How does perceived informational and managerial continuity affect quality of care? Patients’ opinions on the Catalan public health services

Objectives To determine the nature and extent of governance activities by health service boards in relation to quality and safety of care and to gauge the expertise and perspectives of board members in this area. Methods This study used an online and postal survey of the Board Chair, Quality Committee Chair and two randomly selected members from the boards of all 85 health services in Victoria. Seventy percent (233/332) of members surveyed responded and 96% (82/85) of boards had at least one member respond. Results Most boards had quality performance as a standing item on meeting agendas (79%) and reviewed data on medication errors and hospital-acquired infections at least quarterly (77%). Fewer boards benchmarked their service’s quality performance against external comparators (50%) or offered board members formal training on quality (53%). Eighty-two percent of board members identified quality as a top priority for board oversight, yet members generally considered their boards to be a relatively minor force in shaping the quality of care. There was a positive correlation between the size of health services (total budget, inpatient separations) and their board’s level of engagement in quality-related activities. Ninety percent of board members indicated that additional training in quality and safety would be ‘moderately useful’ or ‘very useful’. Almost every respondent believed the overall quality of care their service delivered was as good as, or better than, the typical Victorian health service. Conclusions Collectively, health service boards are engaged in an impressive range of clinical governance activities. However, the extent of engagement is uneven across boards, certain knowledge deficits are evident and there was wide agreement among board members that further training in quality-related issues would be useful. What is known about the topic? There is an emerging international consensus that effective board leadership is a vital element of high-quality healthcare. In Australia, new National Health Standards require all public health service boards to have a ‘system of governance that actively manages patient safety and quality risks’. What does this paper add? Our survey of all public health service Boards in Victoria found that, overall, boards are engaged in an impressive range of clinical governance activities. However, tensions are evident. First, whereas some boards are strongly engaged in clinical governance, others report relatively little activity. Second, despite 8 in 10 members rating quality as a top board priority, few members regarded boards as influential players in determining it. Third, although members regarded their boards as having strong expertise in quality, there were signs of knowledge limitations, including: near consensus that (additional) training would be useful; unfamiliarity with key national quality documents; and overly optimistic beliefs about quality performance. What are the implications for practitioners? There is scope to improve board expertise in clinical governance through tailored training programs. Better board reporting would help to address the concern of some board members that they are drowning in data yet thirsty for meaningful information. Finally, standardised frameworks for benchmarking internal quality data against external measures would help boards to assess the performance of their own health service and identify opportunities for improvement.

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Comparative quality of private and public health services in rural Vietnam

Health Policy and Planning ◽

10.1093/heapol/czi037 ◽

2005 ◽

Vol 20 (5) ◽

pp. 319-327 ◽

Cited By ~ 50

Author(s):

Tran Tuan ◽

Van Thi Mai Dung ◽

Ingo Neu ◽

Michael J Dibley

Keyword(s):

Public Health ◽

Health Services ◽

Public Health Services ◽

Private And Public

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Total quality management (TQM) movement in public health

International Journal of Quality & Reliability Management ◽

10.1108/ijqrm-12-2013-0193 ◽

2015 ◽

Vol 33 (1) ◽

pp. 25-41 ◽

Cited By ~ 6

Author(s):

Jeffrey E. Jarrett

Keyword(s):

Public Health ◽

Quality Control ◽

Quality Management ◽

Health Services ◽

Multivariate Methods ◽

Total Quality ◽

Public Health Services ◽

Content Type ◽

The Public

Purpose – The purpose of this paper is to suggest better methods for monitoring the diagnostic and treatment services for providers of public health and the management of public health services. In particular, the authors examine the construction and use of industrial quality control methods as applied to the public providers, in both the prevention and cure for infectious diseases and the quality of public health care providers in such applications including water quality standards, sewage many others. The authors suggest implementing modern multivariate applications of quality control techniques and/or better methods for univariate quality control common in industrial applications in the public health sector to both control and continuously improve public health services. These methods entitled total quality management (TQM) form the foundation to improve these public services. Design/methodology/approach – The study is designed to indicate the great need for TQM analysis to utilize methods of statistical quality control. All this is done to improve public health services through implementation of quality control and improvement methods as part of the TQM program. Examples of its use indicate that multivariate methods may be the best but other methods are suggested as well. Findings – Multivariate methods provide the best solutions when quality and reliability tests show indications that the variables observed are inter-correlated and correlated over time. Simpler methods are available when the above factors are not present. Research limitations/implications – Multivariate methods will provide for better interpretation of results, better decisions and smaller risks of both Type I and Type II errors. Smaller risks lead to better decision making and may reduce costs. Practical implications – Analysts will improve such things as the control of water quality and all aspects of public health when data are collected through experimentation and/or periodic quality management techniques. Social implications – Public health will be better monitored and the quality of life will improve for all especially in places where public development is undertaking rapid changes. Originality/value – The manuscript is original because it uses well known and scientific methods of analyzing data in area where data collection is utilized to improve public health.

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Profile of unnatural mortality at tertiary hospital

Gaceta Médica de Caracas - Supplement 1 ◽

10.47307/gmc.2021.129.s2.30 ◽

2021 ◽

Vol 129 (s2) ◽

Author(s):

Mustika Chasanatusy Syarifah ◽

Diyan Wahyu Kurniasari

Keyword(s):

Public Health ◽

Health Services ◽

General Hospital ◽

Tertiary Hospital ◽

Public Health Services ◽

Unnatural Death ◽

External Causes

Introduction: Unnatural deaths are deaths that can be prevented, the frequency of which reflects the quality of public health services. Unnatural deaths occur due to external causes such as suicide, homicide, and accidents. This study aims to analyze the profile of cases of unnatural death at Dr. Soetomo General Hospital, Surabaya, Indonesia.

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Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states

Gates Open Research ◽

10.12688/gatesopenres.13134.1 ◽

2020 ◽

Vol 4 ◽

pp. 61

Author(s):

Sumit Kane ◽

Prarthna Dayal ◽

Tanmay Mahapatra ◽

Sanjiv Kumar ◽

Shikha Bhasin ◽

...

Keyword(s):

Public Health ◽

Health Services ◽

Newborn Care ◽

Uttar Pradesh ◽

Improve Quality ◽

Public Health Services ◽

Indian States ◽

Middle Income ◽

Implementing Change

Background: Few studies have explicitly examined the implementation of change interventions in low- and middle-income country (LMIC) public health services. We contribute to implementation science by adding to the knowledge base on strategies for implementing change interventions in large, hierarchical and bureaucratic public services in LMIC health systems. Methods: Using a mix of methods, we critically interrogate the implementation of an intervention to improve quality of obstetric and newborn services across 692 facilities in Uttar Pradesh and Bihar states of India to reveal how to go about making change happen in LMIC public health services. Results: We found that focusing the interventions on a discreet part of the health service (labour rooms) ensured minimal disruption of the status quo and created room for initiating change. Establishing and maintaining respectful, trusting relationships is critical, and it takes time and much effort to cultivate such relationships. Investing in doing so allows one to create a safe space for change; it helps thaw entrenched practices, behaviours and attitudes, thereby creating opportunities for change. Those at the frontline of change processes need to be enabled and supported to: lead by example, model and embody desirable behaviours, be empathetic and humble, and make the change process a positive and meaningful experience for all involved. They need discretionary space to tailor activities to local contexts and need support from higher levels of the organisation to exercise discretion. Conclusions: We conclude that making change happen in LMIC public health services, is possible, and is best approached as a flexible, incremental, localised, learning process. Smaller change interventions targeting discreet parts of the public health services, if appropriately contextualised, can set the stage for incremental system wide changes and improvements to be initiated. To succeed, change initiatives need to cultivate and foster support across all levels of the organisation.

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Quality of Public Health Services Received by Immigrant Labours: A Case Study in Klang Valley

Jurnal Sains Kesihatan Malaysia ◽

10.17576/jskm-1201-2014-07 ◽

2014 ◽

Vol 12 (1) ◽

pp. 47-56

Author(s):

Normah Awang Noh ◽

Haris Abdul Wahab ◽

Siti Hajar Abu Bakar Ah

Keyword(s):

Public Health ◽

Health Services ◽

Public Health Services ◽

Klang Valley

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Perceived Corruption and Quality of Health Services in Mbeya Urban District, Mbeya Region Tanzania

International Journal of Social Science Research ◽

10.5296/ijssr.v5i1.10519 ◽

2017 ◽

Vol 5 (1) ◽

pp. 150

Author(s):

Samwel J. Kabote

Keyword(s):

Public Health ◽

Health Services ◽

Health Sector ◽

Perceived Quality ◽

Public Health Services ◽

The Public ◽

Significant Difference ◽

Quality Of Health Services ◽

Level Of Significance

This paper examines the effect of corruption on quality of public health services. Corruption, in Tanzania, is a national concern that upsets public health services. There is a public outcry that corruption is increasing in the public health sector while the government’s effort to combat the phenomenon is unimpressive. This poses worries on the quality of public health services. The current study adopted cross-sectional research design, and a total of 180 respondents were involved in the survey. The Mann Whitney U Test was used to compare differences between perceived quality of health services and respondents’ characteristics. Overall, 87.2% of the respondents perceived low quality of health services, and corruption affected quality of health services to a greater extent. Based on age, employment and wealth status, there was significant difference on reporting perceived quality of health services at 5% and 1% level of significance. In addition, respondents’ sex and employment status showed significant difference in reporting the extent to which corruption affected quality of health services at 5% level of significance. The paper draws out two conclusions: first, the quality of health services was low. Second, corruption exacerbated poor quality of health services. To that effect, interventions to combat corruption in the public health sector are needed so as to improve quality of health services.

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Final Products: a regional integrated output assessment in Public Health services, 2017-19 Italy

European Journal of Public Health ◽

10.1093/eurpub/ckz185.582 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C Smaniotto ◽

F Del Bianco ◽

E Giardinelli ◽

G Bravo ◽

C Oppi ◽

...

Keyword(s):

Public Health ◽

Health Services ◽

Accounting System ◽

Public Health Services ◽

Exact Test ◽

Managerial Skills ◽

Public Health Professionals ◽

June July

Abstract Issue/problem The classification of Public Health services (PHS) and related healthcare information systems (HIS) in Friuli Venezia Giulia, Italy, are complex and non-homogeneous. Since 2017 the Region has been realigning HIS according to the new Final Products (FP) System to classify PHS. The aim is to implement an integrated FP-based HIS, easing data transmission and improving the quality of planning, scheduling and expense reporting activities. Description of the problem From June 2017 to October 2018 68 Public Health professionals (PHP) from 10 Public Health areas outlined 102 PF from HIS through flowcharts and technical dossiers. Afterwards (10/5th-10/29th 2018) they assessed HIS through a questionnaire of 24 items. Statistical analysis was performed with Fisher’s Exact Test, stratifying 4 categories (physician, veterinarian, prevention technician, other professional). In June-July 2019, through a matrix-based assessment, PHP of regional PHS were invited to weight each FP activity on the basis of involved personnel and possible required transfer (valorisation phase). Results The questionnaire got 45/68 responses (66%). Among responders, 27% reported a HIS for their PHS not being available at all; 65% of responders agreed on the usefulness of an integrated regional HIS for PHS. Fisher’s Test showed significant differences in HIS features according to profession, as interoperability with national/regional databases (p = 0.0144), mobile usability for external activities (p = 0.0302), real correspondence between monitored data and performed activities (p = 0.0215). Valorisation was performed by 445/557 PHP (80%). Lessons PHS currently often deal with functional flaws or inappropriateness of HIS when compared to real activities. Valorisation data will be submitted to the attention of policymakers in October 2019 in order to apply an integrated classification of PHS considering both effectiveness and generation of value of activities performed in Public Health. Key messages Healthcare is a multilayered product and measuring healthcare outputs requires managerial skills and tools, to assess need of resources and to plan activities. The regional Final Products project defines a uniform classification of Public Health services and implements a standardised accounting system for activities performed in Public Health.

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Partnering with consumers in the public reporting of quality of care: review of the Victorian quality of care reports

Australian Health Review ◽

10.1071/ah16272 ◽

2018 ◽

Vol 42 (5) ◽

pp. 550

Author(s):

Charissa Zaga ◽

Sandra Leggat ◽

Sophie Hill

Keyword(s):

Quality Of Care ◽

Health Services ◽

Public Reporting ◽

Consumer Participation ◽

Public Health Services ◽

Department Of Health ◽

Observational Study Design ◽

Quality Health ◽

Unexpected Findings

Objective The aim of the present study was to investigate whether the content of annual Victorian quality of care reports had an increased consumer participation focus following the introduction of the National Safety and Quality Health Service (NSQHS) Partnering with Consumers standard. Methods A mixed-methods approach comprising a comparative descriptive observational study design with quantitative data analysis was used. Nine large Victorian metropolitan public health services’ annual quality of care reports from 2011 and 2014 were analysed using a newly devised analysis framework consisting of elements of the NSQHS ‘Partnering with Consumers’ standard and minimal requirements for Quality of Care reporting by the Department of Health and Human Services. Results Of the nine 2014 quality of care reports, in only three were total scores higher compared with scores in the 2011 reports; in one of the 2014 reports, the total scores remained the same, and in the remaining five reports total scores were lower than in the 2011 reports. Overall, there was an improved total score for the 2014 reports compared with the 2011 reports, corresponding to a higher consumer participation focus. Conclusion Overall, the present study demonstrated mixed findings and, in some cases, lower scores for the 2014 reports, which was after the introduction of the Partnering with Consumers NSQHS standard, compared with the 2011 reports. Overall, there is future scope to enhance the degree of consumer participation evident within the quality of care reports. What is known about the topic? Partnering with consumers has been associated with improved clinical outcomes, decreased readmission rates and rates of hospital-acquired infections, and improved adherence to treatment recommendations and health literacy. Engaging consumers has been recognised as a means to increase the accessibility and appropriateness of healthcare to individuals. Public reporting is a tool through which health services communicate with and engage their consumers in order to improve the quality of care they provide, and is a key element in Australia of the NSQHS Partnering with Consumers standard. What does the paper add? This paper links the principles of consumer participation with public reporting. The paper highlights the potential for healthcare organisations to use their public reporting media to engage with consumers and communicate about the quality of care they deliver. What are the implications for practitioners? The unexpected findings of a lower emphasis on consumer participation suggests the need for Victorian health services to review the purpose and processes for developing the publicly reported quality of care reports in order to improve their compliance.

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Moderating effect of people-oriented public health services on depression among people under mandatory social isolation during the COVID-19 pandemic: a cross-sectional study in China

BMC Public Health ◽

10.1186/s12889-021-11457-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bolin Cao ◽

Dongya Wang ◽

Yifan Wang ◽

Brian J. Hall ◽

Nan Wu ◽

...

Keyword(s):

Public Health ◽

Depressive Symptoms ◽

Health Services ◽

Social Isolation ◽

Media Coverage ◽

Perceived Risk ◽

Perceived Quality ◽

Public Health Services ◽

Cross Sectional

Abstract Background Public health measures, such as social isolation, are vital to control the spread of the coronavirus disease 2019 (COVID-19), but such measures may increase the risk of depression. Thus, this study examines the influencing and moderating factors of depressive symptoms among individuals subjected to mandatory social isolation. Methods An online cross-sectional survey was conducted to collect data from people under mandatory home or centralized social isolation in Shenzhen, China, from February 28 to March 6, 2020. The perceived risk of infection with COVID-19, perceived tone of media coverage, perceived quality of people-oriented public health services, and their depressive symptoms were assessed. Three rounds of stepwise multiple regression were performed to examine the moderating effects after controlling various variables, such as demographics, duration and venue of mandatory social isolation, infection and isolation status of family, time spent on COVID-related news, and online social support. Results Among the 340 participants, 57.6% were men, the average age was 35.5 years old (SD = 8.37), and 55.6% held a bachelor’s degree or above. Individuals subjected to mandatory social isolation generally reported low levels of depressive symptoms. Perceived susceptibility to infection was relatively low, whereas perceived tone of media coverage was mainly positive. In terms of perceived quality of public health services, 12 (3.5%), 103 (30.3%), and 225 (66.2%) participants reported low, medium, and high quality of people-oriented services, respectively. Perceived susceptibility was positively associated with depression, whereas perceived tone of media coverage was negatively associated. The quality of people-centered public health services moderated the association between perceived risk and depressive symptoms and between perceived tone of media coverage and depressive symptoms. Conclusions This study revealed the depressive symptoms among individuals subjected to mandatory social isolation during the COVID-19 pandemic and highlighted that frontline public health workers play a critical role in protecting public mental health.

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