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1 – 10 of over 6000Avichai Shuv-Ami and Tamar Shalom
Service quality and patient satisfaction have a significant impact in healthcare. Health organizations have also begun to put the customer at the center and meet his or her needs…
Abstract
Purpose
Service quality and patient satisfaction have a significant impact in healthcare. Health organizations have also begun to put the customer at the center and meet his or her needs. This study aims to indicate the need to develop a simple and appropriate scale for measuring quality of service in hospital emergency rooms.
Design/methodology/approach
The validity and reliability of the scale were established by three separated and independent studies that used exploratory factor analysis, confirmatory factor analysis and correlation analysis to test the nomological network validity of the scale. The data was collected randomly from an internet panel that comprises more than 50,000 people over the age of 18. The research is based on 1,002 Israelis who accompanied a patient to a hospital emergency room.
Findings
In total, 23 items comprised the new scale of emergency room service quality with three dimensions: “staff professionalism”, “staff caring” and “tangibles”. The internal reliability for the total scale was high with Cronbach's α of 0.97.
Research limitations/implications
In Israel, there is a state health system, and therefore, it is necessary to check the scale elsewhere in the world.
Originality/value
The measurement of service quality for emergency room needed to be focused on the unique charters of the service provided in hospitals’ emergency room. The findings show that a client may assesses the service their loved one has received to decides whether to return to the same hospital and recommend it to his or her friends.
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Pasquale Caponnetto, Rosanna Magro, Lucio Inguscio and Maria Concetta Cannella
Emergency room have particularly stressful work situations. Emergency room personnel cope with stressors on a daily basis. These stressors can be risks factor for burn out and for…
Abstract
Emergency room have particularly stressful work situations. Emergency room personnel cope with stressors on a daily basis. These stressors can be risks factor for burn out and for reduced quality of life and work motivation. Emergency room staff of one of ASP 3 CT urban hospital in Acireale, Italy participated to stress management program by autogenic training twice a month for 16 weeks. This program were prepared based on existing research and studies, and were conducted by clinical psychologists. We found that the mean value in pre-test is significantly different from mean value in post-test for: Perceived Stress Scale PPS (t=7.72 with 27 df and P<0.001); Euro Quality for life (t=-14,13 with 27 df and P<0.001); Work motivation assessed by Visual Analogue scale VAS (t=-4.52 with 27 df and P<0.001). In the Maslach Burnout Inventory, the mean value is significantly different for emotional exhaustion sub-scale (t=5.64 with 27 with 27 df and P<0.001) and for depersonalization subscale (t=6.67 with 27 df and P<0.001). No significant difference was observed for the personal accomplishment sub-scale. This research suggests that psychological interventions with emergency room staff are effective. Our study showed effectiveness of an auto-genic and stress management training in improvement of quality of life, work motivation, burn-out and stress perceptions for emergency department team.
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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.
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Patricia Khokher, Ivy Lynn Bourgeault and Ivan Sainsaulieu
This paper sets out to explore health professionals' views and experiences regarding the work culture that exists in their hospital units, and further how patients influence these…
Abstract
Purpose
This paper sets out to explore health professionals' views and experiences regarding the work culture that exists in their hospital units, and further how patients influence these experiences.
Design/methodology/approach
The paper employs a qualitative approach involving individual interviews with 60 health professionals in Canada employed in what is conceptualised as “open” (emergency room and maternity care) and “closed” (intensive care, head and neck surgery) units.
Findings
The paper finds that the influence of the hospital unit outweighs the influence of professional boundaries but for some groups more than for others. Health professionals in more open units tend to be less satisfied with their work, have more difficult relations with patients, and experience tensions with co‐workers and management. Those in closed units tend to be more satisfied with their work, have relatively better relations with patients and co‐workers, and tend to have more cooperative relations with management. The different structural conditions of work in open and closed units are also clearly important.
Research limitations/implications
The sample for the study was self‐selected from one hospital, which may limit the generalisability of some of the findings.
Practical implications
The insights garnered from the study may help professionals and managers to develop unit‐specific policies to create a more positive workplace culture.
Originality/value
There is a growing body of research on professional culture and oganisational culture that often does not clearly delineate how the two exist concurrently. The paper explicitly investigates this issue by examining work culture across various health professional groups and also across hospital units, and further how patients figure in these experiences.
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Avichai Shuv-Ami and Tamar Shalom
The purpose of this paper is to test three visual, demographically based perceptions of service quality at several emergency rooms (ERs) of hospital organizations in Israel.
Abstract
Purpose
The purpose of this paper is to test three visual, demographically based perceptions of service quality at several emergency rooms (ERs) of hospital organizations in Israel.
Design/methodology/approach
This research is based on the evaluations of 1,002 people who accompanied a patient to hospital ERs in Israel. The data were collected randomly from an internet panel that comprised more than 50,000 people aged over 18 years.
Findings
The findings showed that female patients were perceived as receiving significantly lower service quality than males; elderly patients were treated well by medical staff, and treatment was similar to all other adult groups; children were perceived as receiving the best service; and religious individuals perceived service quality in ERs at a higher level than non-religious patients.
Research limitations/implications
The current study uses a service quality scale derived from a marketing scale that was modified to study the quality of service in hospital ERs. The current study measures only differences in visual demographics.
Originality/value
This paper attempts to provide the ER staff of hospital organizations with some knowledge about the ways which their service is perceived and encourages a more sensitive attitude toward their patients’ needs. This may influence the hospital customer satisfaction and the hospital financial bottom-line.
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Charles M. Carson and Jennings B. Marshall
Dr. Lawrence Frazier was an emergency room physician who was an employee of Honore Staffing Services of Baton Rouge, Louisiana. He worked at Methodist Health System hospital in…
Abstract
Dr. Lawrence Frazier was an emergency room physician who was an employee of Honore Staffing Services of Baton Rouge, Louisiana. He worked at Methodist Health System hospital in Grant, Georgia. He had recently added the title of ER Medical Director and served as liaison between Honore staffing and the Methodist hospital. His additional duties included overseeing the other physicians which staff the emergency room. Methodist had a bonus system in place based on obtaining 31 patients’ satisfaction surveys each month. Dr. Frazier believed that the small sample lead to erroneous results and created problems for the physicians under his supervision. He wanted to change the data collection process (e.g. sample size collected, instrument), but encountered obstacles when he broached the subject with his hospital administrators.
Jared Reynolds, Zhen Zeng, Jingshan Li and Shu‐Yin Chiang
Improving quality of care is important in health care management. For health care clinics, reducing patient waiting time and improving throughput with efficient utilization of the…
Abstract
Purpose
Improving quality of care is important in health care management. For health care clinics, reducing patient waiting time and improving throughput with efficient utilization of the workforce are important issues to achieve better quality of care. This paper seeks to introduce a simulation study on design and analysis of a health clinic for homeless patients in Lexington, Kentucky, USA.
Design/methodology/approach
Using the simulation model, the patient flow of the clinic and analyze quality of care for different staffing levels is simulated. In addition, the dependence of distributions on service times is investigated. Moreover, the impact of service time variability on quality of care (e.g. patient waiting time) is analyzed.
Findings
The necessary staffing level and utilizations to reduce patient waiting times and improve throughput to achieve better quality of care are obtained. In addition, it is shown that the system performance is primarily dependent on the mean and coefficients of variation, rather than a complete distribution, of service times. In addition, a piece‐wise linear approximation formula is proposed so that patient waiting time in the clinic can be estimated for any variability with only two simulations.
Research limitations/implications
The simulation method may need long model development time and long simulation executing time for complex systems.
Practical implications
The quality of care delivery in a health care clinic can be evaluated using simulations. The results presented in the paper provide an easier approach for medical practitioners to evaluate different scenarios, examine needed resources, and carry out what‐if analysis to predict the impact of any changes in the system, to determine an optimal system configuration.
Originality/value
The paper shows that such models provide a quantitative tool for clinic operations and management to achieve better care quality. Moreover, it can be easily adapted to model other health care facilities, such as hospitals, emergency rooms, operating rooms, supply chain in health care industry.
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Christian Huber, Nadine Gerhardt and Jacob T. Reilley
The purpose of this study is to provide insight into the roles of accounting in the management of the coronavirus (COVID-19) pandemic in five German hospitals.
Abstract
Purpose
The purpose of this study is to provide insight into the roles of accounting in the management of the coronavirus (COVID-19) pandemic in five German hospitals.
Design/methodology/approach
The authors conducted three rounds of interviews, ethnographic observations of meetings and document analyses in five German hospitals between February and August 2020.
Findings
The authors found that actors repeatedly used a central set of indicators (the number of beds for COVID-19 patients) when adapting a healthcare infrastructure to the pandemic. Accounting figures allowed actors to problematize prior configurations, organize processes to make uncertainty plannable and virtualize changes to resume treating non-COVID-19 patients.
Practical implications
The authors offer suggestions about scenario planning and interorganizational learning which have implications for healthcare practitioners.
Originality/value
The authors contribute to the accounting in crisis literature by adding an organization-focused study. Adding nuance to key themes in the literature, they show how the organizations and the field level interact and how organizing locally preceded economizing. They also offer a nonbinary answer to the question of whether or not changes revert back to “normal” after a crisis event.
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Sandra C. Buttigieg, Wilfried von Eiff, Patrick Farrugia and Maximilian C. von Eiff
Point-of-care testing (POCT) at the Emergency Department (ED) attains better objectives in patient care while aiming to achieve early diagnosis for faster medical decision-making…
Abstract
Purpose
Point-of-care testing (POCT) at the Emergency Department (ED) attains better objectives in patient care while aiming to achieve early diagnosis for faster medical decision-making. This study assesses and compares the benefits of POCT in the ED in Germany and Malta, while considering differences in their health systems.
Methodology/approach
This chapter utilizes multiple case study approach using Six Sigma. The German case study assesses the use of POCT in acute coronary syndrome patients, compared to the central lab setting. The Maltese case study is a pilot study of the use of medical ultrasonography as a POCT to detect abdominal free fluid in post-blunt trauma.
Findings
This study provides clear examples of the effectiveness of POCT in life-threatening conditions, as compared to the use of traditional central lab or the medical imaging department. Therapeutic quality in the ED and patient outcomes directly depend upon turnaround time, particularly for life-threatening conditions. Faster turnaround time not only saves lives but reduces morbidity, which in the long-term is a critical cost driver for hospitals.
Originality/value
The application of Six Sigma and the international comparison of POCT as best practice for life-threatening conditions in the ED.
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Rimantas Stašys, Gintautas Virketis and Daiva Labanauskaitė
The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient…
Abstract
Purpose
The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient transfers. Scientific research and statistical data show the increased number of interhospital transportation services; therefore, timely and qualified patient transportation between different health-care institutions must be considered, the activity that directly and significantly impacts the patient’s health status and overall quality of the health-care services. The successful patient transportation from the smaller hospitals to the health-care institutions with advanced intensive care or urgent care units can be enhanced through the partnership between private and public health-care institutions.
Design/methodology/approach
The methodology included quantitative method, statistical data analysis and theoretical data generalization. Both primary and secondary data were collected and analyzed during the research. Expert quantification was performed using the survey research method. The survey was conducted in Lithuania. The respondents were selected to be the general managers of the health-care and urgent care institutions, the chief doctors of the reanimation and intensive care department also the chief doctors of the emergency department.
Findings
Because of the centralization and regionalization of health-care services, the number of patients transferred between hospitals by the emergency medical services (EMS) and personal health-care institutions has increased. University hospitals are not sufficiently prepared to accept an increasing flow of patients in accordance with the Ministry of Health orders. Not all regional or district hospitals have the right to provide such assistance, which increases transportation time and costs as well as requires additional human resources. The five EMS categories could be used to improve the patient transfer between different levels of health-care institutions. To increase partnership between private and public health-care organizations, incentives should be provided for the development of private health-care organizations, as well as encouraging actions should be taken to increase the demand for private health-care services by Lithuanian patients.
Practical implications
Five EMS categories identified in this paper could be used to ensure a smooth mechanism for the patient transfer between different levels of the personal health-care institutions. The proposed categories should also be used in the pre-stationary emergency phase (for reducing the interhospital patient transportation amount).
Social implications
Properly organized secondary and tertiary interhospital patient transfers influence the availability and quality of the EMS and reduce inequalities in the provided services and social exclusion.
Originality/value
This paper presents the classification of the interhospital transfer issues, determines the main reasons for the patient interhospital transfer, creates the model for the EMS patient process flows and defines five EMS categories for the assessment of patient conditions. Therefore, the research conducted and the results obtained have both theoretical and social-practical value.
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