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The purpose of this paper is to assess patient perceptions regarding South African hospital foodservice quality.

In total, 419 questionnaires were administered to surgical and medical inpatients consuming a normal diet in six South African provinces. A number of 23 urban and 10 rural hospitals were sampled. Inpatients were surveyed for their opinions on hospital foodservice quality with a view to improving meals and food delivery processes.

Results revealed lower patient satisfaction with aspects relating to foodservice reliability. Among other issues, inpatients were not informed about meal times (overall median=0), had to wait longer than expected for their meals and were not informed about delays (overall median=2). Menu items were not explained to inpatients (overall median=0), and inpatients were not informed about nutritional values (overall median=0). Consequently, patients opined that they were not willing to use the hospital foodservice in future (overall median=2).

To identify South African healthcare issues that need improvement, it is necessary to establish where to act. These findings create awareness among authorities and hospital managers to consider patient perceptions when they review and try to improve public hospital foodservice quality, which could also assist in ensuring improvement in food consumption levels, thereby combating South African hospital malnutrition.

Research was conducted to investigate whether, and how, political accountability might stabilise when agents are faced with profound changes in external structures such as competition laws and austerity policies.

We performed a field study from 2007 to 2015 in a regional hub in Finland and worked with data from document analysis, interviews and meeting observations. We have used embedded research design, where we apply methodological bracketing as well as composite sequence analysis for field research.

Accountability declined when irresistible external structures were the dominant influence on the unreflective actions of agents-in-focus. With time, however, the agents started acting critically by drawing on structures that could facilitate strategic actions to stabilise political accountability.

The field research and interpretation of the data were limited to the organisation analysed; however, the theoretical arguments allow for analytical generalisations.

The research demonstrates how public officials and political decision-makers can eventually adopt a strategic approach when faced with irresistible change in external structures.

The research demonstrates how public officials and political decision-makers can eventually adopt a strategic approach when faced with irresistible changes in external structures.

The study locates political accountability in the context of strong structuration theory and discusses how it is redefined by external structures.

To investigate the association between implementation of clinical governance and patient safety.

A pre-post study was conducted in an Australian health service following the implementation of clinical governance systems (CGS) in the inpatient wards in 2016. Health service audit data from 2017 on CGS implementation and the rate of adverse patient safety events (PSE) for 2015 (pre-implementation) and 2017 (post-implementation), across 45 wards in six hospitals were collected. CGS examined compliance with 108 variables, based on the Australian National Safety and Quality Health Service standards. Patient safety was measured as PSE per 100 bed days. Data were analysed using odds ratios to explore the association between patient safety and CGS percentage compliance score.

There was no change in PSE between 2015 and 2017 (MD 0.04 events/100 bed days, 95% CI -0.11 to 0.21). There were higher odds that wards with a CGS score >90% reported reduced PSE, compared to wards with lower compliance. The domains of leadership and culture, risk management and clinical practice had the strongest association with the reduction in PSE.

Given that wards with a CGS score >90% showed increased odds of reduced PSE health service boards need to put in place strategies that engage frontline managers and staff to facilitate full implementation of clinical governance systems for patient safety.

The findings provide evidence that implementation of all facets of CGS in a large public health service is associated with improved patient safety.

The Maturity Matrix is a tool designed in the UK to assess family practice organisational development and to stimulate quality improvement. It is practice‐led, formative and undertaken by a practice team with the help of trained facilitators. The aim of this study is to assess the Maturity Matrix as a tool and an organisational development measure in European family practice settings.

Using a convenience sample of 153 practices and 11 facilitators based in the UK, Germany, The Netherlands, Switzerland and Slovenia, feasibility was assessed against six criteria: completion; coverage; distribution; scaling; translation; and missing data. Information sources were responses to evaluation questionnaires by facilitators and completed Maturity Matrix profiles.

All practices taking part completed the Maturity Matrix sessions successfully. The Netherlands, the UK and Germany site staff suggested including additional dimensions: interface between primary and secondary care; access; and management of expendable materials. Maturity Matrix scores were normally distributed in each country. Scaling properties, translation and missing data suggested that the following dimensions are most robust across the participating countries: clinical performance audit; prescribing; meetings; and continuing professional development. Practice size did not make a significant difference to the Maturity Matrix profile scores.

The study suggests that the Maturity Matrix is a feasible and valuable tool, helping practices to review organisational development as it relates to healthcare quality. Future research should focus on developing dimensions that are generic across European primary care settings.

The current study is aimed at identifying the prominent influencers that affect the response behaviour of patients in a hospital environment.

The research is based on the data collected through the participant observation method while interviewing patients about the quality of healthcare services in nine community health centres of the Kashmir division. Thematic analysis was performed on the information collected from patients admitted to various hospital sections.

The analysis of the qualitative data revealed that the presence of hospital staff near respondents, perceived risk of maltreatment, social desirability, the sensitivity of the topic, risk of information sharing and attitude towards surveys are the most frequently observed factors that modulate the patient's tendency to truthfully report critical facts about the problem understudy.

These results can help researchers to exercise caution while communicating with respondents and collecting data related to serious issues in a natural setting.

The purpose of this paper is to describe a case study undertaken at Al Buraimi Hospital in Oman, which used computer simulation and the Delphi approach to improve efficiency by reducing prescription dispensing waiting times.

This study’s framework was based on a discrete event simulation (DES) to identify the as-is pharmacy process and to create a to-be (future situation) to achieve an improvement in pharmacy workflow and service quality. Owing to healthcare environment complexity, and to gain a deeper understanding about Al Buraimi Hospital pharmacy problems, a Delphi technique was also used.

Based on Delphi, and according to the expert panel suggestions, two alternative scenarios were proposed to improve Al Buraimi Hospital pharmacy efficiency: fast-track and direct-dispensing, which should help to reduce the prescription dispensing waiting time process by 7.3 and 9.8 min, respectively.

The main limitation is the pharmacists’ shortage, which may affect the prescription dispensing process’s quality as insufficient manpower to check the prescriptions may increase the medication errors’ risk.

Based on this case study’s real-world data, findings can be used to improve public healthcare sector pharmacy efficiency. The DES can be used in healthcare services to describe and test actual and proposed situations.

Provides an overview of the content of the current issue of CGIJ.

This review is prepared by the review editor to highlight key points within each article.

Enables readers to scan content and select articles of most interest or relevance to their needs.

CGIJ is the only Emerald health journal providing this service to its readers.

In the present context of a health-concious society, management of pharmaceutical supply chains has become more complex because it involves the life-saving interest of human being and requires the participation of different stakeholders such as pharmaceutical manufacturers, wholesalers, distributors, customers, information service providers and regulatory agencies. Limited research is available in the area of pharmaceutical supply chains. This paper aims to find the gaps in the literature by reviewing research papers on different strategic issues of supply chain management in the pharmaceutical sector.

In total, 136 research papers, mainly from refereed international journals, were reviewed to identify the issues of supply chain management (SCM) in the pharmaceutical supply chain. On the basis of a review, gaps are identified and research agenda is proposed.

It is observed from review that the pharmaceutical sector is not widely researched in developing countries because of many complexities in this supply chain. The share of pharmaceutical firms in the global market is also not very significant. Based on an extensive review of pharmaceutical supply chains, research gaps are identified in different areas such as inventory management, new product development, process development, capacity planning, network design, plant design, pipeline and development management, outsourcing logistics activities, reverse logistics, Lean manufacturing, green SCM and implementation of E-business processes and performance management. These strategic issues have been further classified into three broad categories, i.e. resources, processes and performance.

This paper explores major strategic areas of pharmaceutical supply chains for research. Findings of the paper will be highly useful for researchers to decide direction of future research.