...influencing healthcare service quality Ali Mohammad Mosadeghrad* Abstract Background: The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality. Keywords: Healthcare Organisations, Quality, Pluralistic Evaluation, Iran Copyright: © 2014 by Kerman University of Medical Sciences Citation: Mosadeghrad AM. Factors influencing healthcare service...
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...of change in the nursing profession and includes recommendations for this transformation in order to meet the demands of the new and complex health care system. The main segments of suggested modifications are nursing education, practice, and leadership (Institute of Medicine [IOM], 2010). Nurses must achieve higher levels of education and implement obtained knowledge to encounter the challenges of health care. The IOM report emphasizes the need of health care professionals that are better prepared to care for people with chronic conditions. To do this, nurses will need to be better educated as care becomes more complicated. Through advanced education, nurses will gain better understanding, more abilities, and perspectives to participate with other health care providers and become more independent (Herter, 2011). The IOM recommends that 80% of the nurses should have baccalaureate degree in nursing by the year 2020 (Institute of Medicine [IOM], 2010). Bachelor of...
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...FOR IMPROVING HEALTHCARE DELIVERY AND ORGANIZATION PERFORMANCE The present report is focused on identifying strategies for defining, measuring, and improving performance of the healthcare delivery system in any organization. The scope of the report is kept limited to the frontline health service delivery system like hospitals and clinics which directly interacts with patients. The main objective of the report is to identify important determinants of organizational performance in healthcare and to present examples of solutions which can improve its functioning and performance. Identifying present performance: Before formatting future strategy for any organization, it is important to evaluate its present performance. It is important for any organization to deliver healthcare of high quality, high efficiency, easy accessibility, and easy utility; to be considered as a high performance organization. Additionally, the high performance organization must be open to enable learning and to have well planned strategies to access support from different parts of the society to attain sustainability. Thus section discusses the six main outcomes required by high performance organization which are quality, efficiency, utilization, access, learning, and sustainability. 1. Quality: Research on the clinical quality of the healthcare is as old as the healthcare delivery system itself. The researchers identify clinical quality as safe and medically appropriate healthcare. Furthermore,...
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... UNDERSTANDING ON LEADERSHIP STYLES 3-9 DISCUSSION ON LEADERSHIP STYLE OF A LEADER 10-11 THAT IS APPARENT IN THE EFFECTIVE PROVISION OF HEALTHCARE DISCUSSION ON LEADERSHIP STYLE OF A LEADER 11-12 THAT FACILITATES POSITIVE STAFF DEVELOPMENT CONCLUSION 12-13 INTRODUCTION in today ever rapid changing and challenging healthcare environment, nurses are required to develop their leadership skills where effective leadership styles they choose to deliver high quality care with improved patient safety outcome (Treguno et al, 2009); healthy work environments (Shirey, 2009): job satisfaction (Heller et al, 2004; Sellgren et al, 2007); lower turnover rates (Gelinas and Bohen, 2000); and positive outcome for organization and patients (Wong and Cummings, 2007) and healthcare providers (Cummings et al, 2005). It must be emphasized that leadership should not be viewed as an optional role or function for nurses. Nurse leaders nowadays confronting challenges like new roles, new technology, financial constraints, greater participation, cultural diversity and education We must be aware and realized that leadership is a must in all healthcare facility where effecting change and achieving high standards of patient care are stipulated in job titles, such as Director of Nursing, Nurse Consultant, or Modern Matron...
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...that evidence based practice (EBP) be adopted when analyzing an article. According to Sackett et al (1996, pg 71-72) “Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients”. The best available and current research is utilized in making a judgment about the article in question (Drisko and Grady2012). The research article, Healthcare Providers’ Intentions to Engage in an Interprofessional Approach to Shared Decision-Making in Home Care Programs: A Mixed Methods Study by Legare et al., presents views of the healthcare providers in the implementation of the interprofessional approach to shared decision-making (IP-SDM). In addition, it evaluates their intention for engaging in the program. The IP-SDM program has been gaining popularity in Canada but it is yet to be incorporated into the healthcare system (Reeves et al., 2008) Interprofessional approach entails the engagement of different professionals within the healthcare system, where all contribute towards the achievement of a common method of patient care. In addition, the aspect of shared decision-making entails the development of a system that involves the patients in determining the type of treatment that is given to them. The research concludes that the health professionals are not in any way opposed to the program (Legare et al. 2013, pg 221). The research objective is clearly defined by establishing the two main items under...
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...POLICY ANALYSIS TASK Introduction: This assignment requires that I develop and thoroughly analyze a public policy in order to advocate for one that improves the health of the public and/or the nursing profession globally (local, state, national or international). To do this, I must reflect on several aspects of being a policy maker within the nursing profession. I was instructed to consider the following: · Why did I select the health or nursing profession policy issue? · How does this issue affect nursing practice, healthcare delivery and health outcomes for individual, families and/or communities? · What are the values and the ethical positions that underpin my perspectives? · What criteria will I use to evaluate the success (outcomes) of my proposed policy change? I will use both, a top-down and bottom-up approach, in order to analyze and bring the nursing perspective to policy makers and stakeholders. By identifying the values and ethical perspectives that underpin my position, I will develop criteria to evaluate the success of my work which will lead to the creation of a policy brief that can be sent to decision makers and create a plan to work with an organization/community to promote policy change at the local level. Nursing research to support my position is vital in guiding me to my conclusion and will include principles of community based participatory research (CBPR). Keywords/Terminology: · Top-down approach – one in which a person or regulatory agency (an...
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...in exploring ethical aspects of patient care. Nurses’ ethical perspective will be respected by other professionals and as a result, nurses in larger numbers will sit and serve on ethics committees as ethics consultants. As new roles become the norm, nurses need to be trained in these specific areas to have the knowledge how to care for these patients. Nursing care will become more important in the future as the nation’s demographic changes. Nurses must be culturally competent and recognize that cultural sensitivity begins with health care providers. The rise of community base health care is seen throughout the United States and nurses will be needed to fulfill these roles in the community base setting such as school nursing, hospice, clinics, HMOs, and other health care settings (Chitty & Black, 2010). Conclusion As different trend in nursing become more popular in the future professional nurses must keep up with the new trends and practice evidence-based nursing. Professional nurses must be aware of and incorporate in their daily practice nursing theories to care for their patients. Finally, with new trends and roles available to nurses, most nurses at the professional level are removing themselves from the traditional bedside nursing practice. Nurses are moving into new roles created due to rise in technology and a need for community based nursing practice. This will only enhance the nursing profession and allow nurses to give care to patients in whichever area of nursing practice...
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...Organizational Leadership and Inter-professional Team Development The Patient and Family Care Organizational Self-Assessment Tool (PFCC) for current practice setting will be completed as well as the organization in its entirety. The results will be analyzed based on a one to five scoring system with one being the lowest. The areas where the organization could improve its PFCC care will be discussed. The analysis of how business practices and regulatory requirements impact patient family centered care. A strategy will be created that includes goals and an operational plan to increase PFCC of the organization by improving one of the gaps that’s identified. I will discuss financial implications that this strategy may have on the organization. I will identify potential members for the multidisciplinary team who could assist in improving the identified gap. I will discuss the purpose and scope of the team to include the member’s roles, and importance of diversity within the team. The team will focus in a meaningful way using self-assessment, and awareness of self-reflective techniques. I will use PDAC to monitor whether the strategy was effective in increasing patient and family centered care. Self-Assessment Tool The PFCC tool was used to evaluate Medical Center Health System (MCHS) see attached. Setting Description Medical Center Hospital System (MCHS) is an acute care, not for profit regional 402 bed Level II Trauma Center, located in West Texas of the...
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...Instructor: Eugene Elliott March 4, 2014 Do Not Resuscitate (DNR) orders are medical directives to withhold efforts to revive a patient who has a cardiac or respiratory arrest (Lee, M. B., M.D. 2012). DNR laws started in the late 70s because of the extensive practice of cardiopulmonary resuscitation (CPR). An unending discussion about DNR has involved the level to which patients or their surrogate have to make the decision to agree to such orders. Throughout the late 70’s and early 80s, a lot hospitals normally made DNR orders that did not including an discussion with the patient or the patient's family. Also, a lot hospitals did not clearly document the DNR order in the patient's chart. This practices were forsaken as the bioethics drive and the courts stressed the right of patients or their surrogate decision makers to decline medical treatment. This also including life insufficient treatment for example CPR. Most of health care providers, health professional groups and indorsing bodies started to support DNR policies. The DNR policies require that the patient be informed of the risks and benefits of CPR and to give consent that CPR not be used. (Lee, M. B., M.D. 2012) DNR is reflect one of the ethical dilemma in current society that came from medical development, ethical dilemmas arise in the area of health care when health care providers is in a position to choose between two or more harmful option, and a lot of time the physician are forced to deal with their value...
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...Cronin 2013). The purpose of literature review in nursing includes evaluating current practice and making recommendations for policy development and change. Thus, the purpose of this literature review is to establish the current perspectives of patients, family and nurses on the factors that improve dignity in the end of life. Resultantly, this literature review will explore the role of nurses’ based on the findings of the perspectives that patients, family and health professionals have concerning the issue of dignity in the end of life care. In that regard, the paper follows a systematic approach which involves an introduction that explains the concept of end of life and the types of end of life care available. The paper then proceeds to explore the concept of dignity as viewed from several perspectives through the use of literature on the models of dignity means of measuring dignity and the themes associated with this conception. Consequently, the factors that improve dignity are laid out and discussed at length. Eventually, the paper will achieve its secondary goal which is to determine and expound on the topic of the roles that a nurse plays in end of life care not only for the patient but also for their family. End of life care Before the discussion of the main topic of this literature review which is determining the factors that promote dignity in the end of life in order to determine the role of nurses in the end of life, there is need to understand the meaning of the concepts...
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...understanding the concept of “being human”. Personalities, life experiences, and core values allow an individual to become a certain type of provider. Being aware of personality traits and how they impact us as individuals can help us to become more efficient providers of healing for the diverse population as it stands today. Fostering a healing environment that can encourage excellence for nursing practice that involves mindful presence can create greater outcomes for patients. Models of Health and Healing The history of nursing dates back centuries with different eras of health and healing that have led us to this moment in time and the way nursing is currently practiced. Although there are many types of health and healing, in the United States predominately conventional medicine is practiced. There are three Eras that require review to gather information and understanding that help to redefine how health and healing has arrived at its current form. The first Era is Era I which took foothold in the 1860’s and focused on biomedicine. Era II, which began in the 1950’s, focused on mind and body healing. Finally, we find ourselves in the current Era III which concentrates on body, mind, and spiritual healing, which also may be referred to as the bio/psycho/social model. Moving forward from one era to the next has allowed healthcare providers to reach a state of acceptance, awareness, and appreciation for the various modalities of healing therefore...
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...Pay for Performance Incentive Programs in Healthcare: Market Dynamics and Business Process Executive Briefing AUTHOR Geoffrey Baker, MBA President, Med-Vantage® Inc. 1 California Street, Suite 2800 San Francisco, California 94111 CONTRIBUTORS John Haughton, MD, MS Founder, DocSite LLC 540 Main Street Winchester, Massachusetts 01890 Peter Mongroo Director, Healthcare Industries Markets Oracle Corporation 500 Oracle Parkway Redwood Shores, California 94065 A Research Report sponsored by ViPSSM, Inc. in partnership with Med-Vantage® 2003 Table of Contents Introduction.......................................................................................................................2 Goals and Motivations behind Pay for Performance..................................................................4 Market Adoption .................................................................................................................5 Funding and Incentives .......................................................................................................7 Measuring Performance: Physicians and Hospitals..................................................................10 P4P Operations and Business Processes for Health Plans.........................................................12 Key Lessons Learned and Critical Success Factors ..................................................................14 Conclusion...........................................................
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...A Marketing Plan for an Imaginary Managed Care Organization Executive Summary and Situation Analysis Working for the Managed Care Organization of America, the ultimate goal would be to ensure cooperation in the understanding, agreement, and commitment between all divisions and units. One of the problems at the Managed Care Organization of America is that the healthcare professionals are put in a position where they are inhibited in their involvement over the communication and networking systems between the Nursing Administration, the head of each nursing unit or the RN or LVN in charge, and the certified nursing aids. This executive summary takes a brief look at designing and developing a contract process program that integrates cooperation and communication systems between the Nursing Administration, the head of each nursing unit or the RN or LVN in charge, and the certified nursing aids. Another challenge for the Managed Care Organization of America is the unclear policies in the Hospital Equipment Management Program. This executive summary offers a proposal whereby the healthcare professionals would develop and monitor a two-way communication channel and incorporate it into the Hospital Equipment Management Program, hold related workshops that can be attended by the Director of Hospital Operations and the division managers, build a cooperation team that unites operational goals and develop systems that evaluate whether these operational goals are being met and implemented...
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...provision of humanitarian aid or it is the manufacturing of pharmaceutical drugs, there are certain ethical boundaries that are important to be mindful of so that they are not breached as it comes attached with severe negative consequences. In the light of this argument for the purpose of strengthening it, a book edited by Caroline Abu-Sada named ‘Dilemmas, Challenges, and Ethics of Humanitarian Action: Reflections on Médecins Sans Frontières' Perception Project’ will be reviewed. Discussion As obvious from the book title, Médecins Sans Frontière s' also known as ‘Doctors without Borders’ is used as the case study for the purpose of enlightening the audience of the ethical challenges and moral dilemmas in addition to the ethics that revolve around humanitarian action (Kramer, Soskolne, Mustapha and Al-Delaimy, 2012, a299-301). The prominent theme that characterises this book is the self-questioning regarding forces of health determinants and their denial in certain economies to the patients that should be undertaken by doctors and MSF (Birn, Pillay and Holtz, 2009, pp. 309-364). Lack of it leads to humanitarian vocation that is inevitable when such self-assessment is not undertaken by the MSF aid workers on the field. This is what introduces...
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...care systems are rapidly evolving with current processes of globalisation. What is the contribution of the social sciences to an understanding of this field? A structured scoping exercise was conducted to identify relevant literature using the lens of India – a ‘rising power’ with a rapidly expanding healthcare economy. A five step search and analysis method was employed in order to capture as wide a range of material as possible. Documents published in English that met criteria for a social science contribution were included for review. Via electronic bibliographic databases, websites and hand searches conducted in India, 113 relevant articles, books and reports were identified. These were classified according to topic area, publication date, disciplinary perspective, genre, and theoretical and methodological approaches. Topic areas were identified initially through an inductive approach, then rationalised into seven broad themes. Transnational consumption of health services; the transnational healthcare workforce; the production, consumption and trade in specific health-related commodities, and transnational diffusion of ideas and knowledge have all received attention from social scientists in work related to India. Other themes with smaller volumes of work include new global health governance issues and structures; transnational delivery of health services and the transnational movement of capital. Thirteen disciplines were found represented in our review, with social...
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