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Publisher: Emerald   (Total: 310 journals)

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A Life in the Day     Hybrid Journal   (Followers: 9)
Accounting Auditing & Accountability J.     Hybrid Journal   (Followers: 19)
Accounting Research J.     Hybrid Journal   (Followers: 23, SJR: 0.148, h-index: 3)
Accounting, Auditing and Accountability J.     Hybrid Journal   (Followers: 4, SJR: 0.972, h-index: 30)
Advances in Accounting Education     Hybrid Journal   (Followers: 10)
Advances in Appreciative Inquiry     Hybrid Journal   (Followers: 2, SJR: 0.107, h-index: 4)
Advances in Dual Diagnosis     Hybrid Journal   (Followers: 34)
Advances in Mental Health and Intellectual Disabilities     Hybrid Journal   (Followers: 44, 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: 9)
Agricultural Finance Review     Hybrid Journal   (Followers: 1)
Aircraft Engineering and Aerospace Technology     Hybrid Journal   (Followers: 103, SJR: 0.339, h-index: 15)
American J. of Business     Hybrid Journal   (Followers: 7)
Anti-Corrosion Methods and Materials     Hybrid Journal   (Followers: 5, SJR: 0.309, h-index: 23)
Arts Marketing : An Intl. J.     Hybrid Journal   (Followers: 11)
Asia Pacific J. of Marketing and Logistics     Hybrid Journal   (Followers: 6)
Asia-Pacific J. of Business Administration     Hybrid Journal   (Followers: 2, SJR: 0.237, h-index: 4)
Asian Education and Development Studies     Hybrid Journal   (Followers: 6)
Asian J. on Quality     Hybrid Journal   (Followers: 2)
Asian Review of Accounting     Hybrid Journal   (Followers: 1, SJR: 0.174, h-index: 3)
Aslib J. of Information Management     Hybrid Journal   (Followers: 6)
Aslib Proceedings     Hybrid Journal   (Followers: 166, 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: 5, SJR: 0.554, h-index: 28)
British Food J.     Hybrid Journal   (Followers: 8, SJR: 0.361, h-index: 25)
Built Environment Project and Asset Management     Hybrid Journal   (Followers: 16, 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: 9, SJR: 0.721, h-index: 22)
China Agricultural Economic Review     Hybrid Journal   (Followers: 1, SJR: 0.419, h-index: 6)
China Finance Review Intl.     Hybrid Journal   (Followers: 4)
Chinese Management Studies     Hybrid Journal   (Followers: 4, SJR: 0.424, h-index: 7)
Circuit World     Hybrid Journal   (Followers: 14, SJR: 0.297, h-index: 15)
Clinical Governance: An Intl. J.     Hybrid Journal   (Followers: 20, SJR: 0.176, h-index: 13)
Collection Building     Hybrid Journal   (Followers: 9, SJR: 0.461, h-index: 8)
COMPEL: The Intl. J. for Computation and Mathematics in Electrical and Electronic Engineering     Hybrid Journal   (Followers: 3, 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: 15)
Corporate Communications An Intl. J.     Hybrid Journal   (Followers: 4, 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: 6, SJR: 0.648, h-index: 6)
Development and Learning in Organizations     Hybrid Journal   (Followers: 5, SJR: 0.123, h-index: 6)
Direct Marketing An Intl. J.     Hybrid Journal   (Followers: 6)
Disaster Prevention and Management     Hybrid Journal   (Followers: 14, SJR: 0.352, h-index: 24)
Drugs and Alcohol Today     Hybrid Journal   (Followers: 55, SJR: 0.129, h-index: 2)
Education + Training     Hybrid Journal   (Followers: 15, 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: 16, 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: 9, SJR: 0.109, h-index: 1)
EuroMed J. of Business     Hybrid Journal  
European Business Review     Hybrid Journal   (Followers: 5, SJR: 0.368, h-index: 15)
European J. of Innovation Management     Hybrid Journal   (Followers: 15, SJR: 0.442, h-index: 22)
European J. of Marketing     Hybrid Journal   (Followers: 18, 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: 7)
Facilities     Hybrid Journal   (Followers: 2, SJR: 0.34, h-index: 13)
foresight     Hybrid Journal   (Followers: 7, SJR: 0.62, h-index: 16)
Gender in Management : An Intl. J.     Hybrid Journal   (Followers: 10, SJR: 0.495, h-index: 17)
Grey Systems : Theory and Application     Hybrid Journal  
Health Education     Hybrid Journal   (Followers: 3, SJR: 0.345, h-index: 13)
Higher Education, Skills and Work-based Learning     Hybrid Journal   (Followers: 34, SJR: 0.121, h-index: 2)
History of Education Review     Hybrid Journal   (Followers: 8, 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: 2, 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: 3, SJR: 0.989, h-index: 54)
Industrial Robot An Intl. J.     Hybrid Journal   (Followers: 2, SJR: 0.421, h-index: 25)
Info     Hybrid Journal   (SJR: 0.337, h-index: 17)
Information and Computer Security     Hybrid Journal   (Followers: 15, SJR: 0.29, h-index: 28)
Information Technology & People     Hybrid Journal   (Followers: 57, SJR: 0.664, h-index: 21)
Interactive Technology and Smart Education     Hybrid Journal   (Followers: 13)
Interlending & Document Supply     Hybrid Journal   (Followers: 75, SJR: 0.593, h-index: 10)
Internet Research     Hybrid Journal   (Followers: 59, SJR: 0.846, h-index: 44)
Intl. J. for Lesson and Learning Studies     Hybrid Journal   (Followers: 2)
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)
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: 10, SJR: 0.322, h-index: 31)
Intl. J. of Contemporary Hospitality Management     Hybrid Journal   (Followers: 9, SJR: 1.2, h-index: 24)
Intl. J. of Culture Tourism and Hospitality Research     Hybrid Journal   (Followers: 13, SJR: 0.113, h-index: 1)
Intl. J. of Development Issues     Hybrid Journal   (Followers: 6)
Intl. J. of Disaster Resilience in the Built Environment     Hybrid Journal   (Followers: 5, 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: 1)
Intl. J. of Emerging Markets     Hybrid Journal   (Followers: 2)
Intl. J. of Energy Sector Management     Hybrid Journal   (Followers: 4, SJR: 0.187, h-index: 7)
Intl. J. of Entrepreneurial Behaviour & Research     Hybrid Journal   (Followers: 6, SJR: 0.545, h-index: 20)

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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  [310 journals]
  • Exploring the effect of complex patients on care delivery tasks
    • Authors: Mustafa Ozkaynak, Sharon Johnson, Bengisu Tulu, Jennifer Donovan, Abir Kanaan, Adam Rose
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.
      Purpose The needs of complex patients with chronic conditions can be unpredictable and can strain resources. Exploring how tasks vary for different patients, particularly those with complex needs, can yield insights about designing better processes in healthcare. This study explored the tasks required to manage complex patients in an anticoagulation therapy context. Design/methodology/approach We analyzed interviews with 55 staff in six anticoagulation clinics using the Systems Engineering Initiative for Patient Safety (SEIPS) work system framework. We qualitatively described complex patients and their effects on care delivery. Findings Data analysis highlighted how identifying complex patients and their effect on tasks and organization, and the interactions between them was important. Managing complex patients required similar tasks as non-complex patients, but with greater frequency or more intensity and several additional tasks. After complex patients and associated patient interaction and care tasks were identified, a work system perspective was applied to explore how such tasks are integrated within clinics and the resulting implications for resource allocation. Practical implications We present a complex patient management framework to guide workflow design in specialty clinics, to better support high quality, effective, efficient and safe healthcare. Originality/value The complex patient framework presented here, based on the SEIPS framework, suggests a more formal and integrated analysis be completed to provide better support for appropriate resource allocation and care coordination.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:18:43 GMT
      DOI: 10.1108/IJHCQA-11-2014-0105
       
  • Improving screening for diabetes in cystic fibrosis
    • Authors: Ibrahim Abdulhamid, Lokesh Guglani, Jennifer Bouren, Kathleen C Moltz
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.
      Purpose Annual screening for cystic fibrosis-related-diabetes (CFRD) using oral glucose tolerance test (OGTT) is recommended, but national testing rates are low. Our quality improvement initiative’s purpose was to improve cystic fibrosis (CF) annual screening rates among patients at one CF center. Design/methodology/approach To improve screening for CFRD at our CF Center, we used the Dartmouth Microsystem Improvement Ramp method and formed a collaborative working group. A process map was created to outline the steps and a fishbone analysis was performed to identify barriers and to utilize resources for implementing new interventions. Findings Prior to these interventions, 21% of eligible patients had completed annual screening and after the intervention, it rose to 72%. The initial completion rate with the first prescription was only 50%, but it improved steadily to 54/75 (72%) in response to reminder letters sent six weeks after the initial script was given. Practical implications Close tracking and reminder letters can improve adherence with annual OGTT screening for CFRD among CF patients, with special emphasis on high-risk patients. Originality/value There should be a special emphasis on screening for CFRD in high-risk CF patients (those with low BMI or higher age). This quality improvement initiative brought about several operational changes in the annual OGTT screening process that have now become the standard operating procedure at our center.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:18:42 GMT
      DOI: 10.1108/IJHCQA-05-2014-0059
       
  • Investigating emergency room service quality using lean manufacturing
    • Authors: Abdelhakim Abdelhadi
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.
      Purpose To investigate a lean manufacturing metric called Takt time as a benchmark evaluation measure to evaluate a public hospital’s service quality. Lean manufacturing is an established managerial philosophy with a proven track record in industry. A lean metric called Takt time is applied as a measure to compare the relative efficiency between two emergency departments (EDs) belonging to the same public hospital. Outcomes guide managers to improve patient services and increase hospital performances. Design/methodology/approach The patient treatment lead time within the hospital's two EDs (one department serves male and the other female patients) are the study’s focus. A lean metric called Takt time is used to find the service’s relative efficiency. Findings Findings show that the lean manufacturing metric called Takt time can be used as an effective way to measure service efficiency by analysing relative efficiency and identifies bottlenecks in different departments providing the same services. Originality/value The article presents a new procedure to compare relative efficiency between two EDs. It can be applied to any healthcare facility.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:18:33 GMT
      DOI: 10.1108/IJHCQA-01-2015-0006
       
  • Customer perceived service quality, satisfaction and loyalty in Indian
           private healthcare
    • Authors: Rama Koteswara Rao Kondasani, Rajeev Kumar Panda
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.
      Purpose To analyse how perceived service quality and customer satisfaction lead to loyalty towards healthcare service providers. Design/methodology/approach Four hundred and seventy-five hospital patients participated in a questionnaire survey in five Indian private hospitals. Descriptive statistics, factor analysis, regression and correlation statistics were employed to analyse customer perceived service quality and how it leads to loyalty towards service providers. Findings Results indicate that the service seeker-service provider relationship, quality of facilities and the interaction with supporting staff have a positive effect on customer perception. Practical implications Findings help healthcare managers to formulate effective strategies to ensure a better quality of services to the customers. This study helps healthcare managers to build customer loyalty towards healthcare services, thereby attracting and gaining more customers. Originality/value This article will help healthcare managers and service providers to analyse customer perceptions and their loyalty towards Indian private healthcare services.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:18:08 GMT
      DOI: 10.1108/IJHCQA-01-2015-0008
       
  • Improving ED specimen TAT using Lean Six Sigma
    • Authors: Janet H Sanders, Tedd Karr
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.
      Purpose Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. This manuscript discusses a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. Design/methodology/approach This case study provides details on the completion of a Lean Six Sigma project in a 1000 bed tertiary care teaching hospital. Six Sigma's DMAIC methodology is very similar to good medical practice: 1) relevant information is obtained and assembled; 2) a careful and thorough diagnosis is completed; 3) a treatment is proposed and implemented; and 4) checks are made to determine if the treatment was effective. Lean’s primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. Findings The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50% decrease in vials used for testing, a 50% decrease in unused or extra specimens, a 90% decrease in ED specimens without orders, a 30% decrease in CBCA Median TAT, a 50% decrease in CBCA TAT Variation, a 10% decrease in Troponin TAT Variation, a 18.2% decrease in URPN TAT Variation, and a 2 to 5 minute decrease in ED RN rainbow draw time. Practical implications This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve the blood draw process for a 1000 bed tertiary care teaching hospital. The blood draw process is a standard process used in hospitals to collect blood chemistry and hematology information for clinicians. The methods used in this case study demonstrated valuable and practical applications of process improvement methodologies that can be used for any hospital process and/or service environment. Originality/value While this is not the first case study that has demonstrated the use of continuous process improvement methodologies to improve a hospital process, it is unique in the way in which it utilizes the strength of the project focused approach that adheres more to the structure and rigor of Six Sigma and relied less on the speed of lean. Additionally, the application of these methodologies in healthcare is emerging research.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:17:58 GMT
      DOI: 10.1108/IJHCQA-10-2013-0117
       
  • Care quality instruments
    • Authors: Manela Glarcher, Petra Schumacher, Elfriede Fritz
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.
      Purpose This article describes instruments used for quality assessment in acute care. Quality care assessment is essential for improving care delivery. Quality instruments can be used to evaluate nurse and patient perspectives in multi-professional care. Therefore, valid and reliable measurement instruments are vital. Design/methodology/approach A literature search identified several instruments that measure quality from a nurse and patient perspectives. The questionnaires were appraised in several steps with specific criteria: psychometric properties, underlying construct or test theory, study context, sample characteristics and target population. Findings Overall, 14 instruments were evaluated, but only eight questionnaires represented nurse and patient views regarding quality. Instruments showed several disparities in their theoretical foundations and their psychometric properties. Two instruments did not provide validity data and one questionnaire did not report reliability data. Practical implications To inform healthcare managers about acute care quality, the authors demonstrated the need for more valid and reliable measurements by using the Guidelines for Critiquing Instrument Development and Validation Reports to evaluate quality care instruments’ psychometric properties. Originality/value There is a long tradition in quality care evaluations using questionnaires. Only a few instruments can be recommended for practical use.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:17:53 GMT
      DOI: 10.1108/IJHCQA-01-2015-0010
       
  • Editorial, Volume 28.5: Doing more with the same resources.
    • Authors: Keith Hurst
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:17:52 GMT
      DOI: 10.1108/IJHCQA-04-2015-0043
       
  • Agile, a guiding principle for health care improvement?
    • Authors: Sara Tolf, Monica Elisabeth Nyström, Carol Tishelman, Mats Brommels, Johan Hansson
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.
      Purpose To contribute to increased understanding of the concept agile and its potential for hospital managers to optimize design of organizational structures and processes to combine internal efficiency and external effectiveness. Design/methodology/approach An integrative review was conducted using the reSEARCH database. Articles met the following criteria: 1) a definition of agility, 2) descriptions of enablers of becoming an agile organization, and 3) discussions of agile on multiple organizational levels. Sixty articles qualified for the final analysis. Findings Organizational agility rests on the assumption that the environment is uncertain, ranging from frequently changing to highly unpredictable. Proactive, reactive or embracive coping strategies were described as possible ways to handle such uncertain environments. Five organizational capacities were derived as necessary for hospitals to use the strategies optimally: transparent and transient inter-organizational links; market sensitivity and customer focus, management by support for self-organizing employees, organic structures that are elastic and responsive, flexible human and resource capacity for timely delivery. Agile is portrayed as either the “new paradigm” following lean, the needed development on top of a lean base, or as complementary to lean in distinct hybrid strategies. Practical implications Environmental uncertainty needs to be matched with coping strategies and organizational capacities to design processes responsive to real needs of health care. This implies that lean and agile can be combined to optimize the design of hospitals, to meet different variations in demand and create good patient management. Originality/value While considerable value has been paid to strategies to improve the internal efficiency within hospitals, this review raise the attention to the value of strategies of external effectiveness.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:17:10 GMT
      DOI: 10.1108/IJHCQA-04-2014-0044
       
  • Service quality in contracted facilities
    • Authors: Fauziah Rabbani, Nousheen Akber Pradhan, Shehla Zaidi, Iqbal Azam, Farheen Yousuf
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 5, June 2015.
      Purpose This study explores the readiness of contracted and non-contracted first level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework. Design/methodology/approach Using a cross sectional study design, two Rural Health Centres (RHCs) contracted out to Aga Khan Health Services, were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. Twenty indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson Chi-Square, Fisher’s Exact and the Mann-Whitney test were applied as appropriate to detect significant service quality differences among the two facilities. Findings Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients’ inclination for facility-based delivery at contracted facilities was however significantly higher than non-contracted facilities (80% contracted vs. 43% non-contracted, p= 0.006). Practical implications The study shows that contracting out initiatives have the potential to improve MNH care. Originality/value This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Fri, 10 Apr 2015 00:17:08 GMT
      DOI: 10.1108/IJHCQA-05-2014-0066
       
  • Editorial, Volume 28.4: Asking health and social care staff to go the
           extra QA mile.
    • Authors: Keith Hurst
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:13:50 GMT
      DOI: 10.1108/IJHCQA-03-2015-0031
       
  • Sustainability: orthopaedic surgery wait time management strategies
    • Authors: Claudia Amar, Marie-Pascale Pomey, Claudia SanMartin, Carolyn De Coster, Tom Noseworthy
      First page: 320
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.
      Purpose This research examined Canadian organizational and systemic factors that made it possible to keep wait times within federally established limits for at least 18 months. Design/methodology/approach The research design is a multiple cases study. We selected three cases: case one staff were able to maintain compliance with requirements for more than 18 months; case two staff were able to meet requirements for 18 months, but unable to sustain this level; case three staff were never able to meet the requirements. For each case we interviewed persons involved in the strategies and collected documents. We analyzed systemic and organisational level factors; including governance and leadership, culture, resources, methods and tools. Findings Findings indicate that the hospital that was able to maintain compliance with the wait time requirements had specific characteristics: (i) an exclusive mandate to do only hip and knee replacement surgery; (ii) motivated staff who were not distracted by other concerns; and (iii) a strong team spirit. Originality/value Our research highlights an important gradient between three cases regarding the factors that sustain waiting times. We show that the hospital factory model seems attractive in a super-specialized surgery context. However, patients are selected for simple surgeries, without complications, and so this cannot be considered a unique model.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:14:00 GMT
      DOI: 10.1108/IJHCQA-11-2013-0131
       
  • Patient assessment of primary care physician communication: segmentation
           approach
    • Authors: Elena A. Platonova, Richard M. Shewchuk
      First page: 332
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.
      Purpose This article aims to examine how patient assessment of primary care physician (PCP) communication is related to patient satisfaction with the PCP, patient perception of PCP professional competence, patient assessment of the relationship with the doctor and patient demographic characteristics using a segmentation approach. Design/methodology/approach We surveyed 514 adult patients waiting for appointments with their PCPs in two US primary care clinics. A latent class analysis was used to identify mutually exclusive unobserved homogeneous classes of patients. Findings We identified three distinct classes/groups with regard to patient assessment of physician communication and the physician-patient relationship. The largest group (53% of the sample) assessed their PCP communication and other doctor-patient relationship aspects as excellent. However, 37% provided mostly negative assessments, expressed high general dissatisfaction with the physician and disagreed with the statement that their PCP was well qualified to manage their health problems. These patients were on average more educated and affluent and the group included more males. About 10% of patients expressed generally lower satisfaction with the PCP, though their dissatisfaction was not as extreme as in the highly dissatisfied group. Research limitations/implications Further studies are needed to help physicians develop skills to communicate with different patients. Originality/value Patient segmentation can be an important tool for healthcare quality improvement particularly for emerging approaches to primary care such as patient-centered care.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:13:58 GMT
      DOI: 10.1108/IJHCQA-11-2013-0136
       
  • Implementing hospital quality assurance policies in Iran: balancing
           licensing, annual evaluation, inspections and quality management systems
    • Authors: Asgar Aghaei Hashjin, Bahram Delgoshaei, Dionne S Kringos, Seyed Jamaladin Tabibi, Jila Manouchehri, Niek S Klazinga
      First page: 343
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.
      Purpose This article provides an overview of applied hospital quality assurance (QA) policies in Iran. Design/methodology/approach A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010. Findings The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government’s strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity. Practical implications The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries. Originality/value This article describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:13:51 GMT
      DOI: 10.1108/IJHCQA-03-2014-0034
       
  • Small and big quality in health care
    • Authors: Paul Martin Lillrank
      First page: 356
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.
      Purpose This article’s purpose is to: (i) clarify healthcare quality’s ontological and epistemological foundations; and (ii) examine how these lead to different measurements and technologies. Design/methodology/approach Conceptual analysis. Findings Small quality denotes conformance to ex ante requirements. Big quality includes product and service design, based on customer requirements and expectations. Healthcare quality can be divided into three areas: (i) clinical decision-making; (ii) patient safety; and (iii) patient experience, each with distinct measurement and improvement technologies. Practical implications The conceptual model is expected to bring clarity to constructing specific definitions, measures, objectives and technologies for improving healthcare. Originality/value This article claims that before healthcare quality can be defined, measured and integrated into systems, it needs to be clearly separated into ontologically and epistemologically different parts.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:13:31 GMT
      DOI: 10.1108/IJHCQA-05-2014-0068
       
  • Service quality framework for clinical laboratories
    • Authors: Vinaysing Ramessur, Dinesh Kumar Hurreeram, Kaylasson Maistry
      First page: 367
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.
      Purpose This article illustrates a service quality framework that enhances service delivery in clinical laboratories by gauging medical practitioner satisfaction and by providing avenues for continuous improvement. Design/methodology/approach The case study method has been used for conducting the exploratory study, with focus on the Mauritian public clinical laboratory. A structured questionnaire based on the SERVQUAL service quality model was used for data collection, analysis and for the development of the service quality framework. Findings The study confirms the pertinence of the following service quality dimensions within the context of clinical laboratories: tangibility, reliability, responsiveness, turnaround time, technology, test reports, communication and laboratory staff attitude and behaviour. Practical implications The service quality framework developed, termed LabSERV, is vital for clinical laboratories in the search for improving service delivery to medical practitioners. Originality/value This is a pioneering work carried out in the clinical laboratory sector in Mauritius. Medical practitioner expectations and perceptions have been simultaneously considered to generate a novel service quality framework for clinical laboratories.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:13:41 GMT
      DOI: 10.1108/IJHCQA-07-2014-0077
       
  • Roadmap for developing a national quality indicator set for general
           practice
    • Authors: Ailis Ni Riain, Catherine Vahey, Conor Kennedy, Stephen Campbell, Claire Collins
      First page: 382
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.
      Purpose This article describes a national, comprehensive quality indicator set to support delivering high quality clinical care in Irish general practice. Design/methodology/approach Potential general practice quality indicators were identified through a literature review. A modified two-stage Delphi process was used to rationalise international indicators into an indicator set, involving both experts from key stakeholder groups (GPs, practice nurses, practice managers, patient and health policy representatives) and predominantly randomly selected GPs. An illustrative evaluation approach was used to road test the indicator set and supporting materials. Findings Eighty panellists completed the two Delphi rounds and staff in 13 volunteer practices participated in the road test. The original 171 indicators was reduced to 147 during the Delphi process and further reduced to 68 indicators during the road test. The indicators were set out in 14 sub-domains across three areas (practice infrastructure, practice processes and procedures, and practice staff). Practice staff planned 77 quality improvement activities after their assessment against the indicators and 31 (40%) were completed with 44 (57%) ongoing and two (3%) not advanced after a six month road test. A General Practice Indicators of Quality (GP-IQ) indicator set and support materials were produced at the conclusion. Practical implications It is important and relatively easy to customise existing quality indicators to a particular setting. The development process can be used to raise awareness, build capacity and drive quality improvement activity in general practices. Originality/value We describe in detail a method to develop general practice quality indicators for a regional or national population from existing validated indicators using consensus, action research and an illuminative evaluation.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:13:18 GMT
      DOI: 10.1108/IJHCQA-09-2014-0091
       
  • Clinical pathways in China – an evaluation
    • Authors: Jingwei Alex He, Wei Yang
      First page: 394
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.
      Purpose Clinical pathways are multidisciplinary care plans with essential care steps for patients with specific clinical problems. Clinical pathways were introduced in China in 2009 to assure quality, reduce risks, increase resource efficiency and control costs. We present a Chinese public hospital case study where a clinical pathway pilot was undertaken where we evaluate two main outcomes: stay and hospitalization costs for a tertiary hospital from 2010 to 2012 using a mixed methods approach. Design/methodology/approach Data were drawn from hospital records and in-depth interviews with hospital staff in a Shanxi Province tertiary hospital, northern China. Findings We found that the main objectives: to standardize treatment procedures by reducing stay and containing costs, were not fully achieved. Staff implementing clinical pathways clearly encountered several barriers; i.e., managers did not see the pilot as a useful managerial instrument driven by revenue generation. Physicians, too, lacked incentive to follow the guidelines due to income concerns. Practical implications We point to the daunting challenges brought about by perverse incentives embedded in the country’s health system. We argue that concerted efforts are needed to undertake difficult health policy reforms in China. Originality/value We present the first empirical study in the English-language literature that examines China’s ongoing clinical pathway pilots from a micro perspective. We combine qualitative and quantitative methods and reveal the hospital-level dynamics in its implementation.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:13:30 GMT
      DOI: 10.1108/IJHCQA-09-2014-0096
       
  • An improvement project within urological care
    • Authors: Annelie Khatami, Kristina Rosengren
      First page: 412
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 4, May 2015.
      Purpose The article’s aim was to describe staff experiences in an on-going improvement project regarding patients with ureteral stones. Design/methodology/approach A qualitative descriptive study based on eight group interviews and 48 narratives, was performed. Data were analysed using qualitative content analysis. Trustworthiness was ensured by using a well-documented improvement process method during six months. Findings The results formed three categories: an absent comprehensive view; complexity and vulnerability within the organisation. A holistic perspective regarding urological care at the micro- meso- and macro-levels is needed to improve planning and caring processes. Research limitations/implications This study includes one team (six members, different health professionals) within the same urology department. Practical implications Results show that staff need information, such as guidelines and support throughout the improvement work to deliver high quality care. Moreover, there is a need for evidence-based guidelines at national level to support improvement work. Originality/value Urological improvement projects, generally, are lacking, which is why this study is important to improve nephrolithiasis patient care.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 12 Mar 2015 18:13:24 GMT
      DOI: 10.1108/IJHCQA-10-2014-0104
       
  • Editorial, Volume 28.3: Supporting Healthcare Staff in their QA Duties.
    • Authors: Keith Hurst
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:28 GMT
      DOI: 10.1108/IJHCQA-01-2015-0015
       
  • Does sustained involvement in a quality network lead to improved
           performance'
    • Authors: Jane Solomon, Crispin Day, Adrian Worrall, Peter Thompson
      First page: 228
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.
      Purpose This article’s purpose is to explore the effects of prolonged investment in one quality improvement method, which are uncertain. We examine (i) the extent to which sustained involvement in a quality network over five years led to improved performance against standards, and (ii) whether improvement was achieved in areas where service staff could exercise direct control. Design/methodology/approach A prospective cohort design was used to examine data from 48 United Kingdom inpatient child and adolescent mental health units between 2005/06 and 2009/10, which have been Quality Network for In-patient CAMHS members for two years. These were selected to remove the initial marked increase in compliance identified in an earlier study. The main outcome measure was compliance with organisation process standards. Findings Units meeting ‘excellent’ quality status across all standards rose from seven (14.6%) to 18 (37.5%). Standards for Environment and Facilities and Access, Admission and Discharge improved the most. Units meeting the ‘excellent’ quality status for criteria over which staff had direct control criteria rose from 17 (35.4%) to 29 (60.4%) over the five year period. The unit modal quality status categorisation for criteria where staff had no direct control in 2005/06 was ‘poor’ (n=25; 52.1%) but had progressed to ‘good’ in 2009/10 (n=24; 50.0%). Originality/value We provide evidence that sustained investment in one QI method raises service compliance against standards. Trends showed improvement for direct control standards from ‘good’ to ‘excellent’ levels and improvement for no direct control from ‘poor’ to ‘good’.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:30 GMT
      DOI: 10.1108/IJHCQA-05-2013-0054
       
  • TeamSTEPPS implementation in community hospitals: Adherence to recommended
           training approaches
    • Authors: Marcia M Ward, Xi Zhu, Michelle Lampman, Greg L. Stewart
      First page: 234
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.
      Purpose TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) is being widely promoted in healthcare settings to train staff in evidence-based approaches that promote patient safety. It involves a comprehensive curriculum that spells out key principles and actionable tools for a culture change toward patient-safety-focused teamwork. Activities begin with selected personnel attending TeamSTEPPS Master Trainer Training and then organizing and providing TeamSTEPPS training for staff in their organization. We conducted interviews with respondents at community hospitals conducting TeamSTEPPS staff training. To structure our interviews, we used 11 key questions identified by Weaver et al., (2010) in their in-depth team training literature review. The primary objective was to examine approaches taken by community hospital personnel and compare those to the best practices recommended by Weaver et al., (2010). Design/methodology/approach We interviewed 57 staff and administrators at 22 community hospitals sending teams to TeamSTEPPS Master Trainer Training. Findings We find that training implementation in community hospitals differs significantly from the established, research-based principles for effective team training described in the research literature, which is largely based in academic medical centers. Originality/value The current findings suggest that several TeamSTEPPS training features could be enhanced in community hospitals including: (i) choosing staff who have the skills to be effective trainers in this train-the-trainer model; (ii) emphasising active learning; and (iii) sustaining lessons through on-the-job application, practice and feedback. These principles apply to many training approaches employed in small healthcare organizations.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:26 GMT
      DOI: 10.1108/IJHCQA-10-2013-0124
       
  • National Early Warning Score (NEWS) evaluation in surgery
    • Authors: Peter M Neary, Mark Regan, Myles J Joyce, Oliver J Mcanena, Ian Callanan
      First page: 245
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.
      Purpose This study aimed to evaluate staff opinion on the impact of the National Early Warning Score (NEWS) system on surgical wards. In 2012, the NEWS system was introduced to Irish hospitals on a phased basis as part of a national clinical programme in acute care. Design/methodology/approach A modified established questionnaire was given to surgical nursing staff, surgical registrars, surgical senior house officers (SHOs) and surgical interns for completion six months following the introduction of the NEWS system into an Irish university hospital. Findings Amongst the registrars, 89% were unsure if the NEWS system would improve patient care. Less than half of staff felt consultants and surgical registrars supported the NEWS system. Staff felt the NEWS did not correlate well clinically with patients within the first 24 hours (day zero) post-operatively. Furthermore, 78-85% of nurses and registrars felt a rapid response team should be part of the escalation protocol. Research limitations/implications Senior medical staff were not convinced that the NEWS system may improve patient care. Appropriate audit proving a beneficial impact of the NEWS system on patient outcome may be essential in gaining support from senior doctors. Deficiencies with the system were also observed including the absence of a rapid response team as part of the escalation protocol and a lack of concordance of the NEWS in patients day zero post-operatively. These issues should be addressed moving forward. Originality/value Appropriate audit of the impact of the NEWS system on patient outcome may be pertinent to obtain the support from senior doctors. Deficiencies with the system were also observed including the absence of a rapid response team as part of the escalation protocol and a lack of concordance of the NEWS in patients day zero post-operatively. These issues should be addressed moving forward.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:29 GMT
      DOI: 10.1108/IJHCQA-01-2014-0012
       
  • The trust-commitment challenge in service quality-loyalty relationships
    • Authors: Antonio Carrizo Moreira, Pedro Miguel Silva
      First page: 253
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.
      Purpose This research develops and empirically tests a model to examine service quality, satisfaction, trust and commitment as loyalty antecedents in a private healthcare service. Design/methodology/approach The approach was tested using structural equation modelling (SEM), involving 175 patients from a private Portuguese healthcare unit, using a revised SQAS scale for service quality evaluation. Findings The scale used to evaluate service quality is valid and meaningful. Service quality proved to be a multidimensional construct and relevant to build satisfaction. The path satisfaction → trust → loyalty was validated, whereas the path satisfaction → commitment → loyalty was not statistically supported. Research limitations/implications The revised SQAS scale showed good internal consistency in healthcare context. Further trust-commitment antecedents must be examined in a private healthcare landscape to generalise the findings. Practical implications Healthcare quality managers must explore the service quality dimensions to generate satisfaction among their patients. Developing trust generates positive patient attitudes and loyalty. Originality/value This study explores using the SQAS scale in a private healthcare context. We provide further evidence that service quality is an antecedent and different from satisfaction. All the measures used proved to be valid and reliable. Trust and commitment play different roles in their relationship with loyalty.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:27 GMT
      DOI: 10.1108/IJHCQA-02-2014-0017
       
  • Medical laboratory quality systems – a management review
    • Authors: Dimitris Theodorou, Padelis Giannelos
      First page: 267
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.
      Purpose This article highlights changes in ISO 15189:2012 and ISO 15189:2007 concerning management review requirements and presents a management review checklist, which includes all the revised ISO 15189’s requirements. Design/methodology/approach The recent revised and updated ISO 15189 (2012) standard recommends a management review using a process approach and includes some additional topics. Findings The management review is a key element in many quality management systems, including medical laboratory management systems in accordance with ISO 15189. The process approach enables laboratory top managers and personnel to achieve all the quality management system’s important inputs and outputs. Originality/value As laboratory staff often encounter difficulties fully exploiting the management review process, this checklist helps laboratory staff carry out an effective management review covering all the quality management system’s important aspects.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:34 GMT
      DOI: 10.1108/IJHCQA-04-2014-0039
       
  • Can patients detect hazardous dental practice' A patient complaint
           study
    • Authors: Nora Hiivala, Helena Mussalo-Rauhamaa, Heikki Murtomaa
      First page: 274
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.
      Purpose This study aimed to: (i) determine the prevalence and distribution of patient/family-generated, dentistry-related complaints to Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland from 2000 to 2011; (ii) study patient/family safety incident experiences and other reasons for complaints; (iii) assess complaint validity and (iv) evaluate factors associated with disciplinary processes against dentists. Design/methodology/approach Data included closed cases handled by AVIs and Valvira (2000–2011) against dental practitioners or dental practice units (n = 782). We analysed the complaints distribution and examined the antecedent factors and circumstances. Findings This study demonstrated that patients/families can detect many dental treatment hazards, substandard processes and even serious safety risks rather well. The investigation processes revealed some physical harm or potential patient safety risks in more than half the alleged cases. Many complaints accumulated against certain individuals and statistically significant positive correlations were found between some patient/family complaints, dentist-specific variables and disciplinary actions. Practical implications Patient/family-generated complaints must be taken seriously and seen as relatively good safety risk indicators. However, more knowledge on how patients might cooperate with dental care providers to prevent errors is needed. Originality/value This work provides a unique opportunity to learn from several dentistry-related patient complaints. Despite some limitations, patient complaints appear to be useful as a complementary source together with other patient safety study methods.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:31 GMT
      DOI: 10.1108/IJHCQA-05-2014-0052
       
  • Human factors paradigm and customer care perceptions
    • Authors: Colin Clarke, Lesley-Jane Eales-Reynolds
      First page: 288
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.
      Purpose This article’s purpose is to examine if customer care (CC) can be directly linked to patient safety through a Human Factors (HF) framework. Design/methodology/approach Data from an online questionnaire, completed by a convenience healthcare worker sample (n=373), was interrogated using thematic analysis within the Vincent et al., (1998) HF theoretical framework. This proposes seven areas affecting patient safety: institutional context, organisation and management, work environment, team factors, individual, task and patient. Findings Analysis identified responses addressing all framework areas. Responses (597) principally focused on work environment 40.7% (n=243), organisation and management 28.8% (n=172). Nevertheless, reference to other framework areas were clearly visible within the data: teams 10.2% (n=61); individual 6.7% (n=40); patients 6.0% (n=36); tasks 4.2% (n=24) and institution 3.5% (n=21). Findings demonstrate congruence between CC perceptions and patient safety within a HF framework. Research limitations/implications The questionnaire requested participants to identify barriers to rather than CC enablers. Although this was at a single site complex organization, it was similar to those throughout the NHS and other international health systems. Practical implications Customer care can be viewed as consonant with patient safety rather than the potentially dangerous consumerisation stance, which could ultimately compromise patient safety. Originality/value This work provides an original perspective on the link between CC and patient safety and has the potential to re-focus healthcare perceptions.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:26 GMT
      DOI: 10.1108/IJHCQA-05-2014-0067
       
  • Perceived service quality’s effect on patient satisfaction and
           behavioural compliance
    • Authors: Bahari Mohamed, Noor Azlinna Azizan
      First page: 300
      Abstract: International Journal of Health Care Quality Assurance, Volume 28, Issue 3, April 2015.
      Purpose The study’s purpose was to advance healthcare service quality research using hierarchical component models. Design/methodology/approach This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling, and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses. Findings The study extends health service quality literature by showing that: (i) patient satisfaction is dominant, significant and indirect determinant of behavioural compliance; (ii) perceived service quality has the strongest effect on behavioural compliance via patient satisfaction. Research limitations/implications Only one hospital was evaluated. Practical implications The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design. Originality/value Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: Thu, 05 Mar 2015 17:30:33 GMT
      DOI: 10.1108/IJHCQA-06-2014-0074
       
 
 
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