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Article

Karin Newman and Tanya Pyne

Presents the results of an empirical study of junior doctors’ views on quality and clinical audit in health care. Claims that the requirement for annual efficiency gains…

Abstract

Presents the results of an empirical study of junior doctors’ views on quality and clinical audit in health care. Claims that the requirement for annual efficiency gains and rising patient expectations, together with the realization that the “costs of quality” can consume between 30 and 50 per cent of costs, has brought quality in health care to the forefront. In this context, and because much of the medical care is delivered by junior doctors, studies their perceptions on dimensions of quality in health care, their knowledge of, and participation in, clinical audit and the obstacles to providing quality care. Makes a striking finding ‐ the low priority given to patient satisfaction ‐ a perspective which is out of alignment with the priorities of government policy, and the whole philosophy ofquality in service”. Asserts that the role, significance and outcome of clinical audit as a quality improvement tool is cast into doubt by these consultants of tomorrow.

Details

Journal of Management in Medicine, vol. 10 no. 4
Type: Research Article
ISSN: 0268-9235

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Article

Albert Puni and Sam Kris Hilton

The purpose of this study is to investigate the causal relationships between the dimensions of authentic leadership and patient care quality in the nursing profession of Ghana.

Abstract

Purpose

The purpose of this study is to investigate the causal relationships between the dimensions of authentic leadership and patient care quality in the nursing profession of Ghana.

Design/methodology/approach

The study used explanatory and cross-sectional survey designs. The data were obtained from 400 respondents, consisting of 200 nurses and 200 patients in selected general hospitals. The analysis was done using descriptive statistics, correlation and multi-linear regression techniques.

Findings

The study found that all four dimensions of authentic leadership, namely, self-awareness, internalized moral perspective, balanced processing and relational transparency positively correlated with patient care quality, however, only internalized moral perspective and self-awareness have positive significant association with patient care quality and internalized moral perspective being the highest predictor. Thus, the results suggest that authentic leadership can positively predict patient care quality.

Practical implications

The study contributes to the understanding of how dimensions of authentic leadership practices affect patient care quality. This understanding is relevant to academics in general and Ghanaian policymakers in particular.

Originality/value

The research makes a significant contribution to the existing authentic leadership literature by establishing that the dimensions of authentic leadership predict patient care quality with an internalized moral perspective being the highest predictor followed by self-awareness. Furthermore, the authors anticipate that the outcomes of this research, which so far is the first study in the Ghanaian context, can significantly shape nursing leadership discourse, practices and policies in Ghana and in other developing countries to improve patient care quality.

Details

Leadership in Health Services, vol. 33 no. 4
Type: Research Article
ISSN: 1751-1879

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Article

Susan Brandis, Stephanie Schleimer and John Rice

Creating a culture of patient safety and developing a skilled workforce are major challenges for health managers. However, there is limited information to guide managers…

Abstract

Purpose

Creating a culture of patient safety and developing a skilled workforce are major challenges for health managers. However, there is limited information to guide managers as to how patient safety culture can be improved. The purpose of this paper is to explore the concept of reflexivity and develop a model for magnifying the effect of patient safety culture and demonstrating a link to improved perceptions of quality of care.

Design/methodology/approach

This research employed a correlational case study design with empirical hypothesis testing of quantitative scores derived from validated survey items. Staff perceptions of patient safety, reflexivity and quality of patient care were obtained via a survey in 2015 and analysed using inferential statistics. The final sample included 227 health service staff from clinical and non-clinical designations working in a large Australian tertiary hospital and health service delivering acute and sub-acute health care.

Findings

Both patient safety culture and reflexivity are positively correlated with perceived quality of patient care at the p<0.01 level. The moderating role of reflexivity on the relationship between patient safety culture and quality of care outcomes was significant and positive at the p<0.005 level.

Practical implications

Improving reflexivity in a health workforce positively moderates the effect of patient safety culture on perceptions of patient quality of care. The role of reflexivity therefore has implications for future pre-professional curriculum content and post-graduate licencing and registration requirements.

Originality/value

Much has been published on reflection. This paper considers the role of reflexivity, a much less understood but equally important construct in the field of patient safety.

Details

Journal of Health Organization and Management, vol. 33 no. 5
Type: Research Article
ISSN: 1477-7266

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Article

T.C.E. Cheng

Presents a case study of hospital quality assurance in a regional hospital in Winnipeg, Manitoba. The focus is on the quality monitoring method used in the hospital. While…

Abstract

Presents a case study of hospital quality assurance in a regional hospital in Winnipeg, Manitoba. The focus is on the quality monitoring method used in the hospital. While the quality monitoring method may not be perfect, it does serve as a basis for evaluating the standard of care and ensuring that the full benefits of medical knowledge are being applied effectively to the needs of patients. It also allows for the recognition of problems so that remedial action can be taken to improve the level of care provided.

Details

International Journal of Quality & Reliability Management, vol. 9 no. 4
Type: Research Article
ISSN: 0265-671X

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Article

Karin Newman, Uvanney Maylor and Bal Chansarkar

This paper proposes an integrated approach to examining and dealing with the complex issue of nurse recruitment, retention, healthcare quality and patient satisfaction…

Abstract

This paper proposes an integrated approach to examining and dealing with the complex issue of nurse recruitment, retention, healthcare quality and patient satisfaction. The paper depicts and describes a generic conceptual framework or chain derived from a review of the literature on nurse recruitment and retention, service quality and human resource management. The chain is made up of the following components: NHS and Trust conditions and environment (internal quality) –service capability – nurse satisfaction –nurse retention – quality of patient carepatient satisfaction. The value of the chain is derived from its synthesis and display of the prime constituents or drivers of nurse satisfaction, quality of patient care and satisfaction. From this holistic picture it is possible for both national and local initiatives to be integrated in a mutually reinforcing way in order to achieve improvements in nurse recruitment, retention, quality of care and patient satisfaction.

Details

International Journal of Health Care Quality Assurance, vol. 14 no. 2
Type: Research Article
ISSN: 0952-6862

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Article

Agneta Schröder, Bodil Wilde Larsson and Gerd Ahlström

The principal aim of this paper is to develop an instrument to measure quality of care in the psychiatric setting from an in‐patient perspective and to describe quality of

Abstract

Purpose

The principal aim of this paper is to develop an instrument to measure quality of care in the psychiatric setting from an in‐patient perspective and to describe quality of care by means of this instrument. A further aim is to investigate the influence of background variables and expectations on the experience of care.

Design/methodology/approach

The instrument “Quality in psychiatric care” consists of two parts: one for measuring the patient's expectations regarding quality of care, the other for measuring his or her experiences regarding it. The instrument was derived from an earlier interview study of patients' perceptions of the quality of psychiatric care. A sample of 116 patients from eight in‐patient wards in Sweden participated in the present study.

Findings

Results indicate a generally high quality of care. Experienced quality of care was significantly lower, however, than expectations in all the dimensions of the instrument: total dimension, dignity, security, participation, recovery and environment. Patients who perceived that the time of discharge was consistent with the stage of their illness experienced significantly higher Recovery; patients with good psychiatric health experienced this too, but also significantly higher participation.

Research limitations/implications

This new instrument needs to be further tested before the psychometric properties can be established.

Originality/value

The value of the research is that instruments for measuring the quality of in‐patient psychiatric care from the patient's perspective and with a theoretical foundation are less common.

Details

International Journal of Health Care Quality Assurance, vol. 20 no. 2
Type: Research Article
ISSN: 0952-6862

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Article

Risha Fayyaz, Fasih Ali Ahmed, Adeel Abid, Afshan Akhtar, Rabail Jarwar, Anila Jasmine, Sameer Ahmad Khan, Shahira Shahid, Iraj Khan, Aneeq Muhammad Yousuf and Imtiaz Jehan

This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and…

Abstract

Purpose

This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to identify domains where improvement is needed.

Design/methodology/approach

This is a cross-sectional study carried out at two tertiary care hospitals of Karachi, Pakistan, belonging to private and public sector, respectively, between February and April 2018. Face-to-face interviews were conducted using a modified questionnaire having five-point Likert scale questions regarding satisfaction of patients with doctors, nursing staff, information provided and the hospital standards. SPSS 20 was used for statistical analysis, and the results were expressed using mean, frequencies, percentages and p-values.

Findings

The authors approached 415 patients, out of which 389 patients agreed to participate in the study. For both hospitals, the lowest mean scores were for sections pertaining to satisfaction with psychosocial support and information provided. The mean satisfaction score of patients from the private hospital were found to be significantly higher as compared to patients from the public hospital for all domains of patient care (p-value < 0.01 using t-test for two independent samples). The data showed an increasing trend of “satisfied” responses as the household income increased.

Research limitations/implications

A comparative study should be conducted with the aim of pinpointing the differences in areas in which there is a significant difference in positive satisfaction levels between private and public sectors. Similar research could also be expanded adding other variables that affect quality of care such as doctor's approach to their patients, time given during each consultation and patient's understanding of doctor's knowledge. Further studies can be done to bridge the gaps between what a doctor views as standard care and what the patient knows will help them receive a more holistic approach to care.

Practical implications

Assessing the quality of care helps determine gaps in care and allocating health resources accordingly. In clinical practice, emphasis needs to be given on increased duration and improved quality of patient counselling to improve the low satisfaction levels of patients regarding the psychosocial support. Addressing patients' concerns should be made part of clinical teaching from an undergraduate level. As far as patient access to doctors of the specific speciality is concerned, hospital managements should adopt systems to ensure continuum of care and come up with mechanisms to bridge the discrepancy between a patient's needs and doctor availability.

Social implications

After being identified as a major deficiency, training doctors in the sensitivities of the population and demographics, especially with respect to socio-economic statuses, can aid in enhancing patient satisfaction to the treatment. Implementation of patient-centred care leads to greater satisfaction with care, which, in turn, increases a patient's self efficacy in managing important aspects of their care and improves health care-related quality of life.

Originality/value

Cancer patients have long-term exposure to the hospital environment. A patient's satisfaction with the quality of care is an important determinant in patient compliance to the treatment protocol and required hospital visits. There is a dearth of research on the outpatient quality of care in the oncology departments in Karachi. This study provides an overview of the quality of care available to cancer patients in Karachi both in public and private sectors. The results of our study identify the gaps in the quality of care being provided to the patients in a developing country like Pakistan, which can be used to improve the quality of care, leading to better patient outcomes.

Details

International Journal of Health Care Quality Assurance, vol. 34 no. 1
Type: Research Article
ISSN: 0952-6862

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Article

E. Joseph Torres and Kristina L. Guo

This paper describes several approaches for implementing quality improvement initiatives to improve patient satisfaction, which enables health‐care organizations to…

Abstract

This paper describes several approaches for implementing quality improvement initiatives to improve patient satisfaction, which enables health‐care organizations to position themselves for success in today's global and increasingly competitive environment. Specifically, measuring the views of patients, improving patient satisfaction through a community‐wide effort, and using a Six Sigma program are discussed. Each of these programs can be an effective mechanism for quality improvement. A key component to quality improvement techniques involves collaborative efforts by all health‐care professionals and managers as they seek to increase patient satisfaction.

Details

International Journal of Health Care Quality Assurance, vol. 17 no. 6
Type: Research Article
ISSN: 0952-6862

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Article

Aaron Asibi Abuosi

The purpose of this paper is to find out whether there are any significant gaps in perceptions of quality of care between patients and healthcare providers in Ghana’s…

Abstract

Purpose

The purpose of this paper is to find out whether there are any significant gaps in perceptions of quality of care between patients and healthcare providers in Ghana’s hospitals.

Design/methodology/approach

A cross-sectional survey of patients seeking outpatient consultations in 17 general hospitals in Ghana was conducted. A total of 818 patients and 152 hospital managers were interviewed. A 22-item quality of care scale was used in data collection. Data were analysed with the aid SPSS version 20. Summary statistics and t-test were used to analyse the data.

Findings

There was a significant difference in the overall perception of quality of care between patients and healthcare providers (Patients: M=89.11, SD=11.457; Providers: M=94.60, SD=10.922; t (845) −4.956, p < 001, two-tailed). Also, 18 items out of the 22-item quality of care scale showed significant difference between patients and providers. However, levels of quality of care is generally rated fairly favourably by both category of respondents.

Research limitations/implications

Further study is required to explore the reasons for the perceived quality gaps between patients and healthcare providers.

Practical implications

Management of hospitals need to evaluate patients’ perceptions of quality of care to inform measures aimed at improving quality of care, since what they may consider as good quality service may be rated less favourably by patients.

Originality/value

Comparing perceptions of quality between patients and healthcare providers is important in order adopt measures to address any differences in perceptions of quality between the two stakeholders. To the best of the author’s knowledge no study has been conducted in Ghana to that effect.

Details

Clinical Governance: An International Journal, vol. 20 no. 4
Type: Research Article
ISSN: 1477-7274

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Article

Ashley Jill Shepherd, Julie Cowie and Michelle Beattie

The purpose of this paper is to determine the relative influence of the different domains of healthcare quality from the Care Experience Feedback Improvement Tool (CEFIT…

Abstract

Purpose

The purpose of this paper is to determine the relative influence of the different domains of healthcare quality from the Care Experience Feedback Improvement Tool (CEFIT) and identify key predictors of healthcare quality from the patients’ perspective. Measurement is necessary to determine whether the quality of healthcare is improving. The CEFIT was developed as a brief measure of patient experience. It is important to determine the relative influence of the different domains of healthcare quality to further clarify how the CEFIT can be used and identify key predictors of healthcare quality from the patients’ perspective.

Design/methodology/approach

In sum, 802 people with a healthcare experience during the previous 12 months were telephoned to complete the CEFIT questions and an additional 11-point global rating of patient experience. To estimate the influence of different domains of healthcare quality on patient overall ratings of quality of healthcare experience, the authors regressed the overall rating of patient experience with each component of quality (safety, effectiveness, timely, caring, enables system navigation and person-centred).

Findings

The authors found that all of the domains of the CEFIT influenced patient experience ratings of healthcare quality. Specifically, results show the degree of influence, the impact of demographics and how high scores for overall rating of patient experience can be predicted.

Originality/value

The findings suggest that all of the CEFIT domains are important in terms of capturing the wholeness of the patient experience of healthcare quality to direct local quality improvement.

Details

International Journal of Health Care Quality Assurance, vol. 32 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

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