Emerald | International Journal of Health Care Quality Assurance | Table of Contents

Measuring patients’ satisfaction with pharmaceutical services at a public hospital in Qatar

literatinetwork@emeraldinsight.com (Imran Fahmi Khudair, Syed Asif Raza) — Fri, 07 Jun 2013 00:00:00 +0100

Abstract

Purpose - The purpose of this article is to present the impact of pharmaceutical services offered at the largest public hospital in Qatar, Hamad General Hospital. A comprehensive structural equation based patients’ satisfaction model composed of five major factors that are regarded to impact patients’ satisfaction is proposed. Design/methodology/approach - A patients’ satisfaction survey is designed considering the literature as well as in consultation with medical experts at Hamad General Hospital. The survey contained 22 items focusing five most influencing factors: services promptness; attitude; supply; location; and medication education for patients’ satisfaction, including demographic aspects of respondents. A total of 220 respondents completed the questionnaire. An exploratory factor analysis is used to group items among aforementioned five factors. In addition, this research uses structural equation model to test causality between the five factors along with their influence onto the patients’ satisfaction.Findings - The causality tests establish statistical evidences that the patients’ satisfaction is positively influenced by services’ promptness, pharmacists’ attitude, medication counseling, physical location and comfort at the pharmacy waiting area. A number of socio-demographic characteristics are noticed to have statistical evidences of different perceived satisfaction with regards to gender, marital status, health status, age, educational level, and monthly income. More importantly, the supply of medication weekly influences the patients’ satisfaction. Originality/value - The proposed model has been found to capture attributes that characterize the impact of pharmaceutical services in health care quality in a developing country. Also, it can be used to evaluate other healthcare services from patients’ viewpoint. The study highlights the importance of pharmaceutical services in healthcare quality.

Teamwork, Organizational Learning, Patient Safety and Job Outcomes

Fri, 07 Jun 2013 00:00:00 +0100

Abstract

Purpose - This article aims to encourage healthcare administrators to consider the learning organization concept and foster collaborative learning among teams in their attempt to improve patient safety. Design/methodology/approach - Relevant health care, organizational behaviour and human resource management literature were reviewed. Findings - A patient safety culture that is fostered by health care leaders should include an organizational culture that encourages collaborative learning, replaces the culture of blame, prioritizes patient safety and rewards individuals who identify serious mistakes. Research limitations/implications - This research is limited to a literature review. The unique socio-political conditions assumed in the various studies may limit the interpretive value. Extant organizational behaviour and human resource management research can complement the current patient safety research. Practical implications - As healthcare institution staff are being asked to deliver more complex medical services with less available resources, there is a need to understand how hospitals can learn from other organizational settings, especially from the non-healthcare sectors. Originality/value - Suggestions for improving patient safety are drawn from health as well as the business literature.

Experienced and Potential Medical Tourists’ Service Quality Expectations

Fri, 07 Jun 2013 00:00:00 +0100

Abstract

Purpose - The research aimed to compare experienced and potential US medical tourists’ foreign healthcare facility service-quality expectations.Design/methodology/approach - Data were collected via an online survey of 1588 US consumers engaging in medical tourism or expressing an interest in doing so. The sample included 219 experienced and 1369 potential medical tourists. Respondents completed a SERVQUAL questionnaire. Mann-Whitney U-tests were used to determine whether there were significant differences between experienced and potential US medical tourists’ service-quality expectations.Findings - For all five service-quality dimensions (tangibles, reliability, responsiveness, assurance, and empathy) experienced medical tourists had significantly lower expectations than potential medical tourists. Experienced medical tourists also had significantly lower service-quality expectations than potential medical tourists for eleven individual SERVQUAL items.Practical implications - Results suggest using experience level to segment medical tourists. The study also has implications for managing medical tourists’ service quality expectations at the point of service delivery as well as via external marketing communications. Originality/value - Managing medical tourists’ service quality expectations is important since expectations can significantly influence choice processes, their experience and post-consumption behavior. This research is the first study to compare experienced and potential US medical tourists’ service-quality expectations. The study establishes a foundation for future service-quality expectations research in the rapidly growing medical tourism industry.

Co-Worker Characteristics and Nurses' Safety Climate Perceptions

Fri, 07 Jun 2013 00:00:00 +0100

Abstract

Purpose - Previous research indicates that nurses’ perception of safety-climate is influenced by individual nurse characteristics, available leadership, staffing levels and workplace structure. No literature was identified that explored the relationship between nurse perception of safety climate and staffing composition on a particular hospital unit. Design/methodology/approach - Data from a survey of 430 registered nurses working in two Midwestern United States hospitals were analyzed to the influence of unit level staff composition on perception of safety-climate. Staff compositon was measured by co-worker education, licensure, experience and full or part time status. Findings - Registered nurses working in hospital units with proportionally more-experienced nurses perceived their workplaces to be significantly safer for patients. Surprisingly, co-worker licensure, education and full or part-time status did not significantly influence nurses’ perception of unit safety climate. Research limitations/implications - Our analysis was limited by the use of cross-sectional data collected from a sample of Registered nurses working within close geographic proximity. Events or policies affecting this region during the time period of data collection may have influenced results.Practical implications - Findings indicate that safety-climate perceptions vary significantly between hospital units and experienced nurses may act as a resource that promotes a positive safety climate. Hospitals retaining experienced nurses may potentially reduce errors.Originality/value - Our results highlight the importance of providing nurses with environments that encourage retention and creating workplaces where experienced nurses’ skills are best utilized.

A Decision Support Model for Prescribing Internal Cardiac Defibrillators

Fri, 07 Jun 2013 00:00:00 +0100

Abstract

Purpose - Purpose: Automatic internal cardiac defibrillators have various indications for placement. However, some patients may not fully benefit from this technology and the devices are expensive. A development model for clinical decision support to help providers offer their patients a more effective decision-making process is decsribed.Design/methodology/approach - Method: The methods involved forming decision tree support tools for implantating intracardiac debfibrillators. A decision tree was built based on previous trials in the cardiac literature.Findings - Findings: A decision-making model for implanting these expensive but lifesaving devices is developed and a model for testing them (pre- and post-implantation) is described.Research limitations/implications - Research Limitations: This is a case report. No model is tested for prospective outcomes. Practical implications - Practical Implications: This model could be used to develop prospective trials. Originality/value - Value: The goal is to potentially lead to better quality and cost-effective care.

Improvements of postnatal care are required by Swedish fathers

Fri, 07 Jun 2013 00:00:00 +0100

Abstract

Purpose - To explore fathers’ postnatal care quality experiences with a specific focus on deficiencies. A second aim was to investigate which deficiencies remained important for fathers one year after childbirth.Design/methodology/approach - Prospective longitudinal study. Two months and one year after birth, the overall satisfaction with care were sought. A quality of care index was created, based on perceived reality and subjective importance of the care given.Findings - 827 fathers answered the questionnaire two months after birth and 655 returned the follow-up questionnaire after one year; 21% were dissatisfied with overall postnatal care. The most important dissatisfying factors were the way fathers were treated by staff and the woman’s check-up/medical care. Two months after the birth, information given about the baby’s care and needs were most deficient when they had been cared for in a hotel ward. Furthermore, information about the baby’s needs and woman’s check-up/medical care was most deficient when fathers had participated in emergency Caesarean section. Research limitations/implications - The study excluded fathers not mastering Swedish. The exact number of eligible fathers was consequently not known, therefore the pregnant women served as an estimate.Practical implications - Most fathers were satisfied with the overall postnatal care, but how fathers are treated by caregivers; the woman’s check-ups/medical care and information given about the baby’s care and needs can be improved. Professionals should view early parenthood as a joint project and support both parents’ needs.Originality/value - Knowledge about postnatal service quality including fathers’ needs.

Service quality in healthcare institutions: establishing the gaps for policy action

literatinetwork@emeraldinsight.com (Roger Ayimbillah Atinga) — Fri, 07 Jun 2013 00:00:00 +0100

Abstract

Purpose - Purpose – The study sought to examine two key issues. The first is to assess patient’s perception and expectation of hospital service quality using the SERVQUAL model. Secondly, to outline the number of distinct concepts used to assess patient perception of healthcare quality. Design/methodology/approach - Design/methodology/approach – Questionnaires were administered to a sample of 250 patients on admission or follow-up visits. The 22 paired items of expectation and perception captured in the SERVQUAL was adopted. Repeated t-measures and principal component factor analysis with varimax rotation were used to analyse data. Findings - Findings – The result showed that patient expectations were not being met during the treatment process. Perceived service quality was rated lower than expectations for all the variables. The mean difference between perception and expectation was statistically significant. Contrary to the five factor model of SERVQUAL, this study identified four factors of patient’s perception of service quality.Research limitations/implications - Limitations – The study’s scope is narrow, only one administrative region and five hospitals. Future researches should consider expanding the scope to better understand patients’ service-quality perception and expectation. Practical implications - Practical implications – The findings have practical implications for hospital manages. Health managers should consider stepping up staffing levels backed by client centred training programmes to enable clinicians deliver care to patients’ expectations. Originality/value - Originality/Value – Limited studies are tailored towards patients’ service-quality perception and expectation in Ghanaian hospitals. The findings therefore provide valuable information for policy and practice.