scholarly journals PRIORITIZATION OF QUALITY CARE CRITERIA TO DELIVER QUALITY SERVICE USING DEMATEL

2015 ◽  
Vol 11 (2) ◽  
Author(s):  
Raja Rub Nawaz ◽  
Keyword(s):  
Decision Making ◽  
Graphical Representation ◽  
Care Delivery ◽  
Quality Care ◽  
Healthcare Services ◽  
Theory Approach ◽  
Quality Service ◽  
Course Of Action ◽  
Importance Ratings ◽  
Multiple Variables

Purpose:-Hospitals are very vital as an element in Quality Care delivery and their evaluation in these terms on perpetual basis are much needed as these organizations contribute in improving health outcomes for general people. Hospitals, especially privately owned, are also run like businesses these days to remain competitive in the respective arena. The environment and situation faced by many hospitals are often complicated and which definitely requires insightful solutions to steer the direction of these businesses. This study was focused on the application of group decision-making tool, DEMATEL as one of the valid methods in Multi-Criteria Decision Making (MCDM). Methodology:- The study was exploratory in nature and efforts were made to justify by highlighting the criteria prioritization procedure to be undertaken by any healthcare organization. A slight deviation from the standard four-steps of DEMATEL, a course of action was created in the shape of an eight-step procedure to exhibit a practical approach rather than mathematical theory approach. In order to make it more empirical in nature, a five-stage research framework was also devised and acted upon with the help of three separate questionnaires. Avedis Donabedian’s (1988) Quality Care framework was followed and multiple variables were devised, importance ratings were collected from patients on these devised variables and after reduction of variables in to manageable latent factors, called criteria in the study, DEMATEL method was applied to depict the prioritization of Quality Care criteria for the delivery of quality service via digraph. Findings:-The graphical representation through digraph showed that criteria were vertically divided in two halves as C1, C5, and C4 are shown as criteria influencing the lower half criteria C3, C6, and C2. The horizontal span of digraph reflected the importance of criteria prioritized and showed C1 criterion as the most important and C2 criterion with the least importance. Implications:-The prioritization of the criteria along with their cause and effect distribution gave an insight into the constitution framework of localized healthcare services of Karachi, Pakistan

scholarly journals WORK LIFE BALANCE INITIATIVES AND SERVICE ENCOUNTERS EMPLOYEES PERSPECTIVE

2015 ◽  
Vol 11 (2) ◽  
Author(s):  
Badar Zaman ◽  
Keyword(s):  
Decision Making ◽  
Graphical Representation ◽  
Care Delivery ◽  
Quality Care ◽  
Healthcare Services ◽  
Service Encounters ◽  
Theory Approach ◽  
Course Of Action ◽  
Importance Ratings ◽  
Multiple Variables

Purpose--Hospitals are very vital as an element in Quality Care delivery and their evaluation in these terms on perpetual basis are much needed as these organizations contribute in improving health outcomes for general people. Hospitals, especially privately owned, are also run like businesses these days to remain competitive in the respective arena. The environment and situation faced by many hospitals are often complicated and which definitely requires insightful solutions to steer the direction of these businesses. This study was focused on the application of group decision-making tool, DEMATEL as one of the valid methods in Multi-Criteria Decision Making (MCDM). Methodology-- The study was exploratory in nature and efforts were made to justify by highlighting the criteria prioritization procedure to be undertaken by any healthcare organization. A slight deviation from standard four-steps of DEMATEL, a course of action was created in shape of eight-step procedure to exhibit a practical approach rather than mathematical theory approach. In order to make it more empirical in nature, a five-stage research framework was also devised and acted upon with the help of three separate questionnaires. Avedis Donabedian’s (1988) Quality Care framework was followed and multiple variables were devised, importance ratings were collected from patients on these devised variables and after reduction of variables in to manageable latent factors, called criteria in the study, DEMATEL method was applied to depict the prioritization of Quality Care criteria for the delivery of quality service via digraph. Findings--The graphical representation through digraph showed that criteria were vertically divided in two halves as C1, C5, and C4 are shown as criteria influencing the lower half criteria C3, C6, and C2. The horizontal span of digraph reflected the importance of criteria prioritized and showed C1 criterion as the most important and C2 criterion with least importance. Implications--The prioritization of the criteria along with their cause and effect distribution gave an insight into the constitution framework of localized healthcare services of Karachi, Pakistan.

scholarly journals Investigate Knowledge Management Technology Implementation for Supporting Decision Making in Ethiopian Health Sectors

2021 ◽  
Author(s):  
Mniyichel Zeru ◽  
Amare Desta ◽  
Steve Smithson ◽  
Million Meshesha
Keyword(s):  
Decision Making ◽  
Knowledge Management ◽  
Technology Implementation ◽  
Care Delivery ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Factors Affecting ◽  
Management Technology

Abstract Introduction: Knowledge management technology is a key tool for facilitating and improving the quality of health care delivery in hospitals. However, the use and implementation of this technology is not an easy task. The aim of this study is to investigate a knowledge management technology implementation in Ethiopian hospitals, with a particular reference to Jimma University Specialized Hospital. Methodology: Information about challenges of knowledge management technology implementation was gathered using qualitative research methods, through conducting semi-structured interviews. Purposive sampling method was applied to select fifty-four participants from a well-defined population. Findings were first validated, according to published literature and research works, and then sorted into three main areas with recommended solutions, such as current usage of KM technology to enhance and improve decision-making, factors affecting implementation of KM technology Results: This study revealed that overall level of KM technology implementation in Ethiopia hospitals is still low. Conclusion: Implementation and use of KM technology with a view to improving the quality of hospital health services is needed. Thus, it suggested that hospital managers should make much more effort to develop a strategy and policy on the implementation and use of KM technology so that the hospital could improve the quality of healthcare services.

Harmonizing hope: A grounded theory study of the experience of hope of registered nurses who provide palliative care in community settings

2011 ◽  
Vol 9 (3) ◽  
pp. 281-294 ◽  
Author(s):  
Kelly Penz ◽  
Wendy Duggleby
Keyword(s):  
Palliative Care ◽  
Grounded Theory ◽  
Registered Nurses ◽  
Care Delivery ◽  
Quality Care ◽  
Work Life ◽  
Main Concern ◽  
Theory Approach ◽  
Community Settings ◽  
Life Challenges

AbstractObjective:The purpose of this study was to explore the hope experience of registered nurses (RNs) who provide palliative care services in community settings. The specific aims of the study were to (1) describe their hope experience, (2) develop a reflexive understanding of the processes of their hope, and (3) construct a substantive theory of hope of palliative care RNs.Methods:Using constructivist grounded theory methodology, purposeful theoretical sampling was used to enroll 14 practicing community palliative care RNs in the study. Twenty-seven open-ended telephone interviews were conducted and nine daily journal entries on hope were copied. Interviews and journals were transcribed verbatim and analyzed using Charmaz's grounded theory approach.Results:Participants described their hope as a positive state of being involving a perseverant and realistic understanding of future possibilities. Their hope sustained and motivated them, and helped them to strive to provide high-quality care. The main concern for participants was keeping their hope when faced with work life challenges and contrasting viewpoints (i.e., when their hopes differed from the hopes of others around them). They dealt with this through harmonizing their hope by the processes of “looking both ways,” “connecting with others,” “seeing the bigger picture,” and “trying to make a difference.” Their experience of hope was defined within the social context of their work and lives.Significance of results:The results of this study suggest that hope is very important to palliative care RNs, in that it helps them to persevere and sustains them when faced with work life challenges in their practice. This study also highlights the need for continued research in this area as there appears to be a lack of evidence on the meaning of hope for healthcare professionals, and, in particular, understanding hope in the context of palliative and end-of-life care delivery.

Gender inequity as a barrier to women’s access to skilled pregnancy care in rural Nigeria: a qualitative study

2019 ◽  
Vol 11 (6) ◽  
pp. 551-560 ◽  
Author(s):  
Sanni Yaya ◽  
Friday Okonofua ◽  
Lorretta Ntoimo ◽  
Ogochukwu Udenige ◽  
Ghose Bishwajit
Keyword(s):  
Decision Making ◽  
Focus Group ◽  
Qualitative Study ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Quality Care ◽  
Healthcare Services ◽  
Maternal Healthcare ◽  
Edo State

Abstract Background Maternal mortality has been an issue of global importance, with continued efforts by the international development community towards its reduction. The provision of high quality maternal healthcare has been identified as a key strategy in preventing maternal mortality. Gendered intrahousehold power structures, gendered dynamics of resource allocation and women’s limited ability in decision-making can have a huge impact on maternal health-seeking behaviour and overall health status. Using a gender lens, this study explores the root causes of women’s limited access to and utilisation of maternal healthcare services in rural areas of Edo State, Nigeria. Methods This qualitative study involved the analysis of data collected from gender- and age-desegregated focus group discussions (FDGs) in 20 communities in Etsako East and Esan South East local government areas of Edo State, Nigeria. Focus group participants comprised women between the ages of 15–45 y who have been pregnant within the last 5 y and their male spouses and partners of varying ages. A total of 20 FGDs were conducted. Coded transcripts were reviewed and analysed using the gender framework as an analytical guide. Results Most responses indicated that women did not entirely have the power to make decisions regarding when to seek care during pregnancy. Women’s experiences of access to quality care showed intersecting areas of gender and social economic status (SES) and how they impact on access to health. Many of the responses suggested high levels of economic marginalisation among women with women being financially dependent on their spouses and partners for pregnancy healthcare-related costs. Furthermore, a man’s financial status determined the type of care his spouse or partner sought. Women identified a high workload as an issue during pregnancy and a barrier to accessing maternal healthcare services. The role of men within households was generally perceived as that of financial providers, therefore a husband’s support was commonly constructed to solely mean financial support. Conclusion This paper brings attention to the role of gender and SES in producing and sustaining limitations to women’s access to quality care. Interventions geared towards supporting women’s financial independence is an important step towards improving their access to skilled healthcare, more so are interventions that improve women’s decision-making capacities.

scholarly journals Nursing Home Staff’s Perceptions of Healthcare Decision Making for Unbefriended Residents

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 384-384
Author(s):  
Hyejin Kim ◽  
Molly Perkins ◽  
Thaddeus Pope ◽  
Patricia Comer ◽  
Mi-Kyung Song
Keyword(s):  
Decision Making ◽  
Geographic Area ◽  
Care Physician ◽  
Healthcare Decision ◽  
Do Not Resuscitate ◽  
Best Interest ◽  
Care Plans ◽  
Course Of Action ◽  
Healthcare Decision Making ◽  
Facility Level

Abstract ‘Unbefriended’ adults are those who lack decision-making capacity and have no surrogates or advance care plans. Little data exist on nursing homes (NHs)’ healthcare decision-making practices for unbefriended residents. This study aimed to describe NH staff’s perceptions of healthcare decision making on behalf of unbefriended residents. Sixty-six staff including administrators, physicians, nurses, and social workers from three NHs in one geographic area of Georgia, USA participated in a 31-item survey. Their responses were analyzed using descriptive statistics and conventional content analysis. Of 66 participants, eleven had been involved in healthcare decision-making for unbefriended residents. The most common decision was do-not-resuscitate orders. Decisions primarily were made by relying on the resident’s primary care physician and/or discussing within a facility interdisciplinary team. Key considerations in the decision-making process included “evidence that the resident would not have wanted further treatment” and the perception that “further treatment would not be in the resident’s best interest”. Compared with decision making for residents with surrogates, participants perceived decision making for unbefriended residents to be equally-more difficult. Key barriers to making decisions included uncertainty regarding what the resident would have wanted in the given situation and concerns regarding the ethically and legally right course of action. Facilitators (reported by 52 participants) included some information/knowledge about the resident, an understanding regarding decision-making-related law/policy, and facility-level support. The findings highlight the complexity and difficulty of healthcare decision making for unbefriended residents and suggest more discussions among all key stakeholders to develop practical strategies to support decision-making practices in NHs.

Evaluations for New Healthcare Environment Commissioning and Operational Decision Making Using Simulation and Human Factors: A Case Study of an Interventional Trauma Operating Room

2021 ◽  
pp. 193758672199966
Author(s):  
Mirette Dubé ◽  
Jason Laberge ◽  
Elaine Sigalet ◽  
Jonas Shultz ◽  
Christine Vis ◽  
...  
Keyword(s):  
Decision Making ◽  
Human Factors ◽  
Operating Room ◽  
Healthcare Services ◽  
Healthcare Team ◽  
Healthcare Environment ◽  
New Process ◽  
Timely Access ◽  
Operational Decision Making

Purpose: The aim of this article is to provide a case study example of the preopening phase of an interventional trauma operating room (ITOR) using systems-focused simulation and human factor evaluations for healthcare environment commissioning. Background: Systems-focused simulation, underpinned by human factors science, is increasingly being used as a quality improvement tool to test and evaluate healthcare spaces with the stakeholders that use them. Purposeful real-to-life simulated events are rehearsed to allow healthcare teams opportunity to identify what is working well and what needs improvement within the work system such as tasks, environments, and processes that support the delivery of healthcare services. This project highlights salient evaluation objectives and methods used within the clinical commissioning phase of one of the first ITORs in Canada. Methods: A multistaged evaluation project to support clinical commissioning was facilitated engaging 24 stakeholder groups. Key evaluation objectives highlighted include the evaluation of two transport routes, switching of operating room (OR) tabletops, the use of the C-arm, and timely access to lead in the OR. Multiple evaluation methods were used including observation, debriefing, time-based metrics, distance wheel metrics, equipment adjustment counts, and other transport route considerations. Results: The evaluation resulted in several types of data that allowed for informed decision making for the most effective, efficient, and safest transport route for an exsanguinating trauma patient and healthcare team; improved efficiencies in use of the C-arm, significantly reduced the time to access lead; and uncovered a new process for switching OR tabletop due to safety threats identified.

scholarly journals Decision Making from the Experience of Orthognathic Surgery Patients: A Grounded Theory Approach

2021 ◽  
pp. 238008442110144
Author(s):  
N.R. Paul ◽  
S.R. Baker ◽  
B.J. Gibson
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Treatment Options ◽  
Study Data ◽  
Primary Objective ◽  
Major Surgery ◽  
Future Research ◽  
Decision Making Process ◽  
Theory Approach

Introduction: Patients’ decisions to undergo major surgery such as orthognathic treatment are not just about how the decision is made but what influences the decision. Objectives: The primary objective of the study was to identify the key processes involved in patients’ experience of decision making for orthognathic treatment. Methods: This study reports some of the findings of a larger grounded theory study. Data were collected through face-to-face interviews of patients who were seen for orthognathic treatment at a teaching hospital in the United Kingdom. Twenty-two participants were recruited (age range 18–66 y), of whom 12 (male = 2, female = 10) were 6 to 8 wk postsurgery, 6 (male = 2, female = 4) were in the decision-making stage, and 4 (male = 0, female = 4) were 1 to 2 y postsurgery. Additional data were also collected from online blogs and forums on jaw surgery. The data analysis stages of grounded theory methodology were undertaken, including open and selective coding. Results: The study identified the central role of dental care professionals (DCPs) in several underlying processes associated with decision making, including legitimating, mediating, scheduling, projecting, and supporting patients’ decisions. Six categories were related to key aspects of decision making. These were awareness about their underlying dentofacial problems and treatment options available, the information available about the treatment, the temporality of when surgery would be undertaken, the motivations and expectation of patients, social support, and fear of the surgery, hospitalization, and potentially disliking their new face. Conclusion: The decision-making process for orthognathic treatment is complex, multifactorial, and heavily influenced by the role of DCPs in patient care. Understanding the magnitude of this role will enable DCPs to more clearly participate in improving patients’ decision-making process. The findings of this study can inform future quantitative studies. Knowledge Transfer Statement: The results of this study can be used both for informing clinical practice around enabling decision making for orthognathic treatment and also for designing future research. The findings can better inform clinicians about the importance of their role in the patients’ decision-making process for orthognathic treatment and the means to improve the patient experience. It is suggested that further research could be conducted to measure some of the key constructs identified within our grounded theory and assess how these change during the treatment process.

scholarly journals Factors influencing decision making for implementing e-health in light of the COVID-19 outbreak in Gulf Cooperation Council countries

2021 ◽  
Author(s):  
Fahad M Al-Anezi
Keyword(s):  
Decision Making ◽  
United Arab Emirates ◽  
Healthcare Access ◽  
Demographic Factors ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Gulf Cooperation Council ◽  
Factors Influencing ◽  
Electronic Health ◽  
Novel Coronavirus

Abstract Background Electronic health (e-health) approaches such as telemedicine, mobile health, virtual healthcare and electronic health records are considered to be effective in increasing access to healthcare services, reducing operational costs and improving the quality of healthcare services during the coronavirus disease 2019 (COVID-19) outbreak, a pandemic resulting from the spread of a novel coronavirus discovered in December 2019. In this context, the aim of this study was to identify the most important factors influencing decision making on the implementation of e-health in Gulf Cooperation Council (GCC) member states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates), which are in the process of digitizing healthcare services. Methods This study reviewed the literature to identify the important factors influencing decision making on e-health. In addition, a questionnaire-based survey was conducted in order to identify the most important criteria to be considered in decision making on e-health. The survey link was forwarded to 978 healthcare practitioners and 42 experts (purposive sampling), from which a final sample of 892 (864 practitioners and 28 experts) was achieved, reflecting a response rate of 87.45%. Results Of the 44 factors identified under seven themes (strategic, quality, management, technology, function characteristics, economic, sociocultural and demographic factors), 22 factors were identified to be the most important criteria. Conclusions Findings from this study suggest that decision making in relation to e-health is a complex process that requires consideration of various factors. It was also found that attention should be paid to sociocultural and demographic factors, which may need to be considered in increasing healthcare access during the COVID-19 outbreak.

scholarly journals Supply and Demand-Related Decisive Factors in the Utilization of Non-Medical Community Healthcare Services among Elderly Chinese

2020 ◽  
Vol 18 (1) ◽  
pp. 228
Author(s):  
Zhao Yu ◽  
Lijian Wang ◽  
Tolulope Ariyo
Keyword(s):  
Supply And Demand ◽  
The Elderly ◽  
Healthcare Services ◽  
Medical Community ◽  
Quality Service ◽  
Related Factors ◽  
Community Healthcare ◽  
Elderly Chinese ◽  
Service Need ◽  
Community Healthcare Services

There is little research on the utilization of non-medical community healthcare services among the elderly, compared with that of medical community healthcare services. From the perspective of both supply and demand, based on the survey data from Shaanxi province, this study examined supply-related factors (including service supply, service quality, service charge and service accessibility) and demand-related factors (including service need, individual financial status, family care support and knowledge of service) affecting the utilization of non-medical community healthcare services among the elderly in China by using Poisson regression. The findings show that service supply, service quality, service need and knowledge of service are positively associated with the utilization of non-medical community healthcare services among elderly Chinese, but the other factors identified in previous studies are not significant predictors for the utilization of the services among the elderly in the context of China. To our knowledge, this is the first study to examine both supply-related factors and demand-related factors affecting the utilization of non-medical community healthcare services among elderly Chinese.

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