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1 – 6 of 6Xiao‐yun Chen, Kazunobu Yamauchi, Ken Kato, Akio Nishimura and Katuski Ito
The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries.
Abstract
Purpose
The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries.
Design/methodology/approach
One hospital from China and another from Japan were chosen and key indicators were selected according to the BSC framework. A comparative hospital performance measurement model was set up using the BSC framework to comprehensively compare hospital performance in two countries.
Findings
The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the hospitals' contribution to performance improvement of each country's total health system.
Research limitations/implications
Hospital performance comparisons between countries using the BSC depend on the selection of feasible and appropriate key performance indicators, which is occasionally limited by data collection problems.
Originality/value
The first use of the BSC to compare hospital performance between China and Japan shows benefits that not only suggests performance improvements in individual hospitals but also reveals effective health factors allowing implementation of valid national health policies.
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Makoto Kobayashi, Toshiki Mano and Kazunobu Yamauchi
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…
Abstract
Purpose
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.
Design/methodology/approach
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).
Findings
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.
Originality/value
The paper provides a relative evaluation of the factors thought to be important for patients in Japan when selecting a medical institution.
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Hiromasa Ida, Masako Miura, Masakazu Komoda, Naonori Yakura, Toshiki Mano, Tsutahiro Hamaguchi, Yoshihiko Yamazaki, Ken Kato and Kazunobu Yamauchi
The purpose of this paper is to describe the relationship between job stress, stress coping ability and performance among Japanese nurses.
Abstract
Purpose
The purpose of this paper is to describe the relationship between job stress, stress coping ability and performance among Japanese nurses.
Design/methodology/approach
Health risk and organization environment as job stress factors, sense of coherence (SOC) as stress coping ability and medical risk indicator and sickness‐absence days as a performance proxy were used to investigate the relationship between stress and performance. Length of professional experience also was included in the investigation.
Findings
The findings suggest a possibility that enriching nurses' professional experiences reduces medical risk. There is also a possibility that raising the SOC, while improving organization environment, contributes to reducing sickness‐absence.
Research limitations/implications
A cross‐sectional study of nurses in a single institution was used. In order to generalize the study's results, it will be necessary to conduct multi‐institutional longitudinal studies.
Originality/value
The present study shows key factors affecting medical risk and sickness‐absence leading to a reduced nursing performance.
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Ken Kato, Kazunobu Yamauchi, Makoto Miyaji, Nakako Fujiwara, Kimiko Katsuyama, Hiroshi Amano, Santaro Kobayashi, Michio Naito, Yasunori Maki, Hirohisa Kawahara, Mitsuaki Maseki and Yoshio Senoo
This study seeks to investigate doctors' desire to change the hospital where they work to sustain higher quality care.
Abstract
Purpose
This study seeks to investigate doctors' desire to change the hospital where they work to sustain higher quality care.
Design/methodology/approach
Self‐administered questionnaires were sent to doctors in Aichi Prefecture, Japan. Data were analyzed using univariate and logistic regression analysis and recursive partitioning.
Findings
Factors related to doctors' desire to change hospitals, according to logistic regression, were interaction between working hours and satisfaction with the hospital, evaluation, local government hospitals versus private ones, small vs large hospitals, ophthalmology versus internal medicine, desire to continue working as a hospital doctor and age. Additionally, working hours were also found to be related, based on recursive partitioning.
Research limitations/implications
The response rate was low and sampling bias was observed – therefore results need careful interpretation. Also, because this was a cross‐sectional study, causal relationships could not be identified. Desire to change hospitals, but not actual behavior, was measured.
Practical implications
Efforts to prevent doctors from changing hospitals should include considering job satisfaction and workload, doctor evaluation methods, support for career progression and organizational management.
Originality/value
As the hospital doctor shortage in rural areas becomes more serious, exploring doctors' desire to leave their current hospital is meaningful for Japanese hospital managers and hospitals worldwide aiming to provide sustainable and higher quality care.
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Kimiko Katsuyama, Yuichi Koyama, Yasushi Hirano, Kenji Mase, Ken Kato, Satoshi Mizuno and Kazunobu Yamauchi
Measurements of the quality of physician‐patient communication are important in assessing patient outcomes, but the quality of communication is difficult to quantify. The aim of…
Abstract
Purpose
Measurements of the quality of physician‐patient communication are important in assessing patient outcomes, but the quality of communication is difficult to quantify. The aim of this paper is to develop a computer analysis system for the physician‐patient consultation process (CASC), which will use a quantitative method to quantify and analyze communication exchanges between physicians and patients during the consultation process.
Design/methodology/approach
CASC is based on the concept of narrative‐based medicine using a computer‐mediated communication (CMC) technique from a cognitive dialog processing system. Effective and ineffective consultation samples from the works of Saito and Kleinman were tested with CASC in order to establish the validity of CASC for use in clinical practice. After validity was confirmed, three researchers compared their assessments of consultation processes in a physician's office with CASCs. Consultations of 56 migraine patients were recorded with permission, and for this study consultations of 29 patients that included more than 50 words were used.
Findings
Transcribed data from the 29 consultations input into CASC resulted in two diagrams of concept structure and concept space to assess the quality of consultation. The concordance rate between the assessments by CASC and the researchers was 75 percent.
Originality/value
In this study, a computer‐based communication analysis system was established that efficiently quantifies the quality of the physician‐patient consultation process. The system is promising as an effective tool for evaluating the quality of physician‐patient communication in clinical and educational settings.
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