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International Journal of Health Care Quality Assurance
Journal Prestige (SJR): 0.358  Citation Impact (citeScore): 1 Number of Followers: 14  Hybrid journal * Containing 1  Open Access article(s) in this issue *ISSN (Print) 0952-6862 - ISSN (Online) 1758-6542 Published by Emerald  [362 journals]
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- Does healthcare access affect trust in institutions' Empirical evidence in
Canada during the COVID-19 pandemic-
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Authors: Olfa Berrich, Moktar Lamari, Faten Lakhal
Abstract: The paper investigates the determinants of citizens’ trust in institutions, including banks and companies, during the COVID-19 pandemic in Canada. We used a survey, conducted in 2020, with 36,851 respondents to identify what made some trust and others distrust institutions during the COVID-19 pandemic. Our methodology incorporated ordinary least squares and logit estimations. Lack of healthcare access had a significant negative impact on people’s trust in institutions. Consistent with life experience theory, we found that individuals facing healthcare barriers may distrust firms and banks. Sociodemographic variables, including gender, education and marital status, were likely to shape the effect of healthcare access problems on trust in institutions. Moreover, mental health issues stemming from healthcare access problems adversely affected trust in banks and firms, suggesting that people who had mental health problems during COVID-19 were more likely to lose trust in these institutions. The relationship between healthcare access and trust in banks and firms was more pronounced among men and highly educated people. The results were robust to the instrumental variable approach. We showed that a link between trust in institutions and problems with healthcare access can inspire partnerships between Canadian institutional entities, typically banks and firms, and healthcare organizations. This would help strengthen long-term trust in these institutions. The potential long-term economic consequences of COVID-19 created a crisis in the public’s trust in institutions, typically firms and banks. This paper examined the relationship between healthcare access and trust in institutions, addressing the limited evidence on this topic.
Citation: International Journal of Health Care Quality Assurance
PubDate: 2025-06-04
DOI: 10.1108/IJHCQA-08-2024-0080
Issue No: Vol. ahead-of-print, No. ahead-of-print (2025)
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- Determinants of life expectancy: evidence from World Bank income groups
using a panel dummy interaction approach-
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Authors: Sameer Ahmad Sofi, Effat Yasmin
Abstract: Achieving optimal health outcomes is central to global health policies. This study examines the impact of out-of-pocket (OOP) health expenditures and other determinants on life expectancy across income groups classified by the World Bank. Using panel data and a fixed-effects model with dummy interactions, the findings reveal that OOP expenditures reduce life expectancy more in low-income economies, underscoring the need to lower financial barriers to healthcare. Gross domestic product (GDP) per capita is significant for improving life expectancy more in low-income economies, but diminishing returns suggest aligning growth with health policies. Immunization consistently improves life expectancy, highlighting preventive care’s importance. Unemployment limits healthcare access, particularly in low-middle-income economies, requiring policies to address economic instability. Alcohol consumption adversely affects life expectancy in high-income economies, highlighting the impact of lifestyle changes and the need for regulatory interventions. By exploring the interplay of health expenditures, socioeconomic factors and lifestyle risks, the study offers insights for equitable global health policies aimed at improving health outcomes across income groups. (1) While previous studies have analysed the impact of various socio-economic factors on life expectancy in developed economies, little is known about the impact of these factors in Low and Middle Income Economies. (2) Moreover, the impact of out-of-pocket health expenditure on life expectancy has not been comprehensively analysed across different income groups. (3) Findings reveal that out-of-pocket expenditures negatively affect life expectancy more in low-income economies than in high-income economies, emphasizing the need for reducing the financial burden to improve healthcare access. (4) Alcohol consumption adversely impacts life expectancy in high-income economies, highlighting the need for regulatory interventions targeting lifestyle-related risks. (5) This study enhances understanding of how health expenditures, socio-economic factors, and lifestyle choices influence life expectancy across income groups, offering insights to guide equitable global health policies.
Citation: International Journal of Health Care Quality Assurance
PubDate: 2025-05-23
DOI: 10.1108/IJHCQA-03-2025-0026
Issue No: Vol. ahead-of-print, No. ahead-of-print (2025)
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- A process improvement study on patient flow from emergency department to
intensive care unit-
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Authors: Nikita Nikita, Ankit Singh
Abstract: This study aimed to improve the efficiency and effectiveness of patient flow from the emergency department (ED) to the intensive care unit (ICU) in a super specialty hospital. The study was conducted in the emergency department of a super-specialized hospital, focusing on inpatients requiring subsequent admission to the intensive care unit (ICU). It employed a cross-sectional observational design, utilizing primary data collected through first-hand observations via a data tracking sheet. Data analysis encompassed pre- and post-intervention phases, with 232 patients, including 108 patients in the pre-intervention phase and 124 patients in the post-intervention phase, to ensure statistically meaningful results. The study has also utilized tools such as Project Charter, Microsoft Excel, SIPOC, CTC and CTQ, DPMO, Six Sigma, Value Stream Mapping and Root Cause Analysis. Reduced turnaround time (TAT) by 81%, increased value-added activity percentage from 24.4 to 37.2%, improved sigma level from 2.25 to 2.82 and decreased DPMO (defects per million opportunities) from 226,852 to 92,742. This study focuses on a specific aspect of healthcare process improvement within a super-specialty hospital, employs a comprehensive Six Sigma methodology and statistical analysis to identify bottlenecks and improve efficiency, and focuses on TAT reduction and defect elimination.
Citation: International Journal of Health Care Quality Assurance
PubDate: 2025-05-20
DOI: 10.1108/IJHCQA-03-2024-0039
Issue No: Vol. ahead-of-print, No. ahead-of-print (2025)
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- Optimizing tracheostomy weaning with PDCA cycles: a four-year
multidisciplinary quality improvement initiative in Northeast Brazil-
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Authors: Roberta Catunda, Bruna Bianchi Bilo, João Luís Farias, Magno F. Formiga
Abstract: We aimed to assess the impact of plan-do-check-act (PDCA) cycles on tracheostomy weaning in ICU patients from 2019 through 2023. A retrospective study was conducted at a private hospital, analyzing recorded data from two PDCA cycles that were implemented to reduce mean tracheostomy weaning times between 2019 and 2023. We further classified distinct timeframes for a separate analysis, including the baseline (April 2019–August 2020), the period post-PDCA cycle I (January 2021–April 2022) and the period post-PDCA cycle II (August 2022–December 2023). A total of 70 individuals completed the protocol (mean age ± SD, 60.51 ± 17.19 years; 31.4% female). One-way ANOVA revealed mean differences in weaning time compared to 2019 were significant: 2020–3.86 days (p = 0.02), 2021–6.56 days (p = 0.00), 2022–7.80 days (p = 0.00) and 2023–8.74 days (p = 0.00). Subgroup analysis also revealed significant differences in weaning time among baseline, post-first PDCA cycle and post-second PDCA cycle (F (2) = 20.15, p = 0.00, η2 = 0.51). This management model underscores the benefits of consistently improving the quality management of physiotherapy, delivering value-based healthcare through the collaboration of a multidisciplinary team.
Citation: International Journal of Health Care Quality Assurance
PubDate: 2025-05-16
DOI: 10.1108/IJHCQA-02-2025-0012
Issue No: Vol. ahead-of-print, No. ahead-of-print (2025)
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- Patient queue analysis as a component of Lean Six Sigma improvement in
healthcare processes: a case study from a chemotherapy day unit-
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Authors: Rowan Abuyadek, Abdalla Shehata, Wafaa Guirguis
Abstract: Oncology patients are a vulnerable group that faces multiple challenges, aggravated by long waiting times and service queues. This article aims to use Lean Six Sigma (LSS) to improve the chemotherapy preparation process and prospectively study the patient files’ queue dynamics to prioritise process improvement remedies against adding resources strategy. Six Sigma methodology has been employed together with Lean tools and queue dynamics in a case study research in a chemotherapy day unit to define, measure, analyse, improve and control the problematic process. The study population involved all internal customers and a sample of external customers (n = 450). The study processes were measured by 25 data points. The most frequent problem was the “Long waiting time from oncologist assessment till receiving chemotherapy”. Mean value-added time for chemotherapy preparation was 42 min, the defect was any patient’s waiting time exceeding it. The average pre-intervention waiting time was 65.5 ± 27.20 min. The defect baseline sigma level was 0.78 sigma. Remedies involved assigning two pharmacists, arranging the pharmacy setting to satisfy chemotherapy preparation steps, adjusting the number of patients/hours, standardising patients’ files interarrival time, delivering files to the pharmacy by piece, not by batch, and fixing the printers and landlines. Post-intervention mean patient waiting time was reduced significantly to 58.7 ± 23.44 min (p-value = 0.05), and the defect sigma level was raised to 0.91 sigma. This study draws attention to prioritising process improvement remedies in complex care settings with long queues. This study enhances service delivery and customer satisfaction. This study serves as one of the few publications to study patient queue behaviour as a part of LSS improvements in healthcare projects.
Citation: International Journal of Health Care Quality Assurance
PubDate: 2025-05-12
DOI: 10.1108/IJHCQA-11-2024-0102
Issue No: Vol. ahead-of-print, No. ahead-of-print (2025)
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- Health professionals’ experiences with participating in quality
improvement in elderly care
Open Access Article-
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Authors: Lisabet Wieslander, Marie Haggström, Ingela Bäckström
Abstract: Employee participation in quality improvement is essential for fostering engagement and job satisfaction and delivering high-quality care, as highlighted in the total quality management literature. However, how employee participation is facilitated during quality improvement processes within healthcare organizations remains largely unexplored. Previous studies have identified a research gap, highlighting the importance of examining this phenomenon from the perspective of health professionals. The purpose of this study was to gain a deeper understanding of how health professionals in nursing homes experience their participation in quality improvement. The underlying aim was to describe their involvement and how it can be strengthened, ultimately improving the quality of care. This study is based on interviews with 17 health professionals from 2 nursing homes in a medium-sized Swedish municipality. Data were analysed with Reflexive Thematic Analysis. The themes identified through the analysis are “experiences of barriers at the organizational level that limit participation in quality improvement” and “experiences of barriers in daily care that limit participation in quality improvement”. The themes address barriers to participation in quality improvement, reflecting an organizational structure that hinders participation and quality improvement. A quality culture, along with structured approaches to improve quality and foster employee participation is lacking. Implementing total quality management could help address the challenges faced by health professionals in these settings.
Citation: International Journal of Health Care Quality Assurance
PubDate: 2025-05-09
DOI: 10.1108/IJHCQA-11-2024-0103
Issue No: Vol. ahead-of-print, No. ahead-of-print (2025)
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- Publisher’s Note
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International Journal of Health Care Quality Assurance, Vol. 38, No. 3, pp.113-114International Journal of Health Care Quality Assurance2025-07-01
DOI: 10.1108/IJHCQA-07-2025-291
Issue No: Vol. 38, No. 3 (2025)
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