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Employing a participatory approach, the purpose of this paper is to identify possible areas for improvement in visiting nurses’ post-hospital medication management and to facilitate suggestions for changes in future practices.

Based on a previous study on visiting nurses’ post-hospital medication management, two workshops were conducted in a visiting nurse department in a Danish municipality.

The visiting nurses emphasised knowledge of patients’ basic needs and prioritised their performance of context-specific nursing assessments, with a preventive focus as a prerequisite for improved patient safety in post-hospital medication management.

The participatory approach can increase the acceptability and feasibility of changes regarding future practices and thereby reduce the gap between official documents and daily practice. Although the local development of suggestions for changes in practices does not provide general knowledge, a subsequent detailed description of the changes in practices can promote transferability to other healthcare settings after local adjustments are made.

Flexible home healthcare, with stable relationships enabling the continuous assessment of the patient’s needs and symptoms, along with subsequent adjustments being made in care and medical treatment, might enhance patient safety in post-hospital medication management.

This paper adds to the knowledge of the need for integrated care in medication management in patients’ homes. It argues for primary healthcare professionals as “experts in complexity” and suggests a reconsideration of the purchaser-provider division of care to patients with unstable health conditions and complex care needs during the first days following hospital discharge.

This paper aims to present findings from a service user controlled research project; essentially it seeks to provide commentary by older people on their experiences as visitors to hospital or as patients receiving visitors.

The method of data collection was to facilitate discussions (focus groups) with diverse older people at eight different locations in North Lancashire and South Cumbria. They were asked about their recent experience of hospital visiting and its value to them, given their individual circumstances and those prevailing at the hospitals.

From verbatim transcripts the authors identified particular concerns or vivid experiences of individuals that were interpreted and classified into common themes such as: getting there and back; on the ward; the value of visiting.

The project maximised the participation of older people at all stages of the research process.

The paper makes recommendations for practice that could improve hospital visiting for older people, and consequently their wellbeing, including: times and rules for visitors; the response they get from staff; the potential of older visitors to help improve the welfare of the older patient; locating older people's wards.

The literature of hospital visiting hardly refers to older people's experience; however some articles of general application suggest that visitors' needs are not always being met. The findings from the perspectives of older people broadly confirm this conclusion.

The purpose of this paper is to evaluate the relative importance of attributes for patient selection of a medical institution and to quantitatively evaluate the impact of different types of organizational forms upon the patient ' s selection of a medical institution.

By using a conjoint analysis, evaluation criteria in patient selection of a medical institution were examined. The paper assumed the selection of a medical institution under the situation of “being given a diagnosis of suspected diabetes with a physical examination and then visiting a medical institution”. The attributes included in the questionnaire were: quality of the medical institution, distance to the hospital, amount paid at the initial visit, amount paid at hospitalization for examinations, and organizational form of the hospital. Relative importance of the attributes and relative importance of organizational form were assessed. A total of 140 people were requested to respond to the questionnaire by way of researchers who have a connection with the authors. Completed responses were obtained from 111 subjects (79 per cent).

The results of the conjoint analysis revealed that the most important attribute was quality of the medical institution. Organizational form was the attribute with the lowest importance. The utility value of being a public hospital was the highest within the organizational form attribute for all respondents and being a private hospital was the lowest. The quality of the medical institution was considered the most important factor in selecting a medical institution and the type of organizational form was considered least important. Regarding organizational form, being a public hospital was most preferred and being a hospital managed by a company and a private hospital were least preferred respectively among healthcare professionals and other occupations.

The paper provides a relative evaluation of the factors thought to be important for patients in Japan when selecting a medical institution.

Bureaucracy to a large extent entrenches orderliness and productive means of achieving goals in both public and private organisations across the world. However, bureaucracy is not suitable in the management of hospitals due to its peculiar nature of operations. This study investigates the conundrum of bureaucratic processes and health-care service delivery in government hospitals in Nigeria.

The study surveyed 600 outpatients and attendees visiting tertiary and government hospitals in Nigeria using descriptive design to obtained data from the respondents. A research instrument, questionnaire, was used to gather data. Out of the 600 outpatients visiting the 20 hospitals in government and tertiary hospitals, 494 responses were returned from the attendees. The study employed random sampling strategy to collect the information.

The findings of this study were that service delivery in government hospitals were in adverse position on all the four constructs of bureaucratic dimensions as against quality of service delivery in hospitals in Nigeria. It discovered that bureaucratic impersonality cannot impact on the quality of service delivery in government hospitals in Nigeria. Separation and division of labour among health workers have no significant effect on quality service delivery in government hospitals. Formal rules and regulations (administrative procedure, rules, and policies) prevent quality service delivery in government hospitals in Nigeria. Also, patient’s waiting time was not significant to the quality of service delivery in government hospitals.

The results are constrained with dimensions of bureaucratic processes. Thus, the implication of this study is that bureaucracy in the Nigerian public hospitals is an unnecessary marriage which should be carefully separated and de-emphasised for quality service delivery in the hospitals to thrive.

Largely, this study is practical essential as it unearths the irrelevant operations procedure that hinder progress in Nigerian hospitals.

The study accomplishes recognised importance to survey how bureaucracy impedes quality service delivery in government hospitals. This study has provided a vital clue to elements that will bring rapid attention to patients’outcome in Nigerian hospitals and health-care facilities which hitherto has not been emphasised. The study has contributed to the existing body of knowledge associated to healthcare service quality in developing country.

The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients’ and medical staff’s perspectives.

A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.

A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.

There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients’ consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.

The study aims to examine the factors influencing the choice of private and public hospitals in Ghana.

Purposive and convenient sampling techniques were used in selection of 225 respondents for the study. An independent samples t-test was used in ascertaining the significant difference in the opinions of both groups. Finally, binary logistics regression was used in ascertaining the factors that significantly influenced the choice of hospitals in Ghana.

In Ghana, patients’ choice of private or public hospital was significantly influenced by service quality, word-of-mouth, type of ailment and National Health Insurance Scheme (NHIS). Patients who made choice decision based on service quality were more likely to attend a private hospital. Word-of-mouth influenced the choice of public hospitals more than private hospitals. Patients preferred visiting public hospitals for more complicated ailments such as spinal defects, HIV/AIDS, heart-related problems, etc. Patients registered under the NHIS also preferred visiting public hospital to private hospital. Although services from private hospitals were more expensive, patients were more satisfied with services provided, as compared to patients from the public hospital. Cost of service and patient satisfaction, however, did not have a statistically significant effect on the choice of hospital.

Most comparative studies done on private and public hospitals studied in isolation focused on service quality, customer satisfaction, national health insurance and cost of health care or a combination of them. This study, however, considered all these selection criteria and extended it by adding word-of-mouth and the type of ailments suffered. The study, thus, provided a more comprehensive hospital selection criteria. The use of logistics regression in this particular area of study was also quite unique.

Describes an action research project to improve quality in three hospital departments including operating theatres, X‐ray, and medical records. The approach combined quality assurance (QA) or audit methods with those of continuous quality improvement (CQI) or TQM. The intention was to bring about improved organizational performance through an emphasis on bottom‐up rather than top‐down methodology, and to assess the relative effectiveness of different quality strategies being used within the hospital. Baseline studies of organizational climate and of patient perceptions enabled evaluation of effectiveness. Provides a description of the background to various health‐care quality strategies, and argues that several perspectives are required if all stakeholders (e.g. policy makers, professionals, patients, and managers) are to be satisfied. Describes the responses of staff, superiors and professionals and recommendations offered for more effective quality strategy implementation.

As social media platforms become increasingly popular among service firms, many US hospitals have been using social media as a means to improve their patients’ experiences. However, little research has explored the implications of social media use within a hospital context. The purpose of this paper is to investigate a hospital’s customer engagement through social media and its association with customers’ experiential quality. Also, this study examines the role of a hospital’s service characteristics, which could shape the nature of the interactions between patients and the hospital.

Data from 669 hospitals with complete experiential quality and demographic data were collected from multiple sources of secondary data, including the rankings of social media friendly hospitals, the Hospital Compare database, the Center for Medicare and Medicaid (CMS) cost report, the CMS impact file, the Healthcare Information and Management Systems Society Analytics database and the Dartmouth Atlas of Health Care. Specifically, the authors designed the instrumental variable estimate to address the endogeneity issue.

The empirical results suggest a positive association between a hospital’s social media engagement and experiential quality. For hospitals with a high level of service sophistication, the association between online engagement and experiential quality becomes more salient. For hospitals offering various services, offline engagement is a critical predictor of experiential quality.

A hospital with more complex services should make efforts to engage customers through social media for better patient experiences. The sample is selected from databases in the US, and the databases are cross-sectional in nature.

Not all hospitals may be better off improving the patient experience by engaging customers through social media. Therefore, practitioners should exercise caution in applying the study’s results to other contexts and in making causal inferences.

The current study delineates customer engagement through social media into online and offline customer engagement. This study is based on the theory of customer engagement and reflects the development of mobile technology. Moreover, this research may be considered as pioneering in that it considers the key characteristics of a hospital’s service operations (i.e., service complexity) when discovering the link between customers’ engagement through a hospital’s social media and experiential quality.

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.