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1 – 10 of over 19000The validity of an approach based on a quality system specification developed from BS5750 is considered, with reference to patient care activity in an out‐patient clinic at a…
Abstract
The validity of an approach based on a quality system specification developed from BS5750 is considered, with reference to patient care activity in an out‐patient clinic at a general hospital. The quality systems specification is presented and the application of this system to the clinic and service departments is demonstrated.
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Serkan Altuntas and Semih Kansu
The purpose of this paper is to propose an innovative and integrated approach based on service quality measurement (SERVQUAL), quality function deployment (QFD) and failure modes…
Abstract
Purpose
The purpose of this paper is to propose an innovative and integrated approach based on service quality measurement (SERVQUAL), quality function deployment (QFD) and failure modes and effects analysis (FMEA) for service quality improvement.
Design/methodology/approach
The SERVQUAL scale is used for service quality measurement, QFD is used for service design and FMEA is used to prevent possible failures during service delivery.
Findings
A case study in a public hospital in Turkey is performed to show how the proposed approach works in practice. The results of the study show that the proposed approach can be used effectively to assess service quality in practice.
Originality/value
Service quality has become an important issue for service enterprises facing a fiercely competitive environment to provide sustainability. This is the first study that applies an integrated methodology based on SERVQUAL scale, QFD and FMEA to service quality improvement.
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Sandra Catherine Buttigieg, Prasanta Kumar Dey and Mary Rose Cassar
The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A & E) unit of a Maltese…
Abstract
Purpose
The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A & E) unit of a Maltese hospital.
Design/methodology/approach
The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A & E unit of the hospital.
Findings
The major and related problems being faced by the hospital under study were overcrowding at A & E and shortage of beds, respectively. The combined framework ensures better A & E services and patient flow. QFD identifies and analyses the issues and challenges of A & E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A & E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A & E unit.
Practical/implications
The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives.
Originality/value
Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A & E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.
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Bahareh Amirkalali, Saeed Hosseini, Fatemeh Ramezani, Sara Nejati, Neda Nayebi and Bagher Larijani
The purpose of this paper is first to examine whether standard hospital food met patients' requirements and second, to evaluate the effect of individualized dietary intervention…
Abstract
Purpose
The purpose of this paper is first to examine whether standard hospital food met patients' requirements and second, to evaluate the effect of individualized dietary intervention on weight, BMI and body composition of the patients.
Design/methodology/approach
In total, 69 patients (37 in the intervention group and 32 in the control group) were randomly selected. Weight, height and body composition measurements were performed in both groups within 24 h after admission and at discharge. In the intervention group, encouraging with eating and drinking, replacing missed meals with supplements or enteral nutrition were used as strategies to improve dietary intake. Frequency, chi‐square, Wilcoxon and paired t‐test were used to analyze data.
Findings
Before intervention daily energy and protein intake were significantly lower than required amounts in both groups. After intervention energy intake met requirements in the intervention group while it was still less than requirements in the control group. Protein intake met requirements in both groups. There were no significant changes in body weight, BMI and body composition in the intervention group during hospitalization but in the control group weight, BMI and body protein decreased significantly.
Originality/value
This paper shows the importance of individualized dietary intervention to prevent weight and body protein loss of patients during hospitalization.
Paul Gemmel and Roland Van Dierdonck
Admission scheduling is identified as an important strategy to match supply and demand in acute care hospitals. During the last decades, many different theoretical models of…
Abstract
Admission scheduling is identified as an important strategy to match supply and demand in acute care hospitals. During the last decades, many different theoretical models of admission scheduling have been developed, but only a few of them have reached the stage of implementation. Several authors have given some indication that there may be a gap between theory and practice of admission scheduling. In this study we try to describe this gap using a two‐stage research methodology: an extensive literature review in order to determine the theoretical functional requirements for a system that supports the admission scheduling decision and a telephone survey in order to learn more about the admission scheduling practice in Belgian hospitals. The study finds a large gap between the theoretical requirements and the practical application of admission scheduling in hospitals. In summary, most hospitals have not worked out an admission scheduling policy indicating which resources are critical in the scheduling process and how information on the availability of these resources can be captured.
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Rosita Jamaluddin, Nurul Aqmaliza Abd Manan, Aina Mardiah Basri and Muhd Shahrim Ab Karim
The purpose of this paper is to determine patients' satisfaction with the bulk trolley food service system and the effect of the system on energy and protein intakes.
Abstract
Purpose
The purpose of this paper is to determine patients' satisfaction with the bulk trolley food service system and the effect of the system on energy and protein intakes.
Design/methodology/approach
An interview‐based questionnaire was used to measure patients' satisfaction (n=70) with the hospital food services. Dietary intake of hospital food was determined through one‐day weighed food intake survey and a food record for non‐hospital food.
Findings
The majority of the patients (98.6 per cent) were satisfied and 1.4 per cent was very satisfied with the food service. Energy (kcal) and protein (g) intakes from hospital food were higher than that of outside food (p<0.05). However, most patients did not obtain their full energy and protein requirements from the hospital food provided. Four food service dimensions were found to be significantly correlated with patients' overall satisfaction (p<0.05).
Research limitations/implications
The questionnaire was adapted from the study by Capra et al. and modified to suit the local food service system, thus the application may be context‐specific. The instrument did not measure factors that influence hospital food consumption, nor did it differentiate between the acceptability of different kinds of food. Also a comparison of patients' acceptance between the plated and bulk trolley system was not conducted in this study.
Practical implications
The results of the study can be used as a basis for decision making and for future planning of the food service system. The findings prompt analytical comparison, between the bulk trolley, and plated systems, in determining patients' preference, and to increase food intake.
Originality/value
Patient satisfaction surveys are regularly conducted in the country but none had ever studied the effectiveness of the bulk trolley system in relation to patients' satisfaction. The findings are noteworthy and, compared with the past literature review, the difference in the way the system is carried out in the country may be the contributing factor regarding patients' satisfaction system.
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Hsiang Ru Chen and Bor‐Wen Cheng
The purpose of this paper is to integrate the ISO 9001:2008 and blueprints by using a process approach, to have systematic regulation in hospital quality management.
Abstract
Purpose
The purpose of this paper is to integrate the ISO 9001:2008 and blueprints by using a process approach, to have systematic regulation in hospital quality management.
Design/methodology/approach
This study promotes a process approach when developing, implementing, and improving the effectiveness of hospital service quality to enhance patients’ satisfaction by meeting their requirements. This study completes the hospital’s blueprints with the process approach by using case study research methods such as in‐depth interviews with relevant personnel, on‐site observations, and experts’ advice.
Findings
The results of hospital blueprints described in this study comprise five‐plane lines to have systematic regulations. The ISO 9001:2008 process approach and service blueprint are not merely a technological application for medical healthcare services, but rather a fully patient‐driven, technologically integrated, and diligently implemented programme.
Practical limitations
Because of organisational financial confidentiality, this study does not consider the financial performance of the case hospital, and the results of blueprints may be revised afterward.
Originality/value
This paper promotes the adoption of a process approach when developing, implementing, and improving the effectiveness of a hospital outpatient service management system, to enhance outpatients’ satisfaction by meeting their requirements.
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Shefali Srivastava and Gyan Prakash
The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic…
Abstract
Purpose
The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic conditions. Care coordination is defined as a process where physicians, nurses and allied professionals work together to clarify responsibilities, care objectives, treatment plans and discharge plans for delivery of unified care. Patient-centricity is defined as an approach of delivering quality care to patients that focuses on creating a positive experience for them.
Design/methodology/approach
A literature review was used to identify measures of care coordination and then partial least square structural equation modeling was used to assess interrelationship among patient-centricity, measures of care coordination and delivery of quality care.
Findings
Results reveal that care coordinated pathways consist of IT-enabled coordination, interprofessional teamwork, information sharing and facilitative infrastructure requirements and are influenced by patient-centricity. These are deliberate requisites for delivering of quality care. Results of this study present a validated model of care coordination for older people, which may be further explored to refine the concept of care coordination.
Practical implications
Based on these results, practitioners may develop an overarching strategy to deliver seamless care and to achieve better health outcomes. Measures of care coordination may be used as a performance benchmarking tool and will also help in the process mapping of hospitals.
Social implications
This paper highlights how patient-centricity may be achieved by focusing on coordinated care processes. This understanding may help in designing processes, which in turn deliver health as a social good in an effective manner.
Originality/value
Results of this study present such a validated model for care coordination, which can be used by researchers.
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Juliana Parise Baldauf, Carlos Torres Formoso and Patricia Tzortzopoulos
This paper proposes a method for managing client requirements with the use of Building Information Modelling (BIM). The development of healthcare projects demands a large amount…
Abstract
Purpose
This paper proposes a method for managing client requirements with the use of Building Information Modelling (BIM). The development of healthcare projects demands a large amount of requirements information, in order to deal with a diversity of clients and frequents changes in healthcare services. The proposed method supports healthcare design by adopting a process-based approach for client requirements management, with the aim of improving value generation.
Design/methodology/approach
Design Science Research was the methodological approach adopted in this investigation. The main outcome of this study emerged from an empirical study carried out in a healthcare project in Brazil.
Findings
The proposed method involves three stages: (1) capturing and processing requirements; (2) product and requirements modelling, which involves the connection between requirements and the BIM 3-D model and (3) supporting design solution refinement, through the communication of requirements and the assessment of design in relation to updated client requirements information.
Originality/value
This study explores client requirements management from a process perspective, proposing activities and their interdependences and possible sources of data, including healthcare services information. The main theoretical contributions are related to the understanding of the nature and complexity of the information involved in client requirements management, and how this can be modelled.
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This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the…
Abstract
Purpose
This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the strategies and contextual influences to attain patient recovery flexibility.
Design/methodology/approach
This paper uses a case study method based on a semi-structured interview with healthcare professionals, observations and informal discussions.
Findings
In the present study, several dimensions of patient recovery flexibility are reported. Different internal and external strategies to exhibit patient recovery flexibility, as well as two contextual influences, are identified. An integrative framework is developed to establish the relationship of patient recovery flexibility with service experience in public healthcare.
Research limitations/implications
The study was conducted in a public healthcare setting in India. The sample size for the semi-structured interview was limited to healthcare professionals, and the patient’s perspective is missing.
Originality/value
This paper contributes to the growing need for patient recovery flexibility as a strategy in the public healthcare delivery system. It offers new insights to address the gap in the literature regarding the linkage of patient recovery flexibility and service experience. The study provides an integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and the impact on the service experience. The framework and propositions presented in the study will guide future research that is needed in this area. This study provides an overview to shape and redesign the after-service support from a flexibility perspective in public healthcare for the improved service experience.
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