African J. of Economic and Management Studies     Hybrid Journal   (Followers: 8)
Agricultural Finance Review     Hybrid Journal  
Aircraft Engineering and Aerospace Technology     Hybrid Journal   (Followers: 91, SJR: 0.339, h-index: 15)
American J. of Business     Hybrid Journal   (Followers: 10)
Anti-Corrosion Methods and Materials     Hybrid Journal   (Followers: 5, SJR: 0.309, h-index: 23)
Arts Marketing : An Intl. J.     Hybrid Journal   (Followers: 8)
Asia Pacific J. of Marketing and Logistics     Hybrid Journal   (Followers: 6)
Asia-Pacific J. of Business Administration     Hybrid Journal   (Followers: 3, SJR: 0.237, h-index: 4)
Asian Education and Development Studies     Hybrid Journal   (Followers: 4)
Asian J. on Quality     Hybrid Journal  
Asian Review of Accounting     Hybrid Journal   (Followers: 1, SJR: 0.174, h-index: 3)
Aslib J. of Information Management     Hybrid Journal   (Followers: 11)
Aslib Proceedings     Hybrid Journal   (Followers: 147, SJR: 0.558, h-index: 23)
Assembly Automation     Hybrid Journal   (Followers: 1, SJR: 0.439, h-index: 20)
Baltic J. of Management     Hybrid Journal   (Followers: 2, SJR: 0.2, h-index: 10)
Benchmarking : An Intl. J.     Hybrid Journal   (Followers: 9, SJR: 0.554, h-index: 28)
British Food J.     Hybrid Journal   (Followers: 13, SJR: 0.361, h-index: 25)
Built Environment Project and Asset Management     Hybrid Journal   (Followers: 14, SJR: 0.248, h-index: 3)
Business Process Management J.     Hybrid Journal   (Followers: 7, SJR: 0.841, h-index: 31)
Business Strategy Series     Hybrid Journal   (Followers: 5, SJR: 0.151, h-index: 3)
Campus-Wide Information Systems     Hybrid Journal   (Followers: 5, SJR: 0.246, h-index: 12)
Career Development Intl.     Hybrid Journal   (Followers: 14, SJR: 0.721, h-index: 22)
China Agricultural Economic Review     Hybrid Journal   (SJR: 0.419, h-index: 6)
China Finance Review Intl.     Hybrid Journal   (Followers: 3)
Chinese Management Studies     Hybrid Journal   (Followers: 4, SJR: 0.424, h-index: 7)
Circuit World     Hybrid Journal   (Followers: 15, SJR: 0.297, h-index: 15)
Clinical Governance: An Intl. J.     Hybrid Journal   (Followers: 23, SJR: 0.176, h-index: 13)
Collection Building     Hybrid Journal   (Followers: 10, SJR: 0.461, h-index: 8)
COMPEL: The Intl. J. for Computation and Mathematics in Electrical and Electronic Engineering     Hybrid Journal   (Followers: 2, SJR: 0.224, h-index: 18)
Competitiveness Review : An Intl. Business J. incorporating J. of Global Competitiveness     Hybrid Journal   (Followers: 3)
Construction Innovation: Information, Process, Management     Hybrid Journal   (Followers: 12)
Corporate Communications An Intl. J.     Hybrid Journal   (Followers: 2, SJR: 0.394, h-index: 18)
Corporate Governance Intl. J. of Business in Society     Hybrid Journal   (Followers: 6, SJR: 0.345, h-index: 21)
Critical Perspectives on Intl. Business     Hybrid Journal   (SJR: 0.311, h-index: 11)
Cross Cultural Management An Intl. J.     Hybrid Journal   (Followers: 7, SJR: 0.648, h-index: 6)
Development and Learning in Organizations     Hybrid Journal   (Followers: 8, SJR: 0.123, h-index: 6)
Direct Marketing An Intl. J.     Hybrid Journal   (Followers: 6)
Disaster Prevention and Management     Hybrid Journal   (Followers: 16, SJR: 0.352, h-index: 24)
Drugs and Alcohol Today     Hybrid Journal   (Followers: 84, SJR: 0.129, h-index: 2)
Education + Training     Hybrid Journal   (Followers: 18, SJR: 0.39, h-index: 21)
Education, Business and Society : Contemporary Middle Eastern Issues     Hybrid Journal   (SJR: 0.243, h-index: 6)
Employee Relations     Hybrid Journal   (Followers: 5, SJR: 0.446, h-index: 16)
Engineering Computations     Hybrid Journal   (Followers: 3, SJR: 0.567, h-index: 36)
Engineering, Construction and Architectural Management     Hybrid Journal   (Followers: 12, SJR: 0.468, h-index: 20)
Equal Opportunities Intl.     Hybrid Journal   (Followers: 3)
Equality, Diversity and Inclusion : An Intl. J.     Hybrid Journal   (Followers: 11, SJR: 0.37, h-index: 4)
Ethnicity and Inequalities in Health and Social Care     Hybrid Journal   (Followers: 8, SJR: 0.109, h-index: 1)
EuroMed J. of Business     Hybrid Journal   (Followers: 1)
European Business Review     Hybrid Journal   (Followers: 6, SJR: 0.368, h-index: 15)
European J. of Innovation Management     Hybrid Journal   (Followers: 16, SJR: 0.442, h-index: 22)
European J. of Marketing     Hybrid Journal   (Followers: 19, SJR: 0.957, h-index: 38)
European J. of Training and Development     Hybrid Journal   (Followers: 8, SJR: 0.296, h-index: 18)
Evidence-based HRM     Hybrid Journal   (Followers: 5)
Facilities     Hybrid Journal   (Followers: 2, SJR: 0.34, h-index: 13)
foresight     Hybrid Journal   (Followers: 8, SJR: 0.62, h-index: 16)
Gender in Management : An Intl. J.     Hybrid Journal   (Followers: 14, SJR: 0.495, h-index: 17)
Grey Systems : Theory and Application     Hybrid Journal   (Followers: 1)
Health Education     Hybrid Journal   (Followers: 4, SJR: 0.345, h-index: 13)
Higher Education, Skills and Work-based Learning     Hybrid Journal   (Followers: 36, SJR: 0.121, h-index: 2)
History of Education Review     Hybrid Journal   (Followers: 10, SJR: 0.102, h-index: 1)
Housing, Care and Support     Hybrid Journal   (Followers: 8, SJR: 0.155, h-index: 3)
Human Resource Management Intl. Digest     Hybrid Journal   (Followers: 12, SJR: 0.105, h-index: 5)
Humanomics     Hybrid Journal   (Followers: 1, SJR: 0.104, h-index: 1)
Indian Growth and Development Review     Hybrid Journal   (SJR: 0.131, h-index: 1)
Industrial and Commercial Training     Hybrid Journal   (Followers: 5, SJR: 0.318, h-index: 10)
Industrial Lubrication and Tribology     Hybrid Journal   (Followers: 6, SJR: 0.46, h-index: 15)
Industrial Management & Data Systems     Hybrid Journal   (Followers: 4, SJR: 0.989, h-index: 54)
Industrial Robot An Intl. J.     Hybrid Journal   (Followers: 3, SJR: 0.421, h-index: 25)
Info     Hybrid Journal   (Followers: 1, SJR: 0.337, h-index: 17)
Information and Computer Security     Hybrid Journal   (Followers: 16, SJR: 0.29, h-index: 28)
Information Technology & People     Hybrid Journal   (Followers: 42, SJR: 0.664, h-index: 21)
Interactive Technology and Smart Education     Hybrid Journal   (Followers: 14)
Interlending & Document Supply     Hybrid Journal   (Followers: 62, SJR: 0.593, h-index: 10)
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: 7)
Intl. J. of Accounting and Information Management     Hybrid Journal   (Followers: 5, SJR: 0.265, h-index: 4)
Intl. J. of Bank Marketing     Hybrid Journal   (Followers: 6, SJR: 0.672, h-index: 26)
Intl. J. of Climate Change Strategies and Management     Hybrid Journal   (Followers: 9, SJR: 0.211, h-index: 3)
Intl. J. of Clothing Science and Technology     Hybrid Journal   (Followers: 4, SJR: 0.436, h-index: 20)
Intl. J. of Commerce and Management     Hybrid Journal  
Intl. J. of Conflict Management     Hybrid Journal   (Followers: 13, SJR: 0.322, h-index: 31)
Intl. J. of Contemporary Hospitality Management     Hybrid Journal   (Followers: 8, SJR: 1.2, h-index: 24)
Intl. J. of Culture Tourism and Hospitality Research     Hybrid Journal   (Followers: 12, SJR: 0.113, h-index: 1)
Intl. J. of Development Issues     Hybrid Journal   (Followers: 8)
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)
Intl. J. of Energy Sector Management     Hybrid Journal   (Followers: 3, SJR: 0.187, h-index: 7)
Intl. J. of Entrepreneurial Behaviour & Research     Hybrid Journal   (Followers: 5, SJR: 0.545, h-index: 20)
Intl. J. of Event and Festival Management     Hybrid Journal   (Followers: 7)
Intl. J. of Gender and Entrepreneurship     Hybrid Journal   (Followers: 4)
Intl. J. of Health Care Quality Assurance     Hybrid Journal   (Followers: 6, SJR: 0.357, h-index: 25)
Intl. J. of Housing Markets and Analysis     Hybrid Journal   (Followers: 7, SJR: 0.32, h-index: 4)
Intl. J. of Intelligent Computing and Cybernetics     Hybrid Journal   (Followers: 1, SJR: 0.323, h-index: 7)
Intl. J. of Intelligent Unmanned Systems     Hybrid Journal   (Followers: 4)
Intl. J. of Islamic and Middle Eastern Finance and Management     Hybrid Journal   (Followers: 6)
Intl. J. of Law and Management     Hybrid Journal   (Followers: 2)
Intl. J. of Law in the Built Environment     Hybrid Journal   (Followers: 4, SJR: 0.104, h-index: 1)
Intl. J. of Leadership in Public Services     Hybrid Journal   (Followers: 5)
Intl. J. of Lean Six Sigma     Hybrid Journal   (Followers: 6)
Intl. J. of Logistics Management     Hybrid Journal   (Followers: 8, SJR: 1.088, h-index: 8)
Intl. J. of Managerial Finance     Hybrid Journal   (Followers: 5, SJR: 0.269, h-index: 8)
Intl. J. of Managing Projects in Business     Hybrid Journal   (Followers: 1)
Intl. J. of Manpower     Hybrid Journal   (Followers: 1, SJR: 0.329, h-index: 29)
Intl. J. of Mentoring and Coaching in Education     Hybrid Journal   (Followers: 14)
Intl. J. of Migration, Health and Social Care     Hybrid Journal   (Followers: 8, SJR: 0.176, h-index: 3)
Intl. J. of Numerical Methods for Heat & Fluid Flow     Hybrid Journal   (Followers: 7, SJR: 0.591, h-index: 26)
Intl. J. of Operations & Production Management     Hybrid Journal   (Followers: 11, SJR: 1.344, h-index: 75)
Intl. J. of Organizational Analysis     Hybrid Journal   (Followers: 3, SJR: 0.226, h-index: 7)
Intl. J. of Pervasive Computing and Communications     Hybrid Journal   (Followers: 3, SJR: 0.185, h-index: 8)
Intl. J. of Pharmaceutical and Healthcare Marketing     Hybrid Journal   (Followers: 4, SJR: 0.221, h-index: 9)
Intl. J. of Physical Distribution & Logistics Management     Hybrid Journal   (Followers: 9, SJR: 1.305, h-index: 34)
Intl. J. of Prisoner Health     Hybrid Journal   (Followers: 8, SJR: 0.195, h-index: 9)
Intl. J. of Productivity and Performance Management     Hybrid Journal   (Followers: 4, SJR: 0.479, h-index: 23)
Intl. J. of Public Sector Management     Hybrid Journal   (Followers: 15, SJR: 0.323, h-index: 28)
Intl. J. of Quality & Reliability Management     Hybrid Journal   (Followers: 6, SJR: 0.653, h-index: 50)
Intl. J. of Quality and Service Sciences     Hybrid Journal   (Followers: 2)
Intl. J. of Retail & Distribution Management     Hybrid Journal   (Followers: 3, SJR: 0.542, h-index: 26)
Intl. J. of Service Industry Management     Hybrid Journal   (Followers: 2)
Intl. J. of Social Economics     Hybrid Journal   (Followers: 9, SJR: 0.261, h-index: 19)
Intl. J. of Sociology and Social Policy     Hybrid Journal   (Followers: 39, SJR: 0.139, h-index: 2)
Intl. J. of Structural Integrity     Hybrid Journal   (SJR: 0.366, h-index: 5)
Intl. J. of Sustainability in Higher Education     Hybrid Journal   (Followers: 9, SJR: 1.081, h-index: 22)
Intl. J. of Web Information Systems     Hybrid Journal   (Followers: 4, SJR: 0.239, h-index: 10)
Intl. J. of Wine Business Research     Hybrid Journal   (Followers: 6)
Intl. J. of Workplace Health Management     Hybrid Journal   (Followers: 8, SJR: 0.203, h-index: 5)
Intl. Marketing Review     Hybrid Journal   (Followers: 13, SJR: 0.906, h-index: 46)
J. of Accounting & Organizational Change     Hybrid Journal   (Followers: 4, SJR: 0.133, h-index: 3)
J. of Accounting in Emerging Economies     Hybrid Journal   (Followers: 7)
J. of Adult Protection, The     Hybrid Journal   (Followers: 12, SJR: 0.287, h-index: 5)
J. of Advances in Management Research     Hybrid Journal   (Followers: 2)
J. of Aggression, Conflict and Peace Research     Hybrid Journal   (Followers: 39, SJR: 0.433, h-index: 6)
J. of Agribusiness in Developing and Emerging Economies     Hybrid Journal   (Followers: 1)
J. of Applied Accounting Research     Hybrid Journal   (Followers: 12, SJR: 0.169, h-index: 2)
J. of Applied Research in Higher Education     Hybrid Journal   (Followers: 40)
J. of Asia Business Studies     Hybrid Journal   (Followers: 1)
J. of Assistive Technologies     Hybrid Journal   (Followers: 17, SJR: 0.159, h-index: 3)
J. of Business & Industrial Marketing     Hybrid Journal   (Followers: 7, SJR: 0.632, h-index: 41)
J. of Business Strategy     Hybrid Journal   (Followers: 12, SJR: 0.398, h-index: 12)
J. of Children's Services     Hybrid Journal   (Followers: 1, SJR: 0.305, h-index: 6)
J. of Chinese Economic and Foreign Trade Studies     Hybrid Journal  
J. of Chinese Entrepreneurship     Hybrid Journal   (Followers: 3)
J. of Chinese Human Resource Management     Hybrid Journal   (Followers: 4)
J. of Communication Management     Hybrid Journal   (Followers: 6, SJR: 0.199, h-index: 2)
J. of Consumer Marketing     Hybrid Journal   (Followers: 14, SJR: 0.57, h-index: 48)
J. of Corporate Real Estate     Hybrid Journal   (Followers: 2)
J. of Criminal Psychology     Hybrid Journal   (Followers: 81)
J. of Criminological Research, Policy and Practice     Hybrid Journal   (Followers: 46)
J. of Cultural Heritage Management and Sustainable Development     Hybrid Journal   (Followers: 9)
J. of Documentation     Hybrid Journal   (Followers: 147, SJR: 0.876, h-index: 42)
J. of Economic and Administrative Sciences     Hybrid Journal   (Followers: 3)
J. of Economic Studies     Hybrid Journal   (Followers: 10, SJR: 0.543, h-index: 21)
J. of Educational Administration     Hybrid Journal   (Followers: 4, SJR: 0.777, h-index: 18)
J. of Engineering, Design and Technology     Hybrid Journal   (Followers: 17, SJR: 0.126, h-index: 7)
J. of Enterprise Information Management     Hybrid Journal   (Followers: 4, SJR: 0.417, h-index: 27)
J. of Enterprising Communities People and Places in the Global Economy     Hybrid Journal   (Followers: 1, SJR: 0.331, h-index: 5)
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: 0.327, h-index: 4)
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: 11, SJR: 0.438, h-index: 22)
J. of Financial Crime     Hybrid Journal   (Followers: 361, SJR: 0.213, h-index: 2)
J. of Financial Economic Policy     Hybrid Journal  
J. of Financial Management of Property and Construction     Hybrid Journal   (Followers: 8)
J. of Financial Regulation and Compliance     Hybrid Journal   (Followers: 5)
J. of Financial Reporting and Accounting     Hybrid Journal   (Followers: 10)
J. of Forensic Practice     Hybrid Journal   (Followers: 36, SJR: 0.403, h-index: 5)
J. of Global Mobility     Hybrid Journal  
J. of Global Responsibility     Hybrid Journal   (Followers: 4)
J. of Health Organisation and Management     Hybrid Journal   (Followers: 18, SJR: 0.36, h-index: 22)
J. of Historical Research in Marketing     Hybrid Journal   (Followers: 3)
J. of Hospitality and Tourism Technology     Hybrid Journal   (Followers: 3, SJR: 0.359, h-index: 6)
J. of Human Resource Costing & Accounting     Hybrid Journal   (Followers: 4)
J. of Humanitarian Logistics and Supply Chain Management     Hybrid Journal   (Followers: 7)
J. of Indian Business Research     Hybrid Journal  
J. of Information, Communication and Ethics in Society     Hybrid Journal   (Followers: 25)
J. of Integrated Care     Hybrid Journal   (Followers: 19, SJR: 0.26, h-index: 5)
J. of Intellectual Capital     Hybrid Journal   (Followers: 3, SJR: 0.788, h-index: 25)
J. of Intellectual Disabilities and Offending Behaviour     Hybrid Journal   (Followers: 23)
J. of Intl. Education in Business     Hybrid Journal   (Followers: 2)
J. of Intl. Trade Law and Policy     Hybrid Journal   (Followers: 12, SJR: 0.239, h-index: 2)
J. of Investment Compliance     Hybrid Journal   (Followers: 2)
J. of Islamic Accounting and Business Research     Hybrid Journal   (Followers: 3)
J. of Islamic Marketing     Hybrid Journal   (Followers: 3, SJR: 0.439, h-index: 7)
J. of Knowledge Management     Hybrid Journal   (Followers: 78, SJR: 0.883, h-index: 36)
J. of Knowledge-based Innovation in China     Hybrid Journal   (Followers: 3)

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Journal Cover International Journal of Health Care Quality Assurance
  [SJR: 0.357]   [H-I: 25]   [6 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0952-6862
   Published by Emerald Homepage  [312 journals]
  • Time dependent patient no-show predictive modelling development
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.
      Purpose The paper aims to develop evident-based predictive no-show models considering patients’ each past appointment status, a time-dependent component, as an independent predictor to improve predictability. Design/methodology/approach A 10-year retrospective dataset was extracted from a pediatric clinic. It consisted of 7,291 distinct patients who had at least two visits along with their appointment characteristics, patient demographics, and insurance information. Logistic regression was adopted to develop no-show models using two-thirds of the data for training and the remaining data for validation. The no-show threshold was then determined based on minimizing the misclassification of show/no-show assignments. There were a total of 26 predictive model developed based on the number of available past appointments. Simulation was employed to test the effective of each model on costs of patient wait time, physician idle time and overtime. Findings The results demonstrated the misclassification rate and the area under the curve (AUC) of the Receiver Operating Characteristic (ROC) gradually improved as more appointment history was included until around the 20th predictive model. The overbooking method with no-show predictive models suggested incorporating up to the 16th model and outperformed other overbooking methods by as much as 9.4% in the cost per patient while allowing two additional patients in a clinic day. Research limitations/implications The challenge now is to actually implement the no-show predictive model systematically to further demonstrate its robustness and simplicity in various scheduling systems. Originality/value This paper provides examples of how to build the no-show predictive models with time-dependent components to improve the overbooking policy. Accurately identifying scheduled patients’ show/no-show status allows clinics to proactively schedule patients to reduce the negative impact of patient no-shows.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:36:05Z
      DOI: 10.1108/IJHCQA-06-2015-0077
       
  • Assessing the organizational Impact of patient involvement: a first STEPP
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.
      Purpose Patient involvement in the design and improvement of health services is increasingly recognized as an essential part of patient-centred care. Yet little research, and no measurement tool, has addressed the organizational impacts of such involvement. Design/methodology/approach We developed and piloted the Scoresheet for Tangible Effects of Patient Participation (STEPP) to measure the instrumental use of patient input. Its items assess the magnitude of each recommendation or issue brought forward by patients, the extent of the organization's response, and the apparent degree of patient influence on this response. In collaboration with teams (staff) from five involvement initiatives, we collected interview and documentary data and scored the STEPP, first independently then jointly. Feedback meetings and a "challenges log" supported ongoing improvement. Findings Although researchers’ and teams’ initial scores often diverged, we quickly reached consensus as new information was shared. Composite scores appeared to credibly reflect the degree of organizational impact, and were associated with salient features of the involvement initiatives. Teams described the STEPP as easy to use and useful for monitoring and accountability purposes. The tool seemed most suitable for initiatives in which patients generated novel, concrete recommendations; less so for broad public consultations of which instrumental use was not a primary goal. Originality/value The STEPP is a promising, first-in-class tool with potential usefulness to both researchers and practitioners. With further research to better establish its reliability and validity, it could make a valuable contribution to full mixed-methods evaluation of patient involvement.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:36:03Z
      DOI: 10.1108/IJHCQA-01-2015-0013
       
  • Surgeons’ efficiency change is a major determinant of their
           productivity change.
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.
      Purpose The sustainability of the Japanese healthcare system is in question because the government has had a huge fiscal debt. Despite an enormous effort to cut the deficit, our healthcare expenditure is increasing every year because of our rapidly aging population. One of the solutions for this problem is to improve the productivity of healthcare. The purpose of this study is to determine the factors that change surgeons’ productivity in one year. Design/methodology/approach The authors collected data of all surgical procedures performed at Teikyo University Hospital from April 1 through September 30 in 2014 and 2015, and computed the surgeons’ Malmquist Index, efficiency change and technical change using non-radial and non-oriented Malmquist model under the constant returns-to-scale assumptions. The authors then divided the surgeons into two groups; one whose productivity progressed and the other whose productivity regressed. These two groups were compared to identify factors that may influence their Malmquist index. Findings The only significant difference between the two groups was efficiency changes (p < 0.0001). The other factors, such as technical change, experience, surgical volume, emergency cases, surgical specialty, academic ranks, medical schools, and gender, were not significantly different between the two groups. Originality/value Efficiency change is a major determinant of surgeons’ productivity change. The best way to improve surgeons’ productivity may be to enhance their efficiency regardless of their surgical volume and personal backgrounds.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:36:02Z
      DOI: 10.1108/IJHCQA-12-2015-0150
       
  • Food and meals in caring institutions – a small dive into research
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.
      Purpose Background: With the growing older population, the increasing interest in the elderly’s eating habits and the meal situation go hand in hand and are challenges in many countries, including Norway. This literature investigation, part of an ongoing project in Norway, addresses four categories of elderly people: healthy elderly, old people with home care, elderly living in institutions, and critical ill elderly. Design/methodology/approach Method: The aim of this study was to investigate related articles concerning food and the elderly in the four identified categories, defining six different meal experience categories to disclose possible gaps in the research in terms of core product, room, personal service, company, atmosphere, and management control systems (MCS). Database searches, conducted through JSTOR and Web of Science, started with words in combination with “elderly and meal experiences” and were narrowed down to the most relevant papers with words from the six meal experience categories. Ultimately, 21 of 51 downloaded papers from international journals were reviewed. Findings Result: A comparison of the four elderly groups was made across the six different meal experience categories, which disclosed several gaps. Among the 21 papers, five focused on healthy elderly, 12 on older people living with home care, 16 on elderly living in institutions, and 1 on critical ill elderly. The specific under-researched gaps include room, company, atmosphere, and MCS. Research limitations/implications Conclusion: Future research will need to investigate these groups more thoroughly, and the research should concentrate on the healthy elderly and critical ill in connection with the six meal experience aspects. Originality/value The combination of meal experience aspects towards different elderly categories is an original perspective on the aim of the literature review.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:36:01Z
      DOI: 10.1108/IJHCQA-08-2015-0092
       
  • Recommendations for health information technology implementation in rural
           hospitals
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.
      Purpose To investigate violations against work standards associated with using a new health information technology (HIT) system. Relevant recommendations for implementing HIT in rural hospitals are provided and discussed to achieve meaningful use. Design/methodology/approach An observational study is conducted to map medication administration process while using a HIT system in a rural hospital. Follow-up focus groups are held to determine and verify potential adverse factors related to using the HIT system while passing drugs to patients. Findings A detailed task analysis demonstrated several violations, such as only relying on the barcode scanning system to match up with patient and drugs could potentially result in the medical staff forgetting to provide drug information verbally before administering drugs. There was also a lack of regulated and clear work procedure in using the new HIT system. In addition, the computer system controls and displays could not be adjusted so as to satisfy the users’ expectations. Nurses prepared medications and documentation in an environment that was prone to interruptions. Originality/value Recommendations for implementing a HIT system in rural healthcare facilities can be categorized into five areas: people, tasks, tools, environment, and organization. Detailed remedial measures are provided for achieving continuous process improvements at resource-limited healthcare facilities in rural areas.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:36:00Z
      DOI: 10.1108/IJHCQA-09-2015-0115
       
  • Telephone follow-up for cataract surgery: feasibility and patient
           satisfaction study
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.
      Purpose To investigate the feasibility of telephone follow-up (TFU) after uncomplicated cataract surgery in low-risk patients and patient satisfaction with this alternative clinical pathway. Design/methodology/approach Prospective, non-randomised cohort study. A 10-point subjective ophthalmic assessment questionnaire and a 6-point patient satisfaction questionnaire were administered to patients following routine cataract surgery at 2-3 weeks post-procedure. All patients were offered a further clinic review if required. Exclusion criteria comprised ophthalmic co-morbidities, hearing/language impairment and high risk of postoperative complications. Patient notes were retrospectively reviewed over the study period to ensure no additional emergency attendances took place. Findings Over three months, 50 eyes of 50 patients (mean age: 80; age range 60-91; 66% second eye surgery) underwent uncomplicated phacoemulsification surgery received a TFU at 12-24 days (mean: 16 days) postoperatively. Subjective visual acuity was graded as good by 92% of patients; 72% patients reported no pain and 20% reported mild occasional grittiness. Patient satisfaction was graded 8.9 out of 10; 81.6% defined TFU as convenient and 75.5% of patients preferred TFU to routine outpatient review. No additional visits were required. Research limitations/implications Non-randomised with no control group; small sample size. One patient was unable to be contacted. Practical implications Postoperative TFU can be suitably targeted to low-risk patients following uncomplicated cataract surgery. This study demonstrated a high patient satisfaction. A larger, randomised study is in progress to assess this further. Originality/value This is the first study reporting telephone follow-up results and patient satisfaction to the usual alternative two-week outpatient review.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:35:57Z
      DOI: 10.1108/IJHCQA-08-2015-0096
       
  • The journey of a thousand steps
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:35:56Z
      DOI: 10.1108/IJHCQA-03-2016-0024
       
  • Ward rounds, participants, roles and perceptions: literature review
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.
      Purpose To classify and describe the purpose of ward rounds, who attends each round and their role, and participants’ perception of each others' role during the respective ward rounds. Design/methodology/approach A literature review of face-to-face ward rounds in medical wards was conducted. Peer reviewed journals and government publications published between 2000-2014 were searched. Articles were classified according to the type of round described in the study. Purposes were identified using key words in the description of why the round was carried out. Descriptions of tasks and interactions with team members defined participant roles. Findings Eight round classifications were identified. The most common were the generalised ward; multidisciplinary; and consultant rounds. Multidisciplinary rounds were the most collaborative round. Medical officers were the most likely discipline to attend any round. There was limited reference to allied health clinicians and patient involvement on rounds. Perceptions attendees held of each other reiterated the need to continue to investigate teamwork. Practical implications A collaborative approach to care planning can occur by ensuring clinicians and patients are aware of different ward round processes and their role in them. Originality/value Analysis fulfills a gap in the literature by identifying and analysing the different ward rounds being undertaken in acute medical wards. It identifies the complexities in the long established routine hospital processes of the ward round.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:35:56Z
      DOI: 10.1108/IJHCQA-04-2015-0053
       
  • Application of bow-tie methodology to improve patient safety
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 4, May 2016.
      Purpose The aim of this study was to apply Bow-tie methodology, a proactive risk assessment technique based on systemic approach, for prospective analysis of the risks threatening patient safety in Intensive Care Unit (ICU). Design/methodology/approach Bow-tie methodology was used to manage clinical risks threatening patient safety by a multidisciplinary team in the ICU. The Bow-tie analysis was conducted on incidents related to high-alert medications, ventilator associated pneumonia (VAP), catheter related blood stream infection (CRBSI), urinary tract infection (UTI), and unwanted extubation (UE). Findings Forty eight potential adverse events were analysed. The causal factors were identified and classified into relevant categories. The number and effectiveness of existing preventive and protective barriers were examined for each potential adverse event. The adverse events were evaluated according to the risk criteria and a set of interventions were proposed with the aim of improving the existing barriers or implementing new barriers. A number of recommendations were implemented in the ICU, while considering their feasibility.. Originality/value The application of Bow-tie methodology led to practical recommendations to eliminate or control the hazards identified. It also contributed to better understanding of hazard prevention and protection required for safe operations in clinical settings.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-04-04T11:35:55Z
      DOI: 10.1108/IJHCQA-10-2015-0121
       
  • Measuring healthcare productivity – from unit to system level
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.
      Purpose Healthcare productivity is a growing issue in most Western countries where healthcare expenditure is rapidly increasing. Therefore, accurate productivity metrics are essential to avoid sub-optimization within a healthcare system. In this article, we focus on healthcare production system productivity measurement. Design/methodology/approach Traditionally, healthcare productivity has been studied and measured independently at the unit, organization, and system level. Suggesting that productivity measurement should be done in different levels, while simultaneously linking productivity measurement to incentives, this study presents the challenges of productivity measurement at the different levels. The study introduces different methods to measure productivity in healthcare. In addition, it provides background information on the methods used to measure productivity and the parameters used in these methods. A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures, and to prove the practical information for managers. Findings The study introduces different approaches and methods to measure productivity in healthcare. Research limitations/implications Practical implications A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures, and to prove the practical benefits for managers. Originality/value We focus on the measurement of the whole healthcare production system and try to avoid sub-optimization. Additionally considering an individual patient approach, productivity measurement is examined at the unit level, the organizational level, and the system level.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:31Z
      DOI: 10.1108/IJHCQA-04-2015-0050
       
  • Measuring patient-perceived hospital service quality: a conceptual
           framework
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.
      Purpose Although measuring healthcare service quality is not a new phenomenon, the instruments used to measure are timeworn. With the shift in focus to patient centric processes in hospitals and recognising healthcare to be different compared to other services, service quality measurement needs to be tuned specifically to healthcare. The study’s purpose is to design a conceptual framework for measuring patient perceived hospital service quality, based on existing service quality literature Design/methodology/approach Using hospital service quality theories, expanding existing healthcare service models and literature, a conceptual framework is proposed to measure hospital service quality. The article outlines inpatient perceived service quality dimensions Findings An instrument for measuring hospital service quality dimensions is developed and compared with other service quality measuring instruments. The latest dimensions are in line with previous studies, but a relationship dimension is added. Practical implications The framework empowers managers to assess healthcare quality in corporate, public and teaching hospitals. Originality/value The article helps academics and practitioners to assess hospital service quality from a patient perspective.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:29Z
      DOI: 10.1108/IJHCQA-05-2015-0069
       
  • Measuring quality in community based housing support - the QPC-H
           instrument
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.
      Purpose The purpose of the study was to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care – Housing (QPC–H) and briefly describe the residents perception of quality of housing support. Design/methodology/approach A sample of 174 residents from 22 housing support services in nine Swedish municipalities participated in the study. Confirmatory factor analysis revealed that the QPC–H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care family of instruments Findings Confirmatory factor analysis revealed that the QPC–H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care family of instruments. The internal consistency of the factors was acceptable except in the case of secure and secluded environment, probably due to few numbers of items. With this exception, the QPC–H shows adequate psychometric properties. Originality/value The QPC–H includes important aspects of residents’ assessment of quality of housing service and offers a simple and inexpensive way to evaluate housing support services from the residents’ perspective.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:28Z
      DOI: 10.1108/IJHCQA-05-2015-0067
       
  • Seizing opportunities for change at the operational level
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.
      Purpose This article presents a method for handling everyday opportunities for improvement, led by floor staff in health care institutions. More than 400,000 incidents and accidents were recorded in Quebec health care institutions in 2013. The burden of treatment falls on hospital floor staff. The purpose is to raise the visibility of this problem and support staff better in their efforts to handle opportunities for improvement. Design/methodology/approach Based on issues identified in the literature, which have been found to exist in various organizations, the method involved reviewing practices in the field, proposing a solution, and testing it to assess its relevance and limitations. The method was tested in partnership with the Centre Hospitalier de l’Université de Montréal, in the internal medicine unit at Hôtel-Dieu campus. The test lasted three months. Indicators from this test have been compared to results in the literature. Findings The proposed method presents a 68% increase in ideas generated per person and per week compared to the reference study. The mean time for closing actions was about 41% better (lower) than in the reference case. Research limitations/implications The test lasted 15 weeks; a longer test is needed to collect more data. Practical implications The first practical implication of this study was the creation of a method allowing employees to seize opportunities for improvement in their daily work. The application of this method revealed (1) the operational nature of the proposal (empowerment of the work team); (2) the operationalization of continuous improvement (71% of ideas were finalized while the initiative was monitored); (3) the smooth operation of the mechanism for facilitating continuous improvement (organization of weekly meetings and team participation in these meetings in 90% of cases); and (4) a shared feeling that intra- and inter-team communication had been strengthened. Originality/value The main value of this paper is that it proposes a simple problem-solving process that gives employees an opportunity to improve their daily work. The originality of this paper resides in comparing results to a standard case and observing an improvement. This paper proposes a new problem-solving structure and tests it scientifically.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:27Z
      DOI: 10.1108/IJHCQA-02-2015-0022
       
  • Monitoring operating room turnaround time: a retrospective analysis
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.
      Purpose Operating room turnaround time is a key process indicator for hospital business management: delays lead to a reduced surgical interventions per day with a consequent increase in costs and decrease in efficiency. This study aims to increase understanding by assessing the process’ steady-state behaviour and identifying changes that indicate either improvement or deterioration in quality. Design/methodology/approach With this purpose, we retrospectively applied Shewhart control charts and exponentially weighted moving average control charts to data extracted from an hospital information system. Findings The results showed that statistical process control is able to identify steady-state behaviour process and to detect positive or negative changes in process performance. In particular we detected a deterioration in the process performance coinciding with the change in the operanting room patient transfer staff. Practical implications This study showed that statistical quality control is a valuable tool for monitoring performance indicators. Currently, hospital managers are designing an operating room dashboard which also includes the control charts. Originality/value The article highlights the control chart application to organizational indicators allowing an objective operating room system performance assessment
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:25Z
      DOI: 10.1108/IJHCQA-08-2015-0105
       
  • Reduced time from diagnosis to stone-free status in patients with ureteral
           calculi – a quantitative study
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.
      Purpose Purpose - The aim was to describe an improvement project and its effects on decreasing the time from diagnosis to treatment for patients with kidney stones and to reduce the negative effects related to untreated stones at one hospital in western Sweden Design/methodology/approach Design and methodology - A quantitative descriptive study based on Nolan’s improvement model was used. The quality improvement effects were evaluated using statistical process control (SPC). Findings Findings – Extracorporeal shock wave lithotripsy ESWL treatment’s positive effects within 48 hours were described as efficiency (decreased waiting time) from diagnosis to treatment, even if a re-treatment was necessary. The results also showed a reduction in the usage of percutaneous nephropyelostomies as a treatment option. Research limitations/implications Research limitations - This study includes data from one department at one hospital in one country. Comparative data include the time from acute radiological examination to final treatment but not total re-treatments, complications or time to up following radiological examination. However, the study was performed over one year and analyzed data from medical records in a systematic way. Practical implications Practical implications - This study may inspire measuring and developing routines from diagnosis to treatment for patients who are transferred within different departments at one hospital. Originality/value Originality - Studies in improvement projects considering ureteral or kidney stones are generally lacking; thus, this study is important for improving the care of patients with this diagnose.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:24Z
      DOI: 10.1108/IJHCQA-03-2015-0028
       
  • Healthcare quality maturity assessment model based on quality drivers
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.
      Purpose Healthcare providers differ in their readiness and maturity levels regarding quality and quality management systems applications. The proposed model serves as a useful quantitative quality maturity level assessment tool for healthcare organizations. Design/methodology/approach The model proposes five quality maturity levels (chaotic, primitive, structured, mature and proficient) based on six quality drivers: top management, people, operations, culture, quality focus and accreditation. Findings Healthcare managers can apply the model to identify the status quo, quality shortcomings and evaluating ongoing progress. Practical implications The model has been incorporated in an interactive Excel worksheet that visually displays the quality maturity level risk meter. The tool has been applied successfully to local hospitals. Originality/value The proposed six quality driver scales appear to measure healthcare provider maturity levels on a single quality meter.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:23Z
      DOI: 10.1108/IJHCQA-08-2015-0100
       
  • Developing, testing and implementing customer-focused, service-quality
           instruments
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:20Z
      DOI: 10.1108/IJHCQA-02-2016-0011
       
  • Measuring patient satisfaction in complex continuing care/rehabilitation
           care
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 3, April 2016.
      Purpose To develop a psychometrically validated survey to assess satisfaction in complex continuing care/rehabilitation patients. Design/methodology/approach A paper or computer-based survey was administered to 252 complex continuing care/ rehabilitation patients (i.e., post-acute hospital care setting for people who require ongoing care before returning home) across two hospitals in Toronto, Ontario, Canada. Findings Using factor analysis, five domains were identified with loadings above 0.4 for all but one item. Behavioral intention and information/communication showed the lowest patient satisfaction, while patient centredness the highest. Each domain correlated positively and significantly predicted overall satisfaction, with quality and safety showing the strongest predictive power and the healing environment the weakest. Gender made a significant contribution to predicting overall satisfaction, but age did not. Research limitations/implications Results provide evidence of the survey’s psychometric properties. Owing to a small sample, supplemental testing with a larger patient-group is required to confirm the five-factor structure and to assess test-retest reliability. Originality/value Improving the health system requires integrating patient perspectives. The patient experience, however, will vary depending on the population being served. This is the first psychometrically validated survey specific to a smaller speciality patient group receiving care at a complex continuing care/rehabilitation facility in Canada.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-01T12:18:19Z
      DOI: 10.1108/IJHCQA-07-2015-0084
       
  • How strange the change, from major to minor, with apologies to Ella
           Fitzgerald
    • Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, March 2016.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-09T02:55:44Z
      DOI: 10.1108/IJHCQA-01-2016-0002
       
  • The impact of person-organization fit on innovative work behavior
    • Pages: 104 - 122
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, Page 104-122, March 2016.
      Purpose – The direct relationship between person-organization (P-O) fit and employee’s positive work attitudes and behaviours have been well researched. However, there has been no study on the impact of P-O fit on innovative work behaviour (IWB) of the nurses. The purpose of this paper is to fill this gap in the literature. In order to give a complete understanding of the psychology surrounding P-O fit, this study has longitudinally analysed the relationship between P-O fit and IWB along with the impact of a potential mediator, i.e. knowledge sharing behaviour (KSB) 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 modelling was used to analyse the relationships. Findings – Results of the study indicate that a nurse’s P-O fit is positively associated with both self and doctor ratings of innovative behaviours; and KSB acts as a partial mediator between P-O fit and IWB at both Times 1 and 2. These results imply that a nurse’s perceived fit in the hospital impacts his/her engagement into IWB. As nurses share knowledge with their co-workers frequently, it tends to strengthen the relationship between P-O fit and IWB. Originality/value – Study findings begin to explain how P-O fit impacts IWB of nurses. Specifically, the author find that KSB explains the relationship between P-O fit and IWB.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2016-03-09T02:55:33Z
      DOI: 10.1108/IJHCQA-01-2015-0017
       
  • Combined quality function deployment and logical framework analysis to
           improve quality of emergency care in Malta
    • Pages: 123 - 140
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, Page 123-140, March 2016.
      Purpose – The purpose of this paper is 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. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, 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: 2016-03-09T02:54:59Z
      DOI: 10.1108/IJHCQA-04-2014-0040
       
  • Improving healthcare practice behaviors
    • Pages: 141 - 161
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, Page 141-161, March 2016.
      Purpose – The purpose of this paper is to present 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., 1997). 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. Social implications – The findings would indicate that the human values of excellence, innovation, joy, respect and integrity play a significant role in building a strong service relationship between consumer and healthcare provider. 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: 2016-03-09T02:55:07Z
      DOI: 10.1108/IJHCQA-07-2015-0089
       
  • Advancing the Big Five of user-oriented care and accounting for its
           variations
    • Pages: 162 - 176
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, Page 162-176, 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 purpose of this paper is to describe 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, the authors 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, the authors conducted interviews with care workers and care unit managers (Study 2). Findings – A new taxonomy for categorizing 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: 2016-03-09T02:55:49Z
      DOI: 10.1108/IJHCQA-03-2015-0040
       
  • Five focus strategies to organize health care delivery
    • Pages: 177 - 191
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, Page 177-191, 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. The purpose of this paper is to discuss 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: population; urgency and severity; illnesses and symptoms; care practices and processes; and 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: 2016-03-09T02:55:45Z
      DOI: 10.1108/IJHCQA-05-2015-0065
       
  • Lean and Six Sigma in acute care: a systematic review of reviews
    • Pages: 192 - 208
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, Page 192-208, March 2016.
      Purpose – The purpose of this paper is 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. To 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 were 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: 2016-03-09T02:55:53Z
      DOI: 10.1108/IJHCQA-05-2014-0058
       
  • Performance management of the public healthcare services in Ireland: a
           review
    • Pages: 209 - 235
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, Page 209-235, 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 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: 2016-03-09T02:55:13Z
      DOI: 10.1108/IJHCQA-07-2014-0079
       
  • Management of surgical instruments with radio frequency identification
           tags
    • Pages: 236 - 247
      Abstract: International Journal of Health Care Quality Assurance, Volume 29, Issue 2, Page 236-247, 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. The purpose of this paper is to evaluate a new management method of RFID-tagged instruments. Design/methodology/approach – The management system of RFID-tagged surgical instruments was used for 27 months in clinical areas. In total, 13 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: 2016-03-09T02:55:41Z
      DOI: 10.1108/IJHCQA-03-2015-0034
       
 
 
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