for Journals by Title or ISSN
for Articles by Keywords
help
  Subjects -> HEALTH AND SAFETY (Total: 1292 journals)
    - CIVIL DEFENSE (18 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (521 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (379 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (101 journals)
    - WOMEN'S HEALTH (81 journals)

HEALTH AND SAFETY (521 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 25)
American Journal of Health Promotion     Hybrid Journal   (Followers: 22)
American Journal of Health Studies     Full-text available via subscription   (Followers: 8)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 179)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 8)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 5)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 4)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 15)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 11)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 3)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription  
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 1)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 8)
Evidence-based Medicine & Public Health     Open Access   (Followers: 4)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 8)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 4)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 7)
Global Journal of Public Health     Open Access   (Followers: 9)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 14)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 46)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 11)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 10)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 32)
Health Policy and Technology     Hybrid Journal  
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 20)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 47)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 9)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 10)
Health, Risk & Society     Hybrid Journal   (Followers: 10)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 2)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 4)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 1)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 19)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 13)
International Journal of Health & Allied Sciences     Open Access   (Followers: 1)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)
International Journal of Health Research     Open Access   (Followers: 4)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services     Full-text available via subscription   (Followers: 9)

        1 2 3 | Last

Journal Cover International Journal of Health Care Quality Assurance
  [SJR: 0.352]   [H-I: 32]   [7 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0952-6862
   Published by Emerald Homepage  [335 journals]
  • Volume-outcome relationship for colorectal cancer in primary care: a
           prospective cohort study
    • First page: 398
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known whether such volume-outcome relationship exist in primary care settings. This study examined general practitioner (GP) CRC-specific caseload for possible associations with referral pathways, disease stage and CRC patients’ overall survival (OS). Design/methodology/approach Retrospectively analysing a prospectively maintained CRC database for 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services. Findings Of 1,145 CRC patients, 937 (81.8%) were diagnosed as symptomatic cancers. Two hundred and ten GPs from 44 practices were stratified according to their CRC caseload over the study period into low-volume (LV, 1-4); medium-volume (MV, 5-7); and high-volume (HV, 8-21 cases). Emergency presentation (LV:49/287 [17.1%]; MV:75/264 [28.4%]; HV:105/386 [27.2%]; p=0.007) and advanced disease at presentation (LV:84/287 [29.3%]; MV:94/264[35.6%]; HV:144/386 [37.3%]; p=0.034) was more common amongst HV GPs. Three-year mortality risk was significantly higher for HV GPs (MV: Hazard Ratio HR 1.185 [confidence interval CI=0.897-1.566], p=0.231, and HV: HR 1.366 [CI=1.061-1.759], p=0.016), but adjustment for emergency presentation and advanced disease largely accounted for this difference. There was some evidence that HV GPs used elective cancer pathways less frequently (LV:166/287 [57.8%]; MV:130/264 [49.2%]; HV:182/386 [47.2%]; p=0.007) and more selectively (CRC/referrals: LV:166/2,743[6.1%]; MV:130/2,321 [5.6%]; HV:182/2,508 [7.3%]; p=0.048). Originality/value Higher GP CRC caseload in primary care may be associated with advanced disease and poorer survival; more work is required to determine the reasons and to develop targeted intervention at local level to improve elective referral rates.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:26Z
      DOI: 10.1108/IJHCQA-01-2016-0001
       
  • Healthcare quality improvement work: a professional employee perspective
    • First page: 410
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose To describe and analyse conditions that influence how employees engage in healthcare quality improvement (QI) work. Design/methodology/approach Qualitative case study based on interviews (n=27) and observations (n=10). Findings The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute. Practical implications Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed. Originality/value Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:32Z
      DOI: 10.1108/IJHCQA-02-2016-0013
       
  • Quality improvement in physiotherapy services
    • First page: 424
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose To evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes. Design/methodology/approach Multiple case study: information was gathered from eight physiotherapy teams over 24 months. Findings The process change was successfully implemented in six teams. It had a clear, positive effect on service quality provided to patients in three teams. Whilst quality also improved in three other teams, other issues make changes difficult to assess. Factors that enabled process change to be effective are suggested. Research limitations/implications Findings are based on results achieved by only eight English teams. Practical implications This process change may be appropriate for other teams providing therapy services if attention is paid to potential enabling factors, and a learning approach is adopted to designing and introducing the change. Originality/value To the best of our knowledge, no other longitudinal process change study in therapy services has been published.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:12:45Z
      DOI: 10.1108/IJHCQA-05-2016-0066
       
  • Using flow diagrams to improve tobacco cessation programs
    • First page: 436
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose To understand how the Wyoming Quit Tobacco Program (WQTP) is used by its subscribers and to better understand how WQTP might be connected to WQTP outcomes. Design/methodology/approach Provider intake and program use data corresponding to the May 2010 to March 2012 enrollment period (N=6,168) were used. All program flows were constructed using frequencies and crosstabs, based on an initial theoretical model prepared by the program provider. Data were adjusted based on analysis that explored all possible uses beyond those specified by the provider’s theoretical model.. Findings Although we could replicate the structure - the theoretical model constructed by the provider - we were not able to replicate all relationships between program components. We also found that most individuals signed up and used web-based services. Only a few individuals finished their treatment regimens in the way they were designed to be used by the program. Originality/value This is the first case study to use a program flow method to investigate an entire comprehensive tobacco cessation program structure and delivery.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:12Z
      DOI: 10.1108/IJHCQA-05-2016-0072
       
  • Improving ICU risk management and patient safety.
    • First page: 445
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose This study aimed to: (i) develop and validate an assessment method for the International Electrotechnical Commission (IEC) 80001-1 (IEC, 2010) standard (the Standard); (ii) raise awareness; (iii) improve medical IT-network project risk management processes; and (iv) improve intensive care unit (ICU) patient safety. Design/methodology/approach An assessment method was developed and piloted. A healthcare IT-network project was undertaken using a semi-structured group interview with risk management stakeholders. Participants provided feedback via a questionnaire. Descriptive statistics and thematic analysis was undertaken. Findings The assessment method was validated as fit for purpose. Participants agreed (63%, n = 7) that assessment questions were clear and easy to understand, and participants agreed (82%, n = 9) that the assessment method was appropriate. Participant’s knowledge of the Standard increased. Non-compliance was identified. Medical IT-network project strengths, weaknesses, opportunities and threats in the risk management processes were identified. Practical implications The study raised awareness of the Standard and enhanced risk management processes that led to improved patient safety. Study participants confirmed they would use the assessment method in future projects. Originality/value Findings add to knowledge relating to IEC 80001-1 implementation.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:19Z
      DOI: 10.1108/IJHCQA-05-2016-0074
       
  • Developing a training package - lessons in partnership-working between
           health professionals, service users and carers.
    • First page: 458
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose This article outlines a training package for service users and carers with an interest in NHS health and social care research. It demonstrates how training package developers used their unique experience and expertise as service users and carers to inform their work. Design/methodology/approach Service users and carers, NHS Research and Development Forum working group members, supported by health professionals, identified a need for research training that was tailored to other service user and carer needs. After reviewing existing provision and drawing on their training and support experience, they developed a training package. Sessions from the training package were piloted, which evaluated positively. In trying to achieve programme accreditation and training roll-out beyond the pilots, the group encountered several challenges. Findings The training package development group formed good working relationships and a co-production model that proved sustainable. However, challenges were difficult to overcome owing to external factors and financial constraints. Practical implications Lessons learnt by the team are useful for other service user and carer groups working with health service professionals. Training for service users and carers should be designed to meet their needs; quality and consistency are also important. The relationships between service user and carer groups, and professionals are important to understanding joint working. Recognising and addressing challenges at the outset can help develop strategies to overcome challenges and ensure project success. Originality/value The training package was developed by service users and carers for other service users and carers. Their unique health research experience underpinned the group’s values and training development.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:13:06Z
      DOI: 10.1108/IJHCQA-06-2016-0084
       
  • Continuous improvement projects: an authorship bibliometric analysis
    • First page: 467
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose This article describes the current research on hospital continuous improvement projects (CIPs) from an author characteristic perspective. This work addresses the following questions: Who are the predominant research authors on hospital CIPs? To what extent are there research communities collaborating in distinct research groups? How internationalized has hospital CIPs research become with respect to author location? Design/methodology/approach A systematic literature review was conducted, identifying 302 academic publications related to hospital CIPs. Publications were analyzed using: author; quantity; diversity; collaboration; and impact. Findings Hospital CIPs are increasingly attracting new scholars each year. Based on our analysis, authors publishing in this area can be described as a relatively new international community given the countries represented. Originality/value This article describes current hospital CIP research by assessing author characteristics. Future work should examine additional attributes to characterize maturity, such as how new knowledge is being created and to what extent new knowledge is being disseminated to practitioners.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:12:59Z
      DOI: 10.1108/IJHCQA-07-2016-0105
       
  • Service quality, patient satisfaction and loyalty in the Bangladesh
           healthcare sector
    • First page: 477
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 5, June 2017.
      Purpose This study investigates service quality, patient satisfaction and loyalty in Bangladesh’s healthcare sector. It identifies healthcare quality conformance, patient satisfaction and loyalty based on demographics such as gender, age and marital status. It examines the differences between public and private healthcare sectors regarding service quality, patient satisfaction and loyalty. Design/methodology/approach We distributed 450 self-administered questionnaires to hospital patients resulting in 204 useful responses (45.3% response rate). Data were analysed based on reliability analysis, exploratory factor analysis (EFA), independent samples t-tests, ANOVA and discriminant analysis using SPSS version 23. Findings Findings indicate that single patients perceive tangibles, reliability, empathy and loyalty higher compared to married patients. Young patients (<=20 years) have a higher tangibles, empathy and loyalty scores compared to other age groups. We observed that private hospital patients perceive healthcare service quality performance higher compared to patients in public hospitals. Research limitations/implications We focused solely on the Bangladesh health sector, so the results might not be applicable to other countries. Originality/value Our findings provide guidelines for enhancing service quality, patient satisfaction and loyalty in the Bangladesh healthcare sector and other countries.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-04-27T01:12:53Z
      DOI: 10.1108/IJHCQA-01-2017-0004
       
  • What is the function of a journal?
    • First page: 302
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 4, May 2017.

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

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:34Z
      DOI: 10.1108/IJHCQA-01-2017-0011
       
  • Failure mode and effect analysis: improving intensive care unit risk
           management processes
    • First page: 208
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. This study aimed to apply FMEA technique to examine the hazards associated with the process of service delivery in Intensive Care Unit of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 to December 2014. By forming a FMEA team, all potential hazards associated with ICU services - their frequency and severity - were identified. Then risk priority number (RPN) was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in Intensive Care Units proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:39Z
      DOI: 10.1108/IJHCQA-04-2016-0053
       
  • Embedding learning from adverse incidents: a UK case study
    • First page: 216
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose This paper reports on a regionally based UK study uncovering what has worked well in learning from adverse incidents in hospitals. It reviews the incident investigation methodology used, identifying strengths or weaknesses and explores the use of a database as a tool to embed learning Design/methodology/approach Documentary examination was conducted of all adverse incidents reported between 1st June 2011 and 30th June 2012 by three UK National Health Service hospitals. One Root Cause Analysis report per adverse incident for each individual hospital was sent an advisory group for review. Using terms of reference supplied, the advisory group feedback was analysed using an inductive thematic approach. The emergent themes led to the generation of questions which informed seven in-depth semi-structured interviews Findings ‘Time’ and ‘Work Pressures’ were identified as barriers to using adverse incident investigations as tools for quality enhancement. Methodologically, a weakness in approach was that no criteria influenced the techniques which were used in investigating adverse incidents. Regarding the sharing of learning, the use of a database as a tool to embed learning across the region was not supported Practical implications Softer intelligence from adverse incident investigations could be usefully shared between hospitals through a regional forum Originality/value The use of a database as a tool to facilitate the sharing of learning from adverse incidents across the health economy is not supported
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:26Z
      DOI: 10.1108/IJHCQA-05-2016-0060
       
  • Improving throughput in a youth mental health service
    • First page: 224
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose The discrepancy between increasing demand and limited resources in public mental health is putting pressure on services to continuously review their practices and develop innovative models of care that redress this discrepancy. To ensure the service models continue to meet the needs of all stakeholders, Children and Young People’s Mental Health (CYPMH) conducts regular reviews of its service models. Accordingly, the Youth Mental Health (YMH) model at CYPMH has evolved significantly over time in response to the needs of young people and service demand. This paper outlines the findings of a recent review of the YMH service, and the subsequent changes to the service model. Design/methodology/approach Informed by a participatory action philosophy, feedback was sought from staff on the service model through a range of methods including a questionnaire, staff consultations through a working party and interviews. This feedback was used to redesign the model, which was then evaluated again. Findings Staff identified a number of challenges with the service model and a range of service improvement solutions. The key issues included exceedingly high caseloads, workplace tensions, and fragmentation of the client journey. This paper outlines the primary solution to these key concerns, namely the introduction of brief intervention as the entry point to the service. Originality/value Brief intervention approaches provide a solution to overly high caseloads as the direct and focussed approach of brief intervention generally reduces the number of sessions people need. Brief intervention is an important addition to other treatment options and should be seen as a valid component of the continuum of mental health care.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:25Z
      DOI: 10.1108/IJHCQA-05-2016-0062
       
  • Nurse staffing levels and outcomes - mining the UK national datasets for
           insight.
    • First page: 235
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose Purpose of this paper Despite the generation of mass data by the nursing workforce, determining the impact of the contribution to patient safety remains challenging. Several cross sectional studies have indicated a relationship between staffing and safety. The aim of this paper was to uncover possible associations and explore if a deeper understanding of relationships between staffing and other factors such as safety could be revealed within nationally routinely collected datasets. Design/methodology/approach Methods Two longitudinal routinely collected datasets consisting of thirty years of UK nurse staffing data and seven years of National Health Service benchmark data such as survey results, safety and other indicators were used. A correlation matrix was built and a linear correlation operation was applied (Pearson Product moment Correlation coefficient). Findings Findings A number of associations were revealed within both the UK Staffing dataset and the NHS benchmarking dataset. However the challenges of using these datasets soon became apparent. Practical implications Practical implications Staff time and effort is required to collect these data. The limitations of these datasets include inconsistent data collection & quality. The mode of data collection and the itemset collected should be reviewed to generate a dataset with robust clinical application. Originality/value What this paper adds This paper revealed that relationships are likely to be complex & non-linear however the main contribution of the paper is the identification of the limitations of routinely collected data. Much time and effort is expended collecting this data however its validity, usefulness & method of routine national data collection appear to require re-examination.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:29Z
      DOI: 10.1108/IJHCQA-08-2016-0118
       
  • Healthcare seeking behaviour among Chinese elderly
    • First page: 248
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose The Chinese population is rapidly ageing before they are rich. This study aimed to describe healthcare seeking behaviour and the critical factors associated with healthcare seeking behaviour. Design/methodology/approach Using a purposive sampling method, we recruited 44 adults age 60 years or older from three provinces, representing the developed (Shanghai), undeveloped (Ningxia) regions and the regions between (Hubei). From July to September 2008, using a semi-structured guide, we interviewed participants in focus group discussions. Findings The healthcare needs for chronic and catastrophic diseases were high; however, the healthcare demands were low and healthcare utilizations were even lower owing to the limited accessibility to healthcare services, particularly, in underdeveloped rural areas. “Too expensive to see a doctor” was a prime complaint, explaining substantial discrepancies between healthcare needs, demands and use. Care seeking behaviour varied, depending on insurance availability, perceived performance - particularly hospital services and prescription medications. Participants consistently rated increasing the healthcare accessibility as a high priority, including offering financial aid, and improving service convenience. Improving social security fairness was as the first on the elderly’s wish list. Originality/value Healthcare demand and use were lower than needs, and influenced by multiple factors, primarily, service affordability and efficiency, perceived performance and hospital service quality.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:36Z
      DOI: 10.1108/IJHCQA-10-2015-0132
       
  • The NICE alcohol misuse standard – evaluating its impact
    • Pages: 260 - 273
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, Page 260-273, April 2017.
      Purpose The purpose of this paper is to explore factors affecting implementing the National Institute for Health and Care Excellence (NICE) quality standard on alcohol misuse (QS11) and barriers and facilitators to its implementation. Design/methodology/approach Qualitative interview study analysed using directed and conventional content analyses. Participants were 38 individuals with experience of commissioning, delivering or using alcohol healthcare services in Southwark, Lambeth and Lewisham. Findings QS11 implementation ranged from no implementation to full implementation across the 13 statements. Implementation quality was also reported to vary widely across different settings. The analyses also uncovered numerous barriers and facilitators to implementing each statement. Overarching barriers to implementation included: inherent differences between specialist vs generalist settings; poor communication between healthcare settings; generic barriers to implementation; and poor governance structures and leadership. Research limitations/implications QS11 was created to summarise alcohol-related NICE guidance. The aim was to simplify guidance and enhance local implementation. However, in practice the standard requires complex actions by professionals. There was considerable variation in local alcohol commissioning models, which was associated with variation in implementation. These models warrant further evaluation to identify best practice. Originality/value Little evidence exists on the implementing quality standards, as distinct from clinical practice guidelines. The authors present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-28T01:22:55Z
      DOI: 10.1108/IJHCQA-03-2016-0025
       
  • Patient non-adherence: an interpretative phenomenological analysis
    • First page: 274
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose While Interpretative Phenomenological Analysis (IPA) has been employed in health psychology research, it has so far not been applied to seek deeper insights into the patients’ experiences about treatment. This paper addresses this gap by employing Interpretative Phenomenological Analysis to understand patient non-adherence. Design/methodology/approach Eighteen patients with chronic conditions seeking health care services in Goa and Karnataka, India, were selected by employing snowball sampling method. In-depth interviews were conducted face to face. Semi-structured questionnaire developed by the researchers was used to collect the data. Interpretative Phenomenological Analysis was employed to explore the themes to predict patient non-adherence. Findings The study results indicate that economic factors, health system related factors, social factors and psychological factors impact patient non-adherence. Patient non-adherence includes medication non-adherence and lifestyle modification non-adherence. Research limitations/implications Being cross sectional in design, the results may not be as appropriate as the results derived from a longitudinal study given that non-adherence occurs over time. Practical implications Patient non-adherence is a global health issue. Multidisciplinary approach to enhance patient adherence to treatment should form the part of public health care policy. Originality/value Although there is extensive quantitative research on the prevalence of non-adherence, qualitative research is limited. This paper addresses this gap by employing Interpretative Phenomenological Analysis to understand patient non adherence and its factors and dimensions.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:31Z
      DOI: 10.1108/IJHCQA-03-2016-0033
       
  • Potential facilitators and barriers to adopting standard treatment
           guidelines in clinical practice: an Indian context
    • First page: 285
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose To assess medicines information sources accessed by clinicians if sources differed in theory and practice and to find out barriers and facilitators to effective guideline adoption. Design/methodology/approach One hundred and eighty-three doctors were surveyed.Barriers and facilitators were classified as: communication; potential adopters: innovation; organization characteristics and environmental/social/economic context Findings Most accessed multiple information sources including standard treatment guidelines (STGs), but consulted seniors/colleagues in practice. Top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in following areas: concerns about flexibility offered by the guideline; denying patients’ individuality; professional autonomy; insights into gaps in current practice and evidence based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance company) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors’ control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value This survey among clinicians, despite limitations, gives helpful insights. While favorable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:32Z
      DOI: 10.1108/IJHCQA-10-2016-0148
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.198.223.170
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2016