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Article
Publication date: 1 November 2006

Pui‐Mun Lee, PohWah Khong and Dhanjoo N. Ghista

Purpose – This paper seeks to look at healthcare service quality from the viewpoint of its negative impact on the industry when there is a deficiency in the delivery of…

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3862

Abstract

Purpose – This paper seeks to look at healthcare service quality from the viewpoint of its negative impact on the industry when there is a deficiency in the delivery of service quality. To measure this impact, the potential loss of customers due to poor quality service is measured. A potential customer loss model is proposed. To address the competitive and financially driven healthcare delivery business, a three‐pillar approach, termed the Excellent Healthcare Service Model (EHSM), is introduced. This approach advocates that the healthcare industry should use a system view to deliver quality healthcare by taking into account quality, cost, and efficiency factors in a holistic manner. Design/methodology/approach – In this paper a survey questionnaire was used to gather data necessary to compute impact of deficient healthcare service. The questionnaire was administered to a sample of 400 people and the survey method used was intercept interview. Customer loss and potential customer loss due to deficient service were computed. Findings – In this paper, findings from the research indicated that, in the healthcare industry, for every 100 customers that experienced deficient service, about 70 customers would be unlikely to patronize the same organization again. In addition, for the same 100 customers who have experienced deficient service, about 75 of them will go on to tell on average nine family members and friends about their experiences. Through word of mouth from these 75 dissatisfied customers, there will eventually be about 465 persons who might have been potential customers but will probably not patronize the organization at all based on what the dissatisfied customers have told them. Practical implications – The ideas presented in this paper provide a new way of looking at service quality performance, through the impact of deficient service. With this knowledge, economic impacts of poor service quality could easily be quantified, and such economic‐based results are usually a better motivator for managers and workers to deploy quality improvement initiatives. Originality/value – The results and ideas presented in this paper are valuable for the healthcare industry. It provides an alternative approach to quantify service quality performance. The paper also proposes a system‐based approach to enhance service process performance.

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The TQM Magazine, vol. 18 no. 6
Type: Research Article
ISSN: 0954-478X

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Article
Publication date: 1 March 2004

Adam Fadlalla and Nilmini Wickramasinghe

Currently the healthcare industry in the US is not only contending with relentless pressures to lower costs while maintaining and increasing the quality of service but is…

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1331

Abstract

Currently the healthcare industry in the US is not only contending with relentless pressures to lower costs while maintaining and increasing the quality of service but is also under a stringent timeline to become compliant with the health insurance, portability and accountability act (HIPAA) regulatory requirements. Robust healthcare information systems (HCIS) become critical to enabling healthcare organizations address these challenges. Hence, it becomes an imperative need that the information that is captured, generated and disseminated by these HCIS be of the highest possible integrity and quality as well as compliant with regulatory requirements. This paper addresses this need by proposing an integrative framework for HIPAA compliant, I*IQ HCIS. It bases this framework on an integration of the requirements for HIPAA compliance, the principles of information integrity, as well as the healthcare quality aims set forth by the Committee on the Quality of Healthcare in America.

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International Journal of Health Care Quality Assurance, vol. 17 no. 2
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 November 2001

Slavica A. Ritonja and Zvonko Hocevar

One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is “healthcare

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1275

Abstract

One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is “healthcare processes classification”. The authors found that a typical problem of many European countries is a lack of reliable information in the field of healthcare, mainly because the development of quality instruments, including healthcare processes classification, is not a priority for medical and other health professions. Additionally, it is difficult to update this instrument coherently with organisational changes and developmental achievements. This article describes the approach used by the University Medical Centre in Ljubjana, Slovenia, to redesign its healthcare processes classification in order to improve the quality of healthcare.

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International Journal of Health Care Quality Assurance, vol. 14 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 29 April 2021

Prachi Verma, Satinder Kumar and Sanjeev K. Sharma

This article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting…

Abstract

Purpose

This article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting the total quality of e-healthcare services and its association with consumer satisfaction using a multidimensional hierarchical 5Qs model of e-healthcare service quality.

Design/methodology/approach

Questionnaire-oriented research was performed at three public hospitals of Punjab and Chandigarh. In total, 53 variables were covered in all quality constructs for data collection from the designated public hospitals. The respondents who agreed to have knowledge regarding e-Healthcare services and were availing these services were included in the study. The analysis comprised structural equation modeling technique using AMOS 21.

Findings

The outcomes suggest that the 5Qs model is more comprehensive and can be used to evaluate service quality perceptions using e-Healthcare services. The research identified 11 sub-dimensions for the five quality constructs of the 5Qs model, representing total quality, which is primary to consumer satisfaction. “Overall objectivity” and “technical objectivity” defined the quality of object. The quality of process of e-Healthcare services was characterized by “functionality,” “timeliness” and “responsiveness.” Quality of infrastructure was defined by “technical infrastructure,” “physical infrastructure,” “manpower skills” and “organizational infrastructure.” “Manner of interaction” and “timely interaction” defined the quality of interaction. The atmosphere was represented by only one factor. The results also suggest that quality of infrastructure, quality of interaction and quality of atmosphere play the most significant role in total quality leading to consumer satisfaction.

Research limitations/implications

Theoretical implications: The multidimensional hierarchical model will help the researchers study the e-Healthcare service quality in a more organized manner, and the outcomes of this study can be linked with that of future studies for more generalized application in other public hospitals. The sub-dimensions of each quality construct of the 5Qs model can be applied in private hospitals, and the hierarchical model can be tested in different industries to measure service quality perceptions of the consumer

Practical implications

The outcomes of the study can be applied in various public sector hospitals to redesign the e-Healthcare services based on consumers' perception for better consumer satisfaction and quality services. This paper identifies the role of each quality construct in e-Healthcare services for improvement in the total quality, which in turn will lead to higher satisfaction for the consumers.

Originality/value

In this study, the original 5Qs model has been used for the first time in a new instrument to understand better and design quality e-Healthcare services. The paper explores the sub-factors of each quality construct and its significance in measuring the total quality.

Details

Benchmarking: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1463-5771

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Article
Publication date: 7 May 2021

Malin Knutsen Glette and Siri Wiig

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…

Abstract

Purpose

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.

Design/methodology/approach

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

Findings

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.

Originality/value

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.

Details

International Journal of Health Governance, vol. 26 no. 3
Type: Research Article
ISSN: 2059-4631

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Article
Publication date: 13 January 2021

Shahidul Islam and Nazlida Muhamad

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has been recognized as a “gold standard” set of “practical standardized measures” for…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Practical implications

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

Originality/value

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.

Details

Benchmarking: An International Journal, vol. 28 no. 6
Type: Research Article
ISSN: 1463-5771

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Article
Publication date: 15 July 2020

Prachi Verma, Satinder Kumar and Sanjeev K. Sharma

Use of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of…

Abstract

Purpose

Use of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of services with consumer satisfaction. With e-Healthcare services, consumer satisfaction is influenced by the quality of healthcare services provided and the demographic characteristics. The purpose of the present case study is to recognize the important predictors of quality, which are significant for consumer satisfaction with e-Healthcare services by using Zineldin's 5Qs model. It also aims to find the strength of association among the predictors of consumer satisfaction and the demographic characteristics of the respondents.

Design/methodology/approach

A questionnaire-based study was conducted at a public (PGIMER, Chandigarh) and a private hospital (Fortis Hospital, Mohali) of Punjab, India, from February 2018 to March 2019. The structured, closed-ended questionnaire, to be marked on a 1–5 point Likert scale, was adapted from Zineldin's 5Qs model and was distributed to the respondents sitting in the waiting halls of the selected hospitals. The respondents comprised of both the patients and their attendants who were aware of e-Healthcare services and were using them.

Findings

The analysis identified quality of interaction, quality of hospital atmosphere and quality of object to be the key predictors of consumer satisfaction with e-Healthcare services. The results reveal a strong association between different demographic characteristics and overall consumer satisfaction with e-Healthcare services.

Practical implications

The results suggest that improvements in the quality of interaction, quality of hospital atmosphere and quality of object may result in higher consumer satisfaction with e-Healthcare services. Working on the identified dimensions of quality will help the e-Healthcare providers in identifying functional problems of e-Healthcare services and developing improvement strategies, which will also result in better health and quality outcomes. The results of this study will help the e-Healthcare providers in better segmentation of e-Healthcare consumers based on their demographic characteristics and in developing better marketing strategies.

Originality/value

This paper focuses on the quality of e-Healthcare services only and attempts to identify the quality dimensions, which leads to the satisfaction of e-Healthcare consumers. The identified quality dimensions will help in designing better e-Healthcare services and framing policies. It also highlights the association of demographic characteristics with important quality dimensions.

Details

International Journal of Health Care Quality Assurance, vol. 33 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 8 June 2012

Diego Fornaciari and Stefaan Callens

Competition rules maximise consumer welfare by promoting efficient use of scarce resource and thus high output, low prices, high quality, varied services, innovation…

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938

Abstract

Purpose

Competition rules maximise consumer welfare by promoting efficient use of scarce resource and thus high output, low prices, high quality, varied services, innovation, production and distribution. European courts consider doctors and hospital staff as undertakings (any entity that performs economic activities), so that if they enter into agreements then they have to comply with competition rules. This paper's objective is to determine whether competition law, which applies to undertakings, can in fact be applied to different healthcare‐sector players and whether specific rules are needed regarding competition between healthcare undertakings.

Design/methodology/approach

Data were selected from relevant European and national case law, European institution legal documents (such as regulations, guidelines and communications) and healthcare competition law literature, and then examined.

Findings

The paper finds that competition rules are applicable to healthcare players considering the consequences if competition rules are applied to the healthcare market. For market processes to result in the appropriate cost, quality and output, competition law must be proactive. In other words, quality must be fully factored into the competitive mix, allowing consumers to weigh healthcare price and non‐price characteristics.

Research limitations/implications

Countries have different healthcare system and competition rules (although similar), competition rule impact is different for each country. Some healthcare systems are more regulated and there will be less opportunity for healthcare players to compete.

Practical implications

Efficiently applying competition law to healthcare players means that several challenges need facing, such as healthcare quality complexity and court scepticism.

Originality/value

This article points out the challenges when competition law is applied to the healthcare sector and how these challenges are faced in certain countries such as The Netherlands.

Details

International Journal of Health Care Quality Assurance, vol. 25 no. 5
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 14 February 2020

Alison Brown

The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective…

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4297

Abstract

Purpose

The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective corporate governance has traditionally focused on board architecture. Emerging research is bringing to light the importance of governance dynamics. This paper contributes to emerging research through highlighting how communication and leadership underpin effective engagement in governing healthcare quality.

Design/methodology/approach

A comparative case study of eight Australian public hospitals was undertaken involving document review, interviews and observations. Case studies were allocated into high- or low-engagement categories based on evidence of governance processes being undertaken, in order to compare and contrast influencing factors. Thematic analysis was undertaken to explore how communication and leadership influence healthcare governance.

Findings

Several key components of communication and leadership are shown to influence healthcare quality governance. Clear logical narratives in reporting, open communication, effective questioning and challenge from board members are important elements of communication found to influence engagement. Leadership that has a focus on healthcare excellence and quality improvement are aligned and promote effective meeting processes is also found to foster governance engagement. Effective engagement in these communication and leadership processes facilitate valuable reflexivity at the governance level.

Practical implications

The findings highlight the way in which boards and senior managers can strengthen governance effectiveness through attention to key aspects of communication and leadership.

Originality/value

The case study approach allows the exploration of communication and leadership in greater depth than previously undertaken at the corporate governance level in the healthcare setting.

Details

Journal of Health Organization and Management, vol. 34 no. 2
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 15 March 2013

Jaap van den Heuvel, Gerard C. Niemeijer and Ronald J.M.M. Does

Current health care quality performance indicators appear to be inadequate to inform the public to make the right choices. The aim of this paper is to define a framework…

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3606

Abstract

Purpose

Current health care quality performance indicators appear to be inadequate to inform the public to make the right choices. The aim of this paper is to define a framework and an organizational setting in which valid and reliable healthcare information can be produced to inform the general public about healthcare quality.

Design/methodology/approach

To improve health care quality information, the paper explores the analogy between financial accounting, which aims to produce valid and reliable information to support companies informing their shareholders and stakeholders, and healthcare aiming to inform future patients about healthcare quality. Based on this analogy, the authors suggest a measurement framework and an organizational setting to produce healthcare information.

Findings

The authors suggest a five‐quality element framework to structure quality reporting. The authors also indicate the best way to report each type of quality, comparing performance indicators with certification/accreditation. Health gain is the most relevant quality indicator to inform the public, but this information is the most difficult to obtain. Finally, the organizational setting, comparable to financial accounting, required to provide valid, reliable and objective information on healthcare quality is described.

Practical implications

Framework elements should be tested in quantitative studies or case studies, such as a performance indicator's relative value compared to accreditation/ certification. There are, however, elements that can be implemented right away such as third party validation of healthcare information produced by healthcare institutions.

Originality/value

Given the money spent on healthcare worldwide, valid and reliable healthcare quality information's value can never be overestimated. It can justify delivering “expensive” healthcare, but also points the way to savings by stopping useless healthcare. Valid and reliable information puts the patient in the driver's seat and enables him or her to make the right decision when choosing their healthcare provider.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 3
Type: Research Article
ISSN: 0952-6862

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