An intelligent case-based knowledge management system for quality improvement in nursing homes

2018 ◽  
Vol 48 (1) ◽  
pp. 103-121 ◽  
Author(s):  
King Lun Tommy Choy ◽  
Kai Yuet Paul Siu ◽  
To Sum George Ho ◽  
C.H. Wu ◽  
Hoi Yan Lam ◽  
...  
Keyword(s):  
Service Quality ◽  
Training Program ◽  
Nursing Staff ◽  
Service Providers ◽  
Term Care ◽  
Content Type ◽  
Knowledge Based ◽  
Case Based

Purpose This paper aims to maintain the high service quality of the long-term care service providers by establishing a knowledge-based system so as to enhance the service quality of nursing homes and the performance of its nursing staff continually. Design/methodology/approach An intelligent case-based knowledge management system (ICKMS) is developed with the integration of two artificial intelligence techniques, i.e. fuzzy logic and case-based reasoning (CBR). In the system, fuzzy logic is adopted to assess the performance through the analysis of the long-term care services provided, nurse performance and elderly satisfaction, whereas CBR is used to formulate a customized re-training program for quality improvement. A case study is conducted to validate the feasibility of the proposed system. Findings The empirical findings indicate that the ICKMS helps in identification of those nursing staff who cannot meet the essential service standard. Through the customized re-training program, the performance of the nursing staff can be greatly enhanced, whereas the medical errors and complaints can be considerably reduced. Furthermore, the proposed methodology provides a cost-saving approach in the administrative work. Practical implications The findings and results of the study facilitate decision-making using the ICKMS for the long-term service providers to improve their performance and service quality by providing a customized re-training program to the nursing staff. Originality/value This study contributes to establishing a knowledge-based system for the long-term service providers for maintaining the high service quality in the health-care industry.

scholarly journals The determinants of customer loyalty in the Indonesian ride-sharing services: offline vs online

2019 ◽  
Vol 17 (1) ◽  
pp. 75-85 ◽  
Author(s):  
Adi Kuswanto ◽  
Sundari Sundari Sundari Sundari ◽  
Ashur Harmadi ◽  
Dwi Asih Hariyanti Dwi Asih Hariyanti
Keyword(s):  
Service Quality ◽  
Goodness Of Fit ◽  
Service Providers ◽  
High Reliability ◽  
Positive Influence ◽  
Private Company ◽  
Content Type ◽  
Ride Sharing ◽  
Fit Index

Purpose This study aims to analyze the effect of service quality on trust, satisfaction and loyalty by adopting two models, namely, conventional service quality model from Parasuraman and information systems (IS) success model from Delone and McLean. Design/methodology/approach Respondents of this study were users of shared-motorcycle services who filled out a complete questionnaire totaling 507. This research used a second-order structural equation model. All question items had quite high reliability and validity based on the result of confirmatory factor analysis with a value of average variance extracted and composite reliability which was higher than 0.70. The goodness of fit was quite good with the values x2/df = 2.493, incremental fit index = 0.921, Tucker-Lewis index = 0.917, comparative fit index = 0.921 and root-mean-square error of approximation = 0.054. Findings Online and offline ride-sharing services reveal a strong and positive influence on trust and satisfaction. Trust reveals a strong and positive influence on satisfaction and loyalty. Finally, satisfaction reveals a strong and positive influence on loyalty. The research in general shows that the quality of offline service is more influential than the quality of online service in the case of ride-sharing service provided by two companies in Indonesia. Research limitations/implications The sampling frame of the research was diverse, including students of various collages and junior high schools, various private company workers and government employees. So, the results cannot be generalized to all populations especially to all Indonesian customers. It is recommended to increase the number of samples by focusing on the community groups of customers of public motorbikes, so that these groups can be compared. Next, the research finds that both service quality based on IS and service quality models reveal a strong and positive influence on loyalty both directly and indirectly. Originality/value The research uses respondents who use motorcycle services both online and offline. The findings of the research are important for online and offline ride-sharing motorbike service providers. They have to maintain their excellent services to the customers.

Examining the role of commercial long-term care insurance in long-term care services

2019 ◽  
Vol 37 (2) ◽  
pp. 565-578 ◽  
Author(s):  
Tsu-Wei Yu ◽  
Lu-Ming Tseng
Keyword(s):  
Service Quality ◽  
Relationship Satisfaction ◽  
Long Term Care ◽  
Customer Relationships ◽  
Term Care ◽  
Policy Makers ◽  
Content Type ◽  
Long Term Care Insurance

PurposeThe purpose of this paper is to explore the role of commercial long-term care insurance (LTCI) in long-term care (LTC) services, and to elucidate the mediating roles of service quality and relationship satisfaction in the relationship between customization and loyalty. In addition, this study offers important recommendations for policy makers in formulating policy aimed at supporting the industry and regulating its customer relationships in life insurers in Taiwan.Design/methodology/approachStudy participants were policyholders of life insurance in Taiwan with experience in purchasing commercial LTCI. They were investigated through in-depth interviews and surveys. The hypotheses were tested using the structural equation modeling (SEM) analysis of variance.FindingsThe findings of this study are important for policy makers in formulating policy aimed at supporting the industry and regulating its customer relationships.Originality/valueThis study represents the first attempt to investigate the role of LTCI in LTC services in Taiwan. Likewise, this study improves our understanding of the main issues relating to the effect of customization on policyholder loyalty, and the partially mediating role of service quality and relationship satisfaction in the insurance marketing context.

scholarly journals Should dehydration in older people be a marker of lack of quality in long term care provision?

2014 ◽  
Vol 15 (4) ◽  
pp. 232-236 ◽  
Author(s):  
Lee Hooper ◽  
Diane K Bunn
Keyword(s):  
Older People ◽  
Residential Care ◽  
Design Methodology ◽  
Long Term Care ◽  
Care Provision ◽  
Good Care ◽  
Term Care ◽  
Content Type

Purpose – The purpose of this paper is to consider whether dehydration in older people should be used as a marker of lack of quality in long-term care provision. Design/methodology/approach – The piece examines the assumed relationship between dehydration and the quality of care, and then considers the factors that can lead to dehydration in older people. Findings – Even with the best care, older people, in the absence of a sense of thirst, and for fear of urinary accidents, difficulties getting to the toilet or choking, may choose to drink less than would be ideal for their health. While good care supports older people to minimise these problems, it also respects older people making their own decisions around when, what and how much to drink. It appears that dehydration may sometimes be a sign of good care, as well as arising from poor care. Social implications – Residential care homes should not be stigmatised on the basis of their residents being dehydrated, but rather helped to explore whether they are achieving an appropriate balance between care and quality of life for their residents. Originality/value – This discussion may be of use to those living in, working in, managing or assessing residential care.

An assessment of service quality and resulting customer satisfaction in Pakistan International Airlines

2015 ◽  
Vol 32 (5) ◽  
pp. 486-502 ◽  
Author(s):  
Faizan Ali ◽  
Bidit Lal Dey ◽  
Raffaele Filieri
Keyword(s):  
Customer Satisfaction ◽  
Service Quality ◽  
Structural Equation ◽  
Convenience Sample ◽  
Content Type ◽  
Quality Dimensions ◽  
Service Quality Dimensions ◽  
International Airlines

Purpose – The purpose of this paper is to assess foreigners and overseas Pakistanis’ evaluation of the quality of the services provided by Pakistan International Airlines (PIA) and its effect on customer satisfaction. Design/methodology/approach – A convenience sample of 498 respondents was used to test the hypotheses of the study through structural equation modelling. Findings – The results of this study indicate that all of the hypotheses are supported and customer satisfaction of PIA customers is influenced by all of the five service quality dimensions (AIRQUAL), including airline tangibles, terminal tangibles, personnel, empathy, and image. Research limitations/implications – This research examines the relationship between service quality dimensions and customer satisfaction. The study focuses on the evaluation of overseas Pakistanis and foreigners regarding the service quality of PIA. The main limitation of this study is that it focuses on PIA: thus, the results cannot be generalised. Practical implications – The results indicate that managers should focus on different dimensions of airline service quality in order to enhance customer satisfaction. Originality/value – This study would enable PIA to have a better understanding of the effects of service quality, which will lead to passengers’ satisfaction and encourage the development of long-term relationships with their customers.

Service quality evaluation of automobile garages using a structural approach

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ajith Tom James ◽  
Jasmin James
Keyword(s):  
Graph Theory ◽  
Service Quality ◽  
Quality Index ◽  
Service Industry ◽  
Service Providers ◽  
Business Environment ◽  
Content Type ◽  
Service Quality Evaluation ◽  
Practical Implications

PurposeThe purpose of this paper is to evaluate the service quality automobile garages through development of a service quality index based on the factors influencing service quality.Design/methodology/approachA structural methodology of graph theory and matrix approach is applied for developing the service quality index.FindingsThe automobile maintenance can be considered as a service industry and in order to sustain in the competitive business environment, the service providers must ensure quality in their services. There are several factors that influence the service quality. Each factor is comprised of several sub-factors. Moreover, the factors are interrelated with each other. Modelling of these factors and their interrelations with due consideration of their structure is accomplished through the graph theory. The directed graph (digraph) of the service quality is defined; the nodes of this symbolize the quality influencing factors, while the edges represent their degrees of interrelationships. An equivalent matrix developed from the digraph establishes a service quality function which leads to evaluation of service quality index (SQI). A greater value of the service quality index displays that the organization and functioning of the garage is adequate.Practical implicationsThe methodology can be applied for evaluating as well as comparing service quality of different garages. The observations would be helpful to the managers the garages to make strategies for improving their service quality.Originality/valueThe paper establishes the interrelations among various factors that influence the service quality at automobile garages and develop a numeric index for the evaluation of the same.

Nursing Staff Time and Care Quality in Long-Term Care Facilities: A Systematic Review

2019 ◽  
Vol 60 (3) ◽  
pp. e200-e217 ◽  
Author(s):  
Susan Armijo-Olivo ◽  
Rodger Craig ◽  
Paula Corabian ◽  
Bing Guo ◽  
Sepideh Souri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Nursing Staff ◽  
Long Term Care ◽  
Staff Time ◽  
Term Care ◽  
Resident Care ◽  
Coverage Models

Abstract Background and Objectives In long-term care (LTC) facilities, nursing staff are important contributors to resident care and well-being. Despite this, the relationships between nursing staff coverage, care hours, and quality of resident care in LTC facilities are not well understood and have implications for policy-makers. This systematic review summarizes current evidence on the relationship between nursing staff coverage, care hours, and quality of resident care in LTC facilities. Research Design and Methods A structured literature search was conducted using four bibliographic databases and gray literature sources. Abstracts were screened by two independent reviewers using Covidence software. Data from the included studies were summarized using a pretested extraction form. The studies were critically appraised, and their results were synthesized narratively. Results The systematic searched yielded 15,842 citations, of which 54 studies (all observational) were included for synthesis. Most studies (n = 53, 98%) investigated the effect of nursing staff time on resident care. Eleven studies addressed minimum care hours and quality of care. One study examined the association between different nursing staff coverage models and resident outcomes. Overall, the quality of the included studies was poor. Discussion and Implications Because the evidence was inconsistent and of low quality, there is uncertainty about the direction and magnitude of the association between nursing staff time and type of coverage on quality of care. More rigorously designed studies are needed to test the effects of different cutoffs of care hours and different nursing coverage models on the quality of resident care in LTC facilities.

scholarly journals The effects of placement on dementia care recipients’ and family caregivers’ quality of life: a literature review

2017 ◽  
Vol 18 (1) ◽  
pp. 44-57 ◽  
Author(s):  
Heehyul Moon ◽  
Peggye Dilworth-Anderson ◽  
Johannes Gräske
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Research Literature ◽  
Term Care ◽  
Content Type ◽  
Care Recipients ◽  
People With Dementia ◽  
Care Facilities

Purpose The purpose of this paper is to review and synthesize the research literature on the quality of life (QoL) of both caregivers (CGs) and care recipients (CRs) with dementia after admission to long-term care facilities. Design/methodology/approach Four databases – AgeLine, Medline, EBSCO, and PyscINFO – were searched and the relevant literature from 2002 onwards was reviewed. Findings The review of 12 studies (five studies, including only family CGs; six studies including residents; one study including both family CGs and CRs) reveals a discrepancy regarding the effects of institutionalization on the CRs’ and CGs’ QoL. Among seven studies on CRs’ QoL change, some reviewed studies found a significant decline in CRs’ QoL after placement with others showing that CRs’ QoL was improved or stable. While some reports indicated that some family CGs benefited from placement, others showed that CGs merely maintained their QoL. However, family CGs in the reviewed studies were more likely to report improved QoL than were their CRs after institutionalization. Research limitations/implications The authors recommend that future studies should focus on understanding the individual’s adaptation to placement, dyadic changes in QoL (including mediators/moderators). They emphasize the need for a comprehensive longitudinal study with more than one wave and includes diverse groups including racial/ethnic minority CGs and CRs. Originality/value This study reviewed and synthesized the research literature on the QoL of both caregiver and the people with dementia they cared for after those they cared for were admitted to long-term care facilities. The conclusions drawn about influences on QoL provide guidance for identifying best practices and research.

Comparison Between Quality of Care Provided by Trained Feeding Assistants and Certified Nursing Assistants During Between-Meal Supplementation in Long-Term Care Settings

2016 ◽  
Vol 37 (11) ◽  
pp. 1391-1410 ◽  
Author(s):  
Emily K. Hollingsworth ◽  
Emily A. Long ◽  
Sandra F. Simmons
Keyword(s):  
Nursing Staff ◽  
Long Term Care ◽  
Nursing Assistants ◽  
Certified Nursing Assistants ◽  
Research Staff ◽  
Term Care ◽  
Trained Staff ◽  
Feeding Assistance

The purpose of this study was to compare the quality of feeding assistance provided by trained non-nursing staff with care provided by certified nursing assistants (CNAs). Research staff provided an 8-hr training course that met federal and state requirements to non-nursing staff in five community long-term care facilities. Trained staff were assigned to between-meal supplement and/or snack delivery for 24 weeks. Using standardized observations, research staff measured feeding assistance care processes between meals across all study weeks. Trained staff, nurse aides, and upper level staff were interviewed at 24 weeks to assess staff perceptions of program impact. Trained staff performed significantly better than CNAs for 12 of 13 care process measures. Residents also consumed significantly more calories per snack offer from trained staff ( M = 130 ± 126 [ SD] kcal) compared with CNAs ( M = 77 ± 94 [ SD] kcal). The majority of staff reported a positive impact of the training program.

scholarly journals Development of an Educational-Training Program for Infection Control Practitioners in Long-Term Care Hospitals Using the Dacum Method: A Descriptive Study

2019 ◽  
Author(s):  
Sun Y Jeong ◽  
Og Son Kim
Keyword(s):  
Training Program ◽  
Elderly Persons ◽  
Educational Training ◽  
Term Care ◽  
Program Satisfaction ◽  
The Mean ◽  
Underlying Diseases ◽  
Educational Training Program

Abstract Background: Elderly persons in Korea are at risk of infection due to underlying diseases and weak immune systems. In addition, they require care in long-term care hospitals (LTCHs) that have well-trained infection control practitioners (ICPs). This study aimed to develop an educational-training program for ICPs working in LTCHs using the Developing A Curriculum (DACUM) method. Methods: A total of 209 ICPs participated in a survey and rated 12 duties and 51 tasks according to frequency, importance, and difficulty. Tasks that scored above the mean for each of the three factors were selected as key tasks and divided into five modules. Subsequently, 29 of the ICPs participated in a pilot educational-training program.Results: Of a maximum of 5.00, the mean task frequency, importance, and difficulty were 2.71, 3.90, and 3.67, respectively. The mean program satisfaction level was 93.23 (standard deviation: ±3.79 points) out of 100 points. The total knowledge, skills, and teaching efficacy scores were significantly higher after the program (p<0.001, p<0.001, and p<0.006, respectively).Conclusions: The DACUM method was used to develop an educational-training program based on the duties of ICPs. This systematically developed program was effective and has the potential to improve ICP performance and the quality of care in LTCHs.

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