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Article
Publication date: 5 December 2019

Terrylyna Baffoe-Bonnie, Samuel Kojo Ntow, Kwasi Awuah-Werekoh and Augustine Adomah-Afari

The purpose of this paper is to explore the influence of health system factors on access to a quality healthcare among prisoners in Ghana.

Abstract

Purpose

The purpose of this paper is to explore the influence of health system factors on access to a quality healthcare among prisoners in Ghana.

Design/methodology/approach

Data were gathered using different qualitative methods (interviews and participant observation) with staff of the James Camp Prison, Accra. Findings were analyzed using a framework method for the thematic analysis of the semi-structured interview data; and interpreted with the theoretical perspective of health systems thinking and innovation.

Findings

The study concludes that health system factors such as inadequate funding for health services, lack of skilled personnel and a paucity of essential medical supplies and drugs negatively affected the quality of healthcare provided to inmates.

Research limitations/implications

The limited facilities available and the sample size (healthcare workers and prison administrators) impeded the achievement of varied views on the topic.

Practical implications

The paper recommends the need for health policy makers and authorities of the Ghana Prison Service to collaborate and coordinate in a unified way to undertake policy analysis in an effort to reform the prisons healthcare system.

Social implications

The national health insurance scheme was found to be the financing option for prisoners’ access to free healthcare with supplementation from the Ghana Prison Service. The study recommends that policy makers and healthcare stakeholders should understand and appreciate the reality that the provision of a quality healthcare for prisoners is part of the entire system of healthcare service delivery in Ghana and as such should be given the needed attention.

Originality/value

This is one of few studies conducted on male only prisoners/prison in the context of Ghana. It recommends the need for an integrated approach to ensure that the entire healthcare system achieves set objectives in response to the primary healthcare concept.

Details

International Journal of Prisoner Health, vol. 15 no. 4
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 6 April 2010

Nana Owusu‐Frimpong, Sonny Nwankwo and Baba Dason

This paper aims to explore patients' satisfaction with access to treatment in both the public and private healthcare sectors in London.

Abstract

Purpose

This paper aims to explore patients' satisfaction with access to treatment in both the public and private healthcare sectors in London.

Design/methodology/approach

Qualitative and quantitative methods were employed to determine patients' levels of satisfaction. A semi‐structured face ‐to‐face non‐probability quota sampling and a probability sample drawn from multistage cluster sampling methods were employed.

Findings

The results revealed varying access experiences among public and private care users. Public, as opposed to private, healthcare users experience unsatisfactory outcomes in relation to service climate factors (e.g. getting attention from doctors, time taken to get appointments, access to core treatment and opening hours). Overall, while women are more disadvantaged by spatial accessibility to treatment than men, both public and private healthcare users indicate major problems in accessing healthcare despite the myriad intervention strategies aimed at ameliorating the situation in both sectors. Therefore, access‐to‐care problems are significant and need to be addressed by managers and healthcare providers in order to improve the quality of service delivery and patient satisfaction. Private care users fare better than public users in obtaining medical care at short notice, having more agreeable opening hours for treatment and getting appointments for treatment with less difficulty.

Research limitations/implications

Whereas the limitation of the study was due to its small sample size, it nevertheless will stimulate insight into further academic endeavours.

Practical implications

Academics and practitioners will find the results very useful when making decisions about healthcare provisions and how they can best meet user/patient satisfaction.

Originality/value

This study is significant in drawing on the current literature on satisfaction which is usefully applied to evaluate patients' response to the quality management initiatives in the healthcare sector.

Details

International Journal of Public Sector Management, vol. 23 no. 3
Type: Research Article
ISSN: 0951-3558

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Article
Publication date: 1 April 2005

Champika Liyanage and Charles Egbu

To explore the role of facilities management (FM) in the control of Healthcare Associated Infections (HAI) and then to discuss a three‐dimensional approach which can be…

Abstract

Purpose

To explore the role of facilities management (FM) in the control of Healthcare Associated Infections (HAI) and then to discuss a three‐dimensional approach which can be used for FM services in the control of infections (HAI).

Design/methodology/approach

Most of what is put forward in this paper is based on a research project which is at its early stages. The discussions are therefore grounded on a thorough review of literature accomplished as part of the research project. Unstructured interviews with experts (sample – 25) in infection control in National Health Service in Scotland (NHSS), carried out concurrently as a pilot study, also provided useful insights when writing up this paper.

Findings

It is suggested that integrating FM effectively with the core services is vital in avoiding duplication of work carried out by the healthcare workers. Continuous measurement and management of performance of FM services is also vital in the control of HAI. In addition, it was identified that managing knowledge is important to retain, develop, organize, and utilize the organization's capability of managing HAI. Overall, an increased concerted effort; better integration of processes and practices between clinical and non‐clinical activities in the healthcare sector and effective dissemination of knowledge are all vital in controlling HAI to achieve “quality” in healthcare provisions. More empirical research is needed to explore the many complex and significant ways in which FM can be exploited for improved control of HAI.

Research limitations/implications

Both targeted guidelines on the role of FM in the control of HAI as well as the paucity of relevant literature on related areas are limitations.

Practical implications

The culture of healthcare managers and functional level staff is a major implication when operationalizing the three‐dimensional approach introduced in the paper.

Originality/value

The paper focuses on one of the major issues in healthcare, i.e. HAI. Few have taken an FM perspective on this issue. This paper therefore adds significantly to our understanding of the control of HAI from a non‐clinical perspective.

Details

Facilities, vol. 23 no. 5/6
Type: Research Article
ISSN: 0263-2772

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Article
Publication date: 3 October 2008

Jeffrey P. Harrison and Geoffrey M. McDowell

The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare

Abstract

Purpose

The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare service provision. Data show that the need for these systems is growing to meet accompanying technological and workload demands. Additionally, laboratory tests provide the majority of information for clinical decision‐making. Laboratory processes automation, including patient result verification, has greatly improved laboratory test throughput while decreasing turn‐around‐times, enabling critical results to reach physicians rapidly for improved clinical outcomes.

Design/methodology/approach

Data were drawn from the 2007 Healthcare Information and Management Systems Society (HIMSS) Analytics Database, which includes over 5,000 US healthcare organizations and provides extensive data on the hardware, software, and information technology infrastructure within healthcare organizations.

Findings

US hospitals are actively involved in laboratory systems planning to improve health service quality. Specifically, data show 76 new laboratory information systems are currently being installed in 2007 with another 399 under contract for future installation. As a result, increasing investment in laboratory information systems is providing state‐of‐the‐art clinical laboratory support, which enhances clinical care processes and improves quality. These state‐of‐the‐art Laboratory Information Systems, when linked with other clinical information systems such as Computerized Physician Order Entry and Electronic Medical Record, will support further healthcare quality improvement.

Originality/value

This article includes the most current information available on the US hospital laboratory information system applications.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 8 February 2020

Alison Brown

The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective…

Abstract

Purpose

The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective corporate governance has traditionally focused on board architecture. Emerging research is bringing to light the importance of governance dynamics. This paper contributes to emerging research through highlighting how communication and leadership underpin effective engagement in governing healthcare quality.

Design/methodology/approach

A comparative case study of eight Australian public hospitals was undertaken involving document review, interviews and observations. Case studies were allocated into high- or low-engagement categories based on evidence of governance processes being undertaken, in order to compare and contrast influencing factors. Thematic analysis was undertaken to explore how communication and leadership influence healthcare governance.

Findings

Several key components of communication and leadership are shown to influence healthcare quality governance. Clear logical narratives in reporting, open communication, effective questioning and challenge from board members are important elements of communication found to influence engagement. Leadership that has a focus on healthcare excellence and quality improvement are aligned and promote effective meeting processes is also found to foster governance engagement. Effective engagement in these communication and leadership processes facilitate valuable reflexivity at the governance level.

Practical implications

The findings highlight the way in which boards and senior managers can strengthen governance effectiveness through attention to key aspects of communication and leadership.

Originality/value

The case study approach allows the exploration of communication and leadership in greater depth than previously undertaken at the corporate governance level in the healthcare setting.

Details

Journal of Health Organization and Management, vol. 34 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 11 March 2019

Ingy Shafei, Jan Walburg and Ahmed Taher

The purpose of this paper is to determine the best measure among several alternatives (SERVQUAL, weighted SERVQUAL, SERVPERF, weighted SERVPERF) and develop a scale which…

Abstract

Purpose

The purpose of this paper is to determine the best measure among several alternatives (SERVQUAL, weighted SERVQUAL, SERVPERF, weighted SERVPERF) and develop a scale which healthcare providers can use for measurement of healthcare service quality.

Design/methodology/approach

The study involved two phases. The first phase was through a series of in-depth interviews with experts and patients followed by a pilot study. Subsequently, the second phase involved a quantitative phase through surveys with 384 patients. Alternative measures were analyzed using coefficient (Cronbach) α, composite reliability, factor analysis and logistic regression analysis.

Findings

Findings confirmed “Weighted SERVPERF” using an interactive methodology as the most appropriate for measurement of healthcare service quality.

Originality/value

Using the model and scale developed, healthcare providers will be able to measure healthcare service quality and identify areas of shortfall and act accordingly to improve delivery through allocating resources in service areas that would generate the greatest returns in customer satisfaction. Enhancing satisfaction will ultimately generate patient loyalty and positive recommendation behavior.

Details

International Journal of Health Care Quality Assurance, vol. 32 no. 2
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 2 May 2017

Kwabena G. Boakye, Charles Blankson, Victor R. Prybutok and Hong Qin

The purpose of this paper is to propose and test a healthcare framework of service quality, perceived value, and satisfaction in Ghana. More specifically, this study…

Abstract

Purpose

The purpose of this paper is to propose and test a healthcare framework of service quality, perceived value, and satisfaction in Ghana. More specifically, this study investigates the role and effect of service quality on patient satisfaction and perceived value in Ghana’s healthcare delivery.

Design/methodology/approach

Data were gathered through surveys administered to 113 healthcare patients in Ghana. partial least square-structural equation modeling analysis was used to empirically test the research model.

Findings

Results show healthcare quality significantly influences satisfaction and perceived value of healthcare delivery. Additionally, perceived value’s impact on satisfaction and behavioral intention shows that increasing perceived benefits while reducing perceived costs leads to repeat behavior and paves the way for retention strategy for healthcare management.

Research limitations/implications

This study yields a series of limitations in its results and conclusions. These limitations and future research are discussed in Section 7 of the study.

Originality/value

This study contributes to the literature by examining the effects of healthcare service quality on patient satisfaction and perceived value, determining the effect of healthcare service quality on patients’ behavioral intention, and testing the proposed framework in Ghana, a fast growing and economically liberalized emerging country in Sub-Saharan Africa.

Details

International Journal of Quality & Reliability Management, vol. 34 no. 5
Type: Research Article
ISSN: 0265-671X

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Article
Publication date: 28 June 2019

David John Sheard, Gregory Clydesdale and Gillis Maclean

A key question in the provision of public health concerns how that provision is governed. The purpose of this paper is to examine the governance structure of a public…

Abstract

Purpose

A key question in the provision of public health concerns how that provision is governed. The purpose of this paper is to examine the governance structure of a public health board and its perceived impact on the efficacy of clinical operations.

Design/methodology/approach

Structural issues examined the level of centralisation and public participation, and whether governance should occur through elected boards or appointed managers. These issues were examined through multiple lenses. First was the intention of the structure, examining the issues identified by parliament when the new structure was created. Second, the activities of the board were examined through an analysis of board meetings. Finally, hospital clinicians were surveyed through semi-structured interviews with both quantitative and qualitative questioning.

Findings

A contradiction was revealed between intention, perception and actual activities. This raises concerns over whether the public are significantly informed to elect the best-skilled appointees to governance positions.

Practical implications

This research holds implications for selecting governance structures of public health providers.

Originality/value

Few studies have looked at the role of a publicly elected healthcare governance structure from the perspective of the clinicians. Hence, this study contributes to the literature on healthcare structure and its impact on clinical operations, by including a clinician’s perspective. However, this paper goes beyond the survey and also considers the intention of the structure as proposed by parliament, and board activities or what the board actually does. This enables a comparison of intention with outcomes and perception of those outcomes.

Details

Journal of Health Organization and Management, vol. 33 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 19 July 2011

Jeffrey P. Harrison and Emily D. Ferguson

Emergency services are critical for high‐quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency…

Abstract

Purpose

Emergency services are critical for high‐quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (US) acute care hospital staff's ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers.

Design/methodology/approach

Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5,000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities.

Findings

US acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, US emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staff's ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state‐of‐the‐art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement.

Research limitations/implications

This research uses the AHA annual surveys, which represent self‐reported data by individual hospital staff. However, the AHA expends significant resources to validate reported information and the annual survey data are widely used for hospital research.

Practical implications

The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure.

Originality/value

This article has important information on US emergency service availability in the hospital industry.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 2 February 2015

Bikash Ranjan Debata, Bhaswati Patnaik, Siba Sankar Mahapatra and Kumar Sree

The purpose of this paper is to identify the dimensions of service quality as well as of service loyalty in the context of medical tourism. It seeks to demonstrate the…

Abstract

Purpose

The purpose of this paper is to identify the dimensions of service quality as well as of service loyalty in the context of medical tourism. It seeks to demonstrate the conceptualization of medical tourism service loyalty (MTSL) construct. This research also attempts to examine the effect of service quality dimensions on service loyalty dimensions of medical tourism.

Design/methodology/approach

The dimensions of service quality as well as of service loyalty are identified using an exploratory factor analysis. Next, the reliability and validity of the quality factors and loyalty factors are established through confirmatory factor analysis using AMOS 18.0 version. The related hypotheses are tested using structural equation modeling (SEM).

Findings

The paper identifies eight-factor construct for medical tourism service quality and three-factor construct for MTSL. It is found that the treatment satisfaction dimension of service quality has positive and significant impact on MTSL. It is also observed that, overall, medical tourism service quality has positive impact on MTSL.

Practical implications

These dimensions of service quality should be viewed as the levers of improving perceived service quality with respect to medical tourism. Examining the service quality dimensions’ impact on customer loyalty for medical tourism sector can offer the industry valuable insights regarding which aspects of the service to focus on in order to improve medical tourist’s satisfaction and loyalty toward the firms.

Originality/value

This paper introduces the concept of service quality and service loyalty in medical tourism sector. In conceptualizing MTSL, the authors propose an integration of behavioral measures, attitudinal measures and cognitive measures. The interrelationship between the service quality construct and medical loyalty construct was established using SEM. This is useful for the healthcare manager to measure the medical tourist’s perceptions of service quality on these dimensions as related to medical tourism performance.

Details

Benchmarking: An International Journal, vol. 22 no. 1
Type: Research Article
ISSN: 1463-5771

Keywords

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