scholarly journals A Comprehensive Strategic Analysis of the Environmental Scanning of Iranian Public Hospitals: A Prospective Approach

2019 ◽  
Author(s):  
Kimia pourmohammadi ◽  
Peivand Bastani ◽  
Payam Shojaei ◽  
nahid hatam ◽  
Asiyeh Salehi
Keyword(s):  
Interest Rates ◽  
Service Providers ◽  
Healthcare Services ◽  
Structured Interview ◽  
Public Hospitals ◽  
Environmental Scanning ◽  
Efficiency And Effectiveness ◽  
Key Issues ◽  
Political Economic ◽  
Strategic Policies

Abstract Objectives: This mixed-method study was conducted to interpret the political, economic, social and technological issues that encourage hospital managers to be aware of the conditions and be equipped to plan and perform proactively. Results: structured interview using Douglas West framework and a researcher-made questionnaire were used to determine the effectiveness and feasibility of hospitals’ environmental factors. The key issues at micro level environment of public hospitals were related to prescription and overuse of pharmaceuticals, inequality in distribution of healthcare services and high demands for luxurious services. At macro level: higher fertility rates, hospital services tariffs, changes in the patterns of diseases and inappropriate hospital budgeting have direct impact and economic sanctions, government corruption, centralization and high bank interest rates have indirect impact on public hospitals in Iran. Generally the strategic policies are required to improve quality-based payment system, enhance the efficiency and effectiveness of services, improving fair income generation and urging positive motivations for service providers are the strategies to cope with the future changes. Key words: public hospital, environmental scanning, strategic management, PESTLE analysis, future, Iran

scholarly journals A Comprehensive Environmental Scanning and Strategic Analysis of Iranian Public Hospitals: A Prospective Approach

2020 ◽  
Author(s):  
Kimia pourmohammadi ◽  
Peivand Bastani ◽  
Payam Shojaei ◽  
nahid hatam ◽  
Asiyeh Salehi
Keyword(s):  
Economic Sanctions ◽  
Healthcare Services ◽  
Public Hospitals ◽  
Environmental Scanning ◽  
Distribution Management ◽  
Strategic Direction ◽  
Efficiency And Effectiveness ◽  
Considerable Impact ◽  
Strategic Policies ◽  
Environmental Level

Abstract Objectives: This study was conducted to provide a strategic direction to public hospitals in Iran via environmental scanning in order to equip hospitals to plan and perform proactively and adapt with the ever-changing environment. Results: A mixed method study including in-depth interview and survey were used to determine influential environmental factors based on PESTLE (Political, Economic, Social, Technological, Legal and Environmental) and Douglas West framework (to determine the effectiveness and feasibility of factors). Issues identified at micro environmental level were over prescription, inequality in distribution of healthcare services and high demands for luxurious health services. Issues identified at the macro environmental level were related to changes in disease patterns, inappropriate hospital budgeting, economic sanctions, government corruption and healthcare centralization. In order to tackle the issues identified, it is paramount to enhance bed distribution management, improve strategic policies for a more equitable payment system, and enhance the efficiency and effectiveness of services by implementing a strategic inventory control. Furthermore, the considerable impact of economic sanctions on financial resources of Iranian hospitals should not be ignored.

A Comprehensive Strategic Analysis of the Environmental Scanning of Iranian Public Hospitals: A Prospective Approach

2020 ◽  
Author(s):  
Kimia pourmohammadi ◽  
Peivand Bastani ◽  
Payam Shojaei ◽  
Nahid Hatam ◽  
Asiyeh Salehi
Keyword(s):  
Waiting Times ◽  
Economic Sanctions ◽  
Healthcare Services ◽  
Public Hospitals ◽  
Macro Level ◽  
Environmental Scanning ◽  
Efficiency And Effectiveness ◽  
Micro Level ◽  
The Government ◽  
Uncertain Future

Abstract Objectives: This study was conducted to interpret the micro and macro environmental issues of public hospitals in order to equip hospital managers to plan and perform proactively and could deal more better with uncertain future. Results: semi-structured in-depth interview and a researcher-made questionnaire were used to determine macro and micro level issues based on PESTLE (Political, Economic, Social, Technological, Legal and Environmental) and Douglas West framework in order to determine the effectiveness and feasibility of factors The key issues at micro level environment were related to prescription and overuse of pharmaceuticals, inequality in distribution of healthcare services and high demands for luxurious services. At macro level: changes in disease patterns, inappropriate hospital budgeting, economic sanctions, government corruption and centralization had a great impact on public hospitals in Iran. following the safety guidelines laid down by the government and better management of bed distribution in order to decrease waiting times at micro level and improve strategic policies in order to have quality-based payment system, enhance the efficiency and effectiveness of services and strategic purchasing are the most important ways at macro level. At this time, the considerable impact of economic sanctions on hospital financial resources should not be ignored.

scholarly journals Analyzing The Presence Of Women’s Wards Facility In Government Hospitals Of Karachi

2019 ◽  
Vol 10 (1) ◽  
pp. 21-44
Author(s):  
Khalid Mahmood Iraqi ◽  
Asma Manzoor ◽  
Seema Manzoor
Keyword(s):  
Service Providers ◽  
Healthcare Services ◽  
Structured Interview ◽  
Public Hospitals ◽  
Data Availability ◽  
Easy Access ◽  
Quality Healthcare ◽  
Quality Life ◽  
Government Hospitals ◽  
The Government

Changing global trends have made people more aware and conscious about their health and attainment of quality life by accessing healthcare services. But countries like Pakistan are not able to maintain quality healthcare services for common people. The healthcare service providers are not able to face challenges in this regard. The system of healthcare in Pakistan faces many issues and challenges of imbalance and insufficiency regarding deliverance and access to effective and quality healthcare services. The governments should develop an appropriate health system whose mechanism can be easily accessible for people especially women. For this purpose data from public hospitals has been collected to analyze specific issues within the boundaries of a specific environment and situation, because proper and accurate data availability can assure the effective policy making mechanism. In this study data has been collected by semi-structured interview schedule. Three public hospitals (Civil, Jinnah and Abbasi Shaheed) were selected as a universe of the study, and the respondents were purposively selected for conducting interviews in detail. The findings of this study reveal that in developing countries like Pakistan the healthcare services are not provided adequately in the public sector. People do not have easy access to healthcare opportunities for many reasons among which one reason is poverty, which leads to ill health and low health status. This growing dissatisfaction leads to imbalance societal gap, which demands appropriate measures and policies by the government. Government hospitals have some women specific wards but public private partnership has not been very effective, despite the establishment of Act and collaborations in public-private domain.

Service Quality, Satisfaction and Trust: a Study of Public Hospitals in Bandung, Indonesia

2018 ◽  
Vol 7 (3.30) ◽  
pp. 393
Author(s):  
Marcellia Susan ◽  
. .
Keyword(s):  
Service Quality ◽  
Structural Equation ◽  
Service Providers ◽  
Clinical Care ◽  
Healthcare Services ◽  
Public Hospitals ◽  
Care Process ◽  
Primary Data ◽  
Equation Modeling ◽  
The Public

Research on service quality has been performed by researchers on various research objects. In many previous studies, service quality provided by service providers became the factor that affects customer satisfaction and other various research variables. The study was conducted at public hospitals that offer healthcare services with a focus on service quality. The purpose of this study was to analyze the service quality provided by public hospitals, and to test their effect on the satisfaction and trust of patients or attendants. The objects of this research are the public hospitals in Bandung with the patients or attendants as the unit of analysis. Primary data were obtained through the dissemination of questionnaires on patients or attendants to obtain data on their evaluation of service quality of public hospitals, and their satisfaction and trust towards public hospitals. Obtained data was processed using structural equation modeling to confirm causality of related research variable. The results depict the service quality provided by public hospitals in Bandung covering infrastructure, personnel quality, clinical care process, administrative procedures, safety indicators, and social responsibility. Moreover, the results of hypothesis testing show that service quality has an influence on patient satisfaction, and ultimately affects their trust in the hospital.  

scholarly journals Young Medical Doctors’ Perspectives on Professionalism: A Qualitative Study Conducted in Public Hospitals in Pakistan

2020 ◽  
Author(s):  
Aisha Jalil ◽  
Qaisar Khalid Mehmood ◽  
Florian Fischer
Keyword(s):  
Qualitative Study ◽  
Performance Monitoring ◽  
Sampling Strategy ◽  
Monitoring And Evaluation ◽  
Healthcare Services ◽  
Structured Interview ◽  
School Curriculum ◽  
Public Hospitals ◽  
Extensive Literature ◽  
Medical Doctors

Abstract Background: Professionalism is amongst the major dimensions indicating the competence of medical doctors. A low professionalism affects the overall outcome of healthcare services. This study explores the perspectives of young medical doctors on professionalism in Pakistan.Methods: A qualitative study based on in-depth interviews was conducted with 60 young medical doctors, aged less than 40 years, who studied medicine in Pakistani universities, were Pakistani nationals, and were employed at various hierarchal levels from house officer to consultant specialist in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Qualitative thematic analysis was applied to analyse the data. Results: The data analysis revealed a rigidity of opinions, inflexibility blocking the acceptance of contrasting perspectives, and perceived superiority over all other professions and over patients. The belief that patients know nothing was common among all participants. Similarly, doctors believed that there is no need to include a professionalism and humanity course in the medical school curriculum. The majority of respondents thought that social science topics are irrelevant to medicine and are common-sense things that they already know. The doctors recognised high professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues. The reported characteristics include using social media applications during duty hours, ridiculing patients, substance use such as cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays and inappropriate salaries. Conclusions: Findings implied low medical professionalism among young doctors. This should be immediately addressed by policymakers. Lack of training about professionalism, ethics and humanity in healthcare service delivery, and a lack of performance monitoring and evaluation mechanisms at public hospitals are the major factors contributing to this substandard medical practice. There is a need to revisit the curriculum taught to medical students in order to strengthen professionalism. It is important to improve the skills of being ‘teachable’ and to provide acceptance of other viewpoints in cases where interprofessional collaborations are to be established by medical doctors.

scholarly journals Young Medical Doctors’ Perspectives on Professionalism: A Qualitative Study Conducted in Public Hospitals in Pakistan

2020 ◽  
Author(s):  
Aisha Jalil ◽  
Qaisar Khali Mehmood ◽  
Florian Fischer
Keyword(s):  
Qualitative Study ◽  
Performance Monitoring ◽  
Sampling Strategy ◽  
Monitoring And Evaluation ◽  
Healthcare Services ◽  
Structured Interview ◽  
School Curriculum ◽  
Public Hospitals ◽  
Extensive Literature ◽  
Medical Doctors

Abstract Background: Professionalism is amongst the major dimensions indicating the competence of medical doctors. A decline in professionalism affects the overall outcome of healthcare services. This study explores the patterns of declining professionalism among young medical doctors in Pakistan.Methods: A qualitative study based on in-depth interviews was conducted with 60 young medical doctors aged less than 40 years who were employed at various levels from house officer to consultant specialist in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Thematic content analysis was applied to analyse the data. Results: The data analysis revealed a rigidity of opinions, inflexibility blocking the acceptance of contrasting perspectives, and perceived superiority over all other professions and over patients. The belief that patients know nothing was common among all participants. Similarly, doctors believed that there is no need to include a professionalism and humanity course in the medical school curriculum. The majority of respondents thought that social science topics are irrelevant to medicine and are common-sense things that they already know. The doctors recognised high professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues. The reported characteristics include using social media applications during duty hours, ridiculing patients, substance use such as cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays and inappropriate salaries. Conclusions: It seems that professionalism has declined among young doctors, and this should be immediately addressed by policymakers. The lack of training about ethics and healthcare service delivery, and a lack of performance monitoring and evaluation mechanisms at public hospitals are the major factors contributing to declining professionalism. There is a need to revisit the curriculum taught to medical students in order to strengthen professionalism.

scholarly journals Antecedents and Contextual Factors Affecting Occupational Turnover among Registered Nurses in Public Hospitals in Hong Kong: A Qualitative Descriptive Study

2020 ◽  
Vol 17 (11) ◽  
pp. 3834
Author(s):  
Maria S. Y. Hung ◽  
Stanley K. K. Lam
Keyword(s):  
Hong Kong ◽  
Registered Nurses ◽  
Healthcare System ◽  
Service Providers ◽  
Contextual Factors ◽  
Healthcare Services ◽  
Public Hospitals ◽  
Healthcare Sector ◽  
Snowball Sampling ◽  
Qualitative Descriptive

Global increases in both population size and ageing have led to a drastic expansion in the demand for healthcare services. The shortage of nursing workforce capacity continues, posing immense challenges for the global healthcare system. We aimed to identify the antecedents and contextual factors that contribute to the decisions of occupational turnover from the clinical duties of registered nurses in public hospitals in Hong Kong. A qualitative descriptive design was used in this study. A total of 18 registered nurses who had resigned from public hospitals in Hong Kong and changed their occupations were recruited via convenience and snowball sampling methods. Data were collected through individual, semi-structured, and face-to-face interviews and were analyzed according to the content analysis approach. The antecedents and contextual factors that contributed to the registered nurses’ decisions regarding occupational turnover were identified from the collected data. These factors were classified into three overarching categories: (1) job dissatisfaction due to a tense work environment, (2) low motivation due to limited career opportunities, and (3) inadequate communication due to ineffective leadership. The identification of these antecedents and contextual factors could help healthcare service providers to develop strategies to enhance nurses’ commitment and engagement in their positions and eventually improve their retention. Based on these factors, healthcare sector policy makers could consider incorporating appropriate strategies into healthcare system policy.

Patients’ willingness to utilize a SMS-based appointment scheduling system at a family practice unit in a developing country

2015 ◽  
Vol 17 (02) ◽  
pp. 149-156 ◽  
Author(s):  
Ayoade Adedokun ◽  
Oladipo Idris ◽  
Tolulope Odujoko
Keyword(s):  
Developing Countries ◽  
Waiting Time ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Developed Countries ◽  
Structured Interview ◽  
Appointment Scheduling ◽  
Public Hospitals ◽  
Delivery Of Healthcare ◽  
Scheduling System

AimThe investigators aimed to assess the willingness of patients to utilize and pay for a proposed short message service- (SMS) based appointment scheduling service.BackgroundTelecommunication applications have been introduced to improve the delivery of healthcare services in developed countries; however, public-funded healthcare systems in developing countries like Nigeria are mostly unfamiliar with the use of such technologies for improving healthcare access.MethodsWe proposed a SMS-based (text message) appointment scheduling system to consenting subjects at an outpatients’ clinic and explored their willingness to utilize and pay for the service. Using semi-structured interview schedules, we collected information on: estimated arrival time, most important worry when seeking for healthcare services at public hospitals in the study setting, ownership of a mobile phone, willingness to utilize a SMS-based appointment for clinic visits and willingness to pay for the service. In addition, respondents were asked to suggest a tariff for the proposed system.FindingsA total of 500 consecutively recruited patients aged 16–86 (42.1±15.4) years participated; 54% (n=270) were females. Waiting time ranged from 1–7.5 h (3.9±1.1). Two overlapping themes emerged as most important worries: crowded waiting rooms and long waiting time. Ownership of mobile phones was reported by 96.4% (n=482) of subjects. Nearly all favoured the proposed appointment scheduling system (n=486, 97.2%). Majority of patients who favoured the system were willing to pay for the service (n=484, 99.6%). Suggested tariff ranged from 0.03 to 20.83 (1.53±2.11) US dollars; 89.8% (n=349) of the subjects suggested tariffs that were greater than the prevailing retail cost of the proposed service. In sum, our findings indicate that patients in this study were willing to utilize and pay for a proposed SMS-based appointment scheduling system. The findings have implications for policies aimed at improving healthcare access and delivery of healthcare services at the primary care level in developing countries like Nigeria.

scholarly journals Young Medical Doctors’ Perspectives on Professionalism: A Qualitative Study Conducted in Public Hospitals in Pakistan

2020 ◽  
Author(s):  
Aisha Jalil ◽  
Qaisar Khalid Mehmood ◽  
Florian Fischer
Keyword(s):  
Qualitative Study ◽  
Role Models ◽  
Medical Curriculum ◽  
Sampling Strategy ◽  
Healthcare Services ◽  
Structured Interview ◽  
Public Hospitals ◽  
Medical Professionalism ◽  
Extensive Literature ◽  
Medical Doctors

Abstract Background: Professionalism is amongst the major dimensions determining the competence of medical doctors. Poor professionalism affects the overall outcome of healthcare services. This study explores the perspectives of young medical doctors on professionalism in Pakistan.Methods: A qualitative study based on in-depth interviews was conducted with 60 young medical doctors, aged less than 40 years, who had studied medicine in Pakistani universities, were Pakistani nationals, and were employed at various hierarchical levels, from house officer to consultant specialist, in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Qualitative thematic analysis was applied to analyse the data. Results: The data analysis revealed that rigidity of opinions, unacceptability of contrasting perspectives, false pride, and perceived superiority over other professions and patients were major components of poor medical professionalism. Most of the young doctors believed that there is no need to include professionalism and humanity course modules in the medical curriculum, because topics related to social sciences are deemed irrelevant to medicine and judged to be common sense. The doctors recognised good professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues and paramedics. Other factors contributing to poor medical professionalism included the use of social media applications during duty hours, ridiculing patients, substance use such as smoking cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays, lack of cooperation from paramedical staff, and inadequate role models. Conclusions: Poor medical professionalism among young doctors needs to be addressed by policymakers. There is a need to revisit the medical curriculum to strengthen professionalism. It is essential to develop the qualities of tolerance, teachability, and acceptance in doctors in order to facilitate interprofessional collaborations and avoid medical errors.

scholarly journals Young Medical Doctors’ Perspectives on Professionalism: A Qualitative Study Conducted in Public Hospitals in Pakistan

2020 ◽  
Author(s):  
Aisha Jalil ◽  
Qaisar Khalid Mehmood ◽  
Florian Fischer
Keyword(s):  
Qualitative Study ◽  
Role Models ◽  
Medical Curriculum ◽  
Sampling Strategy ◽  
Healthcare Services ◽  
Structured Interview ◽  
Public Hospitals ◽  
Medical Professionalism ◽  
Extensive Literature ◽  
Medical Doctors

Abstract Background: Professionalism is amongst the major dimensions indicating the competence of medical doctors. A low professionalism affects the overall outcome of healthcare services. This study explores the perspectives of young medical doctors on professionalism in Pakistan.Methods: A qualitative study based on in-depth interviews was conducted with 60 young medical doctors, aged less than 40 years, who studied medicine in Pakistani universities, were Pakistani nationals, and were employed at various hierarchal levels from house officer to consultant specialist in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Qualitative thematic analysis was applied to analyse the data. Results: The data analysis revealed that the rigidity of opinions, unacceptability of contrasting perspectives, false pride and perceived superiority over other professions and patients as major components of low medical professionalism. Most of the young doctors believed that there is no need to include professionalism and humanity course modules in the medical curriculum, because topics related to social sciences are deemed irrelevant to medicine and judged as common sense. The doctors recognised high professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues and paramedics. Other factors contributing to low medical professionalism included the use of social media applications during duty hours, ridiculing the patients, substance use such as cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays, lack of cooperation from the paramedical staff, inadequate role models and inappropriate salaries. Conclusions: Low medical professionalism among young doctors needs to be addressed by policymakers. Lack of training about professionalism, ethical service delivery, performance monitoring and evaluation mechanisms at public hospitals are contributing to substandard medical practice. There is a need to revisit the medical curriculum to strengthen professionalism. It is essential to develop the qualities of tolerance, teachability and acceptance in the doctors for facilitating interprofessional collaborations and avoiding medical errors.

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