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Bureaucracy to a large extent entrenches orderliness and productive means of achieving goals in both public and private organisations across the world. However, bureaucracy is not suitable in the management of hospitals due to its peculiar nature of operations. This study investigates the conundrum of bureaucratic processes and health-care service delivery in government hospitals in Nigeria.

The study surveyed 600 outpatients and attendees visiting tertiary and government hospitals in Nigeria using descriptive design to obtained data from the respondents. A research instrument, questionnaire, was used to gather data. Out of the 600 outpatients visiting the 20 hospitals in government and tertiary hospitals, 494 responses were returned from the attendees. The study employed random sampling strategy to collect the information.

The findings of this study were that service delivery in government hospitals were in adverse position on all the four constructs of bureaucratic dimensions as against quality of service delivery in hospitals in Nigeria. It discovered that bureaucratic impersonality cannot impact on the quality of service delivery in government hospitals in Nigeria. Separation and division of labour among health workers have no significant effect on quality service delivery in government hospitals. Formal rules and regulations (administrative procedure, rules, and policies) prevent quality service delivery in government hospitals in Nigeria. Also, patient’s waiting time was not significant to the quality of service delivery in government hospitals.

The results are constrained with dimensions of bureaucratic processes. Thus, the implication of this study is that bureaucracy in the Nigerian public hospitals is an unnecessary marriage which should be carefully separated and de-emphasised for quality service delivery in the hospitals to thrive.

Largely, this study is practical essential as it unearths the irrelevant operations procedure that hinder progress in Nigerian hospitals.

The study accomplishes recognised importance to survey how bureaucracy impedes quality service delivery in government hospitals. This study has provided a vital clue to elements that will bring rapid attention to patients’outcome in Nigerian hospitals and health-care facilities which hitherto has not been emphasised. The study has contributed to the existing body of knowledge associated to healthcare service quality in developing country.

This paper aims to examine the factors that affect the quality of healthcare services in the implementation of the National Health Insurance Scheme (NHIS) at the local level in Ghana from the perspectives of health policy implementers and beneficiaries in public-private organisations.

This paper has adopted a mixed research method with both qualitative and quantitative data, with in-depth interviews, document analysis and focus groups discussions. A total of 107 participants took part in the interviews and the questionnaire survey.

The study found that these factors greatly affect the quality of healthcare services from the implementers’ perspectives — referrals, effectiveness in monitoring, timeliness, efficiency, reimbursement, compliance with standard guidelines of Ghana Health Service (GHS) and accreditation process. For the beneficiaries, three healthcare services factors are important, including medical consultations, diagnostic services and the supply of drugs and medicines. Some other factors are found to be the least prioritized healthcare services, namely the issuance of prescription forms, verification of identification (ID) cards and staff attitude. However, the study found that implementers and beneficiaries exhibited a mixed reaction (perspectives) on accessing some healthcare services. In some healthcare services where the implementers perceived that beneficiaries have more access to such services, the beneficiaries think otherwise, an irony in the perspectives of the two actors.

This paper adds to the extant literature on the perspectives of policy implementers and beneficiaries on factors that affect the quality of healthcare services in general and specifically on the implementation of NHIS in Ghana with the public-private dimension.

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

The purpose of this paper is to increase knowledge of the role organizational factors have in how health personnel make efficiency-thoroughness trade-offs, and how these trade-offs potentially affect clinical quality dimensions.

The paper is a thematic synthesis of the literature concerning health personnel working in clinical, somatic healthcare services, organizational factors and clinical quality.

Identified organizational factors imposing trade-offs were high workload, time limits, inappropriate staffing and limited resources. The trade-offs done by health personnel were often trade-offs weighing thoroughness (e.g. providing extra handovers or working additional hours) in an environment weighing efficiency (e.g. ward routines of having one single handover and work-hour regulations limiting physicians' work hours). In this context, the health personnel functioned as regulators, balancing efficiency and thoroughness and ensuring patient safety and patient centeredness. However, sometimes organizational factors limited health personnel's flexibility in weighing these aspects, leading to breached medication rules, skipped opportunities for safety debriefings and patients being excluded from medication reviews.

Balancing resources and healthcare demands while maintaining healthcare quality is a large part of health personnel's daily work, and organizational factors are suspected to affect this balancing act. Yet, there is limited research on this subject. With the expected aging of the population and the subsequent pressure on healthcare services' resources, the balancing between efficiency and thoroughness will become crucial in handling increased healthcare demands, while maintaining high-quality care.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

The purpose of this paper is to assess the applicability of care quality concepts as contract award criteria for public procurement of health and social care, using the case of Sweden.

Based on a literature review, European and Swedish legal texts, government regulations as well as 26 Swedish court review cases concerning care procurement have been analysed.

Methods used for assessing care quality are seldom useful for predicting the quality to be delivered by a potential contractor. Legal principles of transparency and equal treatment of tenderers make it necessary to apply strict requirements for verification.

Results refer primarily to a Swedish context but could be applicable throughout the EU. Further studies of relations between award criteria and public/private collaborative practices for improving care quality during contractual periods are desirable.

Local and regional procurement officials should benefit from a better understanding of how quality criteria should be designed and applied to the award procedures for care contracts. Care providers in the private sector would also be able to develop their quality strategies and present their abilities more efficiently when tendering for public contracts.

Issues of quality of health and social care are of obvious importance for social sustainability. Public awareness of care quality problems is evident and often a cause of media concern.

This investigation pinpoints the difference between traditional care quality thinking and the legal principles underlying contract award in public procurement of care services.

Adolescence is a time when a young person develops his or her identity, acquires greater autonomy and independence, experiments and takes risks and grows mentally and physically. To successfully navigate these changes, an accessible and health system when needed is essential.

We assessed the structure and content of national primary care services against these standards in the field of adolescent health services. The main criteria identified by adolescents as important for primary care are as follows: accessibility, staff attitude, communication in all its forms, staff competency and skills, confidential and continuous care, age appropriate environment, involvement in health care, equity and respect and a strong link with the community.

We found that although half of the Models of Child Health Appraised countries have adopted adolescent-specific policies or guidelines, many countries do not meet the current standards of quality health care for adolescents. For example, the ability to provide emergency mental health care or respond to life-threatening behaviour is limited. Many countries provide good access to contraception, but specialised care for a pregnant adolescent may be hard to find.

Access needs to be improved for vulnerable adolescents; greater advocacy should be given to adolescent health and the promotion of good health habits. Adolescent health services should be well publicised, and adolescents need to feel empowered to access them.

Models of Child Health Appraised (MOCHA) defines school health services (SHSs) as those that exist due to a formal arrangement between educational institutions and primary health care. SHSs are unique in that they are designed exclusively to address the needs of children and adolescents in this age group and setting.

We investigated SHSs have been provided to schools and how they contribute to primary healthcare services for school children. We did this by mapping the national school health systems against the standards of the World Health Organization, and against a framework measuring the strength of primary care, adapting this from an existing, adult-focused framework.

We found that all but two countries in the European Union and European Economic Area have SHSs. There, however, remains a need for much greater investment in the professional workforce to run the services, including training to ensure appropriateness and acceptability to young people. Greater collaboration between SHSs and primary care services would lead to better coordination and the potential for better health (and educational) outcomes. Involving young people and families in the design of SHSs and as participants in its outputs would also improve school health.

The pandemic has reinforced the need for revamping the healthcare service delivery systems around the world to meet the increased challenges of modern-day illnesses. The use of medical cyber–physical system (MCPS) in the healthcare is one of the means of transforming the landscape of the traditional healthcare service delivery system. The purpose of this study is to critically examine the impact of MCPS on the quality of healthcare service delivery.

This paper uses an evidence-based approach, the authors have conducted a systematic literature review to study the impact of MCPS on healthcare service delivery. Fifty-four articles were thematically examined to study the impact of MCPS on eight characteristics of the healthcare service delivery proposed by the world health organisation.

The study proposes support that MCPS will positively impact (1) comprehensiveness, (2) accessibility, (3) coverage, (4) continuity, (5) quality, (6) person-centredness, (7) coordination, (8) accountability and (9) efficiency dimension of the healthcare service delivery. The study further draws nine propositions to support the impact of MCPS on the healthcare service delivery.

This study can be used by stakeholders as a guide point while using MCPS in healthcare service delivery systems. Besides, healthcare managers can use this study to understand the performance of their healthcare system. This study can further be used for designing effective strategies for deploying MCPS to be effective and efficient in each of the dimensions of healthcare service delivery.

The previous studies have focussed on technology aspects of MCPS and none of them critically analysed the impact on healthcare service delivery. This is the first literature review carried out to understand the impact of MCPS on the nine dimensions of healthcare service delivery proposed by WHO. This study provides improved thematic awareness of the resulting body of knowledge, allowing the field of MCPS and healthcare service delivery to progress in a more informed and multidisciplinary manner.

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.

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.

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.

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.

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.