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Article
Publication date: 28 September 2012

Sandra Verelst, Jessica Jacques, Koen Van den Heede, Pierre Gillet, Philippe Kolh, Arthur Vleugels and Walter Sermeus

The purpose of this article is to assess the reliability of an in‐depth analysis on causation, preventability, and disability by two separate review teams on five selected…

1323

Abstract

Purpose

The purpose of this article is to assess the reliability of an in‐depth analysis on causation, preventability, and disability by two separate review teams on five selected adverse events in acute hospitals: pressure ulcer, postoperative pulmonary embolism or deep vein thrombosis, postoperative sepsis, ventilator‐associated pneumonia and postoperative wound infection.

Design/methodology/approach

The analysis uses a retrospective medical record review of 1,515 patient records by two independent teams in eight acute Belgian hospitals for the year 2005. The Mann‐Whitney U‐test is used to identify significant differences between the two review teams regarding occurrence of adverse events as well as regarding the degree of causation, preventability, and disability of found adverse events.

Findings

Team 1 stated a high probability for health care management causation in 95.5 per cent of adverse events in contrast to 38.9 per cent by Team 2. Likewise, high preventability was considered in 83.1 per cent of cases by Team 1 versus 51.7 per cent by Team 2. Significant differences in degree of disability between the two teams were also found for pressure ulcers, postoperative pulmonary embolism or deep vein thrombosis and postoperative wound infection, but not for postoperative sepsis and ventilator‐associated pneumonia.

Originality/value

New insight on the degree of and reasons for the huge differences in adverse event evaluation is provided.

Details

International Journal of Health Care Quality Assurance, vol. 25 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 15 June 2010

Johan Hellings, Ward Schrooten, Niek S. Klazinga and Arthur Vleugels

Improving hospital patient safety means an open and stimulating culture is needed. This article aims to describe a patient safety culture improvement approach in five…

5272

Abstract

Purpose

Improving hospital patient safety means an open and stimulating culture is needed. This article aims to describe a patient safety culture improvement approach in five Belgian hospitals.

Design/methodology/approach

Patient safety culture was measured using a validated Belgian adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. Studies before (autumn 2005) and after (spring 2007) the improvement approach was implemented were completed. Using HSOPSC, safety culture was measured using 12 dimensions. Results are presented as evolving dimension scores.

Findings

Overall, 3,940 and 3,626 individuals responded respectively to the first and second surveys (overall response rate was 77 and 68 percent respectively). After an 18 to 26 month period, significant improvement was observed for the “hospital management support for patient safety” dimension – all main effects were found to be significant. Regression analysis suggests there is a significant difference between professional subgroups. In one hospital the “supervisor expectations and actions promoting safety” improved. The dimension “teamwork within hospital units” received the highest scores in both surveys. There was no improvement and sometimes declining scores in the lowest scoring dimensions: “hospital transfers and transitions”, “non‐punitive response to error”, and “staffing”.

Research limitations/implications

The five participating hospitals were not randomly selected and therefore no representative conclusions can be made for the Belgian hospital sector as a whole. Only a quantitative approach to measuring safety culture was used. Qualitative approaches, focussing on specific safety cultures in specific parts of the participating hospitals, were not used.

Practical implications

Although much needs to be done on the road towards better hospital patient safety, the study presents lessons from various perspectives. It illustrates that hospital staff are highly motivated to participate in measuring patient safety culture. Safety domains that urgently need improvement in these hospitals are identified: hospital transfers and transitions; non‐punitive response to error; and staffing. It confirms that realising progress in patient safety culture, demonstrating at the same time that it is possible to improve management support, is complex.

Originality/value

Safety is an important service quality aspect. By measuring safety culture in hospitals, with a validated questionnaire, dimensions that need improvement were revealed thereby contributing to an enhancement plan.

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 9 October 2007

Johan Hellings, Ward Schrooten, Niek Klazinga and Arthur Vleugels

The purpose of this paper is to measure patient safety culture in five Belgian general hospitals. Safety culture plays an important role in the approach towards greater…

5038

Abstract

Purpose

The purpose of this paper is to measure patient safety culture in five Belgian general hospitals. Safety culture plays an important role in the approach towards greater patient safety in hospitals.

Design/methodology/approach

The Patient Safety Culture Hospital questionnaire was distributed hospital‐wide in five general hospitals. It evaluates ten patient safety culture dimensions and two outcomes. The scores were expressed as the percentage of positive answers towards patient safety for each dimension. The survey was conducted from March through November 2005. In total, 3,940 individuals responded (overall response rate = 77 per cent), including 2,813 nurses and assistants, 462 physicians, 397 physiotherapists, laboratory and radiology assistants, social workers and 64 pharmacists and pharmacy assistants.

Findings

The dimensional positive scores were found to be low to average in all the hospitals. The lowest scores were “hospital management support for patient safety” (35 per cent), “non‐punitive response to error” (36 per cent), “hospital transfers and transitions” (36 per cent), “staffing” (38 per cent), and “teamwork across hospital units” (40 per cent). The dimension “teamwork within hospital units” generated the highest score (70 per cent). Although the same dimensions were considered problematic in the different hospitals, important variations between the five hospitals were observed.

Practical implications

A comprehensive and tailor‐made plan to improve patient safety culture in these hospitals can now be developed.

Originality/value

Results indicate that important aspects of the patient safety culture in these hospitals need improvement. This is an important challenge to all stakeholders wishing to improve patient safety.

Details

International Journal of Health Care Quality Assurance, vol. 20 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 4 February 2014

86

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 1
Type: Research Article
ISSN: 0952-6862

Article
Publication date: 1 September 1989

Eberhard K. Seifert

Schmoller claimed that the basic principle of social reform was acontemporary version of Aristotelian “justice”. On the onehand Schmoller defends the necessity for social…

Abstract

Schmoller claimed that the basic principle of social reform was a contemporary version of Aristotelian “justice”. On the one hand Schmoller defends the necessity for social reform against conservative attacks whilst at the same time denying the legitimacy of Socialist demands for income distribution. The Schmoller approach to justice is re‐examined not only as an important contribution to the history of economics, but of surprising contemporary relevancy.

Details

International Journal of Social Economics, vol. 16 no. 9/10/11
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 1 March 1985

Tomas Riha

Nobody concerned with political economy can neglect the history of economic doctrines. Structural changes in the economy and society influence economic thinking and…

1982

Abstract

Nobody concerned with political economy can neglect the history of economic doctrines. Structural changes in the economy and society influence economic thinking and, conversely, innovative thought structures and attitudes have almost always forced economic institutions and modes of behaviour to adjust. We learn from the history of economic doctrines how a particular theory emerged and whether, and in which environment, it could take root. We can see how a school evolves out of a common methodological perception and similar techniques of analysis, and how it has to establish itself. The interaction between unresolved problems on the one hand, and the search for better solutions or explanations on the other, leads to a change in paradigma and to the formation of new lines of reasoning. As long as the real world is subject to progress and change scientific search for explanation must out of necessity continue.

Details

International Journal of Social Economics, vol. 12 no. 3/4/5
Type: Research Article
ISSN: 0306-8293

Article
Publication date: 1 December 1996

Günter Krause

Reviews the international response to Marktform und Gleichgewicht, and questions the reactions of astonishment by some critics, including Scherer, concerning Stackelberg’s…

333

Abstract

Reviews the international response to Marktform und Gleichgewicht, and questions the reactions of astonishment by some critics, including Scherer, concerning Stackelberg’s explanation of disequilibrium of certain market structures. Defends Stackelberg’s standpoint by considering the specific historical context. Looks at Cournot’s continuity thesis and challenges the assumption of analogous market configurations. Suggests that Stackelberg’s theoretical derivations may have been intended to provoke further scientific study.

Details

Journal of Economic Studies, vol. 23 no. 5/6
Type: Research Article
ISSN: 0144-3585

Keywords

Article
Publication date: 11 January 2016

Shreeranga Bhat, E.V. Gijo and N. A. Jnanesh

The purpose of this paper is to illustrate how Lean Six Sigma (LSS) methodology was applied to a medical records department (MRD) of a hospital in India to reduce the…

2720

Abstract

Purpose

The purpose of this paper is to illustrate how Lean Six Sigma (LSS) methodology was applied to a medical records department (MRD) of a hospital in India to reduce the Turn-Around-Time (TAT) of medical records preparation process and thus to improve the productivity and performance of the department.

Design/methodology/approach

The research reported in this paper is based on a case study carried out using LSS approach and in improving the medical records preparation process.

Findings

The root causes for the problem were identified and validated through data-based analysis from LSS tool box, at different stages in the project. As a result of this project, the TAT was reduced from average 19 minutes to eight minutes and the standard deviation was reduced by one-tenth, which was a remarkable achievement for department under study. This was resulted in the reduction in the work-in-process inventory of medical records from 40 units to 0 at the end of the day. Project in-turn reduced the staffing level from the earlier level of six to a current level of four.

Research limitations/implications

The paper is based on a single case study executed in IP-MRD of a single hospital and hence there is limitation in generalizing the specific results from the study. But the approach adopted and the learning from this study can be generalized.

Originality/value

This paper will be helpful for those professionals who are interested in implementing LSS to healthcare organization to improve the productivity and performance.

Details

International Journal of Productivity and Performance Management, vol. 65 no. 1
Type: Research Article
ISSN: 1741-0401

Keywords

Article
Publication date: 2 October 2019

Shreeranga Bhat, Jiju Antony, E.V. Gijo and Elizabeth A. Cudney

The purpose of this paper is to explore the voice of the customer, key performance indicators, critical to quality characteristics, critical success factors, and commonly…

1608

Abstract

Purpose

The purpose of this paper is to explore the voice of the customer, key performance indicators, critical to quality characteristics, critical success factors, and commonly used tools and techniques for deploying the Lean Six Sigma (LSS) strategy in Indian private hospitals, with special attention to the medical records.

Design/methodology/approach

The study utilizes the action research methodology to obtain a greater understanding of the use of LSS in the Indian healthcare sector. Multiple case studies were designed and successfully deployed to understand and ascertain challenges in LSS implementation. Five case studies were carried out in the Medical Records Departments (MRD) of four private hospitals in India.

Findings

Patients perceive that waiting in queue harms their health, which can be rectified by addressing the cycle time of the system. The research also found that effective leadership, availability of data, involvement of cross-functional team and effective communication are critical to the success of LSS projects. In addition, control charts, cause and effect diagram, 5S, gemba, two-sample t-test, standardization, waste analysis and value stream mapping are some of the common tools used to improve healthcare systems.

Research limitations/implications

The research was restricted to studying the impact of LSS on the workflow and resource consumption of the MRD in Indian allopathic hospitals only. The validity of the results can be improved by including more hospitals and more case studies from the healthcare sector in different countries.

Originality/value

The findings will enable researchers, academicians and practitioners to incorporate the results of the study in LSS implementation within the healthcare system to increase the likelihood of successful deployment. This will provide greater stimulus across other departments in the hospital sector for wider and broader application of LSS for creating and sustaining process improvements.

Details

International Journal of Quality & Reliability Management, vol. 37 no. 1
Type: Research Article
ISSN: 0265-671X

Keywords

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