INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE最新文献

{"title":"Calibration compliance and risk-based maintenance: perceptions and practices of healthcare equipment users on patient safety.","authors":"Fathimath C Nishwa, Niyaz Panakaje, Shafeena Abdul Jabbar, S M Riha Parvin","doi":"10.1108/IJHCQA-07-2025-0096","DOIUrl":"https://doi.org/10.1108/IJHCQA-07-2025-0096","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the influence of perceived calibration compliance (PCC) and risk-based maintenance (RBM) attitudes on perceived patient safety outcomes (PSO) among biomedical technicians and equipment operators. It further explores the mediating role of equipment accuracy (EA) and the moderating role of risk category awareness (RCA).</p><p><strong>Design/methodology/approach: </strong>A structured questionnaire was used to collect responses from 415 biomedical staff across three NABH-accredited private hospitals in Kerala, using stratified purposive sampling. Data were analyzed using SPSS 26.0 for descriptive statistics and Smarts 4.0 for structural equation modeling, including path analysis, mediation and moderation testing.</p><p><strong>Findings: </strong>Both PCC and RBM showed a significant positive impact on PSO. EA was found to mediate these relationships, indicating that calibration and maintenance practices contribute to safety through their effect on equipment performance. RCA was found to moderate the relationships, strengthening the impact of technical practices on safety outcomes when awareness of equipment risk levels was higher.</p><p><strong>Research limitations/implications: </strong>This study was limited to three private hospitals in Kerala, so the findings might not apply to government or smaller healthcare settings. Since the data were collected at one point in time, it doesn't capture changes over time. Also, the responses were self-reported, so there's a chance of bias or overstatement by the participants.</p><p><strong>Practical implications: </strong>The findings emphasize the need for regular calibration training, RBM protocols and staff awareness programs to promote a culture of safety in healthcare environments.</p><p><strong>Originality/value: </strong>The study is novel in its investigation on how technical compliance and staff perception link to patient safety outcomes through equipment accuracy and risk awareness.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-20"},"PeriodicalIF":2.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eight-year longitudinal evaluation of an electronic patient safety reporting system in a public hospital.","authors":"Viviana Rivera, Sandra De la Fuente Gonzalez, Maria Kappes, Brigitte Sievers","doi":"10.1108/IJHCQA-07-2026-0204","DOIUrl":"https://doi.org/10.1108/IJHCQA-07-2026-0204","url":null,"abstract":"<p><strong>Purpose: </strong>This paper aims to evaluate changes in reporting rates and notification timeliness following implementation of an electronic patient safety reporting system in a high-complexity public hospital over eight years.</p><p><strong>Design/methodology/approach: </strong>A quasi-experimental before-after study without a control group analysed all eligible inpatient reports recorded from 2015 to 2022. The pre-implementation period was compared with the post-implementation period. Rates were calculated per 100 discharges and timeliness as notification days. A post hoc temporal sensitivity analysis compared pre-implementation, 2019 (pre-pandemic), 2020-2021 (early pandemic), and 2022 using Poisson rate ratios.</p><p><strong>Findings: </strong>Among 14,017 reports, the rate increased from 3.47 to 13.37 per 100 discharges (RR 3.86, 95% CI 3.70-4.02). It had already reached 7.58 in 2019 (rate ratio 2.19, 95% confidence interval 2.06-2.32 versus pre-implementation), rose to 15.30 during 2020-2021, and remained 15.86 in 2022. Median notification time decreased from 9 to 1 day. The change therefore began before Coronavirus Disease 2019 (COVID-19) and persisted in 2022. The electronic system may have contributed, particularly to notification timeliness, but the design does not support causal attribution.</p><p><strong>Originality/value: </strong>Separating temporal phases shows that the increase preceded COVID-19 and persisted in 2022. The findings are consistent with a possible contribution from electronic implementation, particularly to notification timeliness, while acknowledging that pandemic-related changes, increased safety awareness and previous underreporting may also have influenced reporting volume.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-13"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived service quality and the theory of planned behavior in patients' choice of providers in a dual health system.","authors":"Ana Todorović, Marko Slavković","doi":"10.1108/IJHCQA-05-2026-0136","DOIUrl":"https://doi.org/10.1108/IJHCQA-05-2026-0136","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines psychological mechanisms underlying patients' choice of healthcare providers in a dual health system. Specifically, it applies an extended Theory of Planned Behavior (TPB) model integrating perceived service quality (SERVQUAL) to analyse how attitudes, subjective norms, perceived behavioural control and perceived quality are associated with intention and breadth of provider utilisation across public and private settings.</p><p><strong>Design/methodology/approach: </strong>A cross-sectional survey was conducted among 309 adult healthcare users in Serbia (156 public and 153 private users). TPB constructs and intention were measured across five service types, while utilisation breadth captured the number of service categories used with the current provider. Perceived service quality was assessed using a global SERVQUAL index. Correlations, multiple regressions and exploratory indirect-effect analyses were conducted.</p><p><strong>Findings: </strong>Attitude, subjective norm and perceived behavioural control jointly explained 54% of the variance in intention. Perceived Behavioural Control had the largest coefficient among public users, whereas Attitude and Subjective Norm had the largest coefficients among private users. Intention was weakly associated with utilisation breadth, mainly in the public sector. Exploratory analyses identified indirect associations through perceived quality, particularly for Perceived Behavioural Control and among public-sector users.</p><p><strong>Originality/value: </strong>The study integrates TPB and SERVQUAL-based perceived quality in a comparative analysis of public- and private-sector users within the same dual health system, providing context-specific evidence on predictor patterns and indirect associations.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-16"},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Sustainable hospital accreditation in low- and middle-income countries: lessons for global stakeholders from Sri Lanka's discontinued national program.","authors":"","doi":"10.1108/IJHCQA-09-2026-0270","DOIUrl":"https://doi.org/10.1108/IJHCQA-09-2026-0270","url":null,"abstract":"","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1"},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional exhaustion, job satisfaction and patient safety competency among nurses in Northern Saudi Arabia: a cross-sectional correlational study.","authors":"Khitam Alsaqer, Mashael Alenazy, Ebtisam Abd Elazeem Saber Seleem, Saeed Hussein Alhmoud, Islam Ali Oweidat, Ahmad Rayan","doi":"10.1108/IJHCQA-07-2026-0187","DOIUrl":"https://doi.org/10.1108/IJHCQA-07-2026-0187","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to assess the relationship between emotional exhaustion, job satisfaction and patient safety competency among nurses. While the three variables are linked, their connection in the healthcare setting in Northern Saudi Arabia has received limited attention.</p><p><strong>Design/methodology/approach: </strong>The study employed a quantitative, descriptive, correlational research design involving registered nurses from three government hospitals in Northern Saudi Arabia. Data were collected from participants using standardized questionnaires including the Maslach Burnout Inventory (Emotional Exhaustion subscale), Kuopio University Hospital Job Satisfaction Scale and Patient Safety Competency Nurse Evaluation Scale.</p><p><strong>Findings: </strong>Among 166 nurses, emotional exhaustion was moderate, job satisfaction was moderate and perceived patient safety competency was high. Emotional exhaustion was negatively associated with perceived patient safety competency (r = -0.48, p < 0.001), whereas job satisfaction was positively associated with it (r = 0.52, p < 0.001). In the multivariable analysis, emotional exhaustion (ß = -0.39, p < 0.001) and job satisfaction (ß = 0.34, p < 0.001) were independently associated with perceived patient safety competency. Years of professional experience showed a positive association (ß = 0.18, p = 0.006), whereas weekly working hours showed a negative association (ß = -0.14, p = 0.009). The model explained 46% of the variance in perceived patient safety competency (adjusted R2 = 0.43).</p><p><strong>Originality/value: </strong>The findings indicate that nurses' emotional exhaustion and job satisfaction are associated with their patient safety competency in the participating governmental hospitals in Northern Saudi Arabia. This suggests that nurses' psychological well-being and experiences within the workplace are relevant to their ability to maintain safe patient care practices.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-22"},"PeriodicalIF":2.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A practical model for improving first-case on-time starts performance.","authors":"Kristina Mitreska, Phong Tran, Richard Grygiel, Alison Chircop","doi":"10.1108/IJHCQA-03-2026-0080","DOIUrl":"https://doi.org/10.1108/IJHCQA-03-2026-0080","url":null,"abstract":"<p><strong>Purpose: </strong>Timely initiation of surgical procedures in hospital theatres is crucial for optimising patient care and resource utilisation. Delays in the operating theatre (OT) can lead to high hospital costs and to patient and staff dissatisfaction. However, achieving consistent first-case on-time starts (FCOTS) remains a challenge in many healthcare settings. The purpose of our study is to identify and assess strategies for improving FCOTS in a tertiary metropolitan hospital.</p><p><strong>Design/methodology/approach: </strong>A six-month initiative was undertaken applying a quantitative research methodology, employing a quasi-experimental one-group design with a descriptive scope and using the continuous quality improvement (CQI) methodology, covering 12 structured steps tailored to the hospital's operational context. An independent analysis of the factors contributing to delayed FCOTS was performed, and several low-cost interventions were implemented using the Plan-Do-Check-Action (PDCA) strategic approach.</p><p><strong>Findings: </strong>The results of the study are threefold: (1) increased the number of on-time starts, (2) increased operating room efficiency and (3) improved staff collaboration, punctuality and accountability. FCOTS across all measured indicators improved significantly, from an average of 20% to over 70%, within six weeks of implementation, and have been sustained and continue to stabilise over the 20 months since implementation. Streamlined patient flow protocols facilitated smoother transitions between preoperative and intraoperative phases, minimising idle time and enhancing resource utilisation.</p><p><strong>Practical implications: </strong>This study's systematic, multidisciplinary, collaborative approach demonstrates the feasibility and effectiveness of interventions to improve FCOTS in a hospital setting.</p><p><strong>Originality/value: </strong>The unique contextualised framework has assisted hospital staff in addressing FCOTS challenges through CQI practice.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and analysis of critical factors influencing patient satisfaction for quality healthcare service delivery in Ghana using mixed methods.","authors":"Selina Dussey, Sharath K M Kumar","doi":"10.1108/IJHCQA-01-2026-0019","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2026-0019","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Patient satisfaction is widely recognized as a key indicator of healthcare quality and system responsiveness, particularly in low- and middle-income countries pursuing Universal Health Coverage. In Ghana, despite expanded access through initiatives such as the National Health Insurance Scheme, challenges in service delivery persist. This study examined how administrative processes, clinical interactions and waiting times influence patient satisfaction and perceived quality of care. The findings seek to extend Donabedian's framework by positioning patient satisfaction as a mediating mechanism linking structural and process factors to quality outcomes. The study also examines the implications for interpersonal-centric care theories, suggesting that relational care must be supported by effective administrative and infrastructural systems, and proposes a context-specific, multidimensional model of patient satisfaction for Ghana's health system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;A mixed-methods approach was adopted, combining quantitative surveys with qualitative interviews. The study was carried out in both public and private facilities across Ghana's three ecological zones, capturing perspectives from both urban and rural settings. A total of 385 respondents participated, including 245 patients and 140 healthcare workers. Quantitative data were analyzed using multiple linear regression to identify predictors of satisfaction, while qualitative data were analyzed thematically to draw out key insights from patients and providers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The results showed that the facility environment (ß = 0.553, p &lt; 0.001) and access convenience (ß = 0.400, p &lt; 0.001) were the strongest predictors of patient satisfaction. Waiting time negatively influenced satisfaction (ß = -0.215, p = 0.013), while administrative processes and staff attitudes also had significant effects. Qualitative findings reinforced these results, highlighting themes such as cleanliness, respectful communication, cost transparency and frustrations with delays. Interestingly, technical quality of care was not a significant predictor, pointing to a potential disconnect between professional standards and patient perceptions of quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;The study was conducted at selected health facilities in Ghana, and although it included diverse facility types (public, private and community-based), the findings may not fully capture the entire heterogeneity of Ghana's healthcare system. Differences across regions, facility levels and socioeconomic contexts could influence perceptions of satisfaction and quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical implications: &lt;/strong&gt;The study highlights key strategies for improving patient satisfaction through targeted service quality improvements. Administrative efficiency emerged as the strongest predictor of satisfaction, underscoring the importance of stre","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-21"},"PeriodicalIF":2.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of TeamSTEPPS® mobile-based learning on operating room efficiency.","authors":"Fardin Amiri, Mohammad Reza Sohrabi, Seddigheh Hannani, Nemamali Azadi","doi":"10.1108/IJHCQA-02-2025-0019","DOIUrl":"https://doi.org/10.1108/IJHCQA-02-2025-0019","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Optimizing operating room (OR) utilization is critical for enhancing healthcare delivery and minimizing costs. Poor teamwork and communication are significant barriers to OR efficiency. This study aims to determine the effect of a TeamSTEPPS® mobile-based learning intervention on key OR effectiveness indicators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;This study employed a quasi-experimental, pre-test/post-test design to measure the efficiency of ORs before and after an intervention in 2023. The research sample included all ORs and 105 OR staff members from six medical education centers of Iran University of Medical Sciences. The research tool included demographic characteristics and a researcher-made form to determine OR efficiency. To conduct the research, participants received the TeamSTEPPS® training content via links sent through Short Message Service (SMS) over five weekly sessions. Then, the data related to the efficiency of the OR were collected for two months before and two months after the educational intervention from the medical records archive unit. Finally, the data collected before and after the intervention were compared. Statistical analysis was performed using a paired t-test. The significance level was set at 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The results revealed a statistically significant improvement in the start time of the first surgery(p = 0.05). However, no significant changes were observed in other key indicators, including the rate of surgery cancellation (p = 0.09), case duration accuracy (p = 0.08) or turnover time (p = 0.67).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;This study's findings should be interpreted in light of its pragmatic design, which balanced scientific rigor with the logistical and ethical realities of research in active clinical settings. Key limitations inform specific recommendations for future work. The study's participant scope was intentionally restricted to nursing and technical staff to ensure consistent intervention exposure amidst the scheduling complexities of a multidisciplinary team. This focus, however, narrows the generalizability of the findings. Future research should prioritize multidisciplinary inclusion, engaging surgeons, anesthesiologists and administrative staff to foster a shared mental model and assess the collective impact of teamwork training. The intervention employed a passive, text-based modality (SMS link to a PDF) to maximize scalability and minimize clinical disruption. While practical, this approach limited the ability to measure engagement. Subsequent studies should enhance training modalities by using interactive mobile-learning platforms with video, gamification and simulation to deepen learning and monitor outcomes. Methodologically, the quasi-experimental design and short-term follow-up were necessary for feasibility. To strengthen causal inferences and assess long-term impact, future work should adop","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of hospital environment on patient behavior: the case of Ankara Bilkent city hospital.","authors":"Gamze Arikan, Sezer Korkmaz","doi":"10.1108/IJHCQA-07-2025-0095","DOIUrl":"https://doi.org/10.1108/IJHCQA-07-2025-0095","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aims to investigate how hospital environmental stimuli influence inpatients' pleasure, trust in physicians and behavioral intentions (revisit and recommendation) in a large public-private partnership (PPP) city hospital in Türkiye. Drawing on the stimulus-organism-response (SOR) framework, the study conceptualizes hospital environmental stimuli as a multidimensional service environment comprising physical, functional and interpersonal cues experienced during hospitalization. The study specifically examines whether these environmental perceptions shape behavioral intentions directly and indirectly through pleasure and trust in physicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;This cross-sectional study was conducted between August 2021 and March 2022 with 404 adult inpatients from the obstetrics and gynecology and physical therapy and rehabilitation units of Ankara Bilkent City Hospital. Relationships among environmental stimuli, pleasure, trust in physicians and behavioral intentions were analyzed. Scale validity and reliability were assessed using exploratory and confirmatory factor analyses, and structural equation modeling tested direct and mediating effects within the SOR framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Hospital environmental stimuli advanced technology, safety, ambience, layout and accessibility and physician and/or nurse care had significant direct effects on pleasure, trust in physicians and behavioral intentions. Pleasure and trust partially mediated the relationship between environmental stimuli and behavioral intentions, indicating that emotional and cognitive responses are critical pathways shaping patient behavior.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;Several limitations of this study should be acknowledged. First, the sample consisted only of inpatients from the Gynecology and Obstetrics Hospital and the Physical Therapy and Rehabilitation Hospital of Ankara Bilkent City Hospital because survey permission was granted only for these units. Consequently, the findings may not reflect the experiences of patients treated in other departments. Second, purposive sampling was employed, which may have introduced selection bias and limited the representativeness of the sample. Third, the study was conducted in a single city hospital in Türkiye, limiting the generalizability of the findings to other city hospitals, healthcare organizations or different national contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical implications: &lt;/strong&gt;Given the relatively novel nature of city hospitals, healthcare managers and policymakers need a clearer understanding of how environmental stimuli shape patients' perceptions of service quality, emotional responses, trust in physicians and behavioral intentions. The findings suggest that investments in hospital environments should extend beyond functional infrastructure to include patient-centered design features that enhance comfort, accessibil","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-21"},"PeriodicalIF":2.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey-based assessment of situation awareness in intensive care units: development of the ICU-SCOPE questionnaire.","authors":"Made Indra Wijaya, Luh Gede Pradnyawati, Dewa Ayu Putu Ratna Juwita, Minarni Wiartiningsih, Risky Kusuma Hartono, Sukma Sahadewa","doi":"10.1108/IJHCQA-01-2026-0008","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2026-0008","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aims to develop and evaluate a multidimensional instrument, the ICU-SCOPE questionnaire, for assessing situation awareness in intensive care units (ICUs). The study sought to integrate clinical, organizational, and leadership perspectives to capture situation awareness as a system-level construct relevant to patient safety and quality of care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;A sequential exploratory mixed-methods design was employed between August and December 2025 in Bali, Indonesia. The qualitative phase involved in-depth interviews and focus group discussions with 42 ICU clinicians, hospital quality officers, and hospital administration and management experts from 12 hospitals. Thematic analysis was used to develop a conceptual model and generate questionnaire items. The quantitative phase involved a cross-sectional survey of 732 ICU healthcare professionals from 38 hospitals (19 government and 19 private hospitals), with psychometric evaluation conducted using exploratory factor analysis and descriptive domain-level analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Qualitative analysis identified five interrelated themes shaping ICU situation awareness: situation perception of patient trajectory, communication and team coordination, operational environment and technology awareness, professional workload and cognitive preparedness, and executive leadership and safety climate. Exploratory factor analysis of the 25-item ICU-SCOPE questionnaire supported a five-factor structure consistent with the qualitative model, explaining 68.3% of the total variance. Domain-level analysis showed higher scores for communication and leadership domains, while workload and environmental domains demonstrated comparatively lower scores, indicating potential areas for improvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;The study relied on self-reported data and was conducted within a single geographical region, which may limit generalizability. Further validation using confirmatory factor analysis and application in different healthcare systems is warranted to strengthen external validity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical implications: &lt;/strong&gt;The ICU-SCOPE questionnaire provides healthcare organizations with a structured tool to assess situation awareness across cognitive, team, environmental, workload, and leadership dimensions. The instrument can support targeted quality improvement initiatives, benchmarking, and monitoring of safety-related conditions in ICU settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Social implications: &lt;/strong&gt;By enabling systematic assessment of situation awareness, ICU-SCOPE has the potential to contribute to safer critical care environments, improved teamwork and enhanced patient safety outcomes. Improved situation awareness may also support staff well-being by identifying workload and organizational factors that contribute to cognitive strain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Originality/value: &lt;/strong&gt;This stu","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-19"},"PeriodicalIF":2.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}