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1 – 10 of over 25000Moutasem A. Zakkar, Craig Janes and Samantha Meyer
Patient experience (PE) evaluation can identify critical issues in healthcare quality. Various methods are used for PE evaluation in the healthcare system in Ontario; however…
Abstract
Purpose
Patient experience (PE) evaluation can identify critical issues in healthcare quality. Various methods are used for PE evaluation in the healthcare system in Ontario; however, evidence suggests that PE evaluation is not systematically performed and has not received substantial buy-in from healthcare providers. This study explores the perspectives of healthcare providers, managers and policymakers in Ontario on PE evaluation methods, barriers, utility and reliability.
Design/methodology/approach
The study used a qualitative descriptive design. Twenty-one semistructured interviews were conducted with healthcare providers, managers and policymakers in Ontario between April 2018 and May 2019. The authors used thematic analysis to analyze the data. The Consolidated Criteria for Reporting Qualitative Research quality criteria were used.
Findings
Barriers to PE evaluation include evaluation cost and the time and effort required to collect and analyze the data. Several factors affect the reliability of the evaluation, resulting in an unrealistically high level of patient satisfaction. These include the inclusivity of evaluation, the subjective nature of patient feedback, patients' concerns about health service continuity and the anonymity of evaluation. Participants were skeptical about the meaningfulness of evaluation because it may only yield general information that cannot be acted upon by healthcare providers, managers and policymakers for quality improvement.
Originality/value
This paper reveals that many healthcare providers, managers and policymakers do not see a tangible value in PE evaluation, regardless of Ontario's patient-centeredness and “patient first” rhetoric. An improvement in evaluation methods and a cultural change in the healthcare system regarding the value of PE are required to foster a better appreciation of the benefits of PE evaluation.
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Sina Furnes Øyri, David W. Bates and Siri Wiig
The authors compare perspectives on external evaluation of health service provision between Norway and the USA. External inspection and accreditation are examples of…
Abstract
Purpose
The authors compare perspectives on external evaluation of health service provision between Norway and the USA. External inspection and accreditation are examples of internationally wide-spread external evaluation methods used to assess the quality of care given to patients. Different countries have different national policy strategies and arrangements set up to do these evaluations. Although there is growing attention to the impact and effects on quality and safety from external evaluation, there is still a gap in knowledge to how structures and processes influence these outcomes. Accordingly, the purpose of this article is to describe the structures and processes in external evaluation designed to promote quality improvement in Norway and the USA with attention to comparison of enablers and barriers in external evaluation systems.
Design/methodology/approach
Data collection consisted of documentary evidence retrieved from governmental policies, and reviews of the Joint Commission (the US), international guidelines, recommendations and reports from the International Society for Quality in Health Care, and the World Health Organization, and policies and regulations related to Norwegian governmental bodies such as the Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Board of Health Supervision . Data were analyzed inspired by a deductive, direct content analytical framework.
Findings
The authors found that both accreditation and inspection are strategies put in place to ensure that healthcare providers have adequate quality systems as well as contributing to the wider risk and safety enhancing management and implementation processes in the organizations subjected to evaluation. The US and the Norwegian external regulatory landscapes are complex and include several policymaking and governing institutions. The Norwegian regulatory framework for inspection has replaced an individual blame logic with a model which “blames” the system for inadequate quality and patient harm. This contrasts with the US accreditation system, which focuses on accreditation visits. Although findings indicate an ongoing turning point in accreditation, findings also demonstrate that involving patients and next of kin directly in adverse event inspections is a bigger part of a change in external inspection culture and methods than in processes of accreditation.
Research limitations/implications
The message of this paper is important for policymakers, and bodies of inspection and accreditation because knowledge retrieved from the comparative document study may contribute to better understanding of the implications from the different system designs and in turn contribute to improving external evaluations.
Originality/value
Although there is a growing attention to the impact and effects on quality and safety from external evaluation, the implications of different regulatory strategies and arrangements for evaluation on quality and safety remain unclear.
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Santonab Chakraborty, Rakesh D. Raut, T.M. Rofin and Shankar Chakraborty
Supplier selection along with continuous evaluation of their performance is a crucial activity in healthcare supply chain management for effective utilization of scarce resources…
Abstract
Purpose
Supplier selection along with continuous evaluation of their performance is a crucial activity in healthcare supply chain management for effective utilization of scarce resources while providing quality service at an affordable price, and minimizing chances of stock-out, avoiding serious consequences on the illness or fatality of the patients. Presence of both qualitative and quantitative evaluation criteria, set of potential suppliers and participation of different stakeholders with varying interest make healthcare supplier selection a challenging task which can be effectively solved using any of the multi-criteria decision making (MCDM) methods.
Design/methodology/approach
To deal with various qualitative criteria, like cost, quality, delivery performance, reliability, responsiveness and flexibility, this paper proposes integration of grey system theory with a newly developed MCDM tool, i.e. mixed aggregation by comprehensive normalization technique (MACONT) to identify the best performing supplier for pharmaceutical items in a healthcare unit from a pool of six competing alternatives based on the opinions of three healthcare professionals.
Findings
While assessing importance of the six evaluation criteria and performance of the alternative healthcare suppliers against those criteria using grey numbers, and exploring use of three normalization procedures and two aggregation operations of MACONT method, this integrated approach singles out S5 as the most compromised healthcare supplier for the considered problem. A sensitivity analysis of its ranking performance against varying values of both balance parameters and preference parameters also validates its solution accuracy and robustness.
Originality/value
This integrated approach can thus efficiently solve healthcare supplier selection problems based on qualitative evaluation criteria in uncertain group decision making environment. It can also be deployed to deal with other decision making problems in the healthcare sector, like supplier selection for healthcare devices, performance evaluation of healthcare units, ranking of physicians etc.
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Report cards, performance evaluations, and quality assessments continue to penetrate the lexicon of the healthcare sector. The value of report cards is typically couched as…
Abstract
Report cards, performance evaluations, and quality assessments continue to penetrate the lexicon of the healthcare sector. The value of report cards is typically couched as enhancing consumerism among patients, increasing accountability among healthcare providers, and more broadly increasing the transparency of healthcare information. This paper discusses the potential benefits and pitfalls of these performance assessments.
This paper briefly reviews empirical evidence regarding the impact of report cards for healthcare providers and synthesizes the role and limitations of these performance measures into distinct evaluation criteria. The rapid proliferation of report cards for healthcare providers suggests a growing need to develop mechanisms and tools to evaluate their impact. The risks associated with utilizing report cards for provider oversight include the deleterious impact on vulnerable populations and a failure to accurately measure quality of care. The capacity to create report cards should not be the sole criterion to develop and utilize report cards to evaluate healthcare providers. Rather, careful consideration of the benefits and risks should accompany the implementation and utilization of report cards into regulatory processes. This report proposes an evaluation checklist by which to assess the role of report cards in a given healthcare context.
Céline Bérard, L. Martin Cloutier and Luc Cassivi
If the use of information technology (IT) supporting clinical trial projects offers opportunities to optimize the underlying information management process, the intricacy of the…
Abstract
Purpose
If the use of information technology (IT) supporting clinical trial projects offers opportunities to optimize the underlying information management process, the intricacy of the identification and evaluation of relevant IT options is generally seen as a complex task in healthcare. Hence, the purpose of this paper is to examine the problem of ex ante information system evaluation, and assess the impact of IT on the information management process underlying clinical trials.
Design/methodology/approach
Combining Unified Modeling Language (UML) and system dynamics modeling, a simulation model for evaluating IT was developed. This modeling effort relies on a case study conducted in a clinical research organization, which, at that time, faced an IT investment dilemma.
Findings
Some illustrative results of sensitivity analyzes conducted on error rates in clinical data transmission are presented. These simulation results allow for quantifying the impact of different IT options on human resources' efforts, time delays and costs of clinical trials projects. Notably, the results show that although the technology has no real influence on the duration of a clinical trial project, it impacts the number of projects that can be carried out simultaneously.
Originality/value
The research provides insights into the development of an innovative approach appropriate to the evaluation of IT supporting clinical trials, through the use of a mixed‐method based on qualitative and quantitative modeling. The results illustrate two critical issues addressed in the IS literature: the necessity to extend IT evaluation beyond the quantitative‐qualitative dichotomy; and the role of evaluation in organizational learning, and in learning about business dimensions.
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Rizqy Amelia Zein, Nuzulul Kusuma Putri and Ilham Akhsanu Ridlo
The purpose of this paper is to investigate whether justice, trust in healthcare services, the confidence level of the health system and institutions, political party support and…
Abstract
Purpose
The purpose of this paper is to investigate whether justice, trust in healthcare services, the confidence level of the health system and institutions, political party support and evaluation of healthcare services post-Jaminan Kesehatan Nasional (JKN) affected policy acceptability (PA) in the health workers (n=95) and laypeople (n=308) sample.
Design/methodology/approach
The authors performed a two-level, linear mixed-effects model to test the hypothesis that trust, perceived justice, confidence in healthcare services and national health system evaluation could impact PA in the health workers and laypeople sample. The authors calculated the effect sizes by comparing Level 2 variances and residuals of the null model and the random intercept model.
Findings
The findings suggested that healthcare workers with high concern for justice would be more likely to hold negative acceptability to JKN. The findings implied that health workers tend to associate JKN with unfairness. Also, JKN acceptability in laypeople sample was found to be positively associated with the evaluation of healthcare service post-JKN, whereas justice or political party support did not affect JKN acceptability. It might indicate that laypeople motives for joining JKN scheme could be essentially pragmatic.
Research limitations/implications
The authors administered the questionnaire using an online platform and circulated it through social media and IMS, so that this research poses a problem of self-selection bias, which potentially leads to biased estimates. The authors also oversampled female participants, especially in laypeople sample.
Originality/value
Aiming at universal health coverage in 2019, JKN will cover almost 300m Indonesians and be one of the biggest single-payer national health insurance scheme in the world. The research might offer insight into how health workers and laypeople respond to the policy.
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Vassilios P. Aggelidis and Prodromos D. Chatzoglou
It is widely accepted that the use of information and communication technology (ICT) in the healthcare sector offers great potential for improving the quality of services…
Abstract
Purpose
It is widely accepted that the use of information and communication technology (ICT) in the healthcare sector offers great potential for improving the quality of services provided, the efficiency and effectiveness of personnel, and also reducing organizational expenses. This paper seeks to examine various hospital information system (HIS) evaluation methods.
Design/methodology/approach
In this paper a comprehensive search of the literature concerning the evaluation of complex health information systems is conducted and used to generate a synthesis of the literature around evaluation efforts in this field. Three approaches for evaluating hospital information systems are presented – user satisfaction, usage, and economic evaluation.
Findings
The main results are that during the past decade, computers and information systems, as well as their resultant products, have pervaded hospitals worldwide. Unfortunately, methodologies to measure the various impacts of these systems have not evolved at the same pace. To summarize, measurement of users' satisfaction with information systems may be the most effective evaluation method in comparison with the rest of the methods presented.
Practical implications
The methodologies, taxonomies and concepts presented in this paper could benefit researchers and practitioners in the evaluation of HISs.
Originality/value
This review points out the need for more thorough evaluations of HISs that look at a wide range of factors that can affect the relative success or failure of these systems.
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Duncan E. Jackson and Sally I. McClean
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Originality/value
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.
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Christine Pelletier and Georges Weil
Regional health care planning deals with the regional healthcare resource location‐allocation problem posed to each public healthcare administration. Up to date, the models…
Abstract
Regional health care planning deals with the regional healthcare resource location‐allocation problem posed to each public healthcare administration. Up to date, the models designed to support this kind of decision failed in their application. We found that the main reason is that often these models restrict the problem to a unique aspect (such as “covering of the territory” or “technique efficiency”), leaving outside a set of very important other dimensions, even if these are usually subjective and difficult to formalise. In this paper we present a method to identify formally these dimensions, by assigning measurable attributes to each of them. At a different level, we propose a hierarchical formulation of the overall objective of the regional healthcare resource planning for the facility systems; in this hierarchy, each leaf term corresponds to a formal evaluation criterion.
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Andrea Brambilla, Göran Lindahl, Marta Dell'Ovo and Stefano Capolongo
Several healthcare quality assessment tools measure the processes and outcomes of the care system. The actual physical infrastructure (buildings and organizational) aspects are…
Abstract
Purpose
Several healthcare quality assessment tools measure the processes and outcomes of the care system. The actual physical infrastructure (buildings and organizational) aspects are, however, rarely considered. The purpose of this paper is to describe the process of validation and weighting of an evidence-informed framework for the quality assessment of hospital facilities from social, environmental and organizational perspectives to complement other assessments.
Design/methodology/approach
Sustainable High-quality Healthcare version 2 (SustHealth v2) is the updated version of an existing framework composed of three domains (social, environmental and organizational quality). To validate and establish a relevant weighting, interviews were conducted with 15 professionals within the field of healthcare planning, design, research and management. The study has been conducted through semi-structured interviews and the application of the Simon Roy Figueras (SRF) procedure for the elicitation of weights criteria. The data collected have been processed through the DecSpace web platform.
Findings
Among the three domains, the organizational qualities appear to be the most important (W = 49%), followed by the environmental (W = 29%) and social aspects (W = 22%). Relevant indicators such as future-proofing, wayfinding and users’ space control emerged as the most important within each macro-area. Those results are confirmed by the outcome of the interviews that highlight user/patient-centeredness, wayfinding strategies and space functionality as the most important concepts to foster in existing healthcare facilities improvement.
Practical implications
The study highlights important structural and organizational aspects that hospital managers and planners can consider when dealing with healthcare facilities’ quality improvement.
Originality/value
The use of the SRF multicriteria method is novel in this context when used to weight an assessment tool with a focus on hospital built environment.
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