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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.

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.

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.

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.

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.

The purpose of this study is to determine the interactions between factors such as organizational learning, feedback about errors, punitive response to errors and communication quality in hospitals in the Kingdom of Saudi Arabia and Colombia when adopting a culture of quality and safety (CQS) in patient care.

Based on a literature review, a self-administered questionnaire was developed and used to collect data from 417 Saudi respondents affiliated with hospitals and 483 Colombian respondents at the beginning of the pandemic. Structural equation modeling is used in this study to test the hypothesized relationships.

The results show a solid and significant predictive relationship between feedback about errors and the CQS in both countries (Colombia: b = 0.55, p < 0.001; KSA: b = 0.44, p < 0.001), but a very low and insignificant predictive relationship between no punitive response to errors and CQS (Colombia: b = –0.02, p > 0.05; KSA: b = 0.05, p > 0.05).

This study demonstrates the importance of organizational learning in fostering a CQS in the health-care sector in the Kingdom of Saudi Arabia and Colombia. Recent unprecedented policy actions motivated by the COVID-19 pandemic, such as social distancing, lockdowns and safety practices enforcement, have further highlighted this concern. Moreover, attention to the dimensions addressed in this study is required for accreditation purposes in organizations seeking to promote a CQS. Overall, this research highlights the vital role of safety and quality practices among health-care organizations, which has significant policy implications, especially in the current period of high uncertainty.

This paper contributes to the theory and practice in the health-care sector by extending the current knowledge of the impact of the quality of communications, non-punitive response to errors and feedback about errors in organizational learning and safety culture, and by presenting a novel, quantitative methodology seldom used for these topics.

This purpose of the study is to investigate enablers of building agility capabilities in healthcare organisations in developing countries. The key research questions are: (1) What are the key enablers for building healthcare agility? (2) Is there an interdependence among the enablers of healthcare agility? (3) What is the driving and dependence power of the enabling factors of healthcare agility?

The enablers for building capabilities of organisational agility were identified from the extant literature. Perceptual responses for pair-wise comparison of identified enablers were collected from 17 clinical and non-clinical professionals working in Indian hospitals through online interviews. Participants were selected from India which supposedly represents the socioeconomic contexts and healthcare systems in developing economies. Next, the data was analysed using multicriteria decision-making (MCDM) techniques to develop a structural framework depicting the enablers and their interdependence.

The TISM framework showed that the two most influential enablers of healthcare agility in developing countries are policy and regulatory support and strategic commitment and resource availability. The results were based on the analysis of four enablers identified from the literature. The results of MICMAC analysis revealed the driving and dependence power of each enabler and classified the enablers into driving, autonomous, dependence and linkage groups.

The study will help stakeholders and academics in the healthcare domain in devising effective strategies for building agility within healthcare systems and processes.

The study contributes to the service operations literature on building agile systems for dynamic and complex service environments.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate how the main reform foci of productivity and quality are represented, with a specific focus on the patient.

Drawing on critical discourse analysis (CDA), the authors conduct a longitudinal study (2007–2018) of healthcare reporting foci across the five administrative regions responsible for public hospitals in Denmark. The study analyses sixty annual reports and draws on contemporary reform documents over this period. CDA enables a micro-textual analysis, combined with macro-insights and discussions on social practice.

The findings show complex webs of presentation strategies, but in particular two changes occur during the period. First, the patient is centred throughout but the framing changes from productivity and waiting lists to quality and dialogue. Second, in the first years, the regions present themselves as actively highlighting financial and quality concerns, which changes to a passive and indirect form of presentation steered by indicators and patient legislation enforced by central government. This enhances passivity and distance in healthcare regional non-financial reporting where the regions seek to conform to such demands. Simultaneously, however, the authors find a tendency to highlight very different local initiatives, which shows an attempt to go beyond a pure automatic mode of reporting found in earlier studies.

Responding to the literature on both healthcare and financial reporting, this study identifies novel links between micro-level texts and macro-level social practices, enabling insights into the potentially intertwined impacts of public-sector reporting. The authors offer insights into the complexity of the construction of non-financial reporting in the public sector, which has a wider impact and different intentions than private-sector reporting.

Dominant quality standards are present in all industries. Implicit in their use is the assumption that once adopted, there is little or no reason to replace them. However, there is evidence that, under certain circumstances, such standards do get replaced. The reasons for this action are not well-understood, either as they pertain to the displacement decision or to the selection and adoption of the alternative standard. The purpose of this study is to identify and explore these two issues (displacement and replacement) by drawing on data from the American healthcare system. This study is viewed through the theoretical lens of legitimacy theory. In addition, the process is viewed from a temporal perspective. The resulting findings are used to better understand how this displacement process takes place and to identify directions for interesting and meaningful future research.

This is an explanatory study that draws on data gathered from quality managers in 89 hospitals that had adopted a new healthcare quality standard (of these, some fifty percent had displaced the dominant quality standard – the Joint Commission – with a different standard – DNV Healthcare.

The combined literature review and case study data provide insights into the displacement process. This is a process that evolves over time. Initially, the process is driven by the need to meet customer demands. However, over time, as the organizations try to integrate the guidelines contained within the standards into the organization, gaps in the quality standard emerge. It is these gaps that motivate the need to displace standards. The legitimacy perspective is highly effective at explaining this displacement process. In addition, the study uncovers some critical issues, namely the important role played by the individual auditors in the certification process and the importance of fit between the standard and the context in which it is deployed.

The data for the propositions in this case study were derived from interviews and survey data from 89 healthcare organizations. It would be interesting to examine similar relationships with other quality standards and industries.

Our findings provide new insights related to motivations to decouple from a dominant quality standard. Results provide a cautionary tale for standards that hold a dominant market share such that perceived legitimacy of such standards is not as stable as originally thought.

This study illuminates the fragile nature of the stability of dominant standards and emphasizes the linkages between legitimacy concerns and divestiture of such standards.

This study aims to examine customer preferences toward Sharia hospitals and to provide a new viewpoint by looking at consumers’ perspectives on choosing health-care services. Despite the growing demand for halal products, halal services, particularly hospital and Sharia-based health-care services, receive very little attention in the literature compared to other Sharia-type services such as Sharia banking, insurance or even hospitality. Previous research on health care discussed under the Sharia perspective mainly focused on service quality, directing discussions to the service providers’ perspectives.

This study uses choice-based conjoint analysis to examine customer preferences toward Sharia health-care service. There are five attributes with three levels each. To reduce respondent fatigue, the authors used SPSS Orthoplan to generate an orthogonal factorial design, which resulted in 21 choice cards. Cross-sectional data were collected from an online survey using a platform from Populix, an independent panel survey provider, to ensure no sample selection bias. A total of 270 responses were obtained to represent Muslim populations across Indonesia.

The results showed that the highest preference is highly rated to the familiarity and certification of the hospital brand that implies trust and guarantees to add value with the existence of halal certification for hospitals. In addition, this study revealed that Sharia services have higher positive signals over the physical infrastructure in determining preferences. On the other hand, add-on components that support the integration of other halal industries, such as halal culinary tourism, halal tourism and integration with transportation and halal accommodation, are still minor in the current preference.

Previous research on health care discussed under the Sharia perspective mainly focused on service quality, which directs the discussions to the service providers’ perspectives. This study provides a new point of view by looking at consumers’ perspectives about their preferences and decisions to choose a Sharia hospital.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

The involvement of stakeholders such as employers, alumni, and students has always been considered a key element in improving the higher education (HE) system. While considering stakeholders as key players in serving the market and in improving HE instruction, a two-sided collaborative involvement should aim at satisfying the mutual interests and overcoming existing barriers. Quality assurance systems have always supported crossing these barriers to link with the external stakeholders. However, many of the external quality assurance agencies (EQA) in the Middle East and North Africa (MENA) region specify a group of external holders, limiting the various types of key stakeholders needed to enhance the academic programs. On the other hand, there are encountered risks in involving stakeholders if left with no objective guidance, especially that quality agencies are formidably urging the universities to consider the external stakeholders’ inputs to satisfy the quality assurance standards. The main objective of this chapter is to investigate the types of stakeholders’ and their levels of involvement within the local higher education institutions (HEIs). The chapter aims to provide an insight to invest in this involvement and utilize it to further improve the programs and their graduate attributes and suggests actions that would proficiently and truly enhance the involvement of external stakeholders. The outcomes of this chapter are expected to guide the EQAs and the HEIs to develop new practices in involving stakeholders, such as curriculum input, collegiate internships, aligning graduate attributes to market needs, financial support through endowments, professional development, and partnerships in service-level agreements.

The primary aim of this research was to investigate the mediating effect of the decision-making structure on the relationship between perceived environmental uncertainty and hospital performance.

Online and manual survey questionnaires were used to collect data in this study. The target population of this study consists of all middle managers within 11 COVID-19 referral hospitals in Surabaya. A total of 189 responses were collected, however, 27 incomplete responses were excluded from the final dataset. Data was analyzed using SEM-PLS.

The study's findings indicate that decision-making structure plays a role in mediating the link between perceived environmental uncertainty and hospital performance assessed via the Balanced Scorecard, highlighting the significance of flexible decision-making processes during uncertain periods. Moreover, based on our supplementary test, respondents' demographic characteristics influence their perceptions of hospital performance.

Hospital administrators can consider the significance of decision-making structures in responding to environmental uncertainties like the COVID-19 pandemic. By fostering adaptable decision-making processes and empowering middle managers, hospitals may enhance their performance and resilience in challenging situations. Additionally, based on supplementary tests, it is found that differences in the perception of the three Balanced Scorecard perspectives imply that hospitals categorized as types A, B, C, and D should prioritize specific areas to improve their overall performance.

This research adds substantial originality and value to the existing body of knowledge by exploring the interplay between decision-making structures, environmental uncertainty, and hospital performance. It contributes to the literature by specifically focusing on the Covid-19 pandemic, a unique and unprecedented global crisis.