Downey-Ennis, K. (2009), "Editorial", International Journal of Health Care Quality Assurance, Vol. 22 No. 3. https://doi.org/10.1108/ijhcqa.2009.06222caa.001Download as .RIS
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Copyright © 2009, Emerald Group Publishing Limited
Article Type: Editorial From: International Journal of Health Care Quality Assurance, Volume 22, Issue 3
I am delighted to present to the readers this issue, which contains many valuable studies and insights into quality improvement from a wide perspective.
Walsh and Antony’s paper focused on both the challenges and key observational findings in the use of an electronic adverse incident recording and reporting system in conjunction with quality costs in acute care settings. Their methodology included an eclectic approach utilising action diaries and triangulation in order to understand both the challenges and critical success factors of using this system. The authors used a prevention, appraisal and failure model (PAF) within a quality costing framework in relation to improving patient safety. Their findings reveal important evidence based information for both clinicians and managers for effective use and implementation of an electronic adverse incident management system.
O’Leary, Wharton and Quinlan’s study provides the reader with empirical support for the multidimensionality of physician’s job satisfaction, with the findings indicating that male doctors report higher levels of satisfaction than female doctors while those who work in polyclinics are more satisfied than those employed by hospitals. However female doctors are more satisfied in their relations with patients and colleagues than their male counterparts. Given that job satisfaction is generally conceived as an attitudinal variable that reflects the degree to which people like their jobs and is positively related to employee health and job performance, the practical implications from this study provides advice to hospital and polyclinic managers in Russia attempting to reform and restructure the system.
De Korne, Sol, Custers, van Sprundel, van Ineveld, Lemij and Klazinga outline in their study the importance of unison with all stakeholders within hospitals in Holland to achieve a seamless care delivery system. Currently in Dutch hospitals physicians are primarily focused on medical results while hospital administration is primarily interested in the financial outcomes which can be argued is common to many healthcare systems internationally. However, by law in the Dutch healthcare system a hospital board is responsible for the overall quality delivered by a hospital. This case study developed the use of a quality cost model (QCM) and a care delivery value chain model (CDVC) for use within a defined area. The findings indicated that both frameworks can be useful tools for hospital management to manage both on quality and cost outcomes and also can be a useful tool for the hospital board to be assured of delivery of a seamless service.
Taner’s research paper outlines how the principles of Six Sigma can be applied to the high turnover problem of doctor’s in medical emergency services and paramedic backup. He applied the DMAIC methodology to determine the dependent and independent variables and found that the sigma level of the process increased and that new policy and process changes have been found to effectively decrease the incidence of turnover. This resulted in the process being gained, standardized and institutionalised and it is also the first paper to attempt to use Six Sigma methodology for improving the turnover problem within healthcare.
Simbar and colleagues’ study, undertaken in Kordestan, assessed the quality of care provided in midwifery care. They utilised a descriptive study methodology to assess the quality of care to women with normal pregnancy. Their findings suggest that care delivered in different stages of labour were compatible with desirable standards, however they highlighted that satisfaction with “emotional support and assessment of vital signs” were ranked as less than acceptable. Their paper culminates in instructions and guidelines for the provision and promotion of continuous monitoring and evaluation of care quality which can lead to quality improvement and lead to increased satisfaction.
Lyne, Hill, Burke and Ryan’s paper outlines an audit undertaken in a liaison psychiatric service over a period of six months to establish a baseline for demographics, type of and management of referrals with a view of developing improved evidence based treatments. The findings give an insight for all the stakeholders involved in the liaison psychiatric consultation services within an Irish context. Specifically while referrals were generally seen reasonably quickly there is room for improvement as compared with published standards.
Hsieh compared how patients had their voices taken into consideration between two hospitals in both the UK and Taiwan. The authors used a mixed methodology within a qualitative framework. Their findings suggest that in both hospitals there were a number of strategies developed in order that the hospitals could take the patients voice into account that included both patient satisfaction and suggestions.
Sewitch et al. in their population-based study of three generational cohorts of pharmacologically treated depression provide new insights on overall patterns of inappropriate treatment. Across the three cohorts relational continuity of care was associated with receipt of recommended first-line pharmacotherapy suggesting the patient-provider relationship is key to receiving the accepted standard of care. The study findings are of importance for decision and policy makers to improve pharmacological treatment of new onset depression and to ensure that guidelines concordant pharmacotherapy is employed.
I hope that the readers of this issue will find the papers interesting and of value in the overall day to day service delivery and management of healthcare services.