Search results

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.

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

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

National Health Service (NHS) Emergency Department (ED) attendances are at the second highest level ever recorded, (RCEM, 2021a) and as they soar, performance plummets, putting patient safety at risk (RCEM, 2021b). Managing patient flow in the ED is critical to reduce patient safety incidents and crowding, however, this needs effective leadership (Jensen and Crane, 2014). This paper aims to introduce an innovative form of managing patient flow in ED, which is a two hourly “Board Rounds”, providing a managed process to pull patients through the system meeting pre-determined time critical standards and preventing patient harm. Board Rounds combined with effective leadership can play a contributory role preventing crowding in the ED.

An evaluation of two hourly ED Board Rounds was undertaken using the hospitals’ ED Board Round Standard Operating Procedure to develop a series of short questions. As leadership is the responsibility of all clinicians (Darzi, 2008; Moscrop, 2012), a separate survey was undertaken for clinicians of all grades and managers to self-assess their own leadership styles using the Path-Goal Leadership Theory (House and Mitchell, 1974; Indvik, 1985; Northhouse, 2013). Findings were reported to the team to explore ideas for improvement not only to develop more effective leadership in the ED but also to raise awareness of how to optimise leadership in Board Rounds.

In total, 27 (n = 27) clinicians and managers reported support for a 2 hourly Board Round, for a period of 15 min, in both minor and major injuries departments in ED. A multi-disciplinary Board meeting, led by the lead nurse with support from the Emergency Physician in Charge, was preferred, locating it at the nurse’s station. A validated Path-Goal Leadership survey instrument was returned (n = 24). The findings reveal that leaders and managers are using a high level of the directive leadership style, where there is more potential to use the supportive, participative and achievement approaches to leadership.

This was a small sample, returned from a Hospital ED located in a semi-rural location, department requiring “improvement” from the Health Regulator. This research would benefit from being undertaken in a medium/large NHS ED department to identify if the findings report on a wider leadership culture in the NHS ED. The implications for this study are that improvement interventions such as a “Board Round” can be usefully evaluated alongside a review of leadership styles and approaches to understand the wider implications for continuous improvement and change in the ED.

NHS EDs are facing unprecedented challenges and require innovative evidence-based solutions combined with leadership at this time. The evidence base for improving patient flow is limited, however, this study provides some initial findings on the positive perception and experience of staff to Board Rounds. Board Rounds combined with leadership has the potential to contribute to the wider strategy to prevent crowding in ED. This paper is the first of its kind to evaluate perceptions of Board Rounds in the ED and to engage clinicians and managers in a self-assessment of their own leadership styles to reflect on optimum leadership styles for use in ED.

The purpose of this study is to establish empirical relationships between patient flow problems, healthcare service quality and patient satisfaction with emergency department (ED) service factors from the patient perspective.

In the overall study, of which the current investigation is a part, a mixed-method research approach was to achieve the research objectives. The results reported in this paper are based on a comprehensive questionnaire survey where a well-designed and reliable questionnaire was used to survey ED patients. This study conducted partial least squares structural equation modelling (PLS-SEM) by using Smart PLS software.

Results show that the respondents mostly agreed with the proposed concept of quality in ED and patients were less satisfied with ED services in general and with the internal and external environments in ED in particular. It was found that relationships between nine identified scales of patient flow problems, healthcare service quality, and patient satisfaction are significant. The findings reveal that the relationship between patient flow problems and patient satisfaction is positively mediated through healthcare service quality, which shows the predictive capability of the model, indicating high predictive relevance.

This research involves a relatively small sample from a single case study. The positive relationship between patient flow problems and patient satisfaction indicate practical significance of the model for guiding to improve overall patient satisfaction.

This research, through the involvement of both hospital staff and the patient, brings out a holistic approach in terms of operational excellence in a critical unit such as the ED. The empirically established relationships form the benchmarking and guide for developing guidelines for designing policies for service improvements of ED practices.

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.

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.

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.

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

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

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

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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

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.

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

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.