Search results

1 – 10 of over 26000
To view the access options for this content please click here
Article
Publication date: 1 June 2005

O. Groene, S.J. Jorgensen, A.M. Fugleholm, L. Møller and M. Garcia‐Barbero

To describe the process of development of standards for health promotion in hospitals, including pilot study, method and results.

Abstract

Purpose

To describe the process of development of standards for health promotion in hospitals, including pilot study, method and results.

Design/methodology/approach

A set of standards for health promotion in hospitals was developed by a task force of the International Network of Health Promoting Hospitals, following the recommendations of the ALPHA programme. The standards were pilot tested and assessed qualitatively and quantitatively in 36 hospitals in nine European countries. Subsequently, standards were reviewed by representatives from the piloting hospitals. A self‐assessment tool was produced to evaluate whether hospital managers and professionals perceive the standards to be relevant and applicable and whether they are currently met. Participants provided comments from their national health system perspective and rated the standards.

Findings

General comments and specific comments were provided for each standard regarding its relevance, applicability and current level of compliance. A total of 35 standards' criteria were assessed and 86 per cent (30/35) were rated >80 per cent relevant and applicable, while 14 per cent (5/35) were rated >60 per cent relevant. The degree of current fulfilment of the criteria, however, was low.

Research limitations/implications

While the standards should be applicable to other regions (South America, Africa, Asia) additional testing may be required to adapt them to prevailing health care challenges.

Practical implications

The pilot test revealed that the standards are applicable and were considered relevant, and showed that current compliance is low. It also showed that there is a clear need to facilitate continuous monitoring and improvement of compliance. The standards are regarded as being public domain, are applicable to other organisations and can be incorporated into existing quality systems.

Originality/value

Standards are a common tool for quality assurance in health care, but so far have considered health promotion activities only partly, if at all. The standards for health promotion in hospitals developed by WHO fill this important gap.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article
Publication date: 1 June 1997

Michael B. Robinson, Elizabeth M. Thompson and Nicholas A. Black

The setting of explicit standards against specific criteria is a recognized part of the medical audit cycle, but often in practice it has been neglected, implicit…

Abstract

The setting of explicit standards against specific criteria is a recognized part of the medical audit cycle, but often in practice it has been neglected, implicit judgements being used instead. The conduct of a study to evaluate audit among physicians in four UK district general hospitals provided an opportunity to encourage the setting of explicit standards and observe the results. The subject chosen for audit by the participating physicians was the extent of use of intravenous thrombolysis in patients with suspected acute myocardial infarction (AMI). Standard setting was requested at initial peer review meetings held to review baseline results. This was followed up by a written request to lead consultants and subsequent telephone calls. Two out of the four participating hospitals set technical standards, which excluded patients with contra‐indications from the denominator. The other two hospitals set population standards as requested, one with considerable reluctance and scepticism. Each hospital set separate standards for definite AMIs and for probable AMIs. Six out of the eight standards set were achieved in at least one of four audits conducted in each hospital. Time trends were difficult to interpret because of small numbers. The amount of discussion between the lead consultant and colleagues about standards was highly variable, but there was no clear relationship between the process for agreeing standards in a particular hospital and subsequent attainment.

Details

Journal of Management in Medicine, vol. 11 no. 3
Type: Research Article
ISSN: 0268-9235

Keywords

To view the access options for this content please click here
Article
Publication date: 1 June 1997

Keith Hurst

Discusses the characteristics of health care accreditation schemes, especially the implications of their voluntary status. Singles out the Trent small hospital

Abstract

Discusses the characteristics of health care accreditation schemes, especially the implications of their voluntary status. Singles out the Trent small hospital accreditation scheme (TSHAS) for detailed and systematic evaluation. Describes the quantitative and qualitative evaluation methods, which involved a meta‐analysis of the literature, interviews with key staff and questionnaires completed by other participants in TSHAS. The main findings, divided into ten themes, confirm much of the published work on accreditation. The findings also provide new insights into the nature and value of health care accreditation, notably about the direction in which accreditation needs to go if both community and larger hospital accreditation is to survive.

Details

International Journal of Health Care Quality Assurance, vol. 10 no. 3
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Book part
Publication date: 25 July 2008

Richard A. Culbertson and Julia A. Hughes

The voluntary hospital trustee has traditionally seen issues of medical care, including those of patient safety, as falling within the delegated sphere of the medical…

Abstract

The voluntary hospital trustee has traditionally seen issues of medical care, including those of patient safety, as falling within the delegated sphere of the medical staff. This customary distancing of the trustee from direct involvement in patient safety issues is now challenged by unprecedented scrutiny of hospital safety results through voluntary disclosure or mandatory public reporting. This new climate, fostered by the Institute of Medicine's To Err is Human and the Institute for Healthcare Improvement's 100,000 Lives campaign, has complicated the role of the trustee in satisfying the traditional “prudent person” test for meeting fiduciary obligation as the trustee's breadth of involvement expands. Viewed theoretically, Mintzberg models the hospital as a case of a professional bureaucracy, in which the professional staff is responsible for standard setting and regulation. This traditional role of the professional staff is potentially assumed by others lacking technical background. Trustees are now asked to examine reports identifying physician compliance in attaining safety standards without education in the practice supporting those standards. Physician board members, whose numbers have increased in the past decade, are often sought to take the lead on interpretation of patient safety standards and results. The very public nature of patient safety reporting and its reflection on the reputation of the organization for which the trustee is ultimately accountable create a new level of tension and workload that challenges the dominant voluntary model of trusteeship in the United States health system.

Details

Patient Safety and Health Care Management
Type: Book
ISBN: 978-1-84663-955-5

To view the access options for this content please click here
Article
Publication date: 11 May 2015

Asgar Aghaei Hashjin, Bahram Delgoshaei, Dionne S Kringos, Seyed Jamaladin Tabibi, Jila Manouchehri and Niek S Klazinga

– The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran.

Abstract

Purpose

The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran.

Design/methodology/approach

A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010.

Findings

The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government’s strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity.

Practical implications

The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries.

Originality/value

This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article
Publication date: 7 August 2018

Ahmed Al Kuwaiti and Fahd A. Al Muhanna

This paper aims to examine the challenges faced by health-care leadership in teaching hospitals in attaining accreditation for their institutions.

Abstract

Purpose

This paper aims to examine the challenges faced by health-care leadership in teaching hospitals in attaining accreditation for their institutions.

Design/methodology/approach

This paper is based on a study of current literature on health-care leadership, hospital accreditation and quality of patient care and identifies the challenges facing health-care leadership in attaining accreditation for teaching hospitals.

Findings

Based on a review and analysis of literature, infrastructure, finance, legal support, workforce recruitment and training, documentation and technology are identified as challenges faced by health-care leadership in teaching hospitals. The key challenges facing health-care leadership with respect to medical education and clinical research are found to be integration of education into hospital operations, compliance with all regulatory and professional requirements and adequacy of resources in executing research programs.

Originality/value

This study draws the attention of health-care leadership in teaching hospitals on the challenges they face in obtaining accreditation for their institutions so that they may develop appropriate strategies to overcome them.

Details

Leadership in Health Services, vol. 32 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

To view the access options for this content please click here
Article
Publication date: 1 April 2014

Ahmet Yildiz and Sidika Kaya

– This article aims to investigate perceptions of Turkish nurses on the impact of accreditation on quality of care and the effect of accreditation on quality results.

Abstract

Purpose

This article aims to investigate perceptions of Turkish nurses on the impact of accreditation on quality of care and the effect of accreditation on quality results.

Design/methodology/approach

This study was performed as a cross-sectional, questionnaire-based survey on 258 nurses who started working in the hospital before it was accredited and continued to work during and after accrediation and who therefore knew both the hospital's pre-accrediation and post-accreditation periods. In this study, descriptive statistical analyses (means and standard deviations) were carried out to explore the views of the participants on “quality results,” “benefits of accreditation” and “participation of employees.” “Quality results” was considered to be the dependent variable, while “benefits of accreditation” and “participation of employees” were accepted as the independent variables. The relationship between the dependent variable and the independent variables was tested using Pearson correlation and multiple regression analysis. External patient satisfaction data collected by the quality department of the hospital before and after accreditation were also investigated.

Findings

It was found that nurses had generally high scores for the items concerning the benefits of accreditation. There was a statistically significant positive correlation between the dependent variable (quality results) and the independent variables (benefits of accreditation and participation of employees). Regression analysis indicated that R2=0.461 and the extent to which the independent variables explained the dependent variable was 46.1 per cent, which is a high rate. Patient satisfaction scores increased after accreditation.

Practical implications

Our study suggest that providing support for nurses, especially nurses with administrative responsibilities and incorporating employees into the process are important for exercising quality standards.

Originality/value

Hospital accreditation has a positive impact on quality results especially on quality of care provided to patients and patient satisfaction. Study findings could guide policy makers and hospital managers in Turkey and in other countries who are preparing or implementing accreditation.

Details

Clinical Governance: An International Journal, vol. 19 no. 2
Type: Research Article
ISSN: 1477-7274

Keywords

To view the access options for this content please click here
Article
Publication date: 1 October 2006

Vittorio Cesarotti and Bruna Di Silvio

Health care, one of the most dynamic sectors in Italy, is studied with a particular focus on outsourcing non‐core activities such as facility management (FM) services. The…

Abstract

Purpose

Health care, one of the most dynamic sectors in Italy, is studied with a particular focus on outsourcing non‐core activities such as facility management (FM) services. The project's goals are to define national standards to balance and control facility service evolution, and to drive FM services towards organisational excellence. The authors, in cooperation with a pool of facility service providers and hospitals managers, studied cleaning services – one of the most critical areas.

Design/methodology/approach

This article describes the research steps and findings following definition and publication of the Italian standard and its application to an international benchmarking process. The method chosen for developing the Italian standard was to merge technical, strategic and organisational aspects with the goal of standardising the contracting system, giving service providers the chance to improve efficiency and quality, while helping healthcare organisations gain from a better, more reliable and less expensive service.

Findings

The Italian standard not only improved services but also provided adequate control systems for outsourcing organisations. In this win‐win context, it is hoped to continually drive FM services towards organisational excellence.

Research limitations/implications

This study is specific to the Italian national healthcare system. However, the strategic dynamics described are common to many other contexts.

Practical implications

A systematic method for improving hospital FM services is presented.

Originality/value

The authors believe that lessons learned from their Italian case study can be used to better understand and drive similar services in other countries or in other FM service outsourcing sectors.

Details

International Journal of Health Care Quality Assurance, vol. 19 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article
Publication date: 1 June 2005

Sophie Y. Hsieh, David Thomas and Arie Rotem

To explore and evaluate how hospital staff respond to patient complaints.

Abstract

Purpose

To explore and evaluate how hospital staff respond to patient complaints.

Design/methodology/approach

A teaching hospital with 1,500 beds in Taiwan was purposefully chosen as a case study of hospital response to patients’ complaints. Data was obtained through interviews with quality surveying managers (n=53), government managers (n=4), staff of non‐government organizations (n=3) and a senior social worker, as well as analysis of documents (September 2001‐April 2002).

Findings

Using the managerial‐operational‐technical framework developed by the researchers, the study demonstrated problematic aspects of handling complaints at the case hospital. It was revealed that: complaint handlers were not sufficiently empowered, information sharing was limited within the organization, communication among professional staff and with management was inadequate, the physical safety of workers had been threatened, and improvements could not be sustained. Moreover, it became apparent that the case study hospital generally responded to patient complaints in a reactive and defensive manner.

Originality/value

It is evident that the hospital did not use patient complaints as a source of learning that could have promoted higher standards of care. The case study reveals some of the constraints and identifies requirements for appropriate use of information and feedback from patients. The study raises some issues requiring further research to ensure more appropriate use of patient complaints to improve quality of care.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article
Publication date: 10 August 2010

Sturle Nes and Anne Moen

The aim of the paper is to explore how multiple modes of knowledge play out in the consolidation of nursing procedures in construction of “local universality”. The paper…

Abstract

Purpose

The aim of the paper is to explore how multiple modes of knowledge play out in the consolidation of nursing procedures in construction of “local universality”. The paper seeks to explore processes where nurses negotiate universal procedures that are to become local standards in a hospital.

Design/methodology/approach

The paper is based on a case study design. Working group sessions, where the activity was to consolidate different versions of nursing procedures were observed and videotaped. For this paper, transcribed videotaped observations, where tension‐laden situations were identified, are subject to interaction analysis.

Findings

In the negotiations to construct standards, multiple modes of knowledge play out; personal experience, collective expertise and formalized knowledge. The paper demonstrates the contributions these modes of knowledge make in a process of standardization. This shows that standards, as such, do not stay universal for very long, but are constructed as “local universalities”.

Research limitations/implications

The study elaborates on discursive negotiations of procedures to illustrate how local universality plays out in processes to constitute standards. It is a limitation because how the local universality plays out in clinical work, or make claims about practice transformation, cannot be described.

Originality/value

The paper shows the necessity of confronting standardized procedures through multiple modes of knowledge. The paper exemplifies productive interactions in the construction of local universality, and how professionals account for practice when facing formal and standardized procedures.

Details

Journal of Workplace Learning, vol. 22 no. 6
Type: Research Article
ISSN: 1366-5626

Keywords

1 – 10 of over 26000