INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE最新文献

{"title":"A five-decade review of academic research on healthcare supply chain: a bibliometric approach using co-word analysis and bibliographic coupling.","authors":"Mario Jesús Acuña-Muñoz, Elena Carvajal-Trujillo, Jaime José Orts-Cardador, Francisco Liébana-Cabanillas","doi":"10.1108/IJHCQA-01-2024-0003","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2024-0003","url":null,"abstract":"<p><strong>Purpose: </strong>This paper analysed the impact and evolution of scientific research on the healthcare supply chain (HCS) from a longitudinal perspective, covering the period 1971-2024. The study used data from the Web of Science and Scopus databases to identify emerging and established areas of study in the field of HCS.</p><p><strong>Design/methodology/approach: </strong>A bibliometric study was conducted using a dataset of 3,602 publications. The analysis focused on keyword co-occurrences to examine the evolution of HCS research. The representation of keywords is presented in tables, diagrams and longitudinal maps to highlight research topics in the field.</p><p><strong>Findings: </strong>This study provides insights into the evolution of HCS research in terms of emerging and established areas of study. The analysis of 3,602 publications allowed the identification of key themes and trends in the field and offers a comprehensive view of the state of the art. The results are presented through tables, diagrams and longitudinal maps, thus facilitating a clearer understanding of the research landscape.</p><p><strong>Practical implications: </strong>The findings have practical implications for researchers and scholars in the HSC domain. The identified research areas and trends provide valuable guidance for future research in the field. Researchers can use this information to navigate the current state of the field and make informed decisions about the direction of their research.</p><p><strong>Originality/value: </strong>This study contributes to the understanding of the evolution of scientific research on healthcare supply chain from 1971 to 2024. By employing bibliometric analysis and visual representations, a unique perspective on the HCS landscape is presented. The results provide valuable insights for researchers and scholars, offering a foundation for further investigations in the field of HSC research.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281434","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":"Analyzing the impact of service quality on companion's satisfaction with the Malaysian public hospitals amidst the COVID-19 pandemic.","authors":"Wan Normila Mohamad, Normalini Md Kassim, Zhu Fei","doi":"10.1108/IJHCQA-09-2024-0084","DOIUrl":"https://doi.org/10.1108/IJHCQA-09-2024-0084","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the relationship between five service quality dimensions: communication, courtesy, emotional support, hospital amenities and understanding of needs and the satisfaction of patient companions in Malaysian public hospitals during the COVID-19 pandemic.</p><p><strong>Design/methodology/approach: </strong>This study employed a quantitative research approach, utilizing a structured questionnaire to survey 260 respondents in Malaysian public hospitals. The questionnaire was designed to assess respondents' perceptions of service quality dimensions, measure their satisfaction with public hospital services and gather demographic and background information. The data underwent validation factor analysis to ensure the reliability and validity of the measurement model. Additionally, structural equation modeling (SEM) was conducted to evaluate the strength and significance of the relationships between the variables.</p><p><strong>Findings: </strong>The study findings revealed that emotional support, courteous behavior, hospital amenities and responsiveness to companions' needs in Malaysian public hospitals were positively associated with companion satisfaction. Additionally, communication was found to have a significant and negative impact on companion satisfaction.</p><p><strong>Originality/value: </strong>By integrating emotional, behavioral and infrastructural elements into the SERVQUAL model, this study addresses the often-overlooked perspective of patient companions. It offers actionable insights for improving public hospital service quality in pandemic and post-pandemic contexts.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233804","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":"Quality management control by Six Sigma metrics operating curves for a medical services organization.","authors":"Tomás José Fontalvo Herrera, Keyla Andrea Arnedo Barrios","doi":"10.1108/IJHCQA-11-2024-0111","DOIUrl":"https://doi.org/10.1108/IJHCQA-11-2024-0111","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate a medical service provider organization, operating under variable conditions, using operating curves based on Six Sigma metrics.</p><p><strong>Design/methodology/approach: </strong>Basic research that developed a rational quantitative approach supported by mathematics and statistical quality control, where the performance of the system's quality was evaluated, supported by a sensitivity analysis with the creation of dynamic tables and operation curves of the six sigma metrics.</p><p><strong>Findings: </strong>A method for evaluating the quality of a medical service and its processes is proposed, which allows determining the performance of quality Z under variable conditions using the proposed operation curves.</p><p><strong>Originality/value: </strong>As a contribution and originality of this research, a comprehensive control system is proposed. A statistical study was evaluated using six sigma metric operating curves for a medical service.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-26"},"PeriodicalIF":2.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066075","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":"Dynamic systems modeling for quality improvement in reducing neonatal mortality: evidence from Kerman and Bam, Iran.","authors":"Elham Amini, Mohammadreza Amiresmaili, Zohreh Torabinejad, Mohammad Ali Bagherzadeh","doi":"10.1108/IJHCQA-01-2025-0002","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2025-0002","url":null,"abstract":"<p><strong>Purpose: </strong>Neonatal mortality is a significant global health issue, particularly in low- and middle-income countries. This study aims to identify and understand the factors contributing to high neonatal mortality rates in the cities of Kerman and Bam, Iran, to develop effective strategies for improvement.</p><p><strong>Design/methodology/approach: </strong>We employed systems dynamics to develop Causal Loop Diagrams that capture qualitative interactions among determinants of neonatal mortality. These CLDs were transformed into stock and flow diagrams for quantitative analysis. Using least squares regression techniques in MATLAB, we analyzed 60 months (2017-2021) of historical data from the Iranian Maternal and Neonatal database, the Integrated Health System (SIB), and Iran's Statistical Yearbooks. Expert interviews and hospital informatics were also utilized to enhance the model's robustness.</p><p><strong>Findings: </strong>The developed model demonstrated a validation accuracy of approximately 94% based on Mean Absolute Percentage Error (MAPE). Key determinants were categorized into health factors (e.g. preterm birth, eclampsia), socio-demographic factors (e.g. maternal education, substance abuse), and healthcare system factors (e.g. NICU capacity, specialist staff). Simulation scenarios revealed that a 20% increase in NICU capacity could reduce neonatal mortality by 35% in Bam and 7% in Kerman. Additionally, hiring 15% more specialist staff reduced mortality by 10% in Bam and 7% in Kerman.</p><p><strong>Research limitations/implications: </strong>While this study is based on data from two specific cities, which may limit its applicability to other regions with different healthcare infrastructures and socio-economic conditions, the integrated qualitative and quantitative methodology employed can be effectively applied to other areas and societies. Future research should expand to additional regions and incorporate more factors, such as genetic predispositions and environmental influences, to enhance the model's generalizability and accuracy. The findings provide clear guidance for healthcare policymakers on effective resource allocation, such as expanding NICU capacity and training more healthcare professionals, to reduce neonatal mortality rates.</p><p><strong>Practical implications: </strong>The model offers a robust framework for simulating intervention scenarios, enabling data-driven decision-making for optimizing healthcare strategies. By reducing neonatal mortality, this research contributes to the overall health and well-being of communities, fostering healthier families and populations, and leading to long-term societal benefits, including enhanced quality of life and economic productivity.</p><p><strong>Originality/value: </strong>This study is among the first in Iran to utilize a comprehensive systems dynamics approach to analyze factors affecting neonatal mortality. It presents a highly accurate dynamic model that i","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024467","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 its improvement with QFD for state social enterprises (SSEs).","authors":"Eduin Dionisio Contreras Castañeda, Cristian Alvarez, Augusto Suárez","doi":"10.1108/IJHCQA-07-2023-0046","DOIUrl":"https://doi.org/10.1108/IJHCQA-07-2023-0046","url":null,"abstract":"<p><strong>Purpose: </strong>In health services, the perceived service quality plays a preponderant role in its continuous improvement. This study sought to integrate the perceived service quality as the customer's voice in the quality function deployment (QFD) for the improvement of healthcare services in the city of Tunja, Colombia.</p><p><strong>Design/methodology/approach: </strong>A study was carried out with the adaptation of the SERVQUAL and SERVPERF scales applied to a sample of 378 users of a State Social Company (SSE). An exploratory factor analysis (EFA) was developed to find the factors that influence the quality of the health service under study and integrate them into a QFD matrix, whose output is the criteria for service improvement.</p><p><strong>Findings: </strong>The QFD analysis allowed the formulation of twelve improvement actions for the quality of the service provided by the SSE. Consequently, the improvement in health services can be achieved through the voice of the customer and the identification of priority technical conditions to intervene in the service.</p><p><strong>Originality/value: </strong>In the case of the context under study and for outpatient ambulatory care services, it is the first study on the dimensions of perceived quality that influence the outpatient service and from these results to use QFD to generate improvement alternatives to the service.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974079","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":"Service quality in healthcare: understanding the relationship between patient experience and healthcare outcomes.","authors":"Saniya Zehra, Jayanthi Ranjan, Mahima Shukla","doi":"10.1108/IJHCQA-09-2024-0090","DOIUrl":"https://doi.org/10.1108/IJHCQA-09-2024-0090","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the pivotal role of service quality in shaping patient experiences and influencing healthcare outcomes. It examines multiple dimensions of hospital service quality and how they collectively contribute to enhancing the overall patient experience. Utilizing a quantitative survey-based approach, the research offers a comprehensive analysis of the key factors that drive patient perceptions within the healthcare perspective.</p><p><strong>Design/methodology/approach: </strong>A purposive non-probability sampling technique was employed to select respondents from the outpatient department of a private multi-specialty hospital in the Delhi-NCR region of India. Data were collected using a structured questionnaire, and structural equation modeling (SEM) was applied to test the proposed conceptual model and research hypotheses.</p><p><strong>Findings: </strong>Results indicate a strong positive correlation between multifaceted dimensions of hospital service quality and patient experiences. Patients who report positive experiences are more likely to intend to revisit the same healthcare facility for future medical needs.</p><p><strong>Research limitations/implications: </strong>Overall, this study underscores the importance of prioritizing and optimizing various dimensions of hospital service quality to cultivate positive patient experiences and nurture enduring patient-provider relationships in the healthcare sector. Policymakers may find this study helpful in developing, constructing and modifying quality management systems for healthcare organizations.</p><p><strong>Originality/value: </strong>Very few studies have been performed on healthcare service quality dimensions and measured their impact on healthcare outcomes. This study examined the effects of three new quality indicators on patient experience and healthcare outcomes: environmental quality, process quality and interaction quality.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795845","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":"Patients' perceptions of service quality in mobile health apps: the role of Need-for-Touch and physician characteristics in the post-COVID-19 era.","authors":"Won-Jun Lee, Seungjae Shin","doi":"10.1108/IJHCQA-12-2024-0116","DOIUrl":"https://doi.org/10.1108/IJHCQA-12-2024-0116","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores how doctors' characteristics, including effort, listening, expertise, and credibility, influence patients' perceptions of service quality in mobile health (mHealth) applications in the post-COVID-19 era. It also investigates whether the Need-for-Touch moderates the relationship between doctor-patient rapport and perceived service quality in non-face-to-face consultations.</p><p><strong>Design/methodology/approach: </strong>A survey was conducted among Korean college students who used mHealth applications after the COVID-19 pandemic. A total of 152 valid responses were collected and structural equation modeling was used to evaluate the relationships between doctors' characteristics, rapport, service quality, and the moderating effect of Need-for-Touch.</p><p><strong>Findings: </strong>The results show that doctors' effort, listening, expertise, and credibility significantly enhance patients' perceptions of service quality through rapport-building in mHealth contexts. However, the Need-for-Touch did not moderate the rapport-service quality relationship, indicating that physical presence is less critical in remote healthcare consultations.</p><p><strong>Originality/value: </strong>Previous studies emphasized the importance of Need-for-Touch in face-to-face healthcare environments, highlighting how physical interaction fosters patient trust, satisfaction, and rapport. However, this study shifts the focus to digital healthcare, examining how physician characteristics can compensate for the absence of physical touch in mHealth services. The findings extend current knowledge by demonstrating that service quality can be achieved through non-physical interactions. This perspective offers valuable implications for enhancing mHealth service delivery in the post-COVID-19 era.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733910","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":"Optimizing tracheostomy weaning with PDCA cycles: a four-year multidisciplinary quality improvement initiative in Northeast Brazil.","authors":"Roberta Catunda, Bruna Bianchi Bilo, João Luís Farias, Magno F Formiga","doi":"10.1108/IJHCQA-02-2025-0012","DOIUrl":"10.1108/IJHCQA-02-2025-0012","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to assess the impact of plan-do-check-act (PDCA) cycles on tracheostomy weaning in ICU patients from 2019 through 2023.</p><p><strong>Design/methodology/approach: </strong>A retrospective study was conducted at a private hospital, analyzing recorded data from two PDCA cycles that were implemented to reduce mean tracheostomy weaning times between 2019 and 2023. We further classified distinct timeframes for a separate analysis, including the baseline (April 2019-August 2020), the period post-PDCA cycle I (January 2021-April 2022) and the period post-PDCA cycle II (August 2022-December 2023).</p><p><strong>Findings: </strong>A total of 70 individuals completed the protocol (mean age ± SD, 60.51 ± 17.19 years; 31.4% female). One-way ANOVA revealed mean differences in weaning time compared to 2019 were significant: 2020-3.86 days (<i>p</i> = 0.02), 2021-6.56 days (<i>p</i> = 0.00), 2022-7.80 days (<i>p</i> = 0.00) and 2023-8.74 days (<i>p</i> = 0.00). Subgroup analysis also revealed significant differences in weaning time among baseline, post-first PDCA cycle and post-second PDCA cycle (<i>F</i> (2) = 20.15, <i>p</i> = 0.00, η2 = 0.51).</p><p><strong>Originality/value: </strong>This management model underscores the benefits of consistently improving the quality management of physiotherapy, delivering value-based healthcare through the collaboration of a multidisciplinary team.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"171-180"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081404","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 process improvement study on patient flow from emergency department to intensive care unit.","authors":"Nikita Nikita, Ankit Singh","doi":"10.1108/IJHCQA-03-2024-0039","DOIUrl":"10.1108/IJHCQA-03-2024-0039","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to improve the efficiency and effectiveness of patient flow from the emergency department (ED) to the intensive care unit (ICU) in a super specialty hospital.</p><p><strong>Design/methodology/approach: </strong>The study was conducted in the emergency department of a super-specialized hospital, focusing on inpatients requiring subsequent admission to the intensive care unit (ICU). It employed a cross-sectional observational design, utilizing primary data collected through first-hand observations via a data tracking sheet. Data analysis encompassed pre- and post-intervention phases, with 232 patients, including 108 patients in the pre-intervention phase and 124 patients in the post-intervention phase, to ensure statistically meaningful results. The study has also utilized tools such as Project Charter, Microsoft Excel, SIPOC, CTC and CTQ, DPMO, Six Sigma, Value Stream Mapping and Root Cause Analysis.</p><p><strong>Findings: </strong>Reduced turnaround time (TAT) by 81%, increased value-added activity percentage from 24.4 to 37.2%, improved sigma level from 2.25 to 2.82 and decreased DPMO (defects per million opportunities) from 226,852 to 92,742.</p><p><strong>Originality/value: </strong>This study focuses on a specific aspect of healthcare process improvement within a super-specialty hospital, employs a comprehensive Six Sigma methodology and statistical analysis to identify bottlenecks and improve efficiency, and focuses on TAT reduction and defect elimination.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"144-157"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081403","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":"Patient queue analysis as a component of Lean Six Sigma improvement in healthcare processes: a case study from a chemotherapy day unit.","authors":"Rowan Abuyadek, Abdalla Shehata, Wafaa Guirguis","doi":"10.1108/IJHCQA-11-2024-0102","DOIUrl":"10.1108/IJHCQA-11-2024-0102","url":null,"abstract":"<p><strong>Purpose: </strong>Oncology patients are a vulnerable group that faces multiple challenges, aggravated by long waiting times and service queues. This article aims to use Lean Six Sigma (LSS) to improve the chemotherapy preparation process and prospectively study the patient files' queue dynamics to prioritise process improvement remedies against adding resources strategy.</p><p><strong>Design/methodology/approach: </strong>Six Sigma methodology has been employed together with Lean tools and queue dynamics in a case study research in a chemotherapy day unit to define, measure, analyse, improve and control the problematic process. The study population involved all internal customers and a sample of external customers (<i>n</i> = 450). The study processes were measured by 25 data points.</p><p><strong>Findings: </strong>The most frequent problem was the \"Long waiting time from oncologist assessment till receiving chemotherapy\". Mean value-added time for chemotherapy preparation was 42 min, the defect was any patient's waiting time exceeding it. The average pre-intervention waiting time was 65.5 ± 27.20 min. The defect baseline sigma level was 0.78 sigma. Remedies involved assigning two pharmacists, arranging the pharmacy setting to satisfy chemotherapy preparation steps, adjusting the number of patients/hours, standardising patients' files interarrival time, delivering files to the pharmacy by piece, not by batch, and fixing the printers and landlines. Post-intervention mean patient waiting time was reduced significantly to 58.7 ± 23.44 min (<i>p</i>-value = 0.05), and the defect sigma level was raised to 0.91 sigma.</p><p><strong>Research limitations/implications: </strong>This study draws attention to prioritising process improvement remedies in complex care settings with long queues.</p><p><strong>Social implications: </strong>This study enhances service delivery and customer satisfaction.</p><p><strong>Originality/value: </strong>This study serves as one of the few publications to study patient queue behaviour as a part of LSS improvements in healthcare projects.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":"115-143"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041750","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}