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1 – 10 of over 33000Total quality management (TQM) promises much for service industries yet it has been little used in European healthcare. Of those hospitals and services which have implemented TQM…
Abstract
Total quality management (TQM) promises much for service industries yet it has been little used in European healthcare. Of those hospitals and services which have implemented TQM, few have had great success and many have found difficulties sustaining their programmes. This paper defines TQM in healthcare and considers examples and results of TQM in European healthcare. It distinguishes between team projects using TQM methods and organization‐wide TQM programmes, and finds more evidence for the success of projects than for programmes. The paper discusses whether the differences between healthcare and many other industries explain the mixed results, and considers the prospects for future TQM programmes in European healthcare.
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Adam Fadlalla and Nilmini Wickramasinghe
Currently the healthcare industry in the US is not only contending with relentless pressures to lower costs while maintaining and increasing the quality of service but is also…
Abstract
Currently the healthcare industry in the US is not only contending with relentless pressures to lower costs while maintaining and increasing the quality of service but is also under a stringent timeline to become compliant with the health insurance, portability and accountability act (HIPAA) regulatory requirements. Robust healthcare information systems (HCIS) become critical to enabling healthcare organizations address these challenges. Hence, it becomes an imperative need that the information that is captured, generated and disseminated by these HCIS be of the highest possible integrity and quality as well as compliant with regulatory requirements. This paper addresses this need by proposing an integrative framework for HIPAA compliant, I*IQ HCIS. It bases this framework on an integration of the requirements for HIPAA compliance, the principles of information integrity, as well as the healthcare quality aims set forth by the Committee on the Quality of Healthcare in America.
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Slavica A. Ritonja and Zvonko Hocevar
One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is “healthcare processes…
Abstract
One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is “healthcare processes classification”. The authors found that a typical problem of many European countries is a lack of reliable information in the field of healthcare, mainly because the development of quality instruments, including healthcare processes classification, is not a priority for medical and other health professions. Additionally, it is difficult to update this instrument coherently with organisational changes and developmental achievements. This article describes the approach used by the University Medical Centre in Ljubjana, Slovenia, to redesign its healthcare processes classification in order to improve the quality of healthcare.
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Mohit Datt, Ajay Gupta, Sushendra Kumar Misra and Mahesh Gupta
The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a…
Abstract
Purpose
The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a comprehensive conceptual model for practitioners and researchers.
Design/methodology/approach
This research employs a comprehensive review of available literature by using multiple keywords on different electronic repositories using the recommendations of the PRISMA approach for the selection of articles. A critical analysis of available studies helped in compiling a list of core service quality dimensions in healthcare services.
Findings
This paper presents a comprehensive account of different dimensions and their measurement items used by various researchers to assess service quality in healthcare systems. Most of the researchers have used SERVQUAL model either in its original or modified form while the others have proposed and used totally different dimensions to assess the service quality in healthcare. Many dimensions are just an existing dimension of SERVQUAL that has undergone a name change while others are completely new. The dimensions used by many researchers have items drawn from more than one dimension of SERVQUAL model. The availability of so many dimensions and models adds to the confusion that researchers and practicing managers experience when determining the appropriate model to be used in their work. To mitigate this confusion, there is a need to develop a comprehensive model; the current work is an attempt to meet this need. Through our analysis, we identify four major service quality dimensions: clinical quality, infrastructural quality, relationship and managerial quality and propose a model named CIRMQUAL.
Originality/value
After exploring all available models in the domain of healthcare, this research presents the best possible areas to enhance the quality of healthcare services. It also enhances the research insights for academicians and working professionals by developing and proposing a comprehensive model for measuring healthcare service quality. The proposed model covers almost all of the service quality dimensions used by other researchers and will make the choice of dimensions/model easy for the future researchers/practitioners interested in measuring and improving the quality of services offered by their healthcare units. Such a comprehensive model has not been developed by any researcher thus far.
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Javed Ali, Ahmad Jusoh, Norhalimah Idris and Khalil Md Nor
The current study aims at developing a conceptual framework containing original dimensions of SERVQUAL and adding two modified dimensions: patient safety and medical…
Abstract
Purpose
The current study aims at developing a conceptual framework containing original dimensions of SERVQUAL and adding two modified dimensions: patient safety and medical professionalism in healthcare service quality (HSQ) model.
Design/methodology/approach
An extensive review of HSQ literature pertaining to its dimensions and models with respect to content analysis and bibliometric studies of service quality in healthcare and SERVQUAL in healthcare were performed on 47 relevant studies, 4,689 and 529 documents after applying inclusion and exclusion criteria. Google Scholar and Scopus were the primary sources to find the relevant documents.
Findings
The content analysis was conducted to group HSQ dimensions into seven themes. Co-occurrence analysis of author keywords was performed in VOSviewer to find the links between service quality, SERVQUAL and proposed dimensions. Organization and analysis of different HSQ models and dimensions emerged from the literature result in a comprehensive conceptual framework comprising modified dimensions of healthcare service quality – medical professionalism and patient safety.
Originality/value
SERVQUAL is a widely accepted, tested and validated model in perceiving HSQ from the lenses of patients. But it does not cover the complex nature of healthcare service, thus requiring modification and the addition of new contextual dimensions. Therefore, a comprehensive conceptual framework is developed to validate and test quantitatively.
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Karthik Padamata and Rama Devi Vangapandu
The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between…
Abstract
Purpose
The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between both the groups.
Design/methodology/approach
Authors have referred to the Victorian patient satisfaction monitoring (VPSM) scale and studied the responses of 327 patients and 327 employees collected from six private Indian tertiary care hospitals. SPSS v26 software was used to conduct the data reliability test, descriptive analysis and Mann–Whitney U test.
Findings
Authors have found significant differences in perceptions of quality of care between the patients and employees in the Indian hospitals. Employees have high positive perceptions towards the provided medical care whereas the patients have less favourable perceptions for many quality indicators.
Practical implications
This study findings help the healthcare managers, practitioners and healthcare workers of the Indian hospitals to understand the perceptions of both the employees and the patients towards healthcare quality elements and help to reduce the existing perceptual gap in the process of providing quality healthcare services.
Originality/value
To the best of authors knowledge, this is one of the pioneering studies conducted in Indian healthcare industry to capture and compare the perceptions of both the employees' and the patients' perceptions of various quality of care elements. This study highlighted the existing perceptual gap between the employees and the patients on various healthcare quality elements and indicated the critical areas for improvement to provide high quality healthcare services.
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The aim of this paper is to build a comprehensive conceptual model to understand and measure variables affecting patient satisfaction‐based healthcare quality.
Abstract
Purpose
The aim of this paper is to build a comprehensive conceptual model to understand and measure variables affecting patient satisfaction‐based healthcare quality.
Design/methodology/approach
A total of 24 articles from international journals were systematically reviewed for factors determining patient satisfaction and healthcare quality.
Findings
Patient satisfaction is a multi‐dimensional healthcare construct affected by many variables. Healthcare quality affects patient satisfaction, which in turn influences positive patient behaviours such as loyalty. Patient satisfaction and healthcare service quality, though difficult to measure, can be operationalized using a multi‐disciplinary approach that combines patient inputs as well as expert judgement.
Research limitations/implications
The paper develops a conceptual model that needs to be confirmed empirically. Also, most research pertains to developed countries. Findings are presented that may not be generalized to developing nations, which may be quite different culturally.
Practical implications
The paper has direct implications for health service providers. They are encouraged to regularly monitor healthcare quality and accordingly initiate service delivery improvements to maintain high levels of patient satisfaction.
Originality/value
The paper collates and examines recent healthcare quality study findings. It presents a comprehensive, conceptual model encompassing research work and a holistic view of various aspects affecting patient satisfaction and healthcare quality. Although a large amount of healthcare quality research has been done, each studying a particular service, this paper comprehensively brings together various research findings.
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Asma Shabbir, Shahab Alam Malik and Saquib Yusaf Janjua
The purpose of this paper is to investigate patients’ views toward the perceived service quality of public and private healthcare service providers. Determinants of healthcare…
Abstract
Purpose
The purpose of this paper is to investigate patients’ views toward the perceived service quality of public and private healthcare service providers. Determinants of healthcare service quality were compared by carrying out a GAP analysis to equate perceived and expected services and examined differences in the service quality.
Design/methodology/approach
The study sample comprises 310 inpatients of public and private healthcare service providers. Self-administered questionnaires were used along a five-point Likert scale and analyzed through the Statistical Package for Social Sciences. GAP analysis was used to observe the difference between expectations and perceived service quality.
Findings
A cross-sectional study revealed significant quality gaps between the expected and perceived services of public and private healthcare service providers; conversely patients’ expectations are not fully met in both types of hospitals. Private hospitals surpassed in terms of overall perceived service quality from their counterparts. Perceived services were found better in terms of physician medical services in public sector hospitals, while rooms and housekeeping services were found better in terms of private sector hospitals.
Practical implications
The result can be used by both public and private healthcare service providers to restructure their quality management practices which could only be possible through effective management commitment, regular patients’ feedback and translucent complaint procedures.
Originality/value
The study conceptualizes the expected and perceived hospital service quality dimensions as an eight-dimensional framework. A comparison between public and private sector hospitals is made to get a better understanding about the differences in the perceived healthcare services among two sectors. Consequences of the study will aid hospital managers and policy makers to get a fuller picture of healthcare services in order to contrive enhancement practices.
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Saad Ahmed Javed and Fatima Ilyas
The purpose of this paper is to assess the influence of patients’ expectations from healthcare service quality on their satisfaction with nursing in public and private hospitals of…
Abstract
Purpose
The purpose of this paper is to assess the influence of patients’ expectations from healthcare service quality on their satisfaction with nursing in public and private hospitals of Pakistan.
Design/methodology/approach
Data (n=456) were collected from three public sector hospitals and three private sector hospitals of Lahore, the capital of Pakistan’s most populous province. Male and female patients who have experience of both sectors were surveyed using a self-administered questionnaire developed using the original SERVQUAL approach. Data were analyzed using the statistical techniques and the Laplace criterion.
Findings
This paper attempts to explain degree of influences of five service quality constructs (empathy, responsiveness, tangibility, reliability and assurance) on Pakistani patients’ expectations from the private and public sector hospitals and thus patient satisfaction. Further, this work can offer several intuitions into the effect of five constructs of service quality on patients’ expectations of healthcare service quality and patient satisfaction with the service providers/nursing. The results reveal that the patient satisfaction is most strongly related to empathy in public sector and to responsiveness in private sector.
Research limitations/implications
In light of the previous studies and the current research findings, the study anticipates no apparently significant improvement in healthcare sector of Pakistan in near future considering various factors discussed in the study. The study will also help the service providers and the policy makers in understanding the deteriorating situation of the Pakistani healthcare sector and will guide them in identifying the areas by improving which not only the healthcare service quality in the country can be improved but also the image of healthcare sector among the masses and competitiveness of the healthcare sector can be enhanced.
Originality/value
The value of the study rests in its critical analysis of the current status of the healthcare sector of Pakistan with a view to suggest the areas that need to be worked on by the service providers and policy makers. Also, the study tries to settle a controversy within Pakistani healthcare literature concerning the question that who is producing more satisfied patients: private hospitals or their public counterparts?
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Prachi Verma, Satinder Kumar and Sanjeev K. Sharma
This article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting the total…
Abstract
Purpose
This article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting the total quality of e-healthcare services and its association with consumer satisfaction using a multidimensional hierarchical 5Qs model of e-healthcare service quality.
Design/methodology/approach
Questionnaire-oriented research was performed at three public hospitals of Punjab and Chandigarh. In total, 53 variables were covered in all quality constructs for data collection from the designated public hospitals. The respondents who agreed to have knowledge regarding e-Healthcare services and were availing these services were included in the study. The analysis comprised structural equation modeling technique using AMOS 21.
Findings
The outcomes suggest that the 5Qs model is more comprehensive and can be used to evaluate service quality perceptions using e-Healthcare services. The research identified 11 sub-dimensions for the five quality constructs of the 5Qs model, representing total quality, which is primary to consumer satisfaction. “Overall objectivity” and “technical objectivity” defined the quality of object. The quality of process of e-Healthcare services was characterized by “functionality,” “timeliness” and “responsiveness.” Quality of infrastructure was defined by “technical infrastructure,” “physical infrastructure,” “manpower skills” and “organizational infrastructure.” “Manner of interaction” and “timely interaction” defined the quality of interaction. The atmosphere was represented by only one factor. The results also suggest that quality of infrastructure, quality of interaction and quality of atmosphere play the most significant role in total quality leading to consumer satisfaction.
Research limitations/implications
Theoretical implications: The multidimensional hierarchical model will help the researchers study the e-Healthcare service quality in a more organized manner, and the outcomes of this study can be linked with that of future studies for more generalized application in other public hospitals. The sub-dimensions of each quality construct of the 5Qs model can be applied in private hospitals, and the hierarchical model can be tested in different industries to measure service quality perceptions of the consumer
Practical implications
The outcomes of the study can be applied in various public sector hospitals to redesign the e-Healthcare services based on consumers' perception for better consumer satisfaction and quality services. This paper identifies the role of each quality construct in e-Healthcare services for improvement in the total quality, which in turn will lead to higher satisfaction for the consumers.
Originality/value
In this study, the original 5Qs model has been used for the first time in a new instrument to understand better and design quality e-Healthcare services. The paper explores the sub-factors of each quality construct and its significance in measuring the total quality.
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