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Article
Publication date: 19 July 2011

Jeffrey P. Harrison and Emily D. Ferguson

Emergency services are critical for high‐quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency

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Abstract

Purpose

Emergency services are critical for high‐quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (US) acute care hospital staff's ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers.

Design/methodology/approach

Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5,000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities.

Findings

US acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, US emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staff's ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state‐of‐the‐art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement.

Research limitations/implications

This research uses the AHA annual surveys, which represent self‐reported data by individual hospital staff. However, the AHA expends significant resources to validate reported information and the annual survey data are widely used for hospital research.

Practical implications

The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure.

Originality/value

This article has important information on US emergency service availability in the hospital industry.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 14 May 2018

Gayle Linda Prybutok

The purpose of this paper is to present a case study of a successful quality improvement project in an acute care hospital focused on reducing the time of the total…

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Abstract

Purpose

The purpose of this paper is to present a case study of a successful quality improvement project in an acute care hospital focused on reducing the time of the total patient visit in the emergency department.

Design/methodology/approach

A multidisciplinary quality improvement team, using the PDSA (Plan, Do, Study, Act) Cycle, analyzed the emergency department care delivery process and sequentially made process improvements that contributed to project success.

Findings

The average turnaround time goal of 90 minutes or less per visit was achieved in four months, and the organization enjoyed significant collateral benefits both internal to the organization and for its customers.

Practical implications

This successful PDSA process can be duplicated by healthcare organizations of all sizes seeking to improve a process related to timely, high-quality patient care delivery.

Originality/value

Extended wait time in hospital emergency departments is a universal problem in the USA that reduces the quality of the customer experience and that delays necessary patient care. This case study demonstrates that a structured quality improvement process implemented by a multidisciplinary team with the authority to make necessary process changes can successfully redefine the norm.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 14 June 2021

Rimantas Stašys, Gintautas Virketis and Daiva Labanauskaitė

The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient…

Abstract

Purpose

The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient transfers. Scientific research and statistical data show the increased number of interhospital transportation services; therefore, timely and qualified patient transportation between different health-care institutions must be considered, the activity that directly and significantly impacts the patient’s health status and overall quality of the health-care services. The successful patient transportation from the smaller hospitals to the health-care institutions with advanced intensive care or urgent care units can be enhanced through the partnership between private and public health-care institutions.

Design/methodology/approach

The methodology included quantitative method, statistical data analysis and theoretical data generalization. Both primary and secondary data were collected and analyzed during the research. Expert quantification was performed using the survey research method. The survey was conducted in Lithuania. The respondents were selected to be the general managers of the health-care and urgent care institutions, the chief doctors of the reanimation and intensive care department also the chief doctors of the emergency department.

Findings

Because of the centralization and regionalization of health-care services, the number of patients transferred between hospitals by the emergency medical services (EMS) and personal health-care institutions has increased. University hospitals are not sufficiently prepared to accept an increasing flow of patients in accordance with the Ministry of Health orders. Not all regional or district hospitals have the right to provide such assistance, which increases transportation time and costs as well as requires additional human resources. The five EMS categories could be used to improve the patient transfer between different levels of health-care institutions. To increase partnership between private and public health-care organizations, incentives should be provided for the development of private health-care organizations, as well as encouraging actions should be taken to increase the demand for private health-care services by Lithuanian patients.

Practical implications

Five EMS categories identified in this paper could be used to ensure a smooth mechanism for the patient transfer between different levels of the personal health-care institutions. The proposed categories should also be used in the pre-stationary emergency phase (for reducing the interhospital patient transportation amount).

Social implications

Properly organized secondary and tertiary interhospital patient transfers influence the availability and quality of the EMS and reduce inequalities in the provided services and social exclusion.

Originality/value

This paper presents the classification of the interhospital transfer issues, determines the main reasons for the patient interhospital transfer, creates the model for the EMS patient process flows and defines five EMS categories for the assessment of patient conditions. Therefore, the research conducted and the results obtained have both theoretical and social-practical value.

Details

International Journal of Organizational Analysis, vol. 29 no. 6
Type: Research Article
ISSN: 1934-8835

Keywords

Article
Publication date: 13 July 2015

Hong Qin, Gayle L. Prybutok, Victor R. Prybutok and Bin Wang

The purpose of this paper is to develop, validate, and use a survey instrument to measure and compare the perceived quality of three types of US urgent care (UC) service…

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Abstract

Purpose

The purpose of this paper is to develop, validate, and use a survey instrument to measure and compare the perceived quality of three types of US urgent care (UC) service providers: hospital emergency rooms, urgent care centres (UCC), and primary care physician offices.

Design/methodology/approach

This study develops, validates, and uses a survey instrument to measure/compare differences in perceived service quality among three types of UC service providers. Six dimensions measured the components of service quality: tangibles, professionalism, interaction, accessibility, efficiency, and technical quality.

Findings

Primary care physicians’ offices scored higher for service quality and perceived value, followed by UCC. Hospital emergency rooms scored lower in both quality and perceived value. No significant difference was identified between UCC and primary care physicians across all the perspectives, except for interactions.

Research limitations/implications

The homogenous nature of the sample population (college students), and the fact that the respondents were recruited from a single university limits the generalizability of the findings.

Practical implications

The patient’s choice of a health care provider influences not only the continuity of the care that he or she receives, but compliance with a medical regime, and the evolution of the health care landscape.

Social implications

This work contributes to the understanding of how to provide cost effective and efficient UC services.

Originality/value

This study developed and validated a survey instrument to measure/compare six dimensions of service quality for three types of UC service providers. The authors provide valuable data for UC service providers seeking to improve patient perceptions of service quality.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 11 February 2019

Mehrdad Farzandipour, Mahtab Karami, Mohsen Arbabi and Sakine Abbasi Moghadam

Data comprise one of the key resources currently used in organizations. High-quality data are those that are appropriate for use by the customer. The quality of data is a…

Abstract

Purpose

Data comprise one of the key resources currently used in organizations. High-quality data are those that are appropriate for use by the customer. The quality of data is a key factor in determining the level of healthcare in hospitals, and its improvement leads to an improved quality of health and treatment and ultimately increases patient satisfaction. The purpose of this paper is to assess the quality of emergency patients’ information in a hospital information system.

Design/methodology/approach

This cross-sectional study was conducted on 385 randomly selected records of patients admitted to the emergency department of Shahid Beheshti Hospital in Kashan, Iran, in 2016. Data on five dimensions of quality, including accuracy, accessibility, timeliness, completeness and definition, were collected using a researcher-made checklist and were then analyzed in SPSS. The results are presented using descriptive statistics, such as frequency distribution and percentage.

Findings

The overall quality of emergency patients’ information in the hospital information system was 86 percent, and the dimensions of quality scored 87.7 percent for accuracy, 86.8 percent for completeness, 83.9 percent for timeliness, 79 percent for definition and 62.1 percent for accessibility.

Originality/value

Increasing the quality of patient information at emergency departments can lead to improvements in the timely diagnosis and management of diseases and patient and personnel satisfaction, and reduce hospital costs.

Details

International Journal of Health Care Quality Assurance, vol. 32 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 December 2020

Hojjat Sheikhbardsiri, Zahra Esamaeili Abdar, Hakimeh Sheikhasadi, Shahla Ayoubi Mahani and Arezoo Sarani

Patient right is the most important ethical right in the hospital, which equally, belongs to every human kind. Observance of patient right is responsibility of all…

Abstract

Purpose

Patient right is the most important ethical right in the hospital, which equally, belongs to every human kind. Observance of patient right is responsibility of all treatment staff when they offer treatment and care for patient. This study aims to investigate observance of patients’ rights in emergency department of educational hospitals in south-east Iran.

Design/methodology/approach

This study used a cross-sectional design and was conducted in four educational hospitals affiliated with the Kerman University of Medical Sciences in 2018. Using a two-section standard questionnaire of Patients’ Rights Charter, this study assessed patients’ rights observance using a census method, N = 382. The data from the questionnaire were analyzed using descriptive statistics including mean and standard deviations and analytic statistics such as Kolmogorov – Smirnov, ANOVA, t-test and Pearson test using SPSS 21.

Findings

Means of total score for observing all essentials of patients’ rights in emergency department of educational hospitals were at a moderate level (43.10 ±15.05) from the viewpoint of patients. The area of “providing health services based on respecting patient’s privacy and observing the essentials of secrecy and confidentiality” enjoying the highest mean score (86.89 ± 24.39), was at a good level compared to other areas. The area of “having access to effective complaint management system” showed the lowest mean score (23/85 ± 23/07) from the participants’ perspective proving a poor level. Between the patient rights observance and gender, education level, resident status and duration of hospitalization, a significant relationship was observed.

Originality/value

As regarded in this study, the degree of patients’ rights observance was moderate so, culture, paying attention to the rights of all stakeholders, identifying barriers and various factors, including the professional and environmental differences in the assessment of the need, should be considered by policymakers to design promotional and regulatory programs for improving the rights of the patient.

Details

International Journal of Human Rights in Healthcare, vol. 13 no. 5
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 18 December 2008

Eui H. Park, Jinsuh Park, Celestine Ntuen, Daebeom Kim and Kendall Johnson

Patient satisfaction with the Emergency Department (ED) in a hospital is related to the length of stay, and especially to the amount of waiting time for medical…

Abstract

Patient satisfaction with the Emergency Department (ED) in a hospital is related to the length of stay, and especially to the amount of waiting time for medical treatments. ED overcrowding decreases quality and efficiency, therefore affecting hospitals’ profitability. This paper presents a forecasting and simulation model for resource management of the ED at Moses H. Cone Memorial Hospital. A linear regression forecasting model is proposed to predict the number of ED patient arrivals, and then a simulation model is provided to estimate the length of stay of ED patients, system throughput, and the utilization of resources such as triage nurses, patient beds, registered nurses, and medical doctors. The near future load level of each resource is presented using the proposed models.

Details

Asian Journal on Quality, vol. 9 no. 3
Type: Research Article
ISSN: 1598-2688

Keywords

Article
Publication date: 1 December 2008

Yona Lunsky

This is a case study of a Canadian man with a learning disability who visited emergency departments more than 50 times in a 10‐year period, in times of stress. During…

Abstract

This is a case study of a Canadian man with a learning disability who visited emergency departments more than 50 times in a 10‐year period, in times of stress. During these visits he gave false reports of his current symptoms and psychiatric history, sometimes gaining hospital admission. The case illustrates how such behaviour can develop over time, and how a general health services model (rather than a specialised learning disability service) can fail to meet the needs of independent clients with learning disabilities. It offers some suggestions for how better to meet the needs of such clients in the future.

Details

Advances in Mental Health and Learning Disabilities, vol. 2 no. 4
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 2 May 2008

Joseph S. Guarisco and Stefoni A. Bavin

The purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables…

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Abstract

Purpose

The purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.

Design/methodology/approach

The case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.

Findings

The findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.

Practical implications

These findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.

Originality/value

There are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

Details

Leadership in Health Services, vol. 21 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 1 August 2022

Majd Khatib and Abdulsalam Alshboul

The design of the emergency department (ED) requires high precision in the process of distributing spaces. An increase in population and continuous development during the…

Abstract

Purpose

The design of the emergency department (ED) requires high precision in the process of distributing spaces. An increase in population and continuous development during the past years caused the addition of new services, changes in patients’ numbers, movement flow and treatment procedures which makes the existing layout plan of the ED no longer appropriate for its current needs. Therefore, the purpose of this paper is to generate a process of finding better alternatives for ED’s spatial planning.

Design/methodology/approach

The genetic algorithm method as a part of the systematic layout planning strategy was adopted for decision-making in redesigning the ED layout and finding the most appropriate alternative. This methodology was applied to a teaching hospital in Jordan to create layout alternatives with better functional dimensions.

Findings

The design that is based on the study of the movement of users and the relationship of spaces increases the layout performance.

Research limitations/implications

The structural method of this study can be adopted for different hospital designs, but the results are limited only to the study case itself because of the different factors and data for each building.

Originality/value

This study demonstrates the process of making the most appropriate decision to redesign the ED in the hospital; therefore, the method can be adopted in restructuring the scheme of different hospitals and evaluated, especially before implementation.

Details

Facilities , vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0263-2772

Keywords

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