International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 6 September 2011


Downey-Ennis, K. (2011), "Editorial", International Journal of Health Care Quality Assurance, Vol. 24 No. 7. https://doi.org/10.1108/ijhcqa.2011.06224gaa.001



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited


Article Type: Editorial From: International Journal of Health Care Quality Assurance, Volume 24, Issue 7

This issue of the IJHCQA brings to the readers several papers, which I hope they will find useful in terms of improving healthcare through the various topics the authors have completed research on. The papers come from authors in several countries with three separate studies on patient satisfaction, one on culture and the final paper giving the readers insight into clinical effectiveness of an important disease. The truth about patient satisfaction surveys is that they can help identify ways of improving practice in organizations, which ultimately translates into better care and happier patients.

Culture and culture change has been a topic for many within healthcare organizations for many decades. In this paper Carney argues that aspects of organizational culture may indicate a new terrain in the quality healthcare relationship. The research undertaken stemmed from the author’s belief that viewing the role of heads of departments or directorates as being pivotal to health care management in the delivery of quality healthcare while not new discusses the topic in an Irish context. Several cultural influences such as excellence in care delivery, ethical values, involvement, professionalism, value-for-money, cost of care, commitment to quality and strategic thinking were found to be key cultural determinants in quality care delivery. The author suggests that in order to deliver quality focused care managers need to act in a professional, committed manner and to place excellence at the forefront of care delivery, whilst at the same time being capable of managing the tensions that exist between cost effectiveness and quality of care. The author makes the case that these tensions require further research in order to determine if quality of care is affected in a negative manner by those tensions.

Atinga et al. indicate that the provision of healthcare in Ghana is one of intense competition between public and private service providers. Thus, they argue that the management of patient satisfaction, which is a high priority nationally, is a critical issue in the overall healthcare management process. The authors empirically examine the extent that dimensions of service quality predict patients’ satisfaction. Their findings confirm what others found, however an interesting finding from this research is that the cleanliness of the environment of hospitals emerged as a strong factor influencing patient satisfaction. Given the fact that more than half of all reported diseases in Ghana are related to poor environmental sanitation, this finding is indeed critical for hospital managers to improve the cleanliness of their organizations. The paper outlines several recommendations on improvement measures and that the findings of this research suggest that internal and external health sector stakeholders may possibly use this study as a precursor to improve service quality in hospitals in Ghana.

The paper from Noor Hazilah Abd Manaf looks at the average waiting time in Malaysian public hospitals as a means to gauge the level of patient satisfaction. The author argues that public healthcare in Malaysia is in a state of “excess demand”, where demand for subsidised healthcare far outstrips supply due to the large fee differential between public and private healthcare services. The study was a cross-sectional design involving 21 public hospitals from 13 states, and while waiting times were found to be long, the majority of patients did not indicate dissatisfaction with the length of time they waited. The authors argue that this finding may be due to the fact that patients have low expectations in regard to waiting times for hospital appointments. An interim solution is made that hospital managers should reduce the boredom faced by patients while waiting and to address the waiting time problem in a more scientific manner as has been carried out in other countries through simulation and modeling techniques.

Shewchuk et al. from the USA examined patient satisfaction from a somewhat different perspective with non-physician staff in primary care settings. They were interested in the effect satisfaction had related to patient demographics, satisfaction with physicians, and intentions to recommend their physicians to others. Their results indicate that patients hold different expectations from their non-physician staff, e.g. younger, more affluent, and educated patients expressed dissatisfaction with staff which suggests that non-physician staff should take on board the needs of patients and provide extra/further responsiveness to have these patients’ needs met.

Finally, Kelly Mutch et al.’s research was concerned regarding the centrality of nutritional support in patients with severe acute pancreatitis. They argue that challenges face clinicians in the management of these patients to preserve gut functioning and that enteral feeding is superior to parenteral nutrition, however some hospitals may not consistently implement enteral feeding regimes due to lack of perceived resources coupled with lack of physician support in changing current practices. The authors’ hypothesis was validated in that the findings revealed that parental nutrition tends to be ordered more compared to enteral nutrition despite current literature best practice recommendations. The authors recommend that practice guidelines would be beneficial and given the small study undertaken that more studies are required to test if there is a significant correlation between total cost and co-morbities.

Kay Downey-EnnisCo-Editor