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Defining quality of healthcare and determining how to improve organisational performance in developed countries is still an unresolved issue among healthcare professionals. However, given that it is an important area of responsibility and accountability it is no longer acceptable to view the issue as discretionary. An increasingly acceptable operative option for achieving continuous improvement and excellence seems to be the self‐assessment of an organisation, based on the principles of knowledge management and total quality management (TQM). This article provides an explanation of a two‐level self‐assessment approach for implementing TQM within the Spanish healthcare system. The first level integrates a client‐centred approach using classical healthcare accreditation criteria along with ISO 9000 standards, the aim being to establish quality assurance systems in the whole organisation. The second level uses the European Foundation for Quality Management Excellence Model as a road map for self‐assessment and continuous improvement towards excellence.

The purpose of this paper is to introduce an integrated approach using failure modes and effects analysis (FMEA), multiple-criteria decision making (MCDM), mathematical modeling and quality function deployment (QFD) techniques, for risk assessment and service quality enhancement in coronary artery bypass grafting (CABG) as a treatment for cardiovascular diseases (CVDs).

First, the disruptions in the CABG process are identified and prioritized following FMEA instructions, using two MCDM techniques, called analytic hierarchy process (AHP) and TOPSIS. Consequently, several corrective activities are identified and weighted on the basis of QFD. Finally, a mathematical model is established to determine the most cost-effective activities for implementation. The approach is developed in a fuzzy environment to reflect the uncertainty and ambiguity of human reasoning.

Regarding the CABG process disruption, a total of 30 failure modes in four main categories were identified and prioritized. Moreover, eight corrective activities were devised and ranked according to their impact on the failure modes. Finally, considering a limited amount of budget, a sensitivity analysis on the mathematical model’s objective function indicated that using 30 percent of the total budget, required to implement all corrective activities, was enough to cover more than 70 percent of the effects of corrective activities on the failure modes.

This paper contributes to the quality risk assessment knowledge by introducing an integrated approach to evaluate and improve healthcare services quality. Also, the case study conducted on the CABG process has not been done by other related studies in the literature.

This paper aims to provide an assessment of organisational implementation of the healthcare standards focusing on the annual health check (AHC) in the UK NHS.

Using a postal questionnaire a national survey of all acute and specialist NHS Trusts in England was undertaken. The survey yielded a total of 102 responses, which equates to a 59 per cent response rate.

The findings suggest considerable variation and diversity in the rate of progress individual Trusts made towards implementing the AHC in its first year. However, across many of the organisations surveyed, there was good evidence of some progress towards ensuring that basic operational and strategic components of the framework were in place.

The research appears to reflect the findings of earlier work on the implementation of clinical governance, suggesting that few lessons have been learnt from previous policy initiatives and raising important questions for the future of health care standards.

The findings could be used to support future national health care initiatives by giving an insight into how organisations respond to and manage the process of standards.

This study makes a number of recommendations to facilitate smooth implementation of standards in health care. These include the introduction of a national IT solution; development of regional/national networks; more timely, relevant and consistent national guidance and, the definition of minimum information requirements needed for organisational assurance.

Healthcare facilities are entering an era of increased oversight and heightened expectations concerning both reduced costs and measureable quality. The US Affordable Care Act requires healthcare organizations to collect certain metrics, including patient assessments of quality, in order to monitor and improve the quality of healthcare. These metrics are used as a basis for graduated insurance reimbursements, and are available to consumers as an aid in selecting healthcare providers and insurance plans. The purpose of this paper is to provide healthcare providers with the analytic capabilities to better understand quality of care from the patient’s point of view.

This research examines patient satisfaction data from a multi-specialty Medical Practice Group, and uses regression analysis and paired comparisons to provide insight into patient perceptions of care quality.

Results show that variables related to Access, Moving Through the Visit, Nurse/Assistant, Care Provider and Personal Issues significantly impact overall assessments of care quality. In addition, while gender and type of care provider do not appear to have an impact on overall patient satisfaction, significant differences do exist based on age group, specialty of the physician and clinic type.

This study differs from most academic research as it focusses on medical practices, rather than hospitals, and includes multiple clinic types, medical specialties and physician types in the analysis. The study demonstrates how analytics and patient perceptions of quality can inform policy decisions.

Diabetes is one of the major healthcare challenges in India. The chronic nature of the disease makes the lifetime cost of the treatment exorbitantly high. The medicine cost contributes a major size of expense in diabetes management. To make healthcare available to poorest of the poor, it is imperative to control the rising cost of diabetes treatment. The earlier research works done in this area focuses more on inventory management techniques to control the cost of healthcare. Less interest is shown in the role of better supply chain partnership (SCP) in reducing the cost of procurement of medicine. The purpose of this paper is to develop and use the SCP assessment framework for a diabetes clinic. The approach is generalized enough to be adopted for other similar organization.

This paper adopts self-assessment criteria of the European Foundation for Quality Management (EFQM) business excellence model for analysis of SCP in the supply chain of a private diabetes clinic in Varanasi. The paper uses analytic hierarchy process (AHP) method for calculation of weights of criteria.

The EFQM-based framework can be adopted as easy-to-use tool to make an objective assessment of the SCP. The proposed model in the study is a balanced model between enablers and results, which includes multiple assessment dimensions. The supply chain performance score of the diabetes clinic under study was found as the Tool Pusher, which means the effort in direction of SCP is not too good. The organization needs to clearly define the SCP goal and analyze the results to identify the gap areas.

The study is first of its kind and contributes to the literature by providing non-prescriptive and easy-to-use SCP assessment framework, for chronic disease care. The case study approach provides a procedure for the healthcare organization willing to adopt this approach.

The purpose of the study is to measure the performance of Indian hospitals, both operationally and financially, by using hospital KPI's. The assessment is predominantly done by linking it to the existing Lean practices in Indian hospitals.

An empirical study based on cross-sectional survey of hospital managers and specialists in various private healthcare facilities across India was conducted to validate the proposed Lean framework. From an extensive literature survey, the authors identified quality, delivery, efficiency, accessibility and patient centeredness to be the main operational performance (OP) indicators for hospitals. Business or financial performance was measured based on parameters which are average revenue per occupied bed (ARPOB), earnings before interest, tax, depreciation and amortization (EBITDA) and operating revenue. Confirmatory Factor Analysis (CFA) was carried out using a specialized technique, called Structural Equation Modelling(SEM) and an explicit factor structure was hypothesized.

Management commitment towards Lean in hospitals is statistically proven to have impacted operational and financial performance. However, leanness in technology and business processes showed no statistical significance on either operational or financial performance parameters. Hospital stakeholders showed statistical significance on though it had no impact on the financial performance. Results obtained from the statistical analysis indicate a positive impact of hospital Lean practices on timely delivery of services and improved service quality. Efficiency, accessibility of services and patient centered behavior in hospital operations could not be statistically proven to have impacted the financial performance.

Effectiveness of Lean management (LM) principles in improving hospital operations is largely dependent on patient centered behavior. Empowered employees who are trained to add value from a customer view point, make hospital operations safe and improved. Properly trained and communicated employees who are committed to quality improvements can make a positive impact on patients' quality of life and thus positively impact the society. The study lists ways to attain the required outcomes.

This paper is among the very few that has attempted to suggest ways to link implementation of Lean practices more effectively in Indian hospitals to improve hospital performance at operational and financial levels.

This innovative analysis aims to quantify the use of evaluation criteria in telemedicine and to identify current trends in metric adoption. The focus is to determine the frequency of actual performance metric reporting in telemedicine evaluation, in contrast to systematic reviews where assessment of study quality is the goal.

Automated literature search identified telemedicine studies reporting quantitative performance metrics. Studies were classified by telemedicine class; store‐and‐forward (SAF), real‐time consultation (RTC) and telecare (TC), and study stage. Studies were scanned for evaluation metric reporting, i.e. clinical outcomes, satisfaction, patient quality and cost measures.

Evaluation metric use was compared among telemedicine classes, and between pilot and routine use stages. Diagnostic accuracy was reported significantly more frequently in pilots for RTC and TC. Cost measures were more frequently reported in routine use for TC. Clinical effectiveness and hospital attendance were better reported in routine use for SAF. Comparison also revealed different evaluation strategies. In pilots, SAF favoured diagnostic accuracy, compared to RTC and TC. TC preferred clinical effectiveness evaluations and TC more frequently assessed patient satisfaction. Cost was only reported in less than 20 per cent of studies, but most frequently in RTC. Routine use led to increased reporting of all metrics, except diagnostic accuracy. Clinical effectiveness reporting increased significantly with routine use for RTC and SAF, but declined for TC.

Clinical outcomes and patient satisfaction were reported frequently in telemedicine studies, but reporting of other performance metrics was rare. Understanding current trends in metric reporting will facilitate better design of future telemedicine evaluations.

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has been recognized as a “gold standard” set of “practical standardized measures” for assessing hospital service quality. Beginning with the HCAHPS, the purpose of this paper is to extend efforts to assess patient-centered communication (PCC) and the quality of healthcare and presents a scale for measuring patient perceptions and expectations of service quality in an emerging economy context.

A self-administered survey of patients in private hospitals (N = 171) was conducted to test the proposed framework. Exploratory and confirmatory factor analyses were used to establish the measurement model. Multiple regression analysis was used to explain the scale's predictive ability. ANOVA was used to analyze service quality gaps and rank patients' priorities.

Five components of PCC are identified. Among these, nurse affective communication has a significant positive effect on patient satisfaction. The gap analysis shows that patients have high expectations for doctors' affective communication, while they perceive a low level of service performance in the realm of nurse affective communication. The study highlights a new means of measuring “reliability” in healthcare. Important findings on patients' priorities are evaluated and discussed.

Healthcare organizations and practitioners can improve patient-centered care by stressing the dimensions of PCC, including clinicians' affective and instrumental communication.

The study expands the understanding of HCAHPS instruments in an emerging economy context and opens avenues for more widespread use of the measures. The research contributes to the literature on patient-centered care and healthcare service quality by proposing a scale for managing specific practices and interactions in healthcare.

The purpose of this paper is to investigate the role of intellectual capital (IC) in promoting the sustainable development (SD) program of the Emilia-Romagna Health Service. The contributions of the following assets were investigated: leadership and competences, culture, performance measurement and incentives systems, social capital and technologies.

The case study was conducted following a hierarchical approach: perceptions of the regional directorate of public and social health, the general directors and healthcare professionals of the regional health system (the setting) were analyzed through interviews, focus groups and documentation in order to investigate: the emerging definition of SD within the setting; the role of IC, if any, in the achievement of the regional SD goals.

SD culture did not expand at the operative level because of the lack of involvement of healthcare professionals in a permanent dialogue for sustainability. Sustainability projects were not systematic which restricted the development of staff awareness of sustainability issues. Social capital enabled environmental projects and medical projects that increased patients’ involvement in disease management. Technology could help the shift toward sustainability, but it requires consideration of tangible and intangible costs for its successful adoption. SD performance measurement and incentives were in their infancy and cost accounting continues to dominate the healthcare sustainability debate.

Despite the low number of healthcare professionals involved in the focus groups, the paper represents one of the first attempts to frame their perceptions on SD implementation in healthcare.

Regional institutions should consider new ways of enacting SD which should be more inclusive of healthcare professionals. The establishment of a permanent interdisciplinary dialogue on sustainability would develop human, social and structural capital for sustainability. Healthcare organizations should monitor the environmental and social effects of their operations to enact their primary mission: the promotion of health.

The paper contributes to theory development related to the role of IC for SD in the public sector context and, in particular, in the healthcare sector where evidence is currently limited.

Over the years, despite the best efforts to evaluate service quality through multiple techniques, the connotation between service deliverance and consumer expectation remains sporadic. In the quest to quantify service quality from an innovative perspective, the current study has leveraged consumer-perceived experiences to unveil the novel intricacies of healthcare quality.

Anchoring on the dimensions of patient experience (PX), field data were collected from 244 patients at different private hospitals operating across India. Further, this study incorporated a fuzzy analytic hierarchy process (F-AHP) to evaluate consumer preferences and prioritised the dimensions of PX in three categories of Indian hospitals, namely nursing homes (NHs), mid-tier corporate hospitals (MCHs) and top-tier corporate hospitals (TCHs).

The results establish a performance ranking by demonstrating that MCHs outperform the rest alternatives on the grounds of perceived experiences. Tukey's honestly significance difference (HSD) test was executed to confirm the heterogeneity among the participants' preferences across three different hospital categories. The results reveal that for most of the alternatives, the mean scores of the criterion were statistically significantly different.

In healthcare studies, PX dawned as an entity with an ability to propel healthcare quality in a better way than the classical techniques did. The study's findings present a comprehensive picture of a care delivery system by identifying relatively significant dimensions of PX, hence improving the quality quotients by adjusting healthcare offerings in alignment with consumer expectations and organisational strategies.