Search results

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

The purpose of this paper is to investigate the determinants of best management practices in an Australian state-run healthcare system, namely New South Wales (NSW), and studies the impact of a range of hospital factors in driving best management practices as a means of enhancing healthcare delivery.

This study adapts a unique survey instrument globally tested to quantify the multi-dimensional nature of hospital management practices in 42 acute care public hospitals of NSW. The authors then analysed the role of hospital-specific characteristics in driving best management practices, namely hospital size (measured by the number of hospital beds, employees and doctors), level of skill and education, degree of hospital manager autonomy and organisational hierarchy.

The findings of this study show the areas of strength and potential areas of improvement in NSW hospitals. The authors find a positive association between the adoption of better management practices and hospital size (measured by the number of hospital beds and employees), level of skills and education, degree of hospital manager autonomy and organisational hierarchy. However, hospital size as measured by the number of doctors did not have a statistically significant relationship.

This paper is of interest to both hospital administrators, clinical doctors and healthcare policy-makers who want to improve and develop strategies for better management in the healthcare sector.

This study provides an internationally comparable robust measure of management capability in public hospitals, and contributes to the evidence-base of management practices and performance in hospitals.

Health-care building maintenance has been receiving concern because of the recent global pandemic. However, there are inadequate broad studies affecting health-care facilities maintenance and feasible solutions in Nigeria. This study aims to conduct an all-inclusive review of public hospital building maintenance issues and proffer possible solutions to improve maintenance practices in health-care buildings via a framework that will support studies in the future.

A review of published papers from 2006 to 2020 was conducted. Based on the keywords, 3 pertinent databases were searched and descriptions of the findings from 40 studies were recognised and used in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Two main themes (issues and feasible solutions to improve practices) emerged from public health-care building maintenance practices. The study developed a framework that describes the relationship between issues and possible solutions with an emphasis on how to improve human development, management efficiency, technical competence and professional skills, cost-minimisation and others.

As part of the paper implications, emerged issues were group into five categories (human development, management, technical, limited financial resources and others). The proposed framework for future studies will attempt to mitigate issues and proffer feasible solutions to improve hospital building maintenance practices in Nigeria and other developing countries that are facing similar challenges.

To the best of the author’s knowledge, this paper is possibly the first comprehensive review of public health-care building maintenance practices in Nigeria. Moreover, this review demonstrates how the proposed feasible solutions can mitigate problems.

The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada.

In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a “double blind, double scored” methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management – operations, performance monitoring, targets and people management.

The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most.

This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services.

This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of management practices in the Australian public healthcare systems of Queensland and NSW.

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.

To face profound changes from decreasing funding, growing patient expectations and increasing competition in the health-care market, public hospitals began to implement effective quality management (QM) practices following manufacturing and other service industries. However, there was little knowledge relevant to the impact of QM practices on the performance of public hospitals. The study aims to shed some further light on this issue.

The paper extends the previous empirical research to the health-care sectors and suggests the research framework of QM practice-performance relationships in public hospitals. For validation purposes, a cross-sectional survey involving 204 quality managers and directors of large public hospitals was carried out between April and October 2013 in Zhejiang Province, China. Structural equation modeling was used to test the hypothesized relationship between QM practices and hospital performance.

Empirical results support that the implementation of QM practices can bring many benefits to sample hospitals. The dimensions of employee relations and process management are directly related to the health-care and non-health-care performance of public hospitals.

It explores the relationship between QM practices and hospital performance based on empirical results from Chinese public hospitals, whereas few studies have been conducted within the context of public health-care sectors in developing countries. The empirical results could enhance hospital managers’ understanding of the nature of QM practice-performance relationship and help mangers re-allocate more resources to those elements of the QM systems that have the most significant impact on hospital performance.

The purpose of this paper is to explore the links between various characteristics of hospital administration and the utilization of classes of volunteer resource management (VRM) practices.

This paper uses original data collected via surveys of volunteer directors in 122 hospitals in five Northeastern and Southern US states.

Structural equation modeling results suggest that number of paid volunteer management staff, scope of responsibility of the primary volunteer administrator, and hospital size are positively associated with increased usage of certain VRM practices.

First, the authors begin the exploration of VRM antecedents, and encourage others to continue this line of inquiry; and second, the authors assess dimensionality of practices, allowing future researchers to consider whether specific dimensions have a differential impact on key individual and organizational outcomes.

Based on the findings of a relationship between administrative characteristics and the on-the-ground execution of VRM practice, a baseline audit comparing current practices to those VRM practices presented here might be useful in determining what next steps may be taken to focus investments in VRM that can ultimately drive practice utilization.

The exploration of the dimensionality of volunteer management adds a novel perspective to both the academic study, and practice, of volunteer management. To the authors’ knowledge, this is the first empirical categorization of VRM practices.

This study aims to investigate the perceived role of the Islamic medical care practice of Muslim doctors in Malaysian Muslim-friendly private hospitals.

Data were collection through self-administered questionnaires voluntarily submitted by the respondents. The survey covered selected major Muslim-friendly private hospitals in the country in the states of Kedah, Johor, Penang, Selangor, Kelantan and Kuala Lumpur. The non-probability purposive sampling was used, as the respondents and locations of the survey areas were predetermined.

Five dimensions of the Muslim-friendly medical care practice were identified, namely, medical etiquettes, physical examination, proper cleansing process of blood and body fluids, proper handling and treatment of infectious diseases and doctors’ advice to Muslim patients. The findings also indicate that the scale development analysis produced excellent results which can be used for reproducible or repetitive medical care purposes and for integration facts and figures for inclusion into wider medical care policy and practices.

The results from the study can further develop Islamic medical care practices and enable medical service providers to upgrade their performances to an enviable strategic status.

Islamic medical care is a new mode of healthcare service market, as there are very few studies on this topic from the perspective of Muslim patients or no obvious facts are known. This study has first explored Muslim doctors’ perceived role in Islamic medical care practice in Malaysian Muslim-friendly private hospitals. This empirical study can immensely contribute to the further development of Islamic medical care practice for Muslim doctors in particular and for the Muslim-friendly hospital service marketing strategy in general.

The recent COVID-19 pandemic has exposed the declining conditions of many of the hospital buildings, especially in developing countries. Past studies have shown inadequate maintenance practices but how far regarding Nigerian public hospital buildings is yet to receive empirical research. This paper aims to investigate the underlying issues leading to inadequate maintenance practices and proffers policy options to improve Nigerian public hospital buildings via an unexplored dimension.

The study used a mixed research design method involving both qualitative and quantitative data. First, results from the qualitative phase were analysed and verified at the quantitative phase through a well-structured questionnaire, developed from the qualitative findings across hospital maintenance experts (work/maintenance department, health-care provider, design team and health-care building/service contractor) in Abuja, Lagos and Benin City.

Insufficient funds for maintenance works, absence of planned maintenance programmes, inadequately trained personnel, etc., emerged as the maintenance inadequacies in the public hospital buildings across the cities covered. The paper categorised the cause of inadequate maintenance practices of public hospital buildings into six groups: statutory requirements, design stage, construction stage, budget for maintenance task, managing maintenance unit activities and user’s perception regarding maintenance management.

This paper is limited to maintenance practices of Nigerian public hospital buildings. Future research is needed to evaluate factors that will enhance outsourcing maintenance and the use of the 4th industrial revolution (building information modelling for refurbishment and building automation systems) amongst others in maintenance practices of public hospital buildings.

As part of the practical implication, the government and hospital administrators should make provision for adequate funding and accountability of annual maintenance budgetary allocation. Also, the government should establish a national maintenance policy for public infrastructure with an emphasis on preventive maintenance and contractor’s reputation, outstanding pedigree, technical and financial soundness during build maintenance contract award, etc., were recommended.

This paper reveals that the stakeholders, especially hospital administrators, policymakers and political office holders that are concern with maintenance budget, approval and disbursement concerning maintenance practices in public hospital buildings need to reawaken to her responsibility because of the inadequate implementation across the cities covered.