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Article
Publication date: 20 June 2019

Sukanlaya Sawang, Cindy Yunhsin Chou and Bao Quoc Truong-Dinh

The purpose of this paper is to examine the extent to which the perception of crowding by medical staff and patients impacts patients’ perceived service quality (SQ)…

Abstract

Purpose

The purpose of this paper is to examine the extent to which the perception of crowding by medical staff and patients impacts patients’ perceived service quality (SQ), overall satisfaction and emotional well-being.

Design/methodology/approach

Data were collected from 258 matched pairs of medical staff members and their patients at six public hospitals.

Findings

Medical staff-perceived crowding negatively influences patients’ perceived SQ. The perceived SQ then impacts patients’ overall satisfaction and emotional well-being. Patients’ perceived crowding does not significantly impact their perceived SQ but increases the positive emotional well-being of patients.

Originality/value

Scant research has investigated a matched pair of service providers and their customers. This study concentrates on how individuals’ perceived human crowding and medical staff SQ affect consumers’ emotional well-being. This research leads to the formulation of theoretical and public policy suggestions to improve the quality of interactive services with minimal cost and disruption.

Details

Journal of Health Organization and Management, vol. 33 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 3 October 2016

John Fard, Kathy O. Roper and Jeremy Hess

This study aims to evaluate home-hospital implications for facility management (FM) and, in particular, ED crowding. Home-hospital programs, in which select patients…

Abstract

Purpose

This study aims to evaluate home-hospital implications for facility management (FM) and, in particular, ED crowding. Home-hospital programs, in which select patients receive hospital-level care at home, can extend hospital facility capacity. Emergency department (ED) crowding, a sensitive hospital capacity indicator, is associated with unsafe operations and reduced quality of care.

Design/methodology/approach

The impact of a home-hospital program on crowding was analyzed with a discrete-event simulation model using one month of historical data from a case hospital. Time ED patients waited for inpatient beds was the primary endpoint. Five scenarios with different levels of patient suitability for home-hospital were each run 30 times. Differences were evaluated using paired t-tests.

Findings

Implementing home-hospital reduced ED crowding by up to 3 per cent. Additionally, the simulation yielded insights regarding advantages and limitations of various home-hospital arrangements, suggested which hospital types may be the best candidates for home-hospital and highlighted the role of bed-cleaning turnaround times and environmental services staffing schedules in operations.

Research limitations/implications

This research examined home-hospital and crowding at one hospital. Developing a model that accounts for all hospital types requires significant data and many hospital partnerships but could allow for more informed decisions regarding implementation of such programs.

Social implications

This research has implications for ensuring access to ED care, an important source of acute care generally and particularly for the underserved.

Originality/value

This research systematically evaluates home-hospital’s impact on ED crowding. Simulation modeling resulted in analytical results and allowed for evaluation of what-if scenarios providing recommendations for hospital FMs on their role in decreasing ED boarding.

Details

Facilities, vol. 34 no. 13/14
Type: Research Article
ISSN: 0263-2772

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Article
Publication date: 1 August 2019

Sara Jebbor, Abdellatif El Afia and Raddouane Chiheb

This paper aims to propose an approach by human and material resources combination to reduce hospitals crowding. Hospitals crowding is becoming a serious problem. Many…

Abstract

Purpose

This paper aims to propose an approach by human and material resources combination to reduce hospitals crowding. Hospitals crowding is becoming a serious problem. Many research works present several methods and approaches to deal with this problem. However, to the best of the authors’ knowledge – after a deep reading of literature – in all the proposed approaches, human and material resources are studied separately while they must be combined (to a given number of material resources an optimal number of human resources must be assigned and vice versa) to reflect reality and provide better results.

Design/methodology/approach

Hospital inpatient unit is chosen as framework. This unit crowding reduction is carried out by its capacity increasing. Indeed, inpatient unit modeling is performed to find the adequate combinations of human and material resources numbers insuring this unit stability and providing optimal service rates. At first, inpatient unit is modeled using queuing networks and considering only two resources (beds and nurses). Then, the obtained service rate formula is improved by including other resources and parameters using Baskett, Chandy, Muntz and Palecios (BCMP) queuing networks. This work is applied to “Princess Lalla Meryem” hospital inpatient unit.

Findings

Results are patients’ average number reduction by an average (in each block) of three patients, patients’ average waiting time reduction by an average of 9.98 h and non-admitted patients (to inpatient wards) access percentage of 39.26 per cent on average.

Originality/value

Previous works focus their studies on either human resources or material resources. Only a few works study both resources types, but separately. The context of those studies does not meet the real hospital context (where human resources are combined with material resources). Therefore, the provided results are not very reliable. In this paper, an approach by human and material resources combination is proposed to increase inpatient unit care capacity. Indeed, this approach consists of developing inpatient unit service rate formula in terms of human and material resources numbers.

Details

International Journal of Pervasive Computing and Communications, vol. 15 no. 2
Type: Research Article
ISSN: 1742-7371

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Article
Publication date: 1 April 2014

Dongfeng Liu and Robert Wilson

This study examines the negative impacts of mega sporting events on host cities and the relationship between negative impacts and the travel intentions of potential…

Abstract

This study examines the negative impacts of mega sporting events on host cities and the relationship between negative impacts and the travel intentions of potential international tourists. Data were collected from Shanghai University students, who were asked about their international travel experiences, London Games awareness, the perceived negative impacts of the Games on London and their travel intentions during the London Games. Travel inconvenience was the most negative impact recorded, followed by price inflation, security and crime concern, risk of disease and pollution and environment concern. Respondents were unsure about any negative impact on service quality degradation. Negative impacts did not vary according to age or gender. Travel inconvenience and price inflation were found to be significantly but negatively related to intention to travel.

Details

International Journal of Sports Marketing and Sponsorship, vol. 15 no. 3
Type: Research Article
ISSN: 1464-6668

Keywords

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Book part
Publication date: 7 October 2011

Kenneth R. White, Steven Thompson and John R. Griffith

Substantial and sustained change is inevitable for U.S. hospitals, driven by the Medicare and Medicaid cost inflation curve and embodied in regulatory initiatives and…

Abstract

Substantial and sustained change is inevitable for U.S. hospitals, driven by the Medicare and Medicaid cost inflation curve and embodied in regulatory initiatives and reforms. This study explores the conception that evidence-based management is necessary but not sufficient for 21st century success in health care organizations. Success will require challenging and changing the organization's dominant logic, substituting a more transformational style of problem analysis and decision making. In order for evidence-based management decisions to transform organizations, the organizational culture must be ready to adopt transformation changes. The outcomes of this shift in management style are dramatic changes in worker engagement and retention and a reinforcing cycle of performance improvement efforts. We use a series of examples to illustrate changes in the dominant logic and to identify how the combination of evidence-based management and a new dominant logic results in a fundamental and highly productive shift in how problems are framed and solved. We conclude with recommendations for changing the dominant logic – such as visioning, sensemaking, process questioning, getting the right people together, rewarding innovation, and overcoming risk aversion – all necessary for transforming the dominant logic, allowing evidence-based management techniques to flourish.

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

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Article
Publication date: 26 June 2019

Mohamad Alnajem, Jose Arturo Garza-Reyes and Jiju Antony

The purpose of this paper is to develop a framework to assess the lean readiness within emergency departments (EDs) and identify the key quality practices deemed essential…

Abstract

Purpose

The purpose of this paper is to develop a framework to assess the lean readiness within emergency departments (EDs) and identify the key quality practices deemed essential for lean system (LS) implementation.

Design/methodology/approach

An extensive review of the lean healthcare literature was conducted, including LS implementation within the healthcare sector (both generally and in EDs), best ED quality practices, essential factors for LS implementation within healthcare and lean readiness assessment frameworks. The authors identified six main categories from a literature review (top management and leadership, human resources, patient relations, supplier relations, processes and continuous improvement (CI)), and validated these based on experts’ opinion.

Findings

Several factors were identified as crucial for EDs, including top management and leadership, human resources, patient relations, supplier relations, processes and CI.

Research limitations/implications

The framework has not yet been tested, which prevents the author from declaring it fit for EDs.

Practical implications

This framework will help ED managers determine the factors that will enable/hinder the implementation of LSs within their premises.

Originality/value

To the author’s knowledge, this is the first lean readiness assessment framework for EDs and one of the few lean readiness assessment frameworks in the literature.

Details

Benchmarking: An International Journal, vol. 26 no. 6
Type: Research Article
ISSN: 1463-5771

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Article
Publication date: 3 April 2018

Ahmed Abdelhalim Al-Shiyab and Raed Ismail Ababneh

The purpose of this paper is to examine the consequences of workplace violence against healthcare staff in Jordanian public hospitals.

Abstract

Purpose

The purpose of this paper is to examine the consequences of workplace violence against healthcare staff in Jordanian public hospitals.

Design/methodology/approach

A convenient sample included 334 physicians and nurses employed in eight different public hospitals, different departments and different working shifts were surveyed by filling the designed questionnaire.

Findings

The findings indicated workplace violence had a clear moderate impact on the respondents’ interaction with patients, performing work responsibilities, ability of making decisions, and professional career. The most frequent workplace violence consequences were damaging staff’s personality and prestige, increasing laziness and unwillingness to serve patients. Workplace violence consequences also included aggressive behavior, fear while dealing with patients, increase job insecurity, and lack of professional responsibility. In addition, demographic variables such as gender, education, job title, working shift, and income showed statistical significant differences in the attitudes of participants toward the consequences of workplace violence.

Practical implications

This study highlighted the necessity of healthcare policy makers and hospital administrators to establish violence free and safe working environments in order to retain qualified healthcare staff that in turn improves the health services quality.

Originality/value

There is a lack of research and documentation on violence in the healthcare settings in developing countries. This study is one of the first to examine the consequences of workplace violence that affect public physicians and nurses.

Details

Employee Relations, vol. 40 no. 3
Type: Research Article
ISSN: 0142-5455

Keywords

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Article
Publication date: 14 August 2017

Byungjoon B.J. Kim, Theodore R. Delbridge and Dawn B. Kendrick

Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency…

Abstract

Purpose

Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients’ WTs in the ED. The paper aims to discuss these issues.

Design/methodology/approach

This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients.

Findings

The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system. The patient streaming management would improve the service quality of the ED as well as patients’ opportunity costs by reducing the total LOS in the ED.

Research limitations/implications

The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern.

Practical implications

When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED.

Originality/value

A new streaming scheme of patients’ flow may improve the performance of fast track system.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

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Article
Publication date: 18 June 2020

Sunil Mithas, Charles F. Hofacker, Anil Bilgihan, Tarik Dogru, Vanja Bogicevic and Ajit Sharma

This paper advances a research agenda for service researchers at the intersection of healthcare and information technologies to improve access to quality healthcare at…

Abstract

Purpose

This paper advances a research agenda for service researchers at the intersection of healthcare and information technologies to improve access to quality healthcare at affordable prices. The article reviews key trends to provide an agenda for research focusing on strategies, governance and management of key service processes.

Design/methodology/approach

This paper synthesizes literature in information systems, service management, marketing and healthcare operations to suggest a research agenda. The authors draw on frameworks such as the interpretive model of technology, technology acceptance model, assemblage theories and Baumol's cost disease to develop their arguments.

Findings

The paper situates strategy-related service management questions that service providers and consumers face in the context of emerging healthcare and technology trends. It also derives implications for governance choices and questions related to that.

Research limitations/implications

The paper discusses service management challenges and concludes with an agenda for future research that touches on governance and service management issues.

Practical implications

This paper provides implications for healthcare service providers and policymakers to understand new trends in healthcare delivery, technologies and facilities management to meet evolving customer needs.

Social implications

This paper provides implications for managing healthcare services that touch on many social and societal concerns.

Originality/value

This conceptual paper provides background and review of the work at the intersections of information systems, marketing and healthcare operations to draw implications for future research.

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Article
Publication date: 1 September 2000

G. Stanley Jaya Kumar

Considers the consequences of population growth in relation to space, resources and conflict. Covers environmental issues such as water and pollution. Uses India in the…

Abstract

Considers the consequences of population growth in relation to space, resources and conflict. Covers environmental issues such as water and pollution. Uses India in the year 2000 as a case study, looking at areas such as housing, agriculture, transport, water, food and environment. Discusses the plans of the country and concludes that an integrated plan for population with development is needed to optimize the use of natural resources. Cites four phases of human development: primitive, active, uncontrolled and aware.

Details

International Journal of Sociology and Social Policy, vol. 20 no. 8
Type: Research Article
ISSN: 0144-333X

Keywords

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