INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE最新文献

{"title":"Introducing the \"5S-KAIZEN-TQM\" approach into public hospitals in Egypt.","authors":"Hisahiro Ishijima,&nbsp;Kaori Nishikido,&nbsp;Masashi Teshima,&nbsp;Sayumi Nishikawa,&nbsp;Eman Abdul Gawad","doi":"10.1108/IJHCQA-06-2018-0143","DOIUrl":"https://doi.org/10.1108/IJHCQA-06-2018-0143","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to identify how the introduction and dissemination of the 5S-KAIZEN-TQM approach positively influence the Egyptian health sector and its sustainability. It also seeks to encourage effective and efficient introduction of the 5S-KAIZEN-TQM approach into the health sectors of low- and middle-income countries.</p><p><strong>Design/methodology/approach: </strong>The pilot program introducing the 5S-KAIZEN-TQM approach into five Egyptian public hospitals spanned over 13 months from January 2016 to February 2017. During the pilot program, a series of interventions occurred to introduce the approach, such as seminars on the 5S and KAIZEN approach, consultation visits and progress report meetings. Data and information were collected through conducting interviews, observing directly and evaluating the implementation progress of 5S-KAIZEN-TQM activities.</p><p><strong>Findings: </strong>The study identified the following factors in effective and efficient dissemination of 5S-KAIZEN-TQM activities in the Egyptian health sector: restructuring the quality management structure to establish Quality Improvement Teams and Work Improvement Teams in hospitals, generating strong leadership and commitment among leaders, conducting effective in-house trainings on the 5S-KAIZEN-TQM approach, monitoring and following up on 5S-KAIZEN-TQM activities and introducing the 5S-KAIZEN-TQM approach using non-clinical sections, which could also influence the sustainability of the activities.</p><p><strong>Originality/value: </strong>This study holds value in its clarification of meaningful ways to disseminate and encourage the sustainability of the 5S-KAIZEN-TQM approach in Egyptian public health facilities. Moreover, officials from the Ministry of Health and Population and hospital managers in Egypt can use the findings to plan and disseminate this approach nationwide.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"33 1","pages":"89-109"},"PeriodicalIF":1.5,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-06-2018-0143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37545709","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":"Implementation of the CLiP database.","authors":"Kenneth Ken Siong Lee,&nbsp;Umi Adzlin Silim","doi":"10.1108/IJHCQA-08-2018-0199","DOIUrl":"https://doi.org/10.1108/IJHCQA-08-2018-0199","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to review the findings from an audit of the implementation of a consultation-liaison psychiatry (CLiP) database in all inpatients referred to a CLiP service at the largest hospital in Malaysia with the aim of improving the quality CLiP services.</p><p><strong>Design/methodology/approach: </strong>All inpatient referrals to the CLiP team were recorded over a three-month period and compared to previous audit data from 2017. Four audit standards were assessed: the reporting of referrals, timeliness of response indication of reason for referral and presence of a management plan.</p><p><strong>Findings: </strong>The compliance of reporting using the CLiP form was 70.1 per cent compared to 28 per cent in the audit data from 2017 after interventions were conducted. Analysis of the completed CLiP form reveals that 89 per cent of referrals were seen within the same working day. All referrals included the reason for referral. The most common reason for referral was for depressive disorders, but post-assessment, delirium was the most common diagnosis. In total, 87.8 per cent satisfied the audit criteria for a completed written care plan.</p><p><strong>Originality/value: </strong>Specialised CLiP services are relatively new in Malaysia and this is the first paper to examine the quality of such services in the country. Interventions were effective in improving the compliance of reporting using the CLiP database. The findings suggest that the CLiP services are on par with international audit standards. Furthermore, data from this clinical audit can serve as a benchmark for the development of national operating policies in similar settings.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-08-2018-0199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37499633","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":"Impact of caregiver overnight stay on postoperative outcomes.","authors":"Susan Griffin,&nbsp;Leigh McGrath,&nbsp;Gregory T Chesnut,&nbsp;Nicole Benfante,&nbsp;Melissa Assel,&nbsp;Aaron Ostrovsky,&nbsp;Marcia Levine,&nbsp;Andrew Vickers,&nbsp;Brett Simon,&nbsp;Vincent Laudone","doi":"10.1108/IJHCQA-12-2018-0282","DOIUrl":"https://doi.org/10.1108/IJHCQA-12-2018-0282","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to determine the impact of having a patient-designated caregiver remain overnight with ambulatory extended recovery patients on early postoperative clinical outcomes.</p><p><strong>Design/methodology/approach: </strong>This was a retrospective cohort study of patients undergoing surgery requiring overnight stay in a highly resourced free-standing oncology ambulatory surgery center. Postoperative outcomes in patients who had caregivers stay with them overnight were compared with outcomes in those who did not. All other care was standardized. Primary outcomes were postoperative length of stay, hospital readmission rates, urgent care center (UCC) visits within 30 days and perioperative complication rates.</p><p><strong>Findings: </strong>Among patients staying overnight, 2,462 (57 percent) were accompanied by overnight caregivers. In this group, time to discharge was significantly lower. Readmissions (though rare) were slightly higher, though the difference was not statistically significant (<i>p</i>=0.059). No difference in early (<30 day) complications or UCC visits was noted. Presence of a caregiver overnight was not associated with important differences in outcomes, though further research in a less well-structured environment is likely to show a more robust benefit. Caregivers are still recommended to stay overnight if that is their preference as no harm was identified.</p><p><strong>Originality/value: </strong>This study is unique in its evaluation of the clinical impact of having a caregiver stay overnight with ambulatory surgery patients. Little research has focused on the direct impact of the caregiver on patient outcomes, especially in the ambulatory setting. With increased adoption of minimally invasive surgical techniques and enhanced recovery pathways, a larger number of patients are eligible for short-stay ambulatory surgery. Factors that impact discharge and early postoperative complications are important.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"33 1","pages":"18-26"},"PeriodicalIF":1.5,"publicationDate":"2019-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-12-2018-0282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37545707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional study of the quality of neonatal care services in Armenia.","authors":"S. H. Galstyan, Hrant Z Kalenteryan, Arshak S Djerdjerian, Hovhannes S Ghazaryan, Naira T Gharakhanyan, Viktoria Y Kalenteryan","doi":"10.1108/IJHCQA-01-2019-0012","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2019-0012","url":null,"abstract":"PURPOSE\u0000The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations.\u0000\u0000\u0000FINDINGS\u0000In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure-process-outcomes approach as a theoretical basis.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"32 8 1","pages":"1145-1161"},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-01-2019-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43712627","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":"Developing strategies for patient safety implementation: a national study in Iran.","authors":"A. Maher, A. Ayoubian, S. Rafiei, Donya Sheibani Tehrani, F. Mostofian, Pooneh Mazyar","doi":"10.1108/IJHCQA-02-2019-0043","DOIUrl":"https://doi.org/10.1108/IJHCQA-02-2019-0043","url":null,"abstract":"PURPOSE\u0000Today, healthcare organizations focus mainly on development and implementation of patient safety strategic plan to improve quality and ensure safety of provided services. The purpose of this paper is to recommend potential strategies for successful implementation of patient safety program in Iranian hospitals based on a strengths, weaknesses, opportunities, threats (SWOT) analysis.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000In this qualitative study, key informant interviews and documentation review were done to identify strength and weakness points of Iranian hospitals in addition to opportunities and threats facing them in successful implementation of a patient safety program. Accordingly, the research team formulated main patient safety strategies and consequently prioritized them based on Quantitative Strategic Planning Matrix (QSPM) matrix.\u0000\u0000\u0000FINDINGS\u0000The study recommended some of the potential patient safety strategies including provision of education for employees, promoting a safety culture in hospitals, managerial support and accountability, creating a safe and high-quality delivery environment, developing national legislations for hospital staff to comply with patient safety standards and developing a continuous monitoring system for quality improvement and patient safety activities to ensure the achievement of predetermined goals.\u0000\u0000\u0000PRACTICAL IMPLICATIONS\u0000Developing a comprehensive and integrated strategic plan for patient safety based on accurate information about the health system's weaknesses, strengths, opportunities and threats and trying to implement the plan in accordance with patient safety principles can help hospitals achieve great success.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000Ministry of Health and Medical Education (MOHME) conducted a national study to recommend potential strategies for successful implementation of patient safety in Iranian hospitals based on a SWOT analysis and QSPM matrix.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"32 8 1","pages":"1113-1131"},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-02-2019-0043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41836940","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":"Creating a development force in Swedish healthcare.","authors":"Therese Kahm, Pernilla Ingelsson","doi":"10.1108/IJHCQA-01-2019-0017","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2019-0017","url":null,"abstract":"PURPOSE\u0000The purpose of this paper is to present the results from a study that investigates first-line healthcare managers' views on their role and the conditions that influence their ability to drive improvement work based on Lean.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000A questionnaire was sent to all first-line managers in a healthcare organization to investigate their views on their role, conditions and ability to create change according to Lean. The results from four of the questions are presented, which focus on how crucial they consider their role to be for managing improvement work based on Lean, what work tasks their time is spent on, what factors they consider to be important to their ability to drive change and what factors best describe what Lean provides.\u0000\u0000\u0000FINDINGS\u0000The results show that first-line managers claim that their role is crucial in improvement work, but when they defined their work tasks, the time spent on improvements was not frequently described. Time, support from coworkers, and a clear vision and clear goals were the three factors that they considered to be most important to their ability to drive improvement work. Considering their leadership, Lean contributed to the structure with tools and supportive methods.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000The questions can be used separately or as part of the entire questionnaire before and along a Lean process to obtain a better understanding of how to create a sustainable Lean approach in healthcare. Understanding the factors that first-line managers consider supporting their ability in improvement work and what they consider Lean provides is important in creating a development force in Swedish healthcare.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"32 8 1","pages":"1132-1144"},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-01-2019-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44319519","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":"Cost-effectiveness of Hepatitis A vaccination in a developed and developing country.","authors":"Nidhi Ghildayal","doi":"10.1108/IJHCQA-05-2019-0096","DOIUrl":"https://doi.org/10.1108/IJHCQA-05-2019-0096","url":null,"abstract":"PURPOSE\u0000Hepatitis A is a prevalent disease that is largely preventable by vaccine usage. The vaccine for this illness is highly underused in most regions. In an attempt to find the strategies that are most beneficial in regard to quality-adjusted life years (QALYs) and cost in current environments, the purpose of this paper is to conduct cost-effectiveness analyses to investigate vaccination strategies in a more economically developed country (MEDC), generally known as a \"developed\" area: the USA, and a less economically developed country (LEDC), generally known as a \"developing\" area: the state of Rio de Janeiro, Brazil.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000This study used a dynamic transmission model for comparative effectiveness analyses. The model ran two different scenarios. The two regions studied have different policies and strategies for Hepatitis A vaccination currently, and also used different strategies in 2009. In the USA, a universal vaccination policy was modeled, along with a scenario in which it was removed. In Rio de Janeiro, a no vaccination policy was modeled, along with a scenario in which a universal vaccination policy was effected.\u0000\u0000\u0000FINDINGS\u0000The comparison of resulting incremental cost-effectiveness ratio values to accepted threshold values showed universal vaccination to be cost-effective in both the USA and Rio de Janeiro as compared to no vaccination. When episode and vaccination costs and vaccination efficacy were varied, this still remained true. Universal vaccination was found to result in lower incidence of Hepatitis A in both the USA and Rio de Janeiro. Over the twenty-year time horizon, universal vaccination is projected to prevent 506,945 cases of symptomatic Hepatitis A in the USA and 42,318 cases of Hepatitis A in Rio de Janeiro. Other benefits include a projected increase in cumulative QALYs through the use of universal vaccination.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000This analysis showed universal vaccination to be cost-effective as compared to no vaccination, and portions of the study's approach had not previously been applied in tandem to investigate Hepatitis A interventions. The results may help foster higher compliance rates for Hepatitis A vaccination and even greater per-person economic benefits of universal vaccination, particularly in the USA. The purpose of this study is also to encourage elevated levels of surveillance on age of infection in developing regions and consistent reevaluation utilizing dynamic transmission models in both the USA and Brazil, as well as other rapidly developing regions, in order to prevent future epidemics and costs associated with the disease.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"32 8 1","pages":"1175-1199"},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-05-2019-0096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48315196","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":"Senior citizens' acceptance of connected health technologies in their homes.","authors":"Reza Etemad-Sajadi, Gil Gomes Dos Santos","doi":"10.1108/IJHCQA-10-2018-0240","DOIUrl":"https://doi.org/10.1108/IJHCQA-10-2018-0240","url":null,"abstract":"PURPOSE\u0000The objective of this paper is to focus on seniors' acceptance of the usage of connected healthcare technologies in their homes. The authors integrated into technology acceptance model (TAM) several latent variables such as social presence, trust and degree of intrusiveness perceived with the use of connected health technologies.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000The authors distributed the survey by post to 605 seniors. The authors targeted elderly people using connected health technologies (assistive alarm, telecare, sensors, etc.) at home and/or receiving healthcare at home. The authors received 213 questionnaires back. As The authors had several latent variables, the authors used partial least squares (PLS), a variance-based structural equation modeling method.\u0000\u0000\u0000FINDINGS\u0000The results show that the level of trust in these technologies impacts significantly the perception of usefulness and the degree of intrusiveness. In parallel, the degree of usefulness of these technologies impacts positively elderly people's intention to accept their usage. Finally, one can claim that the perception of the social presence with the use of these technologies impacts positively the degree of perceived usefulness, trust and intrusiveness.\u0000\u0000\u0000RESEARCH LIMITATIONS/IMPLICATIONS\u0000The sample covers a population benefiting from similar connected health technologies. It was difficult to distinguish and interpret the added value of each technology separately. As more and more elderly people use or are least familiarizing themselves with a range of connected technologies it would be interesting to identify which sets of connected technologies contribute the most to a positive feeling of social presence.\u0000\u0000\u0000SOCIAL IMPLICATIONS\u0000These results are particularly relevant to stakeholders in the health industry in their quest to improve their products/services. A better understanding of the relation that the elderly have with connected health technologies is an essential prerequisite to supporting the development of new solutions capable of meeting the specific needs of our seniors.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000The authors want to apply the TAM to connected health technologies designed for elderly people and the authors also want to extend it by integrating the social presence, trust and degree of intrusiveness variables to our research model.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"32 8 1","pages":"1162-1174"},"PeriodicalIF":1.5,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-10-2018-0240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46904010","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":"Safety attitudes in hospital emergency departments: a systematic review.","authors":"Naif Alzahrani, Russell Jones, Amir Rizwan, Mohamed E Abdel-Latif","doi":"10.1108/IJHCQA-07-2018-0164","DOIUrl":"10.1108/IJHCQA-07-2018-0164","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments (EDs).</p><p><strong>Design/methodology/approach: </strong>An electronic search was conducted of PsychINFO, ProQuest, MEDLINE, EMBASE, PubMed and CINAHL databases. The review included all studies that focussed on the safety attitudes of professional hospital staff employed in EDs.</p><p><strong>Findings: </strong>Overall, the review revealed that the safety attitudes of ED health staff are generally low, especially on teamwork and management support and among nurses when compared to doctors. Conversely, two intervention studies showed the effectiveness of team building interventions on improving the safety attitudes of health staff employed in EDs.</p><p><strong>Research limitations/implications: </strong>Six studies met the inclusion criteria, however, most of the studies demonstrated low to moderate methodological quality.</p><p><strong>Originality/value: </strong>Teamwork, communication and management support are central to positive safety attitudes. Teamwork training can improve safety attitudes. Given that EDs are the \"front-line\" of hospital care and patients within EDs are especially vulnerable to medical errors, future research should focus on the safety attitudes of medical staff employed in EDs and its relationship to medical errors.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"32 1","pages":"1042-1054"},"PeriodicalIF":1.0,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48069996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An innovative medical consultation model in mainland China.","authors":"Xiao Ping Xu, D. Ke, D. Deng, S. Houser, Xiao Ning Li, Qing Wang, Ng Chui Shan","doi":"10.1108/IJHCQA-02-2017-0033","DOIUrl":"https://doi.org/10.1108/IJHCQA-02-2017-0033","url":null,"abstract":"PURPOSE\u0000The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients' and medical staff's perspectives.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.\u0000\u0000\u0000FINDINGS\u0000A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients' consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"32 7 1","pages":"1055-1071"},"PeriodicalIF":1.5,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-02-2017-0033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44186128","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}