A new method based on fuzzy logic to evaluate the contract service provider performance.

PubMed

Miguel, C A; Barr, C; Moreno, M J L

2008-01-01

This paper puts forward a fuzzy inference system for evaluating the service quality performance of service contract providers. An application service provider (ASP) model for computerized maintenance management was used in establishing common performance indicators of the quality of service. This model was implemented in 10 separate hospitals. As a result, inference produced a service cost/acquisition cost (SC/AC) ratio reduction from 16.14% to 6.09%, an increase of 20.9% in availability, with a maintained repair quality (NRR) in the period of December 2001 to January 2003.

Service quality in health care setting.

PubMed

Rashid, Wan Edura Wan; Jusoff, Hj Kamaruzaman

2009-01-01

This paper attempts to explore the concept of service quality in a health care setting. This paper probes the definition of service quality from technical and functional aspects for a better understanding on how consumers evaluate the quality of health care. It adopts the conceptual model of service quality frequently used by the most researchers in the health care sector. The paper also discusses several service quality dimensions and service quality problems in order to provide a more holistic conception of hospital service quality. The paper finds that service quality in health care is very complex as compared to other services because this sector highly involves risk. The paper adds a new perspective towards understanding how the concept of service quality is adopted in a health care setting.

Value-added strategy models to provide quality services in senior health business.

PubMed

Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin

2017-06-20

The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Contribution of ecosystem services to air quality and climate change mitigation policies: The case of urban forests in Barcelona, Spain

Treesearch

Francesc Baró; Lydia Chaparro; Erik Gómez-Baggethun; Johannes Langemeyer; David J. Nowak; Jaume Terradas

2014-01-01

Mounting research highlights the contribution of ecosystem services provided by urban forests to quality of life in cities, yet these services are rarely explicitly considered in environmental policy targets. We quantify regulating services provided by urban forests and evaluate their contribution to comply with policy targets of air quality and climate change...

Quality effort decision in service supply chain with quality preference based on quantum game

NASA Astrophysics Data System (ADS)

Zhang, Cuihua; Xing, Peng; Wang, Jianwei

2015-04-01

Service quality preference behaviors of both members are considered in service supply chain (SSC) including a service integrator and a service provider with stochastic demand. Through analysis of service quality cost and revenue, the utility functions are established on service quality effort degree and service quality preference level in integrated and decentralized SSC. Nash equilibrium and quantum game are used to optimize the models. By comparing the different solutions, the optimal strategies are obtained in SSC with quality preference. Then some numerical examples are studied and the changing trend of service quality effort is further analyzed by the influence of the entanglement operator and quality preferences.

Managing imperfect competition by pay for performance and reference pricing.

PubMed

Mak, Henry Y

2018-01-01

I study a managed health service market where differentiated providers compete for consumers by choosing multiple service qualities, and where copayments that consumers pay and payments that providers receive for services are set by a payer. The optimal regulation scheme is two-sided. On the demand side, it justifies and clarifies value-based reference pricing. On the supply side, it prescribes pay for performance when consumers misperceive service benefits or providers have intrinsic quality incentives. The optimal bonuses are expressed in terms of demand elasticities, service technology, and provider characteristics. However, pay for performance may not outperform prospective payment when consumers are rational and providers are profit maximizing, or when one of the service qualities is not contractible. Copyright © 2017 Elsevier B.V. All rights reserved.

Quality of care in contraceptive services provided to young people in two Ugandan districts: a simulated client study.

PubMed

Nalwadda, Gorrette; Tumwesigye, Nazarius M; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence

2011-01-01

Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15-24 in two rural districts in Uganda. Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed.

Quality of Care in Contraceptive Services Provided to Young People in Two Ugandan Districts: A Simulated Client Study

PubMed Central

Nalwadda, Gorrette; Tumwesigye, Nazarius M.; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence

2011-01-01

Background Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15–24 in two rural districts in Uganda. Methods Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Results Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. Conclusions The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed. PMID:22132168

Quality evaluation in health care services based on customer-provider relationships.

PubMed

Eiriz, Vasco; Figueiredo, José António

2005-01-01

To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically. Systematic review of the literature. Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non-technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence). This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing-oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.

Service Quality in Higher Education Using an Enhanced SERVQUAL Approach

ERIC Educational Resources Information Center

Tan, Kay C.; Kek, Sei W.

2004-01-01

Customer service and quality are driving forces in the business community. As higher educational institutions tussle for competitive advantage and high service quality, the evaluation of educational service quality is essential to provide motivation for and to give feedback on the effectiveness of educational plans and implementation. This…

Quality of reproductive healthcare for adolescents: A nationally representative survey of providers in Mexico

PubMed Central

De Castro, Filipa; Barrientos-Gutiérrez, Tonatiuh; Leyva-López, Ahideé

2017-01-01

Objective Adolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world’s adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents. Methods This cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015. Results At the national level 13.9% (95%CI: 6.9–26.0) of healthcare units provide low quality, 68.6% (95%CI: 58.4–77.3) medium quality and 17.5% (95%CI: 11.9–25.0) high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best. Conclusions The study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care. PMID:28273129

Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014.

PubMed

Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

2016-03-01

Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach's Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors' offices had the highest quality gap of -1.420 ± 0.82 and -1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were -0.883 ± 0.67, -0.882 ± 0.83, and -0.804 ± 0.62, respectively. There was a significant relationship between peoples' perceptions and expectations concerning the quality of health services and their educational levels. The higher gaps in quality in hospitals and in doctors' offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors.

Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014

PubMed Central

Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

2016-01-01

Introduction Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. Methods This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach’s Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. Results The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors’ offices had the highest quality gap of −1.420 ± 0.82 and −1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were −0.883 ± 0.67, −0.882 ± 0.83, and −0.804 ± 0.62, respectively. There was a significant relationship between peoples’ perceptions and expectations concerning the quality of health services and their educational levels. Conclusion The higher gaps in quality in hospitals and in doctors’ offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors. PMID:27123214

Design and Testing of an Air Force Services Mystery Shopping Program.

DTIC Science & Technology

1998-11-01

Base level Air Force Services’ lodging and foodservice activities use limited service quality measurement tools to determine customer perceptions of... service quality . These tools, specifically management observation and customer comment cards, do not provide a complete picture of service quality . Other... service quality measurement methods such as mystery shopping are rarely used. Bases do not consider using mystery shopping programs because of the

Quantitative comparison of measurements of urgent care service quality.

PubMed

Qin, Hong; Prybutok, Victor; Prybutok, Gayle

2016-01-01

Service quality and patient satisfaction are essential to health care organization success. Parasuraman, Zeithaml, and Berry introduced SERVQUAL, a prominent service quality measure not yet applied to urgent care. We develop an instrument to measure perceived service quality and identify the determinants of patient satisfaction/ behavioral intentions. We examine the relationships among perceived service quality, patient satisfaction and behavioral intentions, and demonstrate that urgent care service quality is not equivalent using measures of perceptions only, differences of expectations minus perceptions, ratio of perceptions to expectations, and the log of the ratio. Perceptions provide the best measure of urgent care service quality.

Participant and service provider perceptions of an outpatient rehabilitation program for people with acquired brain injury.

PubMed

Poncet, Frédérique; Pradat-Diehl, Pascale; Lamontagne, Marie-Eve; Alifax, Anne; Fradelizi, Pascaline; Barette, Maude; Swaine, Bonnie

2017-09-01

A holistic, intensive and interdisciplinary rehabilitation program for people with acquired brain injury (ABI) was developed at the Pitié-Salpêtrière Hospital, France (5 days/week for 7 weeks). This program, recently demonstrated effective, aimed to optimize the ability of people with ABI to perform activities and improve their participation by using individual and group interventions involving ecologically valid activities inside (e.g., in the gym and kitchen) and outside the hospital. However, the perception of the quality of the program by participants and service providers has not yet been reported. This study had 3 objectives: (1) report the perception of participants (adults with ABI) in terms of service quality of the program, (2) report the strengths, weaknesses, opportunities, and threats (SWOT analysis) of the program as perceived by service providers, and (3) triangulate findings to draw conclusions about the program's quality and provide recommendations for quality improvement. We used a mixed-methods design with a validated questionnaire (Perception of Quality of Rehabilitation Services [PQRS-Montreal]) and interviews (structured around a SWOT analysis) involving program participants and service providers. We included 33 program participants (mean age 43.6 years) and 12 service providers (mean years with program 7.6 years). In general, study participants showed a convergence of opinion about the high quality of the program, particularly regarding the team and its participant-focused approach. Specific aspects of the program were viewed more negatively by both participants and service providers (i.e., addressing sexuality, family involvement and return to work/volunteer work/school). Participant and service provider perceptions of the rehabilitation program under study were generally positive. A reliable and valid questionnaire and interviews helped identify aspects of the program that worked well and those that could be targeted for future quality improvement. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

PubMed

Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

2013-01-01

this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics suggest that the PQI intervention increased the number of Caesarean sections, but showed no impact on other indicators of service utilisation and skilled care. the PQI intervention showed a positive impact on the quality of reproductive health services. The effects of the intervention on service utilisation had likely not yet been fully realized, since none of the facilities had achieved national recognition before the evaluation. Staff turnover needs to be reduced to maximise the effectiveness of the intervention. the PQI intervention evaluated here offers an effective way to improve the quality of health services in low-resource settings and should continue to be scaled up in Malawi. Copyright © 2011 Elsevier Ltd. All rights reserved.

Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

PubMed

Arunasalam, Mark; Paulson, Albert; Wallace, William

2003-01-01

Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

Quantifying The Water Quality Services Of Wetlands

EPA Science Inventory

Wetlands are well recognized for their potential for providing a wide range of important ecological services including their ability to provide water quality protection. Watershed-scale water quality trading could create market driven incentives to restore and construct wetlands...

42 CFR 493.1407 - Standard; Laboratory director responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... developed and used for each of the tests performed in the laboratory provide quality laboratory services for... results are found to be unacceptable or unsatisfactory; (5) Ensure that the quality control and quality assessment programs are established and maintained to assure the quality of laboratory services provided and...

Managing hospital quality performance in two related areas: patient care and customer service.

PubMed

Dwore, R B

1993-01-01

The Joint Commission on Accreditation of Healthcare Organization's new emphasis on continuous quality improvement provides hospitals with an opportunity to enhance both customer service as well as patient care. Both are expected by patients and delivered by providers. Patient care is the core product; customer service augments it by adding value and providing the opportunity for a competitive advantage. This article discusses issues for administrators to consider before including customer service as a component of continuous quality improvement and then presents methods for bringing about change.

Evaluation of service quality in family planning clinics in Lusaka, Zambia.

PubMed

Hancock, Nancy L; Vwalika, Bellington; Sitali, Elizabeth Siyama; Mbwili-Muleya, Clara; Chi, Benjamin H; Stuart, Gretchen S

2015-10-01

To determine the quality of contraceptive services in family planning clinics in Lusaka, Zambia, using a standardized approach. We utilized the Quick Investigation of Quality, a cross-sectional survey tool consisting of a facility assessment, client-provider observation and client exit interview, in public-sector family planning clinics. Data were collected on availability of seven contraceptive methods, information given to clients, interpersonal relations between providers and clients, providers' technical competence and mechanisms for continuity and follow-up. Data were collected from five client-provider observations and client exit interviews in each of six public-sector family planning clinics. All clinics had at least two contraceptive methods continuously available for the preceding 6 months. Most providers asked clients about concerns with their contraceptive method (80%) and told clients when to return to the clinic (87%). Most clients reported that the provider advised what to do if a problem develops (93%), described possible side effects (89%), explained how to use the method effectively (85%) and told them when to come for follow-up (83%). Clients were satisfied with services received (93%). This application of the Quick Investigation of Quality showed that the participating family planning clinics in Lusaka, Zambia, were prepared to offer high-quality services with the available commodities and that clients were satisfied with the received services. Despite the subjective client satisfaction, quality improvement efforts are needed to increase contraceptive availability. Although clients perceived the quality of care received to be high, family planning service quality could be improved to continuously offer the full spectrum of contraceptive options. The Quick Investigation of Quality was easily implemented in Lusaka, Zambia, and this simple approach could be utilized in a variety of settings as a modality for quality improvement. Copyright © 2015 Elsevier Inc. All rights reserved.

FM 100-11 Force Integration

DTIC Science & Technology

1998-01-01

formed or available at an Army installation. It as- sesses both the quantity and quality of service deliv- ery, such as how much service is provided...34 That is, determining how much should it cost to provide services to cus- tomers to maintain a given level of quality and still satisfy their needs. d...ence, and ability to sustain the force (judgmental). (9) Quality of soldier and family support services (judgmental). (10) Civilian and military

Video medical interpretation over 3G cellular networks: a feasibility study.

PubMed

Locatis, Craig; Williamson, Deborah; Sterrett, James; Detzler, Isabel; Ackerman, Michael

2011-12-01

To test the feasibility of using cell phone technology to provide video medical interpretation services at a distance. Alternative cell phone services were researched and videoconferencing technologies were tried out to identify video products and telecommunication services needed to meet video medical interpretation requirements. The video and telecommunication technologies were tried out in a pharmacy setting and compared with use of the telephone. Outcomes were similar to findings in previous research involving video medical interpretation with higher bandwidth and video quality. Patients appreciated the interpretation service no matter how it is provided, while health providers and interpreters preferred video. It is possible to provide video medical interpretation services via cellular communication using lower bandwidth videoconferencing technology that provides sufficient quality, at least in pharmacy settings. However, a number of issues need to be addressed to ensure quality of service.

Using and joining a franchised private sector provider network in Myanmar.

PubMed

O'Connell, Kathryn; Hom, Mo; Aung, Tin; Theuss, Marc; Huntington, Dale

2011-01-01

Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor.

Using and Joining a Franchised Private Sector Provider Network in Myanmar

PubMed Central

O'Connell, Kathryn; Hom, Mo; Aung, Tin; Theuss, Marc; Huntington, Dale

2011-01-01

Background Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. Methods and Findings Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor. PMID:22180781

Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

PubMed

Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

2017-05-01

Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

A Framework and Improvements of the Korea Cloud Services Certification System.

PubMed

Jeon, Hangoo; Seo, Kwang-Kyu

2015-01-01

Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed.

A Framework and Improvements of the Korea Cloud Services Certification System

PubMed Central

Jeon, Hangoo

2015-01-01

Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed. PMID:26125049

A fuzzy inference system to evaluate contract service provider performance.

PubMed

Cruz, Antonio Miguel; Denis, Ernesto Rodriguez

2005-01-01

This paper puts forward a fuzzy inference system for evaluating the quality performance of service contract providers. An Application Service Provider was designed and put online, featuring surveys to establish the most useful indicators to evaluate the quality of the service. This model was implemented in 10 separate hospitals. As a result, the service cost-acquisition cost ratio in these cases was reduced from 16.14% to 6.09% in the period 2001-January 2003.

Linking water quality and well-being for improved assessment and valuation of ecosystem services

PubMed Central

Keeler, Bonnie L.; Polasky, Stephen; Brauman, Kate A.; Johnson, Kris A.; Finlay, Jacques C.; O’Neill, Ann; Kovacs, Kent; Dalzell, Brent

2012-01-01

Despite broad recognition of the value of the goods and services provided by nature, existing tools for assessing and valuing ecosystem services often fall short of the needs and expectations of decision makers. Here we address one of the most important missing components in the current ecosystem services toolbox: a comprehensive and generalizable framework for describing and valuing water quality-related services. Water quality is often misrepresented as a final ecosystem service. We argue that it is actually an important contributor to many different services, from recreation to human health. We present a valuation approach for water quality-related services that is sensitive to different actions that affect water quality, identifies aquatic endpoints where the consequences of changing water quality on human well-being are realized, and recognizes the unique groups of beneficiaries affected by those changes. We describe the multiple biophysical and economic pathways that link actions to changes in water quality-related ecosystem goods and services and provide guidance to researchers interested in valuing these changes. Finally, we present a valuation template that integrates biophysical and economic models, links actions to changes in service provision and value estimates, and considers multiple sources of water quality-related ecosystem service values without double counting. PMID:23091018

Linking water quality and well-being for improved assessment and valuation of ecosystem services.

PubMed

Keeler, Bonnie L; Polasky, Stephen; Brauman, Kate A; Johnson, Kris A; Finlay, Jacques C; O'Neill, Ann; Kovacs, Kent; Dalzell, Brent

2012-11-06

Despite broad recognition of the value of the goods and services provided by nature, existing tools for assessing and valuing ecosystem services often fall short of the needs and expectations of decision makers. Here we address one of the most important missing components in the current ecosystem services toolbox: a comprehensive and generalizable framework for describing and valuing water quality-related services. Water quality is often misrepresented as a final ecosystem service. We argue that it is actually an important contributor to many different services, from recreation to human health. We present a valuation approach for water quality-related services that is sensitive to different actions that affect water quality, identifies aquatic endpoints where the consequences of changing water quality on human well-being are realized, and recognizes the unique groups of beneficiaries affected by those changes. We describe the multiple biophysical and economic pathways that link actions to changes in water quality-related ecosystem goods and services and provide guidance to researchers interested in valuing these changes. Finally, we present a valuation template that integrates biophysical and economic models, links actions to changes in service provision and value estimates, and considers multiple sources of water quality-related ecosystem service values without double counting.

Evaluating health service quality: using importance performance analysis.

PubMed

Izadi, Azar; Jahani, Younes; Rafiei, Sima; Masoud, Ali; Vali, Leila

2017-08-14

Purpose Measuring healthcare service quality provides an objective guide for managers and policy makers to improve their services and patient satisfaction. Consequently, the purpose of this paper is to measure service quality provided to surgical and medical inpatients at Kerman Medical Sciences University (KUMS) in 2015. Design/methodology/approach A descriptive-analytic study, using a cross-sectional method in the KUMS training hospitals, was implemented between October 2 and March 15, 2015. Using stratified random sampling, 268 patients were selected. Data were collected using an importance-performance analysis (IPA) questionnaire, which measures current performance and determines each item's importance from the patients' perspectives. These data indicate overall satisfaction and appropriate practical strategies for managers to plan accordingly. Findings Findings revealed a significant gap between service importance and performance. From the patients' viewpoint, tangibility was the highest priority (mean=3.54), while reliability was given the highest performance (mean=3.02). The least important and lowest performance level was social accountability (mean=1.91 and 1.98, respectively). Practical implications Healthcare managers should focus on patient viewpoints and apply patient comments to solve problems, improve service quality and patient satisfaction. Originality/value The authors applied an IPA questionnaire to measure service quality provided to surgical and medical ward patients. This method identifies and corrects service quality shortcomings and improving service recipient perceptions.

The Effect of Hospital Service Quality on Patient's Trust.

PubMed

Zarei, Ehsan; Daneshkohan, Abbas; Khabiri, Roghayeh; Arab, Mohammad

2015-01-01

The trust is meant the belief of the patient to the practitioner or the hospital based on the concept that the care provider seeks the best for the patient and will provide the suitable care and treatment for him/her. One of the main determinants of patient's trust is the service quality. This study aimed to examine the effect of quality of services provided in private hospitals on the patient's trust. In this descriptive cross-sectional study, 969 patients were selected using the consecutive method from eight private general hospitals of Tehran, Iran, in 2010. Data were collected through a questionnaire containing 20 items (14 items for quality, 6 items for trust) and its validity and reliability were confirmed. Data were analyzed using descriptive statistics and multivariate regression. The mean score of patients' perception of trust was 3.80 and 4.01 for service quality. Approximately 38% of the variance in patient trust was explained by service quality dimensions. Quality of interaction and process (P < 0.001) were the strongest factors in predicting patient's trust, but the quality of the environment had no significant effect on the patients' degree of trust. The interaction quality and process quality were the key determinants of patient's trust in the private hospitals of Tehran. To enhance the patients' trust, quality improvement efforts should focus on service delivery aspects such as scheduling, timely and accurate doing of the service, and strengthening the interpersonal aspects of care and communication skills of doctors, nurses and staff.

Service quality in public health clinics: perceptions of users and health professionals.

PubMed

Campos, Domingos Fernandes; Negromonte Filho, Rinaldo Bezerra; Castro, Felipe Nalon

2017-10-09

Purpose The purpose of this paper is to investigate the expectations and quality gaps in services provided at city public health clinics in the city of Natal, Brazil, from the perspective of patients and healthcare service providers. Design/methodology/approach The research sample consisted of 1,200 patients who used public health services and 265 providers - doctors, nutritionists, physiotherapists, psychologists, pharmacists and managers at three health clinics in the city of Natal, Brazil. A scale with 25 health service attributes was used in data collection. Summary statistics and t-test were used to analyze the data. Findings The results show that the providers think that users have lower levels of expectations than those indicated by the users in all attributes. Providers and users have the most approximate insights into what attributes are considered most important: explanations, level of knowledge and attention dispensed by health professionals. Users and providers perceived similar quality gaps for most of the attributes. The gaps were statistically the same, when comparing the mean quality shortcomings by means of a Student's test, considering a significance level of 5 percent, obtained independently by the manifestation of users and providers. Research limitations/implications The results reveal only a photograph of the moment. The study did not consider the differences that may exist between groups with different income levels, genders or age groups. A qualitative study could improve the understanding of the differences and coincidences of the diverse points of views. A more advanced research could even study possibilities so that health managers could promote changes in the service, some of them low cost, as the health professionals training for contact with patients. Practical implications The evaluation of the service quality complemented by the matrix of opportunities, importance × quality gaps generates information to help make decisions in the rational allocation of available resources and improvement of the quality of the service delivered to patients. Besides, it offers a focus to prioritize specific actions. Originality/value It is important to compare the perceptions of service quality between patients and the healthcare service providers who work in direct contact with them. The managers can smooth out these differences and ensure, over time, customer satisfaction. In this study, providers were asked to express what they think about the expectations of patients and about their own service performance delivered. Thus, not only the traditional gap 5 was measured, but it was also possible to evaluate the distance between what providers think that patients need and their actual needs.

A Conceptual Framework for Quality of Care

PubMed Central

Mosadeghrad, Ali Mohammad

2012-01-01

Despite extensive research on defining and measuring health care quality, little attention has been given to different stakeholders’ perspectives of high-quality health care services. The main purpose of this study was to explore the attributes of quality healthcare in the Iranian context. Exploratory in-depth individual and focus group interviews were conducted with key healthcare stakeholders including clients, providers, managers, policy makers, payers, suppliers and accreditation panel members to identify the healthcare service quality attributes and dimensions. Data analysis was carried out by content analysis, with the constant comparative method. Over 100 attributes of quality healthcare service were elicited and grouped into five categories. The dimensions were: efficacy, effectiveness, efficiency, empathy, and environment. Consequently, a comprehensive model of service quality was developed for health care context. The findings of the current study led to a conceptual framework of healthcare quality. This model leads to a better understanding of the different aspects of quality in health care and provides a better basis for defining, measuring and controlling quality of health care services. PMID:23922534

Quality of antenatal care and client satisfaction in Kenya and Namibia.

PubMed

Do, Mai; Wang, Wenjuan; Hembling, John; Ametepi, Paul

2017-04-01

Despite much progress in maternal health service coverage, the quality of care has not seen parallel improvement. This study assessed the quality of antenatal care (ANC), an entry point to the health system for many women. The study used data from recent Service Provision Assessment (SPA) surveys of nationally representative health facilities in Kenya and Namibia. Kenya and Namibia represent the situation in much of sub-Saharan Africa, where ANC is relatively common but maternal mortality remains high. The SPA comprised an inventory of health facilities that provided ANC, interviews with ANC providers and clients, and observations of service delivery. Not applicable. Quality was measured in terms of structure and process of service provision, and client satisfaction as the outcome of service provision. Wide variations in structural and process attributes of quality of care existed in both Kenya and Namibia; however, better structural quality did not translate to better service delivery process or greater client satisfaction. Long waiting time was a common problem and was generally more serious in hospitals and health centers than in clinics and smaller facilities; it was consistently associated with lower client satisfaction. The study also indicates that the provider's technical preparedness may not be sufficient to provide good-quality services and to ensure client satisfaction. Findings highlight important program implications, including improving ANC services and promoting their use at health clinics and lower-level facilities, and ensuring that available supplies and equipment are used for service provision. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Strategic management of Public Hospitals' medical services.

PubMed

Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

2016-01-01

Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

E-Service Quality Management

ERIC Educational Resources Information Center

Batagan, Lorena; Pocovnicu, Adrian; Capisizu, Sergiu

2009-01-01

A characteristic of today's society is the increasing use of modern information and communication technologies in all areas. Computer applications, called e-services, are being developed to provide efficient access to services, electronically. Quality management systems are needed to provide a consistent way to select, evaluate, prioritize and…

Modelling End-User of Electronic-Government Service: The Role of Information quality, System Quality and Trust

NASA Astrophysics Data System (ADS)

Witarsyah Jacob, Deden; Fudzee, Mohd Farhan Md; Aizi Salamat, Mohamad; Kasim, Shahreen; Mahdin, Hairulnizam; Azhar Ramli, Azizul

2017-08-01

Many governments around the world increasingly use internet technologies such as electronic government to provide public services. These services range from providing the most basic informational website to deploying sophisticated tools for managing interactions between government agencies and beyond government. Electronic government (e-government) aims to provide a more accurate, easily accessible, cost-effective and time saving for the community. In this study, we develop a new model of e-government adoption service by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) through the incorporation of some variables such as System Quality, Information Quality and Trust. The model is then tested using a large-scale, multi-site survey research of 237 Indonesian citizens. This model will be validated by using Structural Equation Modeling (SEM). The result indicates that System Quality, Information Quality and Trust variables proven to effect user behavior. This study extends the current understanding on the influence of System Quality, Information Quality and Trust factors to researchers, practitioners, and policy makers.

How Personality Traits and Job Satisfaction Influence Service Quality in Housing Agencies

ERIC Educational Resources Information Center

Robinson, Donna E.

2010-01-01

Human service organizations are intended to stabilize low-income families and promote self-sufficiency by providing much needed services and benefits. Recipients, however, often do not get everything they need in terms of either benefits or service quality. Understandably, clients want the help they are entitled to and promised from providers who…

[Quality management is associated with high quality services in health care].

PubMed

Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

2013-12-09

In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

Free-standing health care facilities: financial arrangements, quality assurance and a pilot study

PubMed Central

Lavis, J N; Lomas, J; Anderson, G M; Donner, A; Iscoe, N A; Gold, G; Craighead, J

1998-01-01

Free-standing health care facilities now deliver many diagnostic and therapeutic services formerly provided only in hospitals. The financial arrangements available to these facilities differ according to whether the services are uninsured or insured. For an uninsured service, such as cosmetic surgery, the patient pays a fee directly to the service provider. For an insured service, such as cataract surgery, the provincial government uses tax revenues to fund the facility by paying it a facility fee and remunerates the physician who provided the service with a professional fee. No comprehensive, proactive quality assurance efforts have been implemented for either these facilities or the clinical practice provided within them. A pilot study involving therapeutic facilities in Ontario has suggested that a large-scale quality improvement effort could be undertaken in these facilities and rigorously evaluated. PMID:9484263

Free-standing health care facilities: financial arrangements, quality assurance and a pilot study.

PubMed

Lavis, J N; Lomas, J; Anderson, G M; Donner, A; Iscoe, N A; Gold, G; Craighead, J

1998-02-10

Free-standing health care facilities now deliver many diagnostic and therapeutic services formerly provided only in hospitals. The financial arrangements available to these facilities differ according to whether the services are uninsured or insured. For an uninsured service, such as cosmetic surgery, the patient pays a fee directly to the service provider. For an insured service, such as cataract surgery, the provincial government uses tax revenues to fund the facility by paying it a facility fee and remunerates the physician who provided the service with a professional fee. No comprehensive, proactive quality assurance efforts have been implemented for either these facilities or the clinical practice provided within them. A pilot study involving therapeutic facilities in Ontario has suggested that a large-scale quality improvement effort could be undertaken in these facilities and rigorously evaluated.

Exploring the impact of word-of-mouth about Physicians' service quality on patient choice based on online health communities.

PubMed

Lu, Naiji; Wu, Hong

2016-11-26

Health care service is a high-credence service and patients may face difficulties ascertaining service quality in order to make choices about their available treatment options. Online health communities (OHCs) provide a convenient channel for patients to search for physicians' information, such as Word-of-Mouth (WOM), particularly on physicians' service quality evaluated by other patients. Existing studies from other service domains have proved that WOM impacts consumer choice. However, how patients make a choice based on physicians' WOM has not been studied, particularly with reference to different patient characteristics and by using real data. One thousand eight hundred fifty three physicians' real data were collected from a Chinese online health community. The data were analyzed using ordinary least squares (OLS) method. The study found that functional quality negatively moderated the relationship between technical quality and patient choice, and disease risk moderated the relationship between physicians' service quality and patient choice. Our study recommends that hospital managers need to consider the roles of both technical quality and functional quality seriously. Physicians should improve their medical skills and bedside manners based on the severity and type of disease to provide better service.

Service Quality Of Diagnostic Fine Needle Aspiration Cytology In A Tertiary Care Hospital Of Lahore (Process Measure As Patient's Perspective).

PubMed

Rizvi, Zainab; Usmani, Rabia Arshed; Rizvi, Amna; Wazir, Salim; Zahra, Taskeen; Rasool, Hafza

2017-01-01

Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely "procedure, sterilization, conduct and competency of doctor" was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was ≥60, the dimension was 'good quality'. Whereas <60% was 'poor quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value <0.05). Out of the 4 dimensions of service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (p<.05). The study suggests that service quality of therapeutic and diagnostic procedures in public hospitals should be routinely monitored from the patients' point of view as most aspects of service quality in public hospitals of Pakistan, require improvements. In this manner patient's satisfaction regarding use of services in public hospitals can be made better.

Forging a novel provider and payer partnership in Wisconsin to compensate pharmacists for quality-driven pharmacy and medication therapy management services.

PubMed

Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris

2009-01-01

To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to enhance the ambulatory pharmacy practice model.

Service quality of delivered care from the perception of women with caesarean section and normal delivery.

PubMed

Tabrizi, Jafar S; Askari, Samira; Fardiazar, Zahra; Koshavar, Hossein; Gholipour, Kamal

2014-01-01

Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 - (Importance × Performance) based on importance and performance of service quality aspects from the postpartum women's perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. "Confidentiality", "autonomy", "choice of care provider" and "communication" achieved scores at the highest level of quality; and "support group", "prompt attention", "prevention and early detection", "continuity of care", "dignity", "safety", "accessibility and "basic amenities" got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008). A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

Impact of the World Health Organization's Decision-Making Tool for Family Planning Clients and Providers on the quality of family planning services in Iran.

PubMed

Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E

2014-04-01

We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.

Franchising of health services in low-income countries.

PubMed

Montagu, Dominic

2002-06-01

Grouping existing providers under a franchised brand, supported by training, advertising and supplies, is a potentially important way of improving access to and assuring quality of some types of clinical medical services. While franchising has great potential to increase service delivery points and method acceptability, a number of challenges are inherent to the delivery model: controlling the quality of services provided by independent practitioners is difficult, positioning branded services to compete on either price or quality requires trade-offs between social goals and provider satisfaction, and understanding the motivations of clients may lead to organizational choices which do not maximize quality or minimize costs. This paper describes the structure and operation of existing franchises and presents a model of social franchise activities that will afford a context for analyzing choices in the design and implementation of health-related social franchises in developing countries.

Quality improvement: the nurse's role.

PubMed

Moran, M J; Johnson, J E

1992-06-01

Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers participate in reshaping the health care environment. The professional nurse plays a vital role in the quality improvement of health care services. However, nurses cannot make these improvements in a vacuum; they must include other professionals and ancillary personnel in their efforts. Total quality commitment must include all levels of an organization's structure. Quality patient care services will be achieved as the result of positive interactions among departments working together to build a dynamic mechanism that continuously improves the processes and outcomes of health care services.

Enhancing the quality of case studies in health services research.

PubMed Central

Yin, R K

1999-01-01

OBJECTIVE: To provide guidance on improving the quality of case studies in health services research. DATA SOURCES: Secondary data, drawing from previous case study research. RESEARCH DESIGN: Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (four additional items). PRINCIPAL FINDINGS: The guidance demonstrates that many operational steps can be undertaken to improve the quality of case studies. These steps have been a hallmark of high-quality case studies in related fields but have not necessarily been practiced in health services research. CONCLUSIONS: Given higher-quality case studies, the case study method can become a valuable tool for health services research. Images Figure 3 PMID:10591280

The Effect of Hospital Service Quality on Patient's Trust

PubMed Central

Zarei, Ehsan; Daneshkohan, Abbas; Khabiri, Roghayeh; Arab, Mohammad

2014-01-01

Background: The trust is meant the belief of the patient to the practitioner or the hospital based on the concept that the care provider seeks the best for the patient and will provide the suitable care and treatment for him/her. One of the main determinants of patient’s trust is the service quality. Objectives: This study aimed to examine the effect of quality of services provided in private hospitals on the patient’s trust. Patients and Methods: In this descriptive cross-sectional study, 969 patients were selected using the consecutive method from eight private general hospitals of Tehran, Iran, in 2010. Data were collected through a questionnaire containing 20 items (14 items for quality, 6 items for trust) and its validity and reliability were confirmed. Data were analyzed using descriptive statistics and multivariate regression. Results: The mean score of patients' perception of trust was 3.80 and 4.01 for service quality. Approximately 38% of the variance in patient trust was explained by service quality dimensions. Quality of interaction and process (P < 0.001) were the strongest factors in predicting patient’s trust, but the quality of the environment had no significant effect on the patients' degree of trust. Conclusions: The interaction quality and process quality were the key determinants of patient’s trust in the private hospitals of Tehran. To enhance the patients' trust, quality improvement efforts should focus on service delivery aspects such as scheduling, timely and accurate doing of the service, and strengthening the interpersonal aspects of care and communication skills of doctors, nurses and staff. PMID:25763258

Service quality assessment of a referral hospital in southern Iran with SERVQUAL technique: patients' perspective.

PubMed

Aghamolaei, Teamur; Eftekhaari, Tasnim Eghbal; Rafati, Shideh; Kahnouji, Kobra; Ahangari, Shamsieh; Shahrzad, Mohammad Esmaeil; Kahnouji, Ataollah; Hoseini, Seyedeh Hamideh

2014-07-27

Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. According to the results, this hospital was not able to meet patients' expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients.

Agent-Based Framework for Personalized Service Provisioning in Converged IP Networks

NASA Astrophysics Data System (ADS)

Podobnik, Vedran; Matijasevic, Maja; Lovrek, Ignac; Skorin-Kapov, Lea; Desic, Sasa

In a global multi-service and multi-provider market, the Internet Service Providers will increasingly need to differentiate in the service quality they offer and base their operation on new, consumer-centric business models. In this paper, we propose an agent-based framework for the Business-to-Consumer (B2C) electronic market, comprising the Consumer Agents, Broker Agents and Content Agents, which enable Internet consumers to select a content provider in an automated manner. We also discuss how to dynamically allocate network resources to provide end-to-end Quality of Service (QoS) for a given consumer and content provider.

Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

PubMed

Thatte, Nandita; Choi, Yoonjoung

2015-04-01

Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be explored to better understand the relationship between HR management and FP service quality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Update: Providing Quality Family Planning Services - Recommendations from CDC and the U.S. Office of Population Affairs, 2017.

PubMed

Gavin, Loretta; Pazol, Karen; Ahrens, Katherine

2017-12-22

In April 2014, CDC published "Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs" (QFP), which describes the scope of services that should be offered in a family planning visit and how to provide those services (e.g., periodicity of screening, which persons are in need of services, etc.) (1). The sections in QFP include the following: Determining the Client's Need for Services; Contraceptive Services; Pregnancy Testing and Counseling; Clients Who Want to Become Pregnant; Basic Infertility Services; Preconception Health Services; Sexually Transmitted Disease Services; and Related Preventive Health Services. In addition, the QFP includes an appendix entitled Screening Services for Which Evidence Does Not Support Screening.

Reliability and Utility of the Behaviour Support Plan Quality Evaluation Tool (BSP-QEII) for Auditing and Quality Development in Services for Adults with Intellectual Disability and Challenging Behaviour

ERIC Educational Resources Information Center

McVilly, K.; Webber, L.; Paris, M.; Sharp, G.

2013-01-01

Background: Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II…

Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

PubMed

Agha, Sohail; Gage, Anastasia; Balal, Asma

2007-05-01

With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to increased provider willingness to remain part of the franchise and to abide by the standards of quality set by the franchiser.

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

PubMed Central

Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O.

2016-01-01

Background Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Methods Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. Results From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour. Conclusion There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive methods are important to improve the quality of care in family planning services. Strategies to improve provider behavior and competency are important. Moreover, strategies that minimize client waiting time and ensure client confidentiality should be implemented to ensure quality of care in family planning services. However, no strong evidence based conclusions and recommendations may be drawn from the evidence. Future studies are needed to identify the most important factors associated with quality of care in family planning services in a wider range of African countries. PMID:27812124

Identifying role of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

PubMed

Karim, Rizwanul M; Abdullah, Mamun S; Rahman, Anisur M; Alam, Ashraful M

2016-06-24

Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 community clinics. Since most of the outcome indicators focus mainly on women and children, women having children less than 2 years of age were randomly assigned and interviewed for the study purpose. Data were collected through FGD, Key informants interview and a pretested semi- structured questionnaire. About 95 % of the respondents were Muslims and 5 % were Hindus. The average age of the respondents was 23.38 (SD 4.15) and almost all of them are home makers. The average monthly expenditure of their family was 95US $ (SD 32US$). At the beginning of the study, two psychometric research instruments; 24 items perceived quality of primary care services PQPCS scale (chronbach's α = .89) and 22 items community clinic service satisfaction CCSS scale (chronbach's α = .97), were constructed and validated. This study showed less educated, poor, landless mothers utilized the community clinic services more than their educated and wealthier counterpart. Women who lived in their own residence used the community clinic services more frequently than those who lived in a rental house. Perceptions concerning skill and competence of the health care provider and satisfaction indicating interpersonal communication and attitude of the care provider were important predictors for community clinic service utilization. Perception related to the quality of management, administration, physical environment of the service point and satisfaction addressing health promotion and women health issues played significant role on community clinic's services utilization. Besides parental education and income, client's perception and satisfaction played significant role in community clinic service utilization. Provider's perception of service quality should be studied. The study findings will enable policy-makers to improve quality of primary health care services, realizing providers' and patients' ideas of community clinic service quality.

Applying revised gap analysis model in measuring hotel service quality.

PubMed

Lee, Yu-Cheng; Wang, Yu-Che; Chien, Chih-Hung; Wu, Chia-Huei; Lu, Shu-Chiung; Tsai, Sang-Bing; Dong, Weiwei

2016-01-01

With the number of tourists coming to Taiwan growing by 10-20 % since 2010, the number has increased due to an increasing number of foreign tourists, particularly after deregulation allowed admitting tourist groups, followed later on by foreign individual tourists, from mainland China. The purpose of this study is to propose a revised gap model to evaluate and improve service quality in Taiwanese hotel industry. Thus, service quality could be clearly measured through gap analysis, which was more effective for offering direction in developing and improving service quality. The HOLSERV instrument was used to identify and analyze service gaps from the perceptions of internal and external customers. The sample for this study included three main categories of respondents: tourists, employees, and managers. The results show that five gaps influenced tourists' evaluations of service quality. In particular, the study revealed that Gap 1 (management perceptions vs. customer expectations) and Gap 9 (service provider perceptions of management perceptions vs. service delivery) were more critical than the others in affecting perceived service quality, making service delivery the main area of improvement. This study contributes toward an evaluation of the service quality of the Taiwanese hotel industry from the perspectives of customers, service providers, and managers, which is considerably valuable for hotel managers. It was the aim of this study to explore all of these together in order to better understand the possible gaps in the hotel industry in Taiwan.

Cost-Effective Adjustments to Nursing Home Staffing to Improve Quality.

PubMed

Bowblis, John R; Roberts, Amy Restorick

2018-06-01

Health care providers face fixed reimbursement rates from government sources and need to carefully adjust staffing to achieve the highest quality within a given cost structure. With data from the Certification and Survey Provider Enhanced Reports (1999-2015), this study holistically examined how staffing levels affect two publicly reported measures of quality in the nursing home industry, the number of deficiency citations and the deficiency score. While higher staffing consistently yielded better quality, the largest quality improvements resulted from increasing administrative registered nurses and social service staffing. After adjusting for wages, the most cost-effective investment for improving overall deficiency outcomes was increasing social services. Deficiencies related to quality of care were improved most by increasing administrative nursing and social service staff. Quality of life deficiencies were improved most by increasing social service and activities staff. Approaches to improve quality through staffing adjustments should target specific types of staff to maximize return on investment.

Quality audit--a review of the literature concerning delivery of continence care.

PubMed

Swaffield, J

1995-09-01

This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

An Empirical Study of the Impact of Service Quality on Patient Satisfaction in Private Hospitals, Iran

PubMed Central

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2015-01-01

Objective: Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. Method: This cross-sectional study was conducted in the year 2010. The study’s sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. Result: this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Conclusions: Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers. PMID:25560338

An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran.

PubMed

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2014-07-29

Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. This cross-sectional study was conducted in the year 2010. The study's sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers.

A Study of Quality of Service Communication for High-Speed Packet-Switching Computer Sub-Networks

NASA Technical Reports Server (NTRS)

Cui, Zhenqian

1999-01-01

With the development of high-speed networking technology, computer networks, including local-area networks (LANs), wide-area networks (WANs) and the Internet, are extending their traditional roles of carrying computer data. They are being used for Internet telephony, multimedia applications such as conferencing and video on demand, distributed simulations, and other real-time applications. LANs are even used for distributed real-time process control and computing as a cost-effective approach. Differing from traditional data transfer, these new classes of high-speed network applications (video, audio, real-time process control, and others) are delay sensitive. The usefulness of data depends not only on the correctness of received data, but also the time that data are received. In other words, these new classes of applications require networks to provide guaranteed services or quality of service (QoS). Quality of service can be defined by a set of parameters and reflects a user's expectation about the underlying network's behavior. Traditionally, distinct services are provided by different kinds of networks. Voice services are provided by telephone networks, video services are provided by cable networks, and data transfer services are provided by computer networks. A single network providing different services is called an integrated-services network.

Delivery of nutrition services in health systems in sub-Saharan Africa: opportunities in Burkina Faso, Mozambique and Niger.

PubMed

Hampshire, Rachel D; Aguayo, Victor M; Harouna, Hamani; Roley, Julie A; Tarini, Ann; Baker, Shawn K

2004-12-01

In sub-Saharan Africa, underweight and micronutrient deficiencies account for an estimated 25% of the burden of disease. As the coverage of national health systems expands, increased opportunities exist to address the needs of children and women, the most vulnerable to these deficiencies, through high-quality nutrition services. To assess health providers' knowledge and practice with regard to essential nutrition services for women and children in Burkina Faso, Mozambique and Niger, in order to assist the development of a standard guide and tools to assess and monitor the quality of the nutrition services delivered through national health systems. The three surveys reveal the extent of missed opportunities to deliver nutrition services during routine prenatal, postnatal and child-care consultations for the prevention and treatment of highly prevalent nutritional deficiencies. A commitment to improving the quality of facility-based nutrition services is necessary to impact on the health outcomes of women and children 'covered' by national health systems. Rigorous assessment and monitoring of the quality of nutrition services should inform health programme and policy development. Building on the lessons learned in these three assessments, Helen Keller International has developed a standard Guide and Tools to assess the quality of the nutrition services delivered through national health systems. These tools can be adapted to assess ongoing nutrition services in health facilities, provide a framework for nutrition programming, inform the development of pre-service as well as in-service nutrition training curricula for providers, and evaluate the impact of nutrition training on providers' practices.

Analysis Of Provided Service Quality In Flowers And Living Plants Transport

NASA Astrophysics Data System (ADS)

Poliaková, Adela

2015-06-01

This paper analyses quality of the living flowers and plants transportation. A part of this paper compares the demands for a particular transport mode and a practical demonstration of these transport modes within a specific transport mode. The paper presents a survey of quality of services provided by individual transport modes.

Factors affecting dental service quality.

PubMed

Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia

2015-01-01

Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.

Mitigating Provider Uncertainty in Service Provision Contracts

NASA Astrophysics Data System (ADS)

Smith, Chris; van Moorsel, Aad

Uncertainty is an inherent property of open, distributed and multiparty systems. The viability of the mutually beneficial relationships which motivate these systems relies on rational decision-making by each constituent party under uncertainty. Service provision in distributed systems is one such relationship. Uncertainty is experienced by the service provider in his ability to deliver a service with selected quality level guarantees due to inherent non-determinism, such as load fluctuations and hardware failures. Statistical estimators utilized to model this non-determinism introduce additional uncertainty through sampling error. Inability of the provider to accurately model and analyze uncertainty in the quality level guarantees can result in the formation of sub-optimal service provision contracts. Emblematic consequences include loss of revenue, inefficient resource utilization and erosion of reputation and consumer trust. We propose a utility model for contract-based service provision to provide a systematic approach to optimal service provision contract formation under uncertainty. Performance prediction methods to enable the derivation of statistical estimators for quality level are introduced, with analysis of their resultant accuracy and cost.

A Systematic Process for Developing High Quality SaaS Cloud Services

NASA Astrophysics Data System (ADS)

La, Hyun Jung; Kim, Soo Dong

Software-as-a-Service (SaaS) is a type of cloud service which provides software functionality through Internet. Its benefits are well received in academia and industry. To fully utilize the benefits, there should be effective methodologies to support the development of SaaS services which provide high reusability and applicability. Conventional approaches such as object-oriented methods do not effectively support SaaS-specific engineering activities such as modeling common features, variability, and designing quality services. In this paper, we present a systematic process for developing high quality SaaS and highlight the essentiality of commonality and variability (C&V) modeling to maximize the reusability. We first define criteria for designing the process model and provide a theoretical foundation for SaaS; its meta-model and C&V model. We clarify the notion of commonality and variability in SaaS, and propose a SaaS development process which is accompanied with engineering instructions. Using the proposed process, SaaS services with high quality can be effectively developed.

Impact of service quality management (SQM) practices on Indian railways : study of South Central Railways.

DOT National Transportation Integrated Search

2010-09-01

The main objective of this study is to present a framework developed for assisting Railways to monitor and : control the quality of services provided to passengers. The study evaluated the passenger Rail Service quality of : Indian Railways by develo...

Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units

PubMed Central

Güler, Sertaç Ata; Güllüoğlu, Bahadır M.

2014-01-01

Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a “reviewing/auditing” procedure that checks if all of these functions existing in the health system are carried out at the desired level and an “accreditation” system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5–10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer. PMID:28331658

Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units.

PubMed

Güler, Sertaç Ata; Güllüoğlu, Bahadır M

2014-07-01

Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a "reviewing/auditing" procedure that checks if all of these functions existing in the health system are carried out at the desired level and an "accreditation" system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5-10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer.

The structure of service quality perceptions for multiple-encounter services.

PubMed

Andaleeb, Syed Saad; Kara, Ali

2013-01-01

The objective of this study was to examine a complex service environment-hospitals-to suggest how service quality could be reframed and measured for multiple-encounter service situations more effectively. In this cross-sectional study, a sample of 371 patients completed the survey instrument. Service quality measures were guided by the literature but allowed to flow from the respondents at the preliminary stage. Confirmatory factor analysis, along with structural equation modeling, was used to test the hypothesized relationships among key actors' performance metrics (KAPMs). Patient satisfaction is significantly influenced by perceived service quality based on KAPMs. For multiple-encounter services, service quality dimensions and measures ought to be tied to KAPMs. Primary actors-ie, doctors-need knowledge and skills about patient psychology, negotiation, handling difficult patients, and, importantly, "putting the customer first." Sensitivity training on such matters should be provided. The secondary actors are the nurses who have more frequent contact with the patients. Nurses need to be perceived as "patient advocates." Effective advocacy begins with prompt and caring services to build trust. The tertiary actors in their support role also ought to be integrated into becoming vital part of the service provided.

Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients’ perspective

PubMed Central

2014-01-01

Background Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. Methods This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Results Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. Conclusion According to the results, this hospital was not able to meet patients’ expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients. PMID:25064475

Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study)

PubMed Central

Beckett, Kate; Earthy, Sarah; Sleney, Jude; Barnes, Jo; Kellezi, Blerina; Barker, Marcus; Clarkson, Julie; Coffey, Frank; Elder, Georgina; Kendrick, Denise

2014-01-01

Objective To explore views of service providers caring for injured people on: the extent to which services meet patients’ needs and their perspectives on factors contributing to any identified gaps in service provision. Design Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers’ views were elicited through semistructured interviews. Data were analysed using thematic analysis. Setting Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas. Participants 40 service providers from a range of disciplines. Results Service providers described two distinct models of trauma care: an ‘ideal’ model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a ‘real’ model based on the realities of National Health Service (NHS) practice. Participants’ ‘ideal’ model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, ‘real’ care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients’ needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice. Conclusions Service providers envisage an ‘ideal’ model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between ‘real’ and ‘ideal’ care. Using service provider views to inform service design and delivery could enhance the quality, patient experience and outcomes of care. PMID:25005598

A Multicultural Service Sensitivity Exercise for Marketing Students

ERIC Educational Resources Information Center

Rosenbaum, Mark S.; Moraru, Ioana; Labrecque, Lauren I.

2013-01-01

Services marketing and retailing courses place service quality at the heart of the curriculum, painting service providers as defenders of their customers' welfare and thwarters of service failures by ushering in recovery solutions. Yet academic literature and the popular press provide evidence that in some cases, service providers act as…

Tourism guide cloud service quality: What actually delights customers?

PubMed

Lin, Shu-Ping; Yang, Chen-Lung; Pi, Han-Chung; Ho, Thao-Minh

2016-01-01

The emergence of advanced IT and cloud services has beneficially supported the information-intensive tourism industry, simultaneously caused extreme competitions in attracting customers through building efficient service platforms. On response, numerous nations have implemented cloud platforms to provide value-added sightseeing information and personal intelligent service experiences. Despite these efforts, customers' actual perspectives have yet been sufficiently understood. To bridge the gap, this study attempts to investigate what aspects of tourism cloud services actually delight customers' satisfaction and loyalty. 336 valid survey questionnaire answers were analyzed using structural equation modeling method. The results prove positive impacts of function quality, enjoyment, multiple visual aids, and information quality on customers' satisfaction as well as of enjoyment and satisfaction on use loyalty. The findings hope to provide helpful references of customer use behaviors for enhancing cloud service quality in order to achieve better organizational competitiveness.

Investigation of Service Quality of Measurement Reference Points for the Internet Services on Mobile Networks

NASA Astrophysics Data System (ADS)

Lipenbergs, E.; Bobrovs, Vj.; Ivanovs, G.

2016-10-01

To ensure that end-users and consumers have access to comprehensive, comparable and user-friendly information regarding the Internet access service quality, it is necessary to implement and regularly renew a set of legislative regulatory acts and to provide monitoring of the quality of Internet access services regarding the current European Regulatory Framework. The actual situation regarding the quality of service monitoring solutions in different European countries depends on national regulatory initiatives and public awareness. The service monitoring solutions are implemented using different measurement methodologies and tools. The paper investigates the practical implementations for developing a harmonising approach to quality monitoring in order to obtain objective information on the quality of Internet access services on mobile networks.

Trust-Based Service Composition and Binding for Tactical Networks with Multiple Objectives

DTIC Science & Technology

2013-12-01

services, then it will have a set of four-tuple records for each abstract service that it can provide. We assume that the service quality of a SP in...user (i.e., a SR) does not have knowledge of the “best” service quality , so its satisfaction level with services received is based on what has been...hand, when USRm is less than USTm, identifies the culprits with low performance (by comparing the advertised service quality profile with the

Higher-Order Factor Analysis as a Score Validity Evaluation Tool: An Example with a Measure of Perceptions of Library Service Quality.

ERIC Educational Resources Information Center

Cook, Colleen; Thompson, Bruce

The SERVQUAL measure was developed by A. Parasuraman, L. Berry, and V. Zeithaml (1988) to measure perceptions of service quality, originally in the retailing sector. However, libraries and other educational institutions are also service providers. Librarians in particular have increasingly become interested in measuring quality of service as the…

The model of flood control using servqual method and importance performance analysis in Surakarta City – Indonesia

NASA Astrophysics Data System (ADS)

Titi Purwantini, V.; Sutanto, Yusuf

2018-05-01

This research is to create a model of flood control in the city of Surakarta using Servqual method and Importance Performance Analysis. Service quality is generally defined as the overall assessment of a service by the customersor the extent to which a service meets customer’s needs or expectations. The purpose of this study is to find the first model of flood control that is appropriate to the condition of the community. Surakarta This means looking for a model that can provide satisfactory service for the people of Surakarta who are in the location of the flood. The second is to find the right model to improve service performance of Surakarta City Government in serving the people in flood location. The method used to determine the satisfaction of the public on the quality of service is to see the difference in the quality of service expected by the community with the reality. This method is Servqual Method While to assess the performance of city government officials is by comparing the actual performance with the quality of services provided, this method is This means looking for a model that can provide satisfactory service for the people of Surakarta who are in the location of the flood.The second is to find the right model to improve service performance of Surakarta City Government in serving the people in flood location. The method used to determine the satisfaction of the public on the quality of service is to see the difference in the quality of service expected by the community with the reality. This method is Servqual Method While to assess the performance of city government officials is by comparing the actual performance with the quality of services provided, this method is Importance Performance Analysis. Samples were people living in flooded areas in the city of Surakarta. Result this research is Satisfaction = Responsiveness+ Realibility + Assurance + Empathy+ Tangible (Servqual Model) and Importance Performance Analysis is From Cartesian diagram can be made Flood Control Formula as follow: Food Control = High performance

[Quality of service provided to heart surgery patients of the Unified Health System-SUS].

PubMed

Borges, Juliana Bassalobre Carvalho; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes

2010-01-01

To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4 +/- 13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (P<0.05). We observed a significant relationship between the quality of service with: gender, in empathy (P= 0.04) and age, in reliability (P = 0.02). There was no significant association between ECC and quality of service. Service quality was satisfactory. The patient demonstrated a high expectation to hospital medical service. Women present a higher perception of quality in empathy and younger people in reliability. The use of ECC is not related to service quality in this sample. The data obtained in this study suggest that the quality of this health service can be monitored through the periodical application of the SERVQUAL scale.

Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

PubMed

McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

2015-01-01

Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001), out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

Improving sexual health services in the city: can the NHS learn from clients and the service industry

PubMed Central

Patel, Hitesh; Baeza, Juan; Patel, Mitesh; Greene, Linda; Theobald, Nick

2007-01-01

Abstract Objective  Genitourinary service providers are struggling to meet patient demand and have introduced changes in access structure to cope. In this study, we explored the perspectives of clients and providers upon the different models of access introduced and whether these maintained service quality using the SERQUAL model. Methods  Primary data were collected in May 2005 at two genitourinary medicine clinics, two Accident and Emergency Departments and from members of a university ‘gay’ society all of which were located in London. Forty‐four high‐risk clients and 11 health service providers underwent semi‐structured face‐to‐face interviews. Results  Both the walk‐in and appointment‐based access systems were appreciated by clients. Clients said that the most important issue was that they were not turned away when they presented. Health‐care providers had a variety of opinions about the two systems as they had different impacts on morale, training and service provision. Conclusions  Service quality can be maintained by using both walk‐in and appointment‐based systems. This is because our data, in line with Parasuraman's model of service quality, showed that ‘access’ is but one determinant of quality. Having different modes of access facilitates patient choice, which is paramount in a modern health‐care system. However, to provide a good service it is important to maintain a motivated staff, who can be affected by their working environment. PMID:17524007

Evaluating clinical librarian services: a systematic review.

PubMed

Brettle, Alison; Maden-Jenkins, Michelle; Anderson, Lucy; McNally, Rosalind; Pratchett, Tracey; Tancock, Jenny; Thornton, Debra; Webb, Anne

2011-03-01

  Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.   To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.   Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.   There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.   This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

Service quality that improves customer satisfaction in a university: a case study in Institut Teknologi Indonesia

NASA Astrophysics Data System (ADS)

Theresia, L.; Bangun, R.

2017-12-01

Universities should provide better service quality to get more customers. The purpose of this study was to find service quality which has impact on the increasing of customer satisfaction in a university. This study is a case study in Institut Teknologi Indonesia (ITI). The result of the study will help ITI to improve its service quality to increase customer satisfaction. This study employs path analysis technique. The data were collected through questionnaires developed from the literature. Questionnaires have two parts namely 1) service quality and 2) customer satisfaction. Service quality is measured through 22 questions with five service quality dimensions: 1) Tangibles, 2) Reliability, 3) Responsiveness, 4) Assurance and 5) Empathy. Customer Satisfaction is measured through 4 questions. The data then are processed by SPSS. The results showed that the students preferred to tangible quality improvement than intangible aspect.

Tampa's Well-being: A Demonstration of ORD's Human Well-being Index (web content for the Tampa Bay Ecosystem services website)

EPA Science Inventory

Ecosystems provide services to humans that support our well-being. Well-being is not only our health but also our quality of life. We rely upon the services provided by nature to help maintain good health and a high quality of life, including clean water, clean air, food and recr...

Effect of E-Service Quality on Customer Online Repurchase Intentions

ERIC Educational Resources Information Center

Liu, Tung-Hsuan

2012-01-01

In the early years of online retailing, having an online presence and low prices were believed to be key drivers of success. More recently, electronic service quality has become essential as an online marketing strategy. Online stores provide higher service quality to create online customer loyalty, improve customer satisfaction, and keep a…

Competition in Defense Acquisitions

DTIC Science & Technology

2008-05-14

NASA employees to maintain desktop assets No way to track costs, no standardization, not tracking service quality NASA’s Outsourcing Desktop...assets to the private sector. ODIN Goals Cut desktop computing costs Increase service quality Achieve interoperability and standardization Focus...not tracking service quality NASA’s Outsourcing Desktop Initiative (ODIN) transferred the responsibility for providing and managing the vast

Measuring effective coverage of curative child health services in rural Burkina Faso: a cross-sectional study

PubMed Central

Koulidiati, Jean-Louis; Nesbitt, Robin C; Ouedraogo, Nobila; Hien, Hervé; Robyn, Paul Jacob; Compaoré, Philippe; Souares, Aurélia; Brenner, Stephan

2018-01-01

Objective To estimate both crude and effective curative health services coverage provided by rural health facilities to under 5-year-old (U5YO) children in Burkina Faso. Methods We surveyed 1298 child health providers and 1681 clinical cases across 494 primary-level health facilities, as well as 12 497 U5YO children across 7347households in the facilities’ catchment areas. Facilities were scored based on a set of indicators along three quality-of-care dimensions: management of common childhood diseases, management of severe childhood diseases and general service readiness. Linking service quality to service utilisation, we estimated both crude and effective coverage of U5YO children by these selected curative services. Results Measured performance quality among facilities was generally low with only 12.7% of facilities surveyed reaching our definition of high and 57.1% our definition of intermediate quality of care. The crude coverage was 69.5% while the effective coverages indicated that 5.3% and 44.6% of children reporting an illness episode received services of only high or high and intermediate quality, respectively. Conclusion Our study showed that the quality of U5YO child health services provided by primary-level health facilities in Burkina Faso was low, resulting in relatively ineffective population coverage. Poor adherence to clinical treatment guidelines combined with the lack of equipment and qualified clinical staff that performed U5YO consultations seemed to be contributors to the gap between crude and effective coverage. PMID:29858415

42 CFR 493.1445 - Standard; Laboratory director responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... quality laboratory services for all aspects of test performance, which includes the preanalytic, analytic... result is found to be unacceptable or unsatisfactory; (5) Ensure that the quality control and quality assessment programs are established and maintained to assure the quality of laboratory services provided and...

7 CFR 652.7 - Quality assurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Quality assurance. 652.7 Section 652.7 Agriculture... AGRICULTURE SUPPORT ACTIVITIES TECHNICAL SERVICE PROVIDER ASSISTANCE General Provisions § 652.7 Quality assurance. (a) NRCS will review, in consultation with the Farm Service Agency, as appropriate, the quality...

Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.

PubMed

Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B

2016-10-01

This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess change as implementation of recent family planning service recommendations continues. Published by Elsevier Inc.

Information Technology Manager's Perspective on Experiences with Service Quality and Customer Satisfaction: A Phenomenology Study

ERIC Educational Resources Information Center

Porter, Sherry A.

2016-01-01

The general problem was that, in the competitive telecommunications industry, information technology service providers have to develop ways to improve on customer satisfaction and service quality during service disruptions to meet service level agreements. A descriptive phenomenological study was used to explore the lived experiences and…

Barriers to providing quality emergency obstetric care in Addis Ababa, Ethiopia: Healthcare providers' perspectives on training, referrals and supervision, a mixed methods study.

PubMed

Austin, Anne; Gulema, Hanna; Belizan, Maria; Colaci, Daniela S; Kendall, Tamil; Tebeka, Mahlet; Hailemariam, Mengistu; Bekele, Delayehu; Tadesse, Lia; Berhane, Yemane; Langer, Ana

2015-03-29

Increasing women's access to and use of facilities for childbirth is a critical national strategy to improve maternal health outcomes in Ethiopia; however coverage alone is not enough as the quality of emergency obstetric services affects maternal mortality and morbidity. Addis Ababa has a much higher proportion of facility-based births (82%) than the national average (11%), but timely provision of quality emergency obstetric care remains a significant challenge for reducing maternal mortality and improving maternal health. The purpose of this study was to assess barriers to the provision of emergency obstetric care in Addis Ababa from the perspective of healthcare providers by analyzing three factors: implementation of national referral guidelines, staff training, and staff supervision. A mixed methods approach was used to assess barriers to quality emergency obstetric care. Qualitative analyses included twenty-nine, semi-structured, key informant interviews with providers from an urban referral network consisting of a hospital and seven health centers. Quantitative survey data were collected from 111 providers, 80% (111/138) of those providing maternal health services in the same referral network. Respondents identified a lack of transportation and communication infrastructure, overcrowding at the referral hospital, insufficient pre-service and in-service training, and absence of supportive supervision as key barriers to provision of quality emergency obstetric care. Dedicated transportation and communication infrastructure, improvements in pre-service and in-service training, and supportive supervision are needed to maximize the effective use of existing human resources and infrastructure, thus increasing access to and the provision of timely, high quality emergency obstetric care in Addis Ababa, Ethiopia.

Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study.

PubMed

Ejigu Tafere, Tadese; Afework, Mesganaw Fanthahun; Yalew, Alemayehu Worku

2018-01-01

In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery. To assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City Administration. A facility based prospective follow up study was conducted. and nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit were enrolled.Women were followed from their first ANC visit until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation (GEE) was carried out to control cluster effect among women who received ANC in the same facility. Among 823 pregnant women who completed follow up, only about one third (27.6%) received acceptable quality of ANC services. In one health facility syphilis test was not done at all for the last two years. The odds of giving birth at health institution among pregnant women who received acceptable ANC quality service was about 3.38 times higher than among pregnant women who received unacceptable ANC quality service (AOR = 3.38, 95% CI: 1.67, 6.83). In this study the quality of ANC service provision in public health facilities was compromised/low. Provision of quality ANC service had a great role in promoting institutional delivery. Therefore the local authorities at each level of health sector or the nongovernmental organizations working to improve maternal health need to provide training on focused antenatal care protocol for ANC providers.

Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study

PubMed Central

Afework, Mesganaw Fanthahun; Yalew, Alemayehu Worku

2018-01-01

Background In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery. Objective To assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City Administration Methods A facility based prospective follow up study was conducted. and nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit were enrolled.Women were followed from their first ANC visit until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation (GEE) was carried out to control cluster effect among women who received ANC in the same facility. Results Among 823 pregnant women who completed follow up, only about one third (27.6%) received acceptable quality of ANC services. In one health facility syphilis test was not done at all for the last two years. The odds of giving birth at health institution among pregnant women who received acceptable ANC quality service was about 3.38 times higher than among pregnant women who received unacceptable ANC quality service (AOR = 3.38, 95% CI: 1.67, 6.83). Conclusion and recommendation In this study the quality of ANC service provision in public health facilities was compromised/low. Provision of quality ANC service had a great role in promoting institutional delivery. Therefore the local authorities at each level of health sector or the nongovernmental organizations working to improve maternal health need to provide training on focused antenatal care protocol for ANC providers. PMID:29420598

Measuring the quality of provided services for patients with chronic kidney disease.

PubMed

Bahadori, Mohammadkarim; Raadabadi, Mehdi; Heidari Jamebozorgi, Majid; Salesi, Mahmood; Ravangard, Ramin

2014-09-01

The healthcare organizations need to develop and implement quality improvement plans for their survival and success. Measuring quality in the healthcare competitive environment is an undeniable necessity for these organizations and will lead to improved patient satisfaction. This study aimed to measure the quality of provided services for patients with chronic kidney disease in Kerman in 2014. This cross-sectional, descriptive-analytic study was performed from 23 January 2014 to 14 February 2014 in four hemodialysis centers in Kerman. All of the patients on chronic hemodialysis (n = 195) who were referred to these four centers were selected and studied using census method. The required data were collected using the SERVQUAL questionnaire, consisting of two parts: questions related to the patients' demographic characteristics, and 28 items to measure the patients' expectations and perceptions of the five dimensions of service quality, including tangibility, reliability, responsiveness, assurance, and empathy. The collected data were analyzed using SPSS 21.0 through some statistical tests, including independent-samples t test, one-way ANOVA, and paired-samples t test. The results showed that the means of patients' expectations were more than their perceptions of the quality of provided services in all dimensions, which indicated that there were gaps in all dimensions. The highest and lowest means of negative gaps were related to empathy (-0.52 ± 0.48) and tangibility (-0.29 ± 0.51). In addition, among the studied patients' demographic characteristics and the five dimensions of service quality, only the difference between the patients' income levels and the gap in assurance were statistically significant (P < 0.001). Overall, the results of the present study showed that the expectations of patients on hemodialysis were more than their perceptions of provided services. The healthcare providers and employees should pay more attention to the patients' opinions and comments and use their feedback to solve the workplace problems and improve the quality of provided services. In addition, training the health staff to meet the patients' emotional needs and expectations is suggested.

What does quality maternity care mean in a context of medical pluralism? Perspectives of women in Nigeria

PubMed Central

Izugbara, Chimaraoke O; Wekesah, Frederick

2018-01-01

Abstract User priorities regarding quality care in contexts of medical pluralism are poorly documented. Drawing on group and individual interviews with women, we interrogate ideas of quality maternity care in the context of Nigeria’s medical pluralism. We found complex utilization patterns for conventional, complementary and alternative maternity care services as well as ideas of quality maternity care that stress effective coordination and integration of different typologies of maternity health services; socially sensitive and truthful providers; and socioeconomic, physical and parochial forms of safety. Informal providers were the commonly reported source of maternal health services in the study. Maternal health services in the country were also generally viewed as poor quality, characterized by pervasive abuse, quackery and lack of commitment to the needs and sensitivities of women. Convenience, availability and affordability of maternal health services, as well as sociocultural factors were major influences on women’s use of services. Results demonstrate the embeddedness of women’s quality of care notions in the vast socioeconomic inequities that typify Nigeria’s particular form of poorly regulated medical pluralism, raising need for strategies to strengthen the delivery, coordination and supervision of maternal health services in the country. PMID:29036530

Service quality in community pharmacy: an exploration of determinants.

PubMed

White, Lesley; Klinner, Christiane

2012-01-01

Although various instruments have been developed to measure customer satisfaction with community pharmacy services, there is limited research regarding pharmacy staffs' understanding of service quality and its determinants. This study aimed to explore the perceptions of pharmacy staff regarding the factors that constitute a high level of service quality using the service quality determinants proposed by the Conceptual Model of Service Quality. Structured interviews were conducted with 27 pharmacy assistants and 6 pharmacists in 3 community pharmacies in Sydney. The interview questions focused on the participants' perceptions of consumer expectations, the translation of these perceptions into service quality specifications, the actual service delivery, and the communication to customers. From the pharmacy staff perspective, service quality is significantly limited by insufficient internal communication and control processes that impede role clarity and the resolution of conflicting role expectations among customer service personnel. Participants indicated that these problems could be alleviated through the implementation of more transparent, realistic, measurable, and accepted quality specifications by pharmacy management. The study indicates that the extent to which pharmacy management sets, maintains, and communicates service quality specifications to staff directly affects role clarity, role conflict, and organizational commitment among customer service staff, which in turn directly influence the level of service quality provided to the customers. Copyright © 2012 Elsevier Inc. All rights reserved.

Communication-based services for persons with severe disabilities in schools: a survey of speech-language pathologists.

PubMed

Siegel, Ellin B; Maddox, Laura L; Ogletree, Billy T; Westling, David L

2010-01-01

Speech-language pathologists in school settings were surveyed with an instrument created from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities' quality indicators self-assessment tool. Participants valued practice indicators of quality communication assessment and intervention to a higher degree than their actual practice. These findings appear to suggest that SLPs may not provide best practice services to individuals with severe disabilities. Suggestions for enhancing inservice training and intervention practices of SLPs and team members who work with individuals with severe disabilities are provided. The reader will be able to; (1) understand the value of using the NJC quality indicators to guide SLP practices with individuals with severe disabilities in schools; (2) recognize that research indicates that SLPs working with individuals with severe disabilities in schools may not provide best practice services to the extent that they value these practices; (3) discuss possible strategies to increase the quality of services provided to individuals with severe disabilities in schools.

Social Security: Views of Agency Personnel on Service Quality and Staff Reductions

DTIC Science & Technology

1989-02-10

decline was staff reductions, which are expected to continue through fiscal year 1990 (pp. 9 and 13). While service quality in general is perceived as...management forum initiative (and others) will have on service quality and employee morale is hard to predict. Further, SSA’s staff reduction program will...poor morale within the agency. We will provide your Committees with another report in May 1989 on the status of SSA staff cuts and service quality . As

Measuring school health center impact on access to and quality of primary care.

PubMed

Gibson, Erica J; Santelli, John S; Minguez, Mara; Lord, Alyssa; Schuyler, Ashley C

2013-12-01

School health centers (SHC) that provide comprehensive health care may improve access and quality of care for students; however, published impact data are limited. We evaluated access and quality of health services at an urban high school with a SHC compared with a school without a SHC, using a quasiexperimental research design. Data were collected at the beginning of the school year, using a paper and pencil classroom questionnaire (n = 2,076 students). We measured SHC impact in several ways including grade by school interaction terms. Students at the SHC school were more likely to report having a regular healthcare provider, awareness of confidential services, support for health services in their school, and willingness to utilize those services. Students in the SHC school reported higher quality of care as measured by: respect for their health concerns, adequate time with the healthcare provider, understandable provider communications, and greater provider discussion at their last visit on topics such as sexual activity, birth control, emotions, future plans, diet, and exercise. Users of the SHC were also more likely to report higher quality of care, compared with either nonusers or students in the comparison school. Access to comprehensive health services via a SHC led to improved access to health care and improved quality of care. Impact was measureable on a school-wide basis but was greater among SHC users. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study).

PubMed

Beckett, Kate; Earthy, Sarah; Sleney, Jude; Barnes, Jo; Kellezi, Blerina; Barker, Marcus; Clarkson, Julie; Coffey, Frank; Elder, Georgina; Kendrick, Denise

2014-07-08

To explore views of service providers caring for injured people on: the extent to which services meet patients' needs and their perspectives on factors contributing to any identified gaps in service provision. Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers' views were elicited through semistructured interviews. Data were analysed using thematic analysis. Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas. 40 service providers from a range of disciplines. Service providers described two distinct models of trauma care: an 'ideal' model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a 'real' model based on the realities of National Health Service (NHS) practice. Participants' 'ideal' model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, 'real' care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients' needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice. Service providers envisage an 'ideal' model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between 'real' and 'ideal' care. Using service provider views to inform service design and delivery could enhance the quality, patient experience and outcomes of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Service quality framework for clinical laboratories.

PubMed

Ramessur, Vinaysing; Hurreeram, Dinesh Kumar; Maistry, Kaylasson

2015-01-01

The purpose of this paper is to illustrate a service quality framework that enhances service delivery in clinical laboratories by gauging medical practitioner satisfaction and by providing avenues for continuous improvement. The case study method has been used for conducting the exploratory study, with focus on the Mauritian public clinical laboratory. A structured questionnaire based on the SERVQUAL service quality model was used for data collection, analysis and for the development of the service quality framework. The study confirms the pertinence of the following service quality dimensions within the context of clinical laboratories: tangibility, reliability, responsiveness, turnaround time, technology, test reports, communication and laboratory staff attitude and behaviour. The service quality framework developed, termed LabSERV, is vital for clinical laboratories in the search for improving service delivery to medical practitioners. This is a pioneering work carried out in the clinical laboratory sector in Mauritius. Medical practitioner expectations and perceptions have been simultaneously considered to generate a novel service quality framework for clinical laboratories.

A Statistical Analysis of Education Service Quality Dimensions on Business School Students' Satisfaction

ERIC Educational Resources Information Center

Seng, Ernest Lim Kok; Ling, Tan Pei

2013-01-01

This study aims to investigate student satisfaction on quality education services provided by institutions of higher learning in Malaysia. Their level of satisfaction based primarily on the data collected through five dimensions of education service quality. A random sample of 250 students studying in an institution of higher learning was selected…

Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa.

PubMed

Leslie, Hannah H; Gage, Anna; Nsona, Humphreys; Hirschhorn, Lisa R; Kruk, Margaret E

2016-09-01

In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce. We used nationally representative surveys of health systems in seven countries in sub-Saharan Africa to examine the association of in-service training and supervision with provider quality in antenatal and sick child care. The results of our analysis showed that observed quality of care was poor, with fewer than half of evidence-based actions completed by health workers, on average. In-service training and supervision were associated with quality of sick child care; they were associated with quality of antenatal care only when provided jointly. All associations were modest-at most, improvements related to interventions were equivalent to 2 additional provider actions out of the 18-40 actions expected per visit. In-service training and supportive supervision as delivered were not sufficient to meaningfully improve the quality of care in these countries. Greater attention to the quality of health professional education and national health system performance will be required to provide the standard of health care that patients deserve. Project HOPE—The People-to-People Health Foundation, Inc.

42 CFR 441.474 - Quality assurance and improvement plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

42 CFR 441.474 - Quality assurance and improvement plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

42 CFR 441.474 - Quality assurance and improvement plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

42 CFR 441.474 - Quality assurance and improvement plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

42 CFR 441.474 - Quality assurance and improvement plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

Implementation of occupational health service improvements through application of total quality management processes.

PubMed

Thomas, Elizabeth Anne

2011-06-01

The occupational health services department for a manufacturing division of a high-technology firm was redesigned from an outsourced model, in which most services were provided by an outside clinic vendor, to an in-house service model, in which services were provided by an on-site nurse practitioner. The redesign and implementation, accomplished by a cross-functional team using Total Quality Management processes, resulted in a comprehensive occupational health services department that realized significant cost reduction, increased compliance with regulatory and company requirements, and improved employee satisfaction. Implications of this project for occupational health nurses are discussed.

Perceived service quality's effect on patient satisfaction and behavioural compliance.

PubMed

Mohamed, Bahari; Azizan, Noor Azlinna

2015-01-01

The purpose of this paper is to advance healthcare service quality research using hierarchical component models. This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses. The study extends health service quality literature by showing that: patient satisfaction (PS) is dominant, significant and indirect determinant of behavioural compliance (BC); perceived service quality has the strongest effect on BC via PS. Only one hospital was evaluated. The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design. Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.

How and when service quality and satisfaction simultaneously influence purchase intentions?

PubMed

Huang, Yu-Ying; Li, Shyh-Jane; Yang, Miles M

2011-08-01

Th e purpose of this study is to examine how and when service quality and satisfaction simultaneously influence purchase intentions. The study tries to explore and clarify the relationship between service quality and satisfaction, and to examine whether satisfaction simultaneously moderates and mediates the relationship between perceived service quality and purchase intentions. A field survey was conducted for the outpatients of 12 regional hospitals in Taiwan. The findings show that the effects of different dimensions of service quality on purchase intentions are not equal across satisfied and unsatisfied patients. This study provides empirical evidence that show how the dual roles of the moderator and mediator manipulated together by satisfaction, work to affect purchase intentions in hospital settings. In addition, the relationships between service quality and satisfaction are also clarified.

Renewing focus on family planning service quality globally.

PubMed

Hancock, Nancy L; Stuart, Gretchen S; Tang, Jennifer H; Chibwesha, Carla J; Stringer, Jeffrey S A; Chi, Benjamin H

2016-01-01

Reducing the global unmet need for contraception is currently a priority for many governments, multi-lateral initiatives, non-governmental organizations, and donors. Evidence strongly suggests that the provision of quality family planning services can increase uptake, prevalence, and continuation of contraception. While an accepted framework to define the components of family planning service quality exists, translating this framework into assessment tools that are accessible, easily utilized, and valid for service providers has remained a challenge. We propose new approaches to improve the standardization and accessibility of family planning service quality assessment tools to simplify family planning service quality evaluation. With easier approaches to program evaluation, quality improvements can be performed more swiftly to help increase uptake and continuation of contraception to improve the health of women and their families.

A customer oriented systematic framework to extract business strategy in Indian electricity services

NASA Astrophysics Data System (ADS)

Satapathy, Suchismita; Mishra, Pravudatta

2013-11-01

Competition in the electric service industry is highlighting the importance of a number of issues affecting the nature and quality of customer service. The quality of service(s) provided to electricity customers may be enhanced by competition, if doing so offers service suppliers a competitive advantage. On the other hand, service quality offered to some consumers could decline if utilities focus their attention on those customers most likely to exercise choice, while reducing effort and investment to serve customers less likely to choose alternatives. Service quality is defined as the way in which the utility interacts with and responds to the needs of its customers. To achieve maximum consumer satisfaction in electricity service, This paper has designed a framework by QFD by measuring service quality of electricity utility sector in ANN and also find interrelationship between these design requirements by ISM.

Toward Understanding Non-Centralized Technology Support in Higher Education

ERIC Educational Resources Information Center

Jackson, Robert Jonathan

2009-01-01

The focus of this research is an examination of service quality provided by non-centralized technology personnel, Local Technical Support Providers (LSPs), at a southern research university. The SERVQUAL instrument was selected to measure service quality of LSPs within the Academic Affairs Division. The rationale for selecting and testing SERVQUAL…

42 CFR 476.90 - Lack of cooperation by a provider or practitioner.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Lack of cooperation by a provider or practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW...

42 CFR 476.90 - Lack of cooperation by a provider or practitioner.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Lack of cooperation by a provider or practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATION REVIEW...

42 CFR 476.90 - Lack of cooperation by a provider or practitioner.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Lack of cooperation by a provider or practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW...

Effective interventions on service quality improvement in a physiotherapy clinic.

PubMed

Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad

2014-01-01

Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (P<0.001). Service quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

The quality assessment of family physician service in rural regions, Northeast of Iran in 2012

PubMed Central

Vafaee-Najar, Ali; Nejatzadegan, Zohreh; Pourtaleb, Arefeh; Kaffashi, Shahnaz; Vejdani, Marjan; Molavi-Taleghani, Yasamin; Ebrahimipour, Hosein

2014-01-01

Background: Following the implementation of family physician plan in rural areas, the quantity of provided services has been increased, but what leads on the next topic is the improvement in expected quality of service, as well. The present study aims at determining the gap between patients’ expectation and perception from the quality of services provided by family physicians during the spring and summer of 2012. Methods: This was a cross-sectional study in which 480 patients who referred to family physician centers were selected with clustering and simple randomized method. Data were collected through SERVQUAL standard questionnaire and were analyzed with descriptive statistics, using statistical T-test, Kruskal-Wallis, and Wilcoxon signed-rank tests by SPSS 16 at a significance level of 0.05. Results: The difference between the mean scores of expectation and perception was about -0.93, which is considered as statistically significant difference (P≤ 0.05). Also, the differences in five dimensions of quality were as follows: tangible -1.10, reliability -0.87, responsiveness -1.06, assurance -0.83, and empathy -0.82. Findings showed that there was a significant difference between expectation and perception in five concepts of the provided services (P≤ 0.05). Conclusion: There was a gap between the ideal situation and the current situation of family physician quality of services. Our suggestion is maintaining a strong focus on patients, creating a medical practice that would exceed patients’ expectations, providing high-quality healthcare services, and realizing the continuous improvement of all processes. In both tangible and responsive, the gap was greater than the other dimensions. It is recommended that more attention should be paid to the physical appearance of the health center environment and the availability of staff and employees. PMID:24757691

Cultural values and health service quality in China.

PubMed

Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei

2013-01-01

Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.

[ROM and the position of the health insurance companies].

PubMed

Laane, R; Luijk, R

2012-01-01

Up till 2008 the Dutch mental health services came under the Dutch General Law on Special Medical Costs (AWBZ). Health insurers regarded the mental health services as 'black box'. In 2008 the mental health services were transferred to the basic health insurance system and the health insurers became responsible for the healthcare purchasing services. In the same year the mental health services began to use ROM to measure the effects of treatment and thereby improve the quality of treatment. To clarify the use that the insurers make of ROM. The developments in this field are described. The feedback supplied by ROM enables therapists to improve treatment. An additional benefit is that the mental health services are then in a position to improve quality at aggregate level and compare their own results with those of others. Nationally, ROM can provide health insurers with information about treatment quality in combination with the Consumer Quality Index (CQI), and national 'benchmarks' can be implemented. To facilitate the interpretation of these rom data the health insurers set up the independent foundation, Stichting Benchmark GGZ (mental health care), in which GGZ Nederland has participated since 2010. ROM provides therapists with a means for improving treatment and provides insurers with a means by which they can express their views about the quality of the mental health services at aggregate level.

Army Efficiency Initiatives

DTIC Science & Technology

2011-04-28

provide, its customers with products and services that satisfy their needs. A total quality culture requires quality in all aspects of the company’s...operations, with things being done right the first time, with product defects and waste eradicated from operations. Many companies have...government, service, research and development, and education. Yet in today’s global economy of today, the quality of many American products and services

Analysis of Open Education Service Quality with the Descriptive-Quantitative Approach

ERIC Educational Resources Information Center

Priyogi, Bilih; Santoso, Harry B.; Berliyanto; Hasibuan, Zainal A.

2017-01-01

The concept of Open Education (OE) is based on the philosophy of e-Learning which aims to provide learning environment anywhere, anytime, and for anyone. One of the main issue in the development of OE services is the availability of the quality assurance mechanism. This study proposes a metric for measuring the quality of OE service. Based on…

Implementation of Quality Management in Core Service Laboratories

PubMed Central

Creavalle, T.; Haque, K.; Raley, C.; Subleski, M.; Smith, M.W.; Hicks, B.

2010-01-01

CF-28 The Genetics and Genomics group of the Advanced Technology Program of SAIC-Frederick exists to bring innovative genomic expertise, tools and analysis to NCI and the scientific community. The Sequencing Facility (SF) provides next generation short read (Illumina) sequencing capacity to investigators using a streamlined production approach. The Laboratory of Molecular Technology (LMT) offers a wide range of genomics core services including microarray expression analysis, miRNA analysis, array comparative genome hybridization, long read (Roche) next generation sequencing, quantitative real time PCR, transgenic genotyping, Sanger sequencing, and clinical mutation detection services to investigators from across the NIH. As the technology supporting this genomic research becomes more complex, the need for basic quality processes within all aspects of the core service groups becomes critical. The Quality Management group works alongside members of these labs to establish or improve processes supporting operations control (equipment, reagent and materials management), process improvement (reengineering/optimization, automation, acceptance criteria for new technologies and tech transfer), and quality assurance and customer support (controlled documentation/SOPs, training, service deficiencies and continual improvement efforts). Implementation and expansion of quality programs within unregulated environments demonstrates SAIC-Frederick's dedication to providing the highest quality products and services to the NIH community.

The art of customer service.

PubMed

Williams, Jeni

2007-10-01

Strategies for improving the consumer service skills of finance staff include: Hire employees who have a customer service background. Work with your human resources department to provide customer service training. Monitor new hires extensively. Offer front-end employees scripted language for situations they may face on the job. Measure the quality of customer service provided. Provide incentives for performance.

Limited English proficient Hmong- and Spanish-speaking patients' perceptions of the quality of interpreter services.

PubMed

Lor, Maichou; Xiong, Phia; Schwei, Rebecca J; Bowers, Barbara J; Jacobs, Elizabeth A

2016-02-01

Language barriers are a large and growing problem for patients in the US and around the world. Interpreter services are a standard solution for addressing language barriers and most research has focused on utilization of interpreter services and their effect on health outcomes for patients who do not speak the same language as their healthcare providers including nurses. However, there is limited research on patients' perceptions of these interpreter services. To examine Hmong- and Spanish-speaking patients' perceptions of interpreter service quality in the context of receiving cancer preventive services. Twenty limited English proficient Hmong (n=10) and Spanish-speaking participants (n=10) ranging in age from 33 to 75 years were interviewed by two bilingual researchers in a Midwestern state. Interviews were audio taped, transcribed verbatim, and translated into English. Analysis was done using conventional content analysis. The two groups shared perceptions about the quality of interpreter services as variable along three dimensions. Specifically, both groups evaluated quality of interpreters based on the interpreters' ability to provide: (a) literal interpretation, (b) cultural interpretation, and (c) emotional interpretation during the health care encounter. The groups differed, however, on how they described the consequences of poor interpretation quality. Hmong participants described how poor quality interpretation could lead to: (a) poor interpersonal relationships among patients, providers, and interpreters, (b) inability of patients to follow through with treatment plans, and (c) emotional distress for patients. Our study highlights the fact that patients are discerning consumers of interpreter services; and could be effective partners in efforts to reform and enhance interpreter services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Limited English proficient Hmong- and Spanish-speaking patients’ perceptions of the quality of interpreter services

PubMed Central

Lor, Maichou; Xiong, Phia; Schweia, Rebecca J.; Bowers, Barbara; Jacobs, Elizabeth A.

2015-01-01

Background Language barriers are a large and growing problem for patients in the U.S. and around the world. Interpreter services are a standard solution for addressing language barriers and most research has focused on utilization of interpreter services and their effect on health outcomes for patients who do not speak the same language as their healthcare providers including nurses. However, there is limited research on patients’ perceptions of these interpreter services. Objective To examine Hmong- and Spanish-speaking patients’ perceptions of interpreter service quality in the context of receiving cancer preventive services. Methods Twenty limited English proficient Hmong (n=10) and Spanish-speaking participants (N=10) ranging in age from 33 to 75 years were interviewed by two bilingual researchers in a Midwestern state. Interviews were audio taped, transcribed verbatim, and translated into English. Analysis was done using conventional content analysis. Results The two groups shared perceptions about the quality of interpreter services as variable along three dimensions. Specifically, both groups evaluated quality of interpreters based on the interpreters’ ability to provide: (a) literal interpretation, (b) cultural interpretation, and (c) emotional interpretation during the health care encounter. The groups differed, however, on how they described the consequences of poor interpretation quality. Hmong participants described how poor quality interpretation could lead to: (a) poor interpersonal relationships among patients, providers, and interpreters, (b) inability of patients to follow through with treatment plans, and (c) emotional distress for patients. Conclusions Our study highlights the fact that patients are discerning consumers of interpreter services; and could be effective partners in efforts to reform and enhance interpreter services. PMID:25865517

[State of supply services for industrial hygiene and safety in Colombia].

PubMed

Varona, Marcela E; Torres, Carlos Humberto; Díaz, Sonia M; Palma, Ruth Marién; Checa, Diana Milena; Conde, Juan Vicente

2012-01-01

Institutions that supply occupational health services must offer services that are reliable and of high quality across the spectrum of industrial hygiene and safety needs. Services for occupational health were identified at several institutions, and the technical quality and reliability of these services were compared in different regions of Colombia. This descriptive study identified the services available for industrial hygiene and safety in 15 cities of Colombia. A survey was conducted in 192 institutions offering such services and a statistical analysis of these results was undertaken. This sample was taken from a nationwide list of institutions purportedly licensed for this activity. Thirty-two percent (61) of the evaluated institutions provided hygiene services, and 48% (93) provided safety services. The range of health services was provided on a subcontract basis both for professional personnel and the equipment. Six institutions in the area of industrial hygiene and 1 in the area of industrial security were supplying services with pending or suspended institutional licenses. Deficiencies in the quality, infrastructure and levels of automation were identified at institutions that supply services of hygiene and industrial security. The resulting recommendatios are that the Ministry of the Social Protection fortifies mechanisms for (1) the evaluation and control of the supplied services, and (2) verify that the institutional activity is in accordance with current and valid licensing.

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

Dynamic selection mechanism for quality of service aware web services

NASA Astrophysics Data System (ADS)

D'Mello, Demian Antony; Ananthanarayana, V. S.

2010-02-01

A web service is an interface of the software component that can be accessed by standard Internet protocols. The web service technology enables an application to application communication and interoperability. The increasing number of web service providers throughout the globe have produced numerous web services providing the same or similar functionality. This necessitates the use of tools and techniques to search the suitable services available over the Web. UDDI (universal description, discovery and integration) is the first initiative to find the suitable web services based on the requester's functional demands. However, the requester's requirements may also include non-functional aspects like quality of service (QoS). In this paper, the authors define a QoS model for QoS aware and business driven web service publishing and selection. The authors propose a QoS requirement format for the requesters, to specify their complex demands on QoS for the web service selection. The authors define a tree structure called quality constraint tree (QCT) to represent the requester's variety of requirements on QoS properties having varied preferences. The paper proposes a QoS broker based architecture for web service selection, which facilitates the requesters to specify their QoS requirements to select qualitatively optimal web service. A web service selection algorithm is presented, which ranks the functionally similar web services based on the degree of satisfaction of the requester's QoS requirements and preferences. The paper defines web service provider qualities to distinguish qualitatively competitive web services. The paper also presents the modelling and selection mechanism for the requester's alternative constraints defined on the QoS. The authors implement the QoS broker based system to prove the correctness of the proposed web service selection mechanism.

Comparing the services and quality of private and public clinics in rural China.

PubMed

Meng, Q; Liu, X; Shi, J

2000-12-01

After 15 years eradication of the private health sector in Socialist China, private practice was restored in 1980 along with the market oriented economic reform. In recent years, however, debates on its pros and cons are increasing. Arguments against private practice have led to a ban on private practice in some rural counties. The arguments against private practice state that the service quality of private clinics tends to be lower than that of public ones; private clinics are less likely to provide preventive care; and private clinics are more likely to provide over-treatment. This paper presents the major findings from a study conducted in China, aiming at comparing private and public village health clinics in terms of quality of services, willingness to provide preventive care and over-prescription of drugs. While it was found that the quality of services was poor and a large proportion of patient expenditure was due to over-treatment for all village clinics, there was no difference between public and private clinics. Both private and public clinics were willing to provide preventive services if they were subsidized for the provision. This study finds no evidence that care provided by private clinics is inferior to that of public clinics.

Any qualified provider: a qualitative case study of one community NHS Trust's response.

PubMed

Walumbe, Jackie; Swinglehurst, Deborah; Shaw, Sara

2016-02-23

To examine how those managing and providing community-based musculoskeletal (MSK) services have experienced recent policy allowing patients to choose any provider that meets certain quality standards from the National Health Service (NHS), private or voluntary sector. Intrinsic case study combining qualitative analysis of interviews and field notes. An NHS Community Trust (the main providers of community health services in the NHS) in England, 2013-2014. NHS Community Trust employees involved in delivering MSK services, including clinical staff and managerial staff in senior and mid-range positions. Managers (n=4) and clinicians (n=4) working within MSK services understood and experienced the Any Qualified Provider (AQP) policy as involving: (1) a perceived trade-off between quality and cost in its implementation; (2) deskilling of MSK clinicians and erosion of professional values; and (3) a shift away from interprofessional collaboration and dialogue. These ways of making sense of AQP policy were associated with dissatisfaction with market-based health reforms. AQP policy is poorly understood. Clinicians and managers perceive AQP as synonymous with competition and privatisation. From the perspective of clinicians providing MSK services, AQP, and related health policy reforms, tend, paradoxically, to drive down quality standards, supporting reconfiguration of services in which the complex, holistic nature of specialised MSK care may become marginalised by policy concerns about efficiency and cost. Our analysis indicates that the potential of AQP policy to increase quality of care is, at best, equivocal, and that any consideration of how AQP impacts on practice can only be understood by reference to a wider range of health policy reforms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The trust-commitment challenge in service quality-loyalty relationships.

PubMed

Moreira, Antonio Carrizo; Silva, Pedro Miguel

2015-01-01

The purpose of this paper is to develop and empirically test a model to examine service quality, satisfaction, trust and commitment as loyalty antecedents in a private healthcare service. The approach was tested using structural equation modelling, involving 175 patients from a private Portuguese healthcare unit, using a revised Service Quality Assessment Scale (SQAS) scale for service quality evaluation. The scale used to evaluate service quality is valid and meaningful. Service quality proved to be a multidimensional construct and relevant to build satisfaction. The path satisfaction→trust→loyalty was validated, whereas the path satisfaction→commitment→loyalty was not statistically supported. The revised SQAS scale showed good internal consistency in healthcare context. Further trust-commitment antecedents must be examined in a private healthcare landscape to generalise the findings. Healthcare quality managers must explore the service quality dimensions to generate satisfaction among their patients. Developing trust generates positive patient attitudes and loyalty. This study explores using the SQAS scale in a private healthcare context. The authors provide further evidence that service quality is an antecedent and different from satisfaction. All the measures used proved to be valid and reliable. Trust and commitment play different roles in their relationship with loyalty.

Mobile information and communication in the hospital outpatient service.

PubMed

Jen, Wen-Yuan; Chao, Chia-Chen; Hung, Ming-Chien; Li, Yu-Chuan; Chi, Y P

2007-08-01

Most healthcare providers provide mobile service for their medical staff; however, few healthcare providers provide mobile service as part of their outpatient service. The mobile outpatient service system (MOSS) focuses on illness treatment, illness prevention and patient relation management for outpatient service users. Initiated in a local hospital in Taiwan, the MOSS pilot project was developed to improve outpatient service quality and pursue higher patient safety. This study focuses on the development of the MOSS. The workflow, architecture and target users of the MOSS are delineated. In addition, there were two surveys conducted as part of this study. After a focus group of medical staff identified areas in which outpatient services might be improved by the MOSS, the first survey was administered to outpatients to confirm the focus group's intuitions. The second administration of the survey explored outpatient satisfaction after they used the MOSS service. With regard to outpatient attitudes, about 93% of participants agreed that the mobile outpatient service improved outpatient service quality. In the area of outpatient satisfaction, about 89% of participants indicated they were satisfied with the mobile outpatient service. Supported by our study finding, we propose that more diverse mobile outpatient services can be provided in the future.

Dispensing doctor practices and community pharmacies: exploring the quality of pharmaceutical services.

PubMed

Weiss, Marjorie C; Grey, Elisabeth; Harris, Michael; Rodham, Karen

2016-01-01

This research sought (a) to investigate the similarities and differences in how pharmaceutical services are provided by community pharmacies (CPs) and dispensing doctor practices (DPs) and (b) to identify the issues relevant to determining the quality of pharmaceutical services in these settings. UK pharmaceutical services, including dispensing prescriptions and public health advice, can be provided from both (CP) and, in rural areas, (DP). While there is much similarity between CPs and DPs in the types of services provided, there is also the potential for variation in service quality across settings. A postal questionnaire of DPs and CPs in South West England was conducted to provide a descriptive overview of pharmaceutical services across the settings. A subsection of questionnaire respondent sites were selected to take part in case studies, which involved documentary analyses, observation and staff interviews. Survey response was 39% for CPs (52/134) and 48% (31/64) for DPs. There were three CP and four DP case study sites, with 17 staff interviews. More pharmacies than practices were open at the weekend and they had more staff trained above NVQ level 2. Both doctors and pharmacists saw themselves as medicines experts, as being accessible and having good relationships with patients. Workplace practices and organisational ethos varied both within and across settings, with good practice observed in both. Overall, CPs and DPs have much in common. Workplace culture and an evidence-based approach to checking prescriptions and error reporting need to be considered in future assessments of service quality.

The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: a systematic review.

PubMed

Jennings, Natasha; Clifford, Stuart; Fox, Amanda R; O'Connell, Jane; Gardner, Glenn

2015-01-01

To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools. Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis. Synthesis of the available research attempts to provide an evidence base for emergency nurse practitioner service to guide healthcare leaders, policy makers and clinicians in reform of emergency service provision. The findings suggest that further high quality research is required for comparative measures of clinical and service effectiveness of emergency nurse practitioner service. In the context of increased health service demand and the need to provide timely and effective care to patients, such measures will assist in evidence based health service planning. Copyright © 2014 Elsevier Ltd. All rights reserved.

42 CFR 441.585 - Quality assurance system.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Quality assurance system. 441.585 Section 441.585 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... provides information about the provisions of quality improvement and assurance to each individual receiving...

42 CFR 441.585 - Quality assurance system.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Quality assurance system. 441.585 Section 441.585 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... provides information about the provisions of quality improvement and assurance to each individual receiving...

[Structures and processes in outpatient neurorehabilitation].

PubMed

Pöppl, Dominik; Deck, R; Kringler, W; Reuther, P

2014-06-01

Quality of structures, processes and outcome are commonly accepted as dimensions of quality management and quality assurance. Data of structures and processes are not published to date for German outpatient neurorehabilitation. Rehabilitative care and service providers are legally bound to apply concepts of quality management and quality assurance. The service providers pass recommendations, which have to be implemented by outpatient neurorehabilitation centres. Data analysis of existing structures and processes in outpatient neurorehabilitation centres are embedded as a part of a long-term multicentres outcome study. 22 outpatient neurorehabilitation centres participated in an online survey with 227 items using the google tool "Docs" between September and December 2011. Following issues were asked: general information about the centres (e. g. date of establishment, number of therapy places, kind of patients, responsible organization), utility supply contracts with service providers, local cooperation and networking, staff and equipment and appliances, treatment concepts, processes of therapy (e. g. individual and group therapy, frequency, concentration, planning), team processes, goals and team development, quality management and documentation. In the meantime outpatient centres of neurorehabilitation are well-established as care providers and commonly accepted by service providers. However a comprehensive availability does not exist. The results show comparable structures of the centres, what is mostly determined by the service provider audited regulatory framework. Different concepts result in different processes. There are a lot of hints with respect to different concepts in form and content to implement the legally obligated mandate. In general their work with context -factors is still a frequently unused potential. It can be countered by the therapeutic inclusion of the social and environmental living conditions of the patients. © Georg Thieme Verlag KG Stuttgart · New York.

CSRQ Center Report on Education Service Providers

ERIC Educational Resources Information Center

American Institutes for Research, 2006

2006-01-01

This consumer guide, for the first time ever, provides comparative ratings on the effectiveness and quality of seven widely adopted Education Service Providers (ESPs)--nonprofit or for-profit organizations that contract with new or existing public, charter, or private schools and/or school districts to provide comprehensive services. This report…

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed Central

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-01-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific. PMID:21729919

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-07-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific.

Developing a quality assurance program for online services.

PubMed Central

Humphries, A W; Naisawald, G V

1991-01-01

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas. PMID:1909197

Developing a quality assurance program for online services.

PubMed

Humphries, A W; Naisawald, G V

1991-07-01

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries. PMID:21864335

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries.

Clients' Satisfaction with Monopolistic Services and Commitment to the Organization: A University Context

ERIC Educational Resources Information Center

Thomas, James L.; Cunningham, Brent J.

2009-01-01

This study investigates the relationship between monopolistic service providers and customer satisfaction and commitment. The authors investigated how the ethical perceptions of service consumers, their perceptions of service quality, and satisfaction effect commitment to the long-term relationship with monopolistic service providers. Results…

42 CFR 480.102 - Statutory bases for acquisition and maintenance of information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information. 480.102 Section 480.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND... medical necessity and quality of health care services they provide to Medicare patients as required by...

Fundholders' referral patterns and perceptions of service quality in hospital provision of elective general surgery.

PubMed Central

Whynes, D K; Reed, G

1994-01-01

BACKGROUND. The introduction of fundholding established an internal market in public sector health care, involving purchasers and providers contracting for the supply of health care. AIM. This study set out to examine fundholders' hospital referral patterns, and to evaluate the quality of the service provided to patients undergoing elective general surgery, as perceived by fundholding general practitioners. METHOD. A questionnaire was posted to the senior partners of all fundholding practices in the Trent Regional Health Authority area. This questionnaire requested assessments of the importance of 13 specified aspects of service quality and the quality of provision by general practitioners' most frequently-used hospitals. Five-point scales were employed in each case. Respondents were asked to provide additional details about their practice. RESULTS. A 67% response rate was achieved. Confidence in the consultant's ability, short waiting times and informative feedback from the providers emerged as the most important elements in referral decisions, while the cost of treatment and patient convenience received lower importance ratings. In terms of how well their providers were seen to perform, fundholders ranked confidence in the consultant and patient convenience highest, and style of hospital management lowest. The majority of referrals seemed to be local. CONCLUSION. Judged in terms of fundholders' perceptions, sizeable variations in service quality between hospital providers of general surgery are evident. PMID:7748666

Revisiting perceptions of quality of hospice care: managing for the ultimate referral.

PubMed

Churchman, Richard; York, Grady S; Woodard, Beth; Wainright, Charles; Rau-Foster, Mary

2014-08-01

Hospice services provided in the final months of life are delivered through complex interpersonal relationships between caregivers, patients, and families. Often, service value and quality are defined by these interpersonal interactions. This understanding provides hospice leaders with an enormous opportunity to create processes that provide the optimal level of care during the last months of life. The authors argue that the ultimate referral is attained when a family member observes the care of a loved one, and the family member conveys a desire to receive the same quality of services their loved one received at that facility. The point of this article is to provide evidence that supports the methods to ultimately enhance the patient's and family's experience and increase the potential for the ultimate referral. © The Author(s) 2013.

Patients' perceptions of service quality in China: An investigation using the SERVQUAL model.

PubMed

Fan, Li-Hua; Gao, Lei; Liu, Xin; Zhao, Shi-Hong; Mu, Hui-Tong; Li, Zhe; Shi, Lei; Wang, Ling-Ling; Jia, Xiao-Li; Ha, Min; Lou, Feng-Ge

2017-01-01

The doctor-patient relationship has been a major focus of society. Hospitals' efforts to improve the quality of their medical services have been to reduce the probability of doctor-patient conflicts. In this study, we aimed to determine the gap between expectations and perceptions of service quality according to patients to provide reference data for creating strategies to improve health care quality. Twenty-seven hospitals in 15 provinces (municipalities directly beneath the central government) were selected for our survey; we sent out 1,589 questionnaires, of which 1,520 were collected (response rate 95.65%) and 1,303 were valid (85.72% effective recovery rate). Paired t-tests were used to analyze whether there were significant differences between patients' expectations and perceived service quality. A binary logistic regression analysis was used to determine whether there were significant differences in the gap between expectation and perception of service quality according to patients' demographic characteristics. There was a significant difference between the expected and perceived service quality (p < 0.05) according to patients both before and after receiving medical services. Furthermore, the service quality gap of each service dimension was negative. Specifically, the gaps in service quality were as follows: economy, responsiveness, empathy, assurance, reliability, and tangibles. Overall, we can conclude that patients' perceptions of service quality are lower than their expectations. According to the study results, the quality of health care services as perceived by patients was lower than expected. Hospitals should make adjustments according to the actual situation and should strive to constantly improve the quality of medical services for patients.

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya

PubMed Central

Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

2017-01-01

Abstract The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client–provider consultation sessions. The cross-sectional study observed 366 client–provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63–0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07–14.21), adequate infrastructure (5.29; 95% CI: 2.89–7.69) and reagents (1.48; 95% CI: 1.02–1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92–4.36), job satisfaction (2.02; 95% CI: 1.21–2.83) and supervision (1.01; 95% CI: 0.35–1.68), while workload (−0.88; 95% CI: −1.75 to − 0.01) was negatively associated. Technical quality of the client–provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client–provider consultation sessions as measured by both health facility structural and provider factors. PMID:29194543

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

PubMed

Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

2017-11-01

The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility structural and provider factors. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Service quality of hospital outpatient departments: patients' perspective.

PubMed

Zarei, Ehsan

2015-01-01

Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.

Evaluation of Reference Services--A Review

ERIC Educational Resources Information Center

Kuruppu, Pali U.

2007-01-01

Understanding the inherent deficiencies in reference service as provided is critical to providing effective, high quality service. Quantitative and qualitative research methodologies, as well as a combination of both, are being used to evaluate these services. The identification of appropriate research methodology is critical to an effective…

Using a quality improvement model to enhance providers' performance in maternal and newborn health care: a post-only intervention and comparison design.

PubMed

Ayalew, Firew; Eyassu, Gizachew; Seyoum, Negash; van Roosmalen, Jos; Bazant, Eva; Kim, Young Mi; Tekleberhan, Alemnesh; Gibson, Hannah; Daniel, Ephrem; Stekelenburg, Jelle

2017-04-12

The Standards Based Management and Recognition (SBM-R © ) approach to quality improvement has been implemented in Ethiopia to strengthen routine maternal and newborn health (MNH) services. This evaluation assessed the effect of the intervention on MNH providers' performance of routine antenatal care (ANC), uncomplicated labor and delivery and immediate postnatal care (PNC) services. A post-only evaluation design was conducted at three hospitals and eight health centers implementing SBM-R and the same number of comparison health facilities. Structured checklists were used to observe MNH providers' performance on ANC (236 provider-client interactions), uncomplicated labor and delivery (226 provider-client interactions), and immediate PNC services in the six hours after delivery (232 provider-client interactions); observations were divided equally between intervention and comparison groups. Main outcomes were provider performance scores, calculated as the percentage of essential tasks in each service area completed by providers. Multilevel analysis was used to calculate adjusted mean percentage performance scores and standard errors to compare intervention and comparison groups. There was no statistically significant difference between intervention and comparison facilities in overall mean performance scores for ANC services (63.4% at intervention facilities versus 61.0% at comparison facilities, p = 0.650) or in any specific ANC skill area. MNH providers' overall mean performance score for uncomplicated labor and delivery care was 11.9 percentage points higher in the intervention than in the comparison group (77.5% versus 65.6%; p = 0.002). Overall mean performance scores for immediate PNC were 22.2 percentage points higher at intervention than at comparison facilities (72.8% versus 50.6%; p = 0.001); and there was a significant difference of 22 percentage points between intervention and comparison facilities for each PNC skill area: care for the newborn and health check for the mother. The SBM-R quality improvement intervention made a significant positive impact on MNH providers' performance during labor and delivery and immediate PNC services, but not during ANC services. Scaling up the intervention to other facilities and regions may increase the availability of good quality MNH services across Ethiopia. The findings will also guide implementation of the government's five-year (2015-2020) health sector transformation plan and health care quality strategies needed to meet the country's MNH goals.

Quality management in home care: models for today's practice.

PubMed

Verhey, M P

1996-01-01

In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.

Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.

PubMed

Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

2010-01-01

The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic aspects as compared to those working at pharmacies with fewer specialists. Men evaluated both pharmacotherapeutic and socioeconomic aspects worse than women. The evaluation of pharmaceutical service quality did not differ by pharmacy location. Two dimensions of pharmaceutical service quality were determined. According to Lithuanian pharmacy specialists, the quality of pharmacotherapeutic aspects at community pharmacies was worse than that of socioeconomic aspects. The evaluation of the quality of pharmaceutical service significantly differed according to the specialists' sex, age, qualification, and type and size of pharmacies.

Harmonisation Initiatives of Copernicus Data Quality Control

NASA Astrophysics Data System (ADS)

Vescovi, F. D.; Lankester, T.; Coleman, E.; Ottavianelli, G.

2015-04-01

The Copernicus Space Component Data Access system (CSCDA) incorporates data contributions from a wide range of satellite missions. Through EO data handling and distribution, CSCDA serves a set of Copernicus Services related to Land, Marine and Atmosphere Monitoring, Emergency Management and Security and Climate Change. The quality of the delivered EO products is the responsibility of each contributing mission, and the Copernicus data Quality Control (CQC) service supports and complements such data quality control activities. The mission of the CQC is to provide a service of quality assessment on the provided imagery, to support the investigation related to product quality anomalies, and to guarantee harmonisation and traceability of the quality information. In terms of product quality control, the CQC carries out analysis of representative sample products for each contributing mission as well as coordinating data quality investigation related to issues found or raised by Copernicus users. Results from the product analysis are systematically collected and the derived quality reports stored in a searchable database. The CQC service can be seen as a privileged focal point with unique comparison capacities over the data providers. The comparison among products from different missions suggests the need for a strong, common effort of harmonisation. Technical terms, definitions, metadata, file formats, processing levels, algorithms, cal/val procedures etc. are far from being homogeneous, and this may generate inconsistencies and confusion among users of EO data. The CSCDA CQC team plays a significant role in promoting harmonisation initiatives across the numerous contributing missions, so that a common effort can achieve optimal complementarity and compatibility among the EO data from multiple data providers. This effort is done in coordination with important initiatives already working towards these goals (e.g. INSPIRE directive, CEOS initiatives, OGC standards, QA4EO etc.). This paper describes the main actions being undertaken by CQC to encourage harmonisation among space-based EO systems currently in service.

E-Service Quality in Higher Education and Frequency of Use of the Service

ERIC Educational Resources Information Center

Kim-Soon, Ng; Rahman, Abd; Ahmed, Muhudin

2014-01-01

Universities have been at the forefront of online service provision. Regular evaluations and appraisals of its e-services provided to students are regularly improvised to keep pace with the rapid changes of learning technology and competitiveness of its services provided. There is a dread of research works investigating e-service quality…

Any qualified provider: a qualitative case study of one community NHS Trust's response

PubMed Central

Walumbe, Jackie; Swinglehurst, Deborah; Shaw, Sara

2016-01-01

Objective To examine how those managing and providing community-based musculoskeletal (MSK) services have experienced recent policy allowing patients to choose any provider that meets certain quality standards from the National Health Service (NHS), private or voluntary sector. Design Intrinsic case study combining qualitative analysis of interviews and field notes. Setting An NHS Community Trust (the main providers of community health services in the NHS) in England, 2013–2014. Participants NHS Community Trust employees involved in delivering MSK services, including clinical staff and managerial staff in senior and mid-range positions. Findings Managers (n=4) and clinicians (n=4) working within MSK services understood and experienced the Any Qualified Provider (AQP) policy as involving: (1) a perceived trade-off between quality and cost in its implementation; (2) deskilling of MSK clinicians and erosion of professional values; and (3) a shift away from interprofessional collaboration and dialogue. These ways of making sense of AQP policy were associated with dissatisfaction with market-based health reforms. Conclusions AQP policy is poorly understood. Clinicians and managers perceive AQP as synonymous with competition and privatisation. From the perspective of clinicians providing MSK services, AQP, and related health policy reforms, tend, paradoxically, to drive down quality standards, supporting reconfiguration of services in which the complex, holistic nature of specialised MSK care may become marginalised by policy concerns about efficiency and cost. Our analysis indicates that the potential of AQP policy to increase quality of care is, at best, equivocal, and that any consideration of how AQP impacts on practice can only be understood by reference to a wider range of health policy reforms. PMID:26908521

Costs and utilization of public sector family planning services in Pakistan.

PubMed

Abbas, Khadija; Khan, Adnan Ahmad; Khan, Ayesha

2013-04-01

The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector. We used overall budgets and time allocation by health and population departments to estimate the total costs of FP by these departments, costs per woman served, and costs per couple-year of protection (CYP). The public sector is the predominant provider of FP to the poorest and is the main provider of female sterilization services. The overall costs of FP in the public sector are USD 55 per woman served, annually (USD 17 per CYP). Within the public sector, the population welfare departments provide services at USD 72 per woman served, annually (USD 17 per CYP) and the health departments at USD 39 per woman per year (USD 29 per CYP). While the public sector has a critical niche in serving the poor and providing female sterilization, its services are considerably more expensive compared to international and even some Pakistani non-government organization (NGO) costs. This reflects inefficiencies in services provided, client mistrust in the quality of services provided, and inadequate referrals, and will require specific actions for improving referrals and the quality of services.

QaaS (quality as a service) model for web services using big data technologies

NASA Astrophysics Data System (ADS)

Ahmad, Faisal; Sarkar, Anirban

2017-10-01

Quality of service (QoS) determines the service usability and utility and both of which influence the service selection process. The QoS varies from one service provider to other. Each web service has its own methodology for evaluating QoS. The lack of transparent QoS evaluation model makes the service selection challenging. Moreover, most QoS evaluation processes do not consider their historical data which not only helps in getting more accurate QoS but also helps for future prediction, recommendation and knowledge discovery. QoS driven service selection demands a model where QoS can be provided as a service to end users. This paper proposes a layered QaaS (quality as a service) model in the same line as PaaS and software as a service, where users can provide QoS attributes as inputs and the model returns services satisfying the user's QoS expectation. This paper covers all the key aspects in this context, like selection of data sources, its transformation, evaluation, classification and storage of QoS. The paper uses server log as the source for evaluating QoS values, common methodology for its evaluation and big data technologies for its transformation and analysis. This paper also establishes the fact that Spark outperforms the Pig with respect to evaluation of QoS from logs.

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts.

PubMed

Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-11-29

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. The most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts

PubMed Central

Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-01-01

Background In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. Methods This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. Results The most notable improvement across regions was in infection prevention. Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Conclusion Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality. PMID:18047678

Electronic health records: eliciting behavioral health providers' beliefs.

PubMed

Shank, Nancy; Willborn, Elizabeth; Pytlikzillig, Lisa; Noel, Harmonijoie

2012-04-01

Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

Manufacturing Bms/Iso System Review

NASA Technical Reports Server (NTRS)

Gomez, Yazmin

2004-01-01

The Quality Management System (QMS) is one that recognizes the need to continuously change and improve an organization s products and services as determined by system feedback, and corresponding management decisions. The purpose of a Quality Management System is to minimize quality variability of an organization's products and services. The optimal Quality Management System balances the need for an organization to maintain flexibility in the products and services it provides with the need for providing the appropriate level of discipline and control over the processes used to provide them. The goal of a Quality Management System is to ensure the quality of the products and services while consistently (through minimizing quality variability) meeting or exceeding customer expectations. The GRC Business Management System (BMS) is the foundation of the Center's ISO 9001:2000 registered quality system. ISO 9001 is a quality system model developed by the International Organization for Standardization. BMS supports and promote the Glenn Research Center Quality Policy and wants to ensure the customer satisfaction while also meeting quality standards. My assignment during this summer is to examine the manufacturing processes used to develop research hardware, which in most cases are one of a kind hardware, made with non conventional equipment and materials. During this process of observation I will make a determination, based on my observations of the hardware development processes the best way to meet customer requirements and at the same time achieve the GRC quality standards. The purpose of my task is to review the manufacturing processes identifying opportunities in which to optimize the efficiency of the processes and establish a plan for implementation and continuous improvement.

Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

PubMed

Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

2017-09-01

Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Perceptions of a medical microbiology service: a survey of laboratory users.

PubMed Central

Morgan, M S

1995-01-01

AIM--To ascertain the perception of laboratory users regarding the quality of the medical microbiology services in a district general hospital. METHODS--Detailed questionnaires were circulated to all clinicians in the locality, with headings covering the quality of medical advice provided, the availability of information on specimen collection, format of request forms, specimen transport arrangements, turnaround times, the quality and need for interpretative advice, and the overall impression of the quality of the services provided. RESULTS--Two hundred and thirty five replies were received, giving a response rate of 69%. Transportation of specimens and communication of reports were identified as priority areas for improvement. The overall quality of the service was perceived as satisfactory, although areas were identified where substantial improvements could be made, some at little or no cost to the laboratory. CONCLUSIONS--The survey focused clinicians' attention on the service, raised the profile of the laboratory, and resulted in improved communications and a better understanding of customer needs. Overall, the exercise was felt to be extremely useful, and worthwhile repeating to gauge the effect of the changes instituted as a result. PMID:8537489

42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

Code of Federal Regulations, 2012 CFR

2012-10-01

... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

Code of Federal Regulations, 2014 CFR

2014-10-01

... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

Code of Federal Regulations, 2013 CFR

2013-10-01

... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

Comparison Quality of Health Services between Public and Private Providers: The Iranian People's Perspective.

PubMed

Alijanzadeh, Mehran; Zare, Seyed Ali Moosaniaye; Rajaee, Roya; Fard, Seyed Mohammad Ali Mousavi; Asefzadeh, Saeed; Alijanzadeh, Mahnaz; Gholami, Soheyla

2016-09-01

Health services quality has been the most important criteria of judging, and its improvement causes people's satisfaction of health systems. In a health system, public and private sectors provide services and typically have been effective in promoting health services quality of community. The aim of this study was to compare the quality of health services in both public and private sectors from the perspective of residents in Qazvin (Iran). This cross-sectional study was conducted in 2014. The study population included all residents of Qazvin Province, and the sample size was estimated to 1002. The research tool was a perceptions of services quality standard questionnaire. Data were collected by trained interviewers visiting homes and were analyzed by IBM-SPSS software version 22 and t-test and linear regression. Cronbach's alpha coefficient was 0.91 and test-re-test coefficient was 83%. 741 people (74%) in their last visit to receive services were referred to the public sector. Between the perception of people participating in the study about medical equipment and supplies, welfare facilities, competence and experience of doctor, waiting time, rapid reception, and access to doctor in public and private sectors, significant differences were observed (p < 0.05). In the tangible realm in perception of health services, there was a significant difference in quality between the public and private sectors (p < 0.05). In addition, place of receiving services, waiting time, education, occupation, and type of received services were affecting factors in regards to perceptions of health services from the perspective of Iran's population (p < 0.05). The results showed the importance of a tangible realm on people's satisfaction of health services. It seems that the public sector should pay more attention to this issue.

Connecting Latinos with nature

Treesearch

Deborah J. Chavez

2008-01-01

Experts around the world have identified ecosystem services that benefit humans. Ecosystem services provided by natural areas include cultural (such as providing outdoor recreation locations) and regulating (such as protecting water quality) services. It is important to understand both public perceptions about the importance of particular ecosystem services and the...

Social support and responsiveness in online patient communities: impact on service quality perceptions.

PubMed

Nambisan, Priya; Gustafson, David H; Hawkins, Robert; Pingree, Suzanne

2016-02-01

Hospitals frequently evaluate their service quality based on the care and services provided to patients by their clinical and non-clinical staff.(1,2) However, such evaluations do not take into consideration the many interactions that patients have in online patient communities with the health-care organization (HCO) as well as with peer patients. Patients' interactions in these online communities could impact their perceptions regarding the HCO's service quality. The objective of this pilot study was to evaluate the impact of social support and responsiveness that patients experience in an HCO's online community on patients' perceptions regarding the HCO's service quality. The study data are collected from CHESS, a health-care programme (Comprehensive Health Enhancement Support System) run by the Centre for Health Enhancement System Studies at the University of Wisconsin-Madison. Findings show that the social support and the responsiveness received from peer patients in the online patient communities will impact patients' perceptions regarding the service quality of the HCO even when the organizational members themselves do not participate in the online discussions. The results indicate that interactions in such HCO-provided online patient communities should not be ignored as they could translate into patients' perceptions regarding HCOs' service quality. Ways to improve responsiveness and social support in an HCO's online patient community are discussed. © 2014 John Wiley & Sons Ltd.

Improving consistency and quality of service delivery: implications for the addiction treatment field.

PubMed

Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

2008-09-01

Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach.

Quality of asthma care under different primary care models in Canada: a population-based study.

PubMed

To, Teresa; Guan, Jun; Zhu, Jingqin; Lougheed, M Diane; Kaplan, Alan; Tamari, Itamar; Stanbrook, Matthew B; Simatovic, Jacqueline; Feldman, Laura; Gershon, Andrea S

2015-02-14

Previous research has shown variations in quality of care and patient outcomes under different primary care models. The objective of this study was to use previously validated, evidence-based performance indicators to measure quality of asthma care over time and to compare quality of care between different primary care models. Data were obtained for years 2006 to 2010 from the Ontario Asthma Surveillance Information System, which uses health administrative databases to track individuals with asthma living in the province of Ontario, Canada. Individuals with asthma (n=1,813,922) were divided into groups based on the practice model of their primary care provider (i.e., fee-for-service, blended fee-for-service, blended capitation). Quality of asthma care was measured using six validated, evidence-based asthma care performance indicators. All of the asthma performance indicators improved over time within each of the primary care models. Compared to the traditional fee-for-service model, the blended fee-for-service and blended capitation models had higher use of spirometry for asthma diagnosis and monitoring, higher rates of inhaled corticosteroid prescription, and lower outpatient claims. Emergency department visits were lowest in the blended fee-for-service group. Quality of asthma care improved over time within each of the primary care models. However, the amount by which they improved differed between the models. The newer primary care models (i.e., blended fee-for-service, blended capitation) appear to provide better quality of asthma care compared to the traditional fee-for-service model.

The cost of service quality improvements: tracking the flow of funds in social franchise networks in Myanmar.

PubMed

Bishai, David; LeFevre, Amnesty; Theuss, Marc; Boxshall, Matt; Hetherington, John D; Zaw, Min; Montagu, Dominic

2013-01-01

This paper examines the cost of quality improvements in Population Services International (PSI) Myanmar's social franchise operations from 2007 to 2009. The social franchise commodities studied were products for reproductive health, malaria, STIs, pneumonia, and diarrhea. This project applied ingredients based costing for labor, supplies, transport, and overhead. Data were gathered seven during key informant interviews with staff in the central Yangon office, examination of 3 years of payroll data, examination of a time motion study conducted by PSI, and spreadsheets recording the costs of acquiring and transporting supplies. In 2009 PSI Myanmar's social franchise devoted $2.02 million towards a 94% reduction in commodity prices offered to its network of over 1700 primary care providers. These providers retained 1/3 of the subsidy as revenue and passed along the other 2/3 to their patients in the course of offering subsidized care for 1.5 million health episodes. In addition, PSI Myanmar devoted $2.09 million to support a team of franchise officers who conducted quality assurance for the private providers overseeing service quality and to distributing medical commodities. In Myanmar, the social franchise operated by PSI spends roughly $1.00 in quality management and retailing for every $1.00 spent subsidizing medical commodities. Some services are free, but patients also pay fees for other lines of service. Overall patients contribute 1/6 as much as PSI does. Unlike other NGO's, health services in social franchises like PSI are not all free to the patients, nor are the discounts uniformly applied. Discounts and subsidies evolve in response to public health concerns, market demand, providers' cost structures as well as strategic objectives in maintaining the network and its portfolio of services.

Measuring functional service quality using SERVQUAL in a high-dependence health service relationship.

PubMed

Clark, W Randy; Clark, Leigh Anne

2007-01-01

Although there is a growing concern about health care quality, little research has focused on how to measure quality in long-term care settings. In this article, we make the following observations: (1) most users of the SERVQUAL instrument reassess customers' expectations each time they measure quality perceptions; (2) long-term care relationships are likely to be ongoing, dependent relationships; (3) because of this dependence, customers in the long-term care setting are likely to reduce their expectations when faced with poor service quality; (4) by using this "settled" expectations level, service providers may make biased conclusions of quality improvements. We recommend various methods for overcoming or minimizing this "settling" effect and propose modifications to the SERVQUAL gap 5 measure to assess quality in a long-term care setting.

Impact of hospital atmosphere on perceived health care outcome.

PubMed

Narang, Ritu; Polsa, Pia; Soneye, Alabi; Fuxiang, Wei

2015-01-01

Healthcare service quality studies primarily examine the relationships between patients' perceived quality and satisfaction with healthcare services, clinical effectiveness, service use, recommendations and value for money. These studies suggest that patient-independent quality dimensions (structure, process and outcome) are antecedents to quality. The purpose of this paper is to propose an alternative by looking at the relationship between hospital atmosphere and healthcare quality with perceived outcome. Data were collected from Finland, India, Nigeria and the People's Republic of China. Regression analysis used perceived outcome as the dependent variable and atmosphere and healthcare service quality as independent variables. Findings - Results showed that atmosphere and healthcare service quality have a statistically significant relationship with patient perceived outcomes. The sample size was small and the sampling units were selected on convenience; thus, caution must be exercised in generalizing the findings. The study determined that service quality and atmosphere are considered significant for developing and developed nations. This result could have significant implications for policy makers and service providers developing healthcare quality and hospital atmosphere. Studies concentrate on healthcare outcome primarily regarding population health status, mortality, morbidity, customer satisfaction, loyalty, quality of life, customer behavior and consumption. However, the study exposes how patients perceive their health after treatment. Furthermore, the authors develop the healthcare service literature by considering atmosphere and perceived outcome.

Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

PubMed

Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

2015-06-01

Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. Copyright © 2015. Published by Elsevier Ireland Ltd.

Measuring the Quality of the u-Learning Service Using the Zone of Tolerance SERVQUAL

NASA Astrophysics Data System (ADS)

Kim, Seong Jin; Park, Keon Chul; Seo, Hyun Sik; Lee, Bong Gyou

The purpose of this study is to analyze diverse factors that affect service quality of Digital textbook service. The ZOT(Zone of Tolerance) SERVQUAL has been applied to develop the research model. Users of the Digital textbook service were selected as subjects for the sample frame. A total of 115 surveys from over 112 schools were collected and used as data for analysis. Results of the survey by SPSS Win Ver. 12.0 showed that the perceived level of service quality in terms of reliability is particularly low, and is quite different from adequate quality. This paper suggests useful guidelines to education providers for improving their public u-Learning environment.

A case study of a team-based, quality-focused compensation model for primary care providers.

PubMed

Greene, Jessica; Hibbard, Judith H; Overton, Valerie

2014-06-01

In 2011, Fairview Health Services began replacing their fee-for-service compensation model for primary care providers (PCPs), which included an annual pay-for-performance bonus, with a team-based model designed to improve quality of care, patient experience, and (eventually) cost containment. In-depth interviews and an online survey of PCPs early after implementation of the new model suggest that it quickly changed the way many PCPs practiced. Most PCPs reported a shift in orientation toward quality of care, working more collaboratively with their colleagues and focusing on their full panel of patients. The majority reported that their quality of care had improved because of the model and that their colleagues' quality had to. The comprehensive change did, however, result in lower fee-for-service billing and reductions in PCP satisfaction. While Fairview's compensation model is still a work in progress, their early experiences can provide lessons for other delivery systems seeking to reform PCP compensation.

The Copernicus Atmosphere Monitoring Service: facilitating the prediction of air quality from global to local scales

NASA Astrophysics Data System (ADS)

Engelen, R. J.; Peuch, V. H.

2017-12-01

The European Copernicus Atmosphere Monitoring Service (CAMS) operationally provides daily forecasts of global atmospheric composition and regional air quality. The global forecasting system is using ECMWF's Integrated Forecasting System (IFS), which is used for numerical weather prediction and which has been extended with modules for atmospheric chemistry, aerosols and greenhouse gases. The regional forecasts are produced by an ensemble of seven operational European air quality models that take their boundary conditions from the global system and provide an ensemble median with ensemble spread as their main output. Both the global and regional forecasting systems are feeding their output into air quality models on a variety of scales in various parts of the world. We will introduce the CAMS service chain and provide illustrations of its use in downstream applications. Both the usage of the daily forecasts and the usage of global and regional reanalyses will be addressed.

Mechanism Design for Task Procurement with Flexible Quality of Service

NASA Astrophysics Data System (ADS)

Gerding, Enrico H.; Larson, Kate; Rogers, Alex; Jennings, Nicholas R.

In this paper, we consider the problem where an agent wishes to complete a single computational task, but lacks the required resources. Instead, it must contract self-interested service providers, who are able to flexibly manipulate the quality of service they deliver, in order to maximise their own utility. We extend an existing model to allow for multiple such service providers to be contracted for the same task, and derive optimal task procurement mechanisms in the setting where the agent has full knowledge of the cost functions of these service providers (considering both simultaneous and sequential procurement). We then extend these results to the incomplete information setting where the agent must elicit cost information from the service providers, and we characterise a family of incentive-compatible and individually-rational mechanisms. We show empirically that sequential procurement always generates greater utility for the agent compared to simultaneous procurement, and that over a range of settings, contracting multiple providers is preferable to contracting just one.

Patients’ perceptions of service quality in China: An investigation using the SERVQUAL model

PubMed Central

Zhao, Shi-hong; Mu, Hui-tong; Li, Zhe; Shi, Lei; Wang, Ling-ling; Jia, Xiao-li; Ha, Min; Lou, Feng-ge

2017-01-01

Background and aim The doctor–patient relationship has been a major focus of society. Hospitals’ efforts to improve the quality of their medical services have been to reduce the probability of doctor–patient conflicts. In this study, we aimed to determine the gap between expectations and perceptions of service quality according to patients to provide reference data for creating strategies to improve health care quality. Methods Twenty–seven hospitals in 15 provinces (municipalities directly beneath the central government) were selected for our survey; we sent out 1,589 questionnaires, of which 1,520 were collected (response rate 95.65%) and 1,303 were valid (85.72% effective recovery rate). Paired t-tests were used to analyze whether there were significant differences between patients' expectations and perceived service quality. A binary logistic regression analysis was used to determine whether there were significant differences in the gap between expectation and perception of service quality according to patients' demographic characteristics. Results There was a significant difference between the expected and perceived service quality (p < 0.05) according to patients both before and after receiving medical services. Furthermore, the service quality gap of each service dimension was negative. Specifically, the gaps in service quality were as follows: economy, responsiveness, empathy, assurance, reliability, and tangibles. Overall, we can conclude that patients’ perceptions of service quality are lower than their expectations. Conclusions According to the study results, the quality of health care services as perceived by patients was lower than expected. Hospitals should make adjustments according to the actual situation and should strive to constantly improve the quality of medical services for patients. PMID:29272312

21 CFR 900.10 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MAMMOGRAPHY QUALITY STANDARDS ACT MAMMOGRAPHY Quality Standards and Certification § 900.10 Applicability. The... States that provide mammography services, with the exception of the Department of Veterans Affairs. ...

45 CFR 98.84 - Construction and renovation of child care facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... services, quality activities, or administrative costs). (h) A construction or renovation project that... facilities. 98.84 Section 98.84 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION... child care services provided by the Tribal Lead Agency as compared to the level of services provided by...

Mapping Biodiversity Metrics Representing Ecosystem Services at the Landscape Scale in the American Southwest

EPA Science Inventory

It is widely understood that human condition is intrinsically linked to the quality of the environment and the services it provides. Ecosystem services, i.e., "services provided to humans from natural systems," have become a key issue of this century in resource management, conse...

Urban Air Quality Modelling with AURORA: Prague and Bratislava

NASA Astrophysics Data System (ADS)

Veldeman, N.; Viaene, P.; De Ridder, K.; Peelaerts, W.; Lauwaet, D.; Muhammad, N.; Blyth, L.

2012-04-01

The European Commission, in its strategy to protect the health of the European citizens, states that in order to assess the impact of air pollution on public health, information on long-term exposure to air pollution should be available. Currently, indicators of air quality are often being generated using measured pollutant concentrations. While air quality monitoring stations data provide accurate time series information at specific locations, air quality models have the advantage of being able to assess the spatial variability of air quality (for different resolutions) and predict air quality in the future based on different scenarios. When running such air quality models at a high spatial and temporal resolution, one can simulate the actual situation as closely as possible, allowing for a detailed assessment of the risk of exposure to citizens from different pollutants. AURORA (Air quality modelling in Urban Regions using an Optimal Resolution Approach), a prognostic 3-dimensional Eulerian chemistry-transport model, is designed to simulate urban- to regional-scale atmospheric pollutant concentration and exposure fields. The AURORA model also allows to calculate the impact of changes in land use (e.g. planting of trees) or of emission reduction scenario's on air quality. AURORA is currently being applied within the ESA atmospheric GMES service, PASODOBLE (http://www.myair-eu.org), that delivers information on air quality, greenhouse gases, stratospheric ozone, … At present there are two operational AURORA services within PASODOBLE. Within the "Air quality forecast service" VITO delivers daily air quality forecasts for Belgium at a resolution of 5 km and for the major Belgian cities: Brussels, Ghent, Antwerp, Liege and Charleroi. Furthermore forecast services are provided for Prague, Czech Republic and Bratislava, Slovakia, both at a resolution of 1 km. The "Urban/regional air quality assessment service" provides urban- and regional-scale maps (hourly resolution) for air pollution and human exposure statistics for an entire year. So far we concentrated on Brussels, Belgium and the Rotterdam harbour area, The Netherlands. In this contribution we focus on the operational forecast services. Reference Lefebvre W. et al. (2011) Validation of the MIMOSA-AURORA-IFDM model chain for policy support: Modeling concentrations of elemental carbon in Flanders, Atmospheric Environment 45, 6705-6713

Total Quality Management in Information Services. Information Services Management Series.

ERIC Educational Resources Information Center

St. Clair, Guy

Information services managers have a responsibility to provide the best information delivery possible. The basic principles of total quality management can be used by information professionals to help justify library funding through the creation of an environment where customer-patron satisfaction is paramount. This book reveals how to apply the…

[Marketing in hospitals and practices: from theory to implementation].

PubMed

Mattmüller, R; Gebauer, J

2011-12-01

Although hospitals and medical practices are typical service providers from a marketing perspective, only very few engage in topics relevant to marketing. Best practice examples do, however, show how important and meaningful the implementation of marketing tools can be for medical service providers. This article thus deals with the question of how the service of hospitals and practices may be improved by marketing initiatives. As a first step, the particular challenges these service providers face need to be analyzed. A significant focus will therefore be put on the examination of service-related quality and will then be applied to medical services. Thus it becomes evident that the path to success is based on adapting to patients' needs. Possibilities to minimize the uncertainties and risks experienced by the patients need to be identified. At the same time, the perceived service quality needs to be maximized.

A research on service quality decision-making of Chinese communications industry based on quantum game

NASA Astrophysics Data System (ADS)

Zhang, Cuihua; Xing, Peng

2015-08-01

In recent years, Chinese service industry is developing rapidly. Compared with developed countries, service quality should be the bottleneck for Chinese service industry. On the background of three major telecommunications service providers in China, the functions of customer perceived utilities are established. With the goal of consumer's perceived utility maximization, the classic Nash equilibrium solution and quantum equilibrium solution are obtained. Then a numerical example is studied and the changing trend of service quality and customer perceived utility is further analyzed by the influence of the entanglement operator. Finally, it is proved that quantum game solution is better than Nash equilibrium solution.

Quality Assurance Through Quality Improvement and Professional Development in the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Siegl, Elvira J.; Miller, Jacqueline W.; Khan, Kris; Harris, Susan E.

2015-01-01

Quality assurance (QA) is the process of providing evidence that the outcome meets the established standards. Quality improvement (QI), by contrast, is the act of methodically developing ways to meet acceptable quality standards and evaluating current processes to improve overall performance. In the case of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), the desired outcome is the delivery of quality health care services to program clients. The NBCCEDP provides professional development to ensure that participating providers have current knowledge of evidence-based clinical standards regarding breast and cervical cancer screening and diagnosis and are monitoring women with abnormal screening results for timely follow-up. To assess the quality of clinical care provided to NBCCEDP clients, performance data are collected by NBCCEDP grantees and compared against predetermined Centers for Disease Control and Prevention (CDC) benchmarks known as Data Quality Indicator Guides. In this article, the authors describe 1) the development and use of indicators for QI in the NBCCEDP and 2) the professional development activities implemented to improve clinical outcomes. QA identifies problems, whereas QI systematically corrects them. The quality of service delivery and improved patient outcomes among NBCCEDP grantees has enhanced significantly because of continuous monitoring of performance and professional development. By using QA, NBCCEDP grantees can maximize the quality of patient screening, diagnostic services, and follow-up. Examples of grantee activities to maintain quality of care are also described in this report. PMID:25099901

An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan

PubMed Central

Chang, Hsin Hsin; Chang, Ching Sheng

2008-01-01

Background Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. Methods This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data. Results The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction. Conclusion It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust. PMID:18419820

An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan.

PubMed

Chang, Hsin Hsin; Chang, Ching Sheng

2008-04-17

Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data. The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction. It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust.

Analysis of Student Satisfaction Toward Quality of Service Facility

NASA Astrophysics Data System (ADS)

Napitupulu, D.; Rahim, R.; Abdullah, D.; Setiawan, MI; Abdillah, LA; Ahmar, AS; Simarmata, J.; Hidayat, R.; Nurdiyanto, H.; Pranolo, A.

2018-01-01

The development of higher education is very rapid rise to the tight competition both public universities and private colleges. XYZ University realized to win the competition, required continuous quality improvement, including the quality of existing service facilities. Amenities quality services is believed to support the success of the learning activities and improve user satisfaction. This study aims to determine the extent to which the quality of the services effect on user satisfaction. The research method used is survey-based questionnaire that measure perception and expectation. The results showed a gap between perception and expectations of the respondents have a negative value for each item. This means XYZ service facility at the university is not currently meet the expectations of society members. Three service facility that has the lowest index is based on the perception of respondents is a laboratory (2.56), computer and multimedia (2.63) as well as wifi network (2.99). The magnitude of the correlation between satisfaction with the quality of service facilities is 0.725 which means a strong and positive relationship. The influence of the quality of service facilities to the satisfaction of the students is 0.525 meaning that the variable quality of the services facility can explain 52.5% of the variable satisfaction. The study provided recommendations for improvements to enhance the quality of services facility at the XYZ university facilities.

Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia

PubMed Central

Arifin, Nooranida; Hasbollah, Hasif Rafidee; Hanafi, Muhammad Hafiz; Ibrahim, Al Hafiz; Rahman, Wan Afezah Wan Abdul; Aziz, Roslizawati Che

2017-01-01

The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved. PMID:29386978

Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia.

PubMed

Arifin, Nooranida; Hasbollah, Hasif Rafidee; Hanafi, Muhammad Hafiz; Ibrahim, Al Hafiz; Rahman, Wan Afezah Wan Abdul; Aziz, Roslizawati Che

2017-10-01

The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved.

User Satisfaction with Family Planning Services in Government Health Centres in the Congo.

PubMed

Ndziessi, Gilbert; Bintsene-Mpika, Gickelle; Bileckot, Richard

2017-09-01

Patient satisfaction is considered an indicator of quality of care. This study aimed to assess the degree of clients' satisfaction with family planning (FP) services in government health centers in Congo. A cross-sectional study was conducted. A total of 635 clients nested in 27 health facilities were included in the analysis. Satisfaction was defined as "having a good perception of provider technical skills, being satisfied with the service organization and having a general positive appreciation of FP services. Statistical analyses were performed using SPSS v15. Among 635 clients, 57% perceived lack of technical competence in providers, 88% perceived good organization in FP services and 77% declared having general positive appreciation of FP services. Global level of client satisfaction was 42%. In conclusion client satisfaction with FP service was low and strengthening health workers technical competence is crucial. But, as the quality is multidimensional, other aspects especially significant funding investment and quality-assurance interventions must be taken into account.

Using quality function deployment to capture the voice of the customer and translate it into the voice of the provider.

PubMed

Chaplin, E; Bailey, M; Crosby, R; Gorman, D; Holland, X; Hippe, C; Hoff, T; Nawrocki, D; Pichette, S; Thota, N

1999-06-01

Health care has a number of historical barriers to capturing the voice of the customer and to incorporating customer wants into health care services, whether the customer is a patient, an insurer, or a community. Quality function deployment (QFD) is a set of tools and practices that can help overcome these barriers to form a process for the planning and design or redesign of products and services. The goal of the project was to increase referral volume and to improve a rehabilitation hospital's capacity to provide comprehensive medical and/or legal evaluations for people with complex and catastrophic injuries or illnesses. HIGH-LEVEL VIEW OF QFD AS A PROCESS: The steps in QFD are as follows: capture of the voice of the customer, quality deployment, functions deployment, failure mode deployment, new process deployment, and task deployment. The output of each step becomes the input to a matrix tool or table of the next step of the process. In 3 1/2 months a nine-person project team at Continental Rehabilitation Hospital (San Diego) used QFD tools to capture the voice of the customer, use these data as the basis for a questionnaire on important qualities of service from the customer's perspective, obtain competitive data on how the organization was perceived to be meeting the demanded qualities, identify measurable dimensions and targets of these qualities, and incorporate the functions and tasks into the delivery of service which are necessary to meet the demanded qualities. The future of providing health care services will belong to organizations that can adapt to a rapidly changing environment and to demands for new products and services that are produced and delivered in new ways.

Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

ERIC Educational Resources Information Center

Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

2010-01-01

This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

A Quality Improvement Customer Service Process and CSS [Customer Service System]. Burlington County College Employee Development Series, Volumes I & II.

ERIC Educational Resources Information Center

Burlington County Coll., Pemberton, NJ.

Prepared for use by staff in development workshops at Burlington County College (BCC), in New Jersey, this handbook offers college-wide guidelines for improving the quality of service provided to internal and external customers, and reviews key elements of BCC's Customer Service System (CSS), a computerized method of recording and following-up on…

Introducing contemporary shift patterns in a hospice setting.

PubMed

Greene, Kay

For many nurses, quality of life is dependent on the balance of work and home life. Registered, skilled and experienced nurses are necessary to ensure that a high-quality service is provided. The hospice recognised that its main asset in providing such a service is its nursing workforce. This article describes how the hospice introduced new working patterns for nursing staff.

The impact of a quality-improvement package on reproductive health services delivered by private providers in Uganda.

PubMed

Agha, Sohail

2010-09-01

This study assesses the effectiveness of a quality-improvement (QI) package designed to enable small-scale commercial reproductive health (RH) service providers to improve the services they offer. The study was conducted among midwives who are members of the Uganda Private Midwives Association. A pretest-post-test quasi-experimental panel study design was used wherein midwife clinics were allocated to two experimental groups and one control group. Baseline and follow-up measurements of structural and process attributes of quality were taken at the clinics by means of a facility inventory, interviews with midwives, and observations of client-provider interactions. Nearly 70 percent of the midwives who were trained to use the package reported that it was easy to use. Among clinics in which midwives received training in the use of the self-assessment tool and in developing action plans, structural and process attributes of quality improved only among those clinics in which the midwives' supervisors received training in finding solutions to the problems identified through self-assessments. The QI package may be implemented with small-scale private providers of RH services who are part of a professional association, network, or franchise that supervises their performance.

Quality and customer satisfaction: A case study in Brazil

NASA Astrophysics Data System (ADS)

Barcellos, Paulo Fernando Pinto

The dissertation deals with the case of CEEE-Companhia Estadual de Energia Eletrica, an electric power utility located in Rio Grande do Sul, the southernmost state of Brazil. Customer satisfaction with the services provided by CEEE is investigated within three groups of consumers: residential, commercial, and industrial. The purpose of the dissertation is to find answers to the following research questions: (1) What is service quality in public utilities, and particularly in an electric power company? (2) What service quality dimensions do customers want to be provided and favor the most? (3) How does the market measure service quality? (4) What should be done by companies, and particularly by an electric utility monopoly, to increase the performance of the rendered service? (5) How does this impact customer satisfaction, retention, and intention to recommend? and (6) How do we start a company-wide quality program provided that the resources are scarce and therefore priorities should be set forth? To investigate the posed questions, the study begins with an exploratory survey of CEEE's Board. The survey is followed by qualitative research of the three customer groups. After qualitative analysis of the data is concluded, questionnaires for the quantitative research, as well as hypothetical models, are developed. Dillman's "Total Design Method" is used to design the questionnaires. The basic ACSI (American Customer Satisfaction Model) is used to approach customer satisfaction. Data are processed by PLS (Partial Least Squares) which follows the procedure developed at the National Quality Research Center of the University of Michigan Business School. In summary, commercial customers are the most dissatisfied with the services provided by CEEE, while residential customers are the most satisfied. To improve quality, priority should be placed on commercial customers and include efforts to improve productivity gains throughout the company. Also, CEEE's image should be improved through a better communication process with the market and an intensive and extensive training of personnel. A special marketing campaign could help build a better image by explaining CEEE's goals to improve quality. Finally, a bottom line of satisfaction scores (as quality indicators) should be set for the entire company.

Clinical and perceived quality of care for maternal, neonatal and antenatal care in Kenya and Namibia: the service provision assessment.

PubMed

Diamond-Smith, Nadia; Sudhinaraset, May; Montagu, Dominic

2016-08-11

The majority of women in sub-Saharan Africa now deliver in a facility, however, little is known about the quality of services for maternal and newborn basic and emergency care, nor how this is associated with patient's perception of their experiences. Using data from the Service Provision Assessment (SPA) survey from Kenya 2010 and Namibia 2009, we explore whether facilities have the necessary signal functions for providing emergency and basic maternal (EmOC) and newborn care (EmNC), and antenatal care (ANC) using descriptives and multivariate regression. We explore differences by type of facility (hospital, center or other) and by private and public facilities. Finally, we see if patient satisfaction (taken from exit surveys at antenatal care) is associated with the quality of services (specific services provided). We find that most facilities do not have all of the signal functions, with 46 and 27 % in Kenya and 18 and 5 % in Namibia of facilities have high/basic scores in routine and emergency obstetric care, respectively. We found that hospitals preform better than centers in general and few differences emerged between public and private facilities. Patient perceptions were not consistently associated with services provided; however, patients had fewer complaints in private compared to public facilities in Kenya (-0.46 fewer complaints in private) and smaller facilities compared to larger in Namibia (-0.26 fewer complaints in smaller facilities). Service quality itself (measured in scores), however, was only significantly better in Kenya for EmOC and EmNC. This analysis sheds light on the inadequate levels of care for saving maternal and newborn lives in most facilities in two countries of Africa. It also highlights the disconnect between patients' perceptions and clinical quality of services. More effort is needed to ensure that high quality supply of services is present to meet growing demand as an increasing number of women deliver in facilities.

Research Challenges in Managing and Using Service Level Agreements

NASA Astrophysics Data System (ADS)

Rana, Omer; Ziegler, Wolfgang

A Service Level Agreement (SLA) represents an agreement between a service user and a provider in the context of a particular service provision. SLAs contain Quality of Service properties that must be maintained by a provider, and as agreed between a provider and a user/client. These are generally defined as a set of Service Level Objectives (SLOs). These properties need to be measurable and must be monitored during the provision of the service that has been agreed in the SLA. The SLA must also contain a set of penalty clauses specifying what happens when service providers fail to deliver the pre-agreed quality. Hence, an SLA may be used by both a user and a provider - from a user perspective, an SLA defines what is required - often defined using non-functional attributes of service provision. From a providers perspective, an SLA may be used to support capacity planning - especially if a provider is making it's capability available to multiple users. An SLA may be used by a client and provider to manage their behaviour over time - for instance, to optimise their long running revenue (cost) or QoS attributes (such as execution time), for instance. The lifecycle of an SLA is outlined, along with various uses of SLAs to support infrastructure management. A discussion about WS-Agreement - the emerging standard for specifying SLAs - is also provided.

Pricing the Services in Dynamic Environment: Agent Pricing Model

NASA Astrophysics Data System (ADS)

Žagar, Drago; Rupčić, Slavko; Rimac-Drlje, Snježana

New Internet applications and services as well as new user demands open many new issues concerning dynamic management of quality of service and price for received service, respectively. The main goals of Internet service providers are to maximize profit and maintain a negotiated quality of service. From the users' perspective the main goal is to maximize ratio of received QoS and costs of service. However, achieving these objectives could become very complex if we know that Internet service users might during the session become highly dynamic and proactive. This connotes changes in user profile or network provider/s profile caused by high level of user mobility or variable level of user demands. This paper proposes a new agent based pricing architecture for serving the highly dynamic customers in context of dynamic user/network environment. The proposed architecture comprises main aspects and basic parameters that will enable objective and transparent assessment of the costs for the service those Internet users receive while dynamically change QoS demands and cost profile.

Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

PubMed

Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

2017-01-01

Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

Importance-performance analysis as a guide for hospitals in improving their provision of services.

PubMed

Whynes, D K; Reed, G

1995-11-01

As a result of the 1990 National Health Services Act, hospitals now compete with one another to win service contracts. A high level of service quality represents an important ingredient of a successful competitive strategy, yet, in general, hospitals have little external information on which to base quality decisions. Specifically, in their efforts to win contracts from fundholding general practitioners, hospitals require information on that which these purchasers deem important with respect to quality, and on how these purchasers assess the quality of their current service performance. The problem is complicated by the fact that hospital service quality, in itself, is multi-dimensional. In other areas of economic activity, the information problem has been resolved by importance-performance analysis and this paper reports the findings of such an analysis conducted for hosptials in the Trent region. The importance and performance service quality ratings of fundholders were obtained from a questionnaire survey and used in a particular variant of importance-performance analysis, which possesses certain advantages over more conventional approaches. In addition to providing empirical data on the determinants of service quality, as perceived by the purchasers of hospital services, this paper demonstrates how such information can be successfully employed in a quality enhancement strategy.

The influence of service quality and patients' emotions on satisfaction.

PubMed

Vinagre, Maria Helena; Neves, José

2008-01-01

The purpose of this research is to develop and empirically test a model to examine the major factors affecting patients' satisfaction that depict and estimate the relationships between service quality, patient's emotions, expectations and involvement. The approach was tested using structural equation modeling, with a sample of 317 patients from six Portuguese public healthcare centres, using a revised SERVQUAL scale for service quality evaluation and an adapted DESII scale for assessing patient emotions. The scales used to evaluate service quality and emotional experience appears valid. The results support process complexity that leads to health service satisfaction, which involves diverse phenomena within the cognitive and emotional domain, revealing that all the predictors have a significant effect on satisfaction. The emotions inventory, although showing good internal consistency, might be enlarged to other typologies in further research--needed to confirm these findings. Patient's satisfaction mechanisms are important for improving service quality. The research shows empirical evidence about the effect of both patient's emotions and service quality on satisfaction with healthcare services. Findings also provide a model that includes valid and reliable measures.

Using internal marketing to improve organizational commitment and service quality.

PubMed

Tsai, Yafang; Wu, Shih-Wang

2011-12-01

The purpose of this article was to explore the structural relationships among internal marketing, organizational commitment and service quality and to practically apply the findings. Internal marketing is a way to assist hospitals in improving the quality of the services that they provide while executing highly labour-intensive tasks. Through internal marketing, a hospital can enhance the organizational commitment of its employees to attain higher service quality. This research uses a cross-sectional study to survey nursing staff perceptions about internal marketing, organizational commitment and service quality. The results of the survey are evaluated using equation models. The sample includes three regional hospitals in Taiwan. Three hundred and fifty questionnaires were distributed and 288 valid questionnaires were returned, yielding a response rate of 82.3%. The survey process lasted from 1 February to 9 March 2007. The data were analysed with SPSS 12.0, including descriptive statistics based on demographics. In addition, the influence of demographics on internal marketing, organizational commitment and service quality is examined using one-way anova. The findings reveal that internal marketing plays a critical role in explaining employee perceptions of organizational commitment and service quality. Organizational commitment is the mediator between internal marketing and service quality. The results indicate that internal marketing has an impact on both organizational commitment and service quality. Internal marketing should be emphasized to influence frontline nursing staff, thereby helping to create better organizational commitment and service quality. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Data collection automation and total quality management: case studies in the health-service industry.

PubMed

Smith, Alan D; Offodile, O Felix

2008-01-01

The limitations, immeasurable, and seemly unquantifiable aspects of the healthcare service industry, make it imperative that quality assurance programs include total quality management (TQM) and automatic identification and data capture (AIDC)-related technologies. Most of standards used in TQM and AIDC require data, to measure improvement and achieve standardization. Major difference between managing a service firm and managing a product-manufacturing firm is the difficulty of achieving consistently high quality. Examination of two different healthcare service providers in the Pittsburgh, Pennsylvania area offers different views as to the implementation and practice of total quality management techniques and AIDC integration. Since the healthcare service industry must take into account its high customization needs, there are positive steps to make the hospital structure itself more patient friendly and quality related; hence improving its heath-marketing strategies to the general public.

Patient satisfaction in Japan.

PubMed

Elleuch, Amira

2008-01-01

To extend existing knowledge about health care quality and patient satisfaction by exploring Japanese context having a different health care system and a different culture from the USA and Europe. A structural equation model is used to explore links between quality perception and patient satisfaction as well as between patient satisfaction and intentional behavior relying on 159 Japanese outpatient replies. Japanese healthcare service quality is evaluated using its process characteristics (patient-provider interaction) and physical attributes (settings and appearance). Process quality attributes were found to be patient satisfaction antecedents. Satisfaction in turn predicts patient intentional behavior (to return and to recommend). Japanese society cultural specificity seems to be an interesting background to understand Japanese evaluation when patients assess health service quality. The sample investigated is relatively small. The study relied on a linear approach to assess patient satisfaction and intentional behavior. However, the non-linear model should yield a better reality fit. To improve Japanese patient satisfaction, cultural values such as courtesy, empathy and harmony should be emphasized when delivering medical services. Satisfied consumers are an important asset for the healthcare provider as they intend to reuse the service and to recommend it to their families and friends. Both foreign and Japanese providers should adopt a consumer perspective to enhance the service quality and then to maintain long-term relationships with their customers. The study used structural equation analysis to assess patient satisfaction in a scarcely investigated context. Moreover, the study relies on Japanese society's cultural characteristics to explain and understand results.

Effectiveness of presence of physician and midwife in quantity and quality of family planning services in health care centers.

PubMed

Jabbari, Hossein; Bakhshian, Fariba; Velayati, Atefeh; Mehrabi, Esmat; Allahverdizadeh, Shirin; Alikhah, Hossein; Maleki, Ahdieh; Ahadi, Hamid-Reza; Ghorbaniyan, Maryam; Naghavi-Behzad, Mohammad

2014-01-01

Iran's health sector has been engaging the services of physicians and midwives in healthcare centers since 2005, with the hope of improving the quantity and quality of family planning services. The aim of this study was to assess the effect of serving physicians and midwives on the quantity and quality of family planning services in the healthcare centers of Iran. The present cross-sectional study (Jan 2010 until Sep 2011) was carried out on 600 eligible families who were clients of healthcare centers of Tabriz, Azarshahr and Osku, cities of Northwest Iran from 2006 until 2011, in two groups (before and after). Some of the characteristics of the participants and the data on the quality and quantity of family planning services provided were grouped in a checklist of 16 variables by comparing the patients' past medical histories. In comparison with 3 years prior to engaging physician and midwife services in health care centers, the Couple Year Protection (CYP) and the quantity of family planning service indexes significantly increased among eligible families. The family size of participants declined significantly after family physicians and midwives became available in the healthcare centers (P < 0.005). Our findings showed some improvement in the quantity of services without any noticeable changes in the quality of services provided as a consequence of this huge intervention. Therefore, it is suggested that there should be proper oversight of the duties of the health team in order to keep a close watch on primary healthcare, design of proper mechanisms for collecting and maintaining performance reports and statistics, and continuously monitor and control the quality of services.

Identifying perceived barriers to monitoring service quality among substance abuse treatment providers in South Africa

PubMed Central

2014-01-01

Background A performance measurement system is planned for South African substance abuse treatment services. Provider-level barriers to implementing these systems have been identified in the United States, but little is known about the nature of these barriers in South Africa. This study explored the willingness of South African substance abuse treatment providers’ to adopt a performance measurement system and perceived barriers to monitoring service quality that would need to be addressed during system development. Methods Three focus group discussions were held with treatment providers from two of the nine provinces in South Africa. These providers represented the diverse spread of substance abuse treatment services available in the country. The final sample comprised 21 representatives from 12 treatment facilities: eight treatment centres in the Western Cape and four in KwaZulu-Natal. Content analysis was used to extract core themes from these discussions. Results Participants identified barriers to the monitoring of service quality that included outdated modes of collecting data, personnel who were already burdened by paperwork, lack of time to collect data, and limited skills to analyse and interpret data. Participants recommended that developers engage with service providers in a participatory manner to ensure that service providers are invested in the proposed performance measurement system. Conclusion Findings show that substance abuse treatment providers are willing to adopt a performance measurement system and highlight several barriers that need to be addressed during system development in order to enhance the likelihood that this system will be successfully implemented. PMID:24499037

Evaluation of poison information services provided by a new poison information center.

PubMed

Churi, Shobha; Abraham, Lovin; Ramesh, M; Narahari, M G

2013-01-01

The aim of this study is to assess the nature and quality of services provided by poison information center established at a tertiary-care teaching hospital, Mysore. This was a prospective observational study. The poison information center was officially established in September 2010 and began its functioning thereafter. The center is equipped with required resources and facility (e.g., text books, Poisindex, Drugdex, toll free telephone service, internet and online services) to provide poison information services. The poison information services provided by the center were recorded in documentation forms. The documentation form consists of numerous sections to collect information on: (a) Type of population (children, adult, elderly or pregnant) (b) poisoning agents (c) route of exposure (d) type of poisoning (intentional, accidental or environmental) (e) demographic details of patient (age, gender and bodyweight) (f) enquirer details (background, place of call and mode of request) (g) category and purpose of query and (h) details of provided service (information provided, mode of provision, time taken to provide information and references consulted). The nature and quality of poison information services provided was assessed using a quality assessment checklist developed in accordance with DSE/World Health Organization guidelines. Chi-Square test (χ(2)). A total of 419 queries were received by the center. A majority (n = 333; 79.5%) of the queries were asked by the doctors to provide optimal care (n = 400; 95.5%). Most of the queries were received during ward rounds (n = 201; 48.0%), followed by direct access (n = 147; 35.1%). The poison information services were predominantly provided through verbal communication (n = 352; 84.0%). Upon receipt of queries, the required service was provided immediately (n = 103; 24.6%) or within 10-20 min (n = 296; 70.6%). The queries were mainly related to intentional poisoning (n = 258; 64.5%), followed by accidental poisoning (n = 142; 35.5%). The most common poisoning agents were medicines (n = 124; 31.0%). The service provided was graded as "Excellent" for the majority of queries (n = 360; 86%; P < 0.001), followed by "Very Good" (n = 50; 12%) and "Good" (n = 9; 2%). The poison information center provided requested services in a skillful, efficient and evidence-based manner to meet the needs of the requestor. The enquiries and information provided is documented in a clear and systematic manner.

The endoscopy Global Rating Scale – Canada: Development and implementation of a quality improvement tool

PubMed Central

MacIntosh, Donald; Dubé, Catherine; Hollingworth, Roger; van Zanten, Sander Veldhuyzen; Daniels, Sandra; Ghattas, George

2013-01-01

BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer. OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided. METHODS: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C). RESULTS: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes/no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly. CONCLUSION: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide. PMID:23472242

A Study of the Interrelationships among Service Recovery, Relationship Quality, and Brand Image in Higher Education Industries

ERIC Educational Resources Information Center

Chen, Yu-Chuan

2015-01-01

This study aims to investigate the direction and strength of the relationships among service recovery, relationship quality, and brand image in higher education industries. This research provides a framework for school managers to understand service recovery from an operations perspective. Structural equation models were used to test the proposed…

Measuring the Effect of Tourism Services on Travelers' Quality of Life: Further Validation.

ERIC Educational Resources Information Center

Neal, Janet D.; Sirgy, M. Joseph; Uysal, Muzaffer

2004-01-01

lication and extension study provided additional validational support of the original tourism services satisfaction measure in relation to QOL-related measures.Neal, Sirgy and Uysal (1999) developed a model and a measure to capture the effect of tourism services on travelers' quality of life (QOL). They hypothesized that travelers' overall life…

Perceived Service Quality and Student Loyalty in an Online University

ERIC Educational Resources Information Center

Martínez-Argüelles, María-Jesús; Batalla-Busquets, Josep-Maria

2016-01-01

This paper examines the influence that student perceived quality of service (PSQ) has on continuance intention and willingness to recommend a course in a fully online university. A holistic view of the service provided by the university is taken. It is not only the effect of the teaching which is examined, but also that of the administrative…

Using the Donabedian framework to examine the quality and safety of nursing service innovation.

PubMed

Gardner, Glenn; Gardner, Anne; O'Connell, Jane

2014-01-01

To evaluate the safety and quality of nurse practitioner service using the audit framework of Structure, Process and Outcome. Health service and workforce reform are on the agenda of governments and other service providers seeking to contain healthcare costs whilst providing safe and effective health care to communities. The nurse practitioner service is one health workforce innovation that has been adopted globally to improve timely access to clinical care, but there is scant literature reporting evaluation of the quality of this service innovation. A mixed-methods design within the Donabedian evaluation framework was used. The Donabedian framework was used to evaluate the Structure, Process and Outcome of nurse practitioner service. A range of data collection approaches was used, including stakeholder survey (n = 36), in-depth interviews (11 patients and 13 nurse practitioners) and health records data on service processes. The study identified that adequate and detailed preparation of Structure and Process is essential for the successful implementation of a service innovation. The multidisciplinary team was accepting of the addition of nurse practitioner service, and nurse practitioner clinical care was shown to be effective, satisfactory and safe from the perspective of the clinician stakeholders and patients. This study demonstrated that the Donabedian framework of Structure, Process and Outcome evaluation is a valuable and validated approach to examine the safety and quality of a service innovation. Furthermore, in this study, specific Structure elements were shown to influence the quality of service processes further validating the framework and the interdependence of the Structure, Process and Outcome components. Understanding the Structure and Process requirements for establishing nursing service innovation lays the foundation for safe, effective and patient-centred clinical care. © 2013 John Wiley & Sons Ltd.

The New Design Handbook for School Food Service. Revised.

ERIC Educational Resources Information Center

Silberberg, Susan Crowl

A handbook, created for both designers and users of food service facilities in schools, provides reference information and guidance for making sure schools can provide quality food service. The handbook's first six chapters include explanations on how to start a school food service design project; required space, including kitchen work flow and…

A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

PubMed

Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

2015-07-01

The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P < 0.01) and PMTCT services (from 58 to 73%; P = 0.003); there was no significant change at comparison sites. Providers' perceptions of the work environment generally improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

Considering quality of care for young adults with diabetes in Ireland

PubMed Central

2013-01-01

Background Research on the quality of diabetes care provided to young adults with Type 1 diabetes is lacking. This study investigates perceptions of quality of care for young adults with Type 1 diabetes (23–30 years old) living in the Republic of Ireland. Methods Thirty-five young adults with Type 1 diabetes (twenty-nine women, six men) and thirteen healthcare professionals (ten diabetes nurse specialists, three consultant Endocrinologists) were recruited. All study participants completed semi-structured interviews that explored their perspectives on the quality of diabetes services in Ireland. Interviews were analyzed using standard qualitative thematic analysis techniques. Results Most interviewees identified problems with Irish diabetes services for young adults. Healthcare services were often characterised by long waiting times, inadequate continuity of care, overreliance on junior doctors and inadequate professional-patient interaction times. Many rural and non-specialist services lacked funding for diabetes education programmes, diabetes nurse specialists, insulin pumps or for psychological support, though these services are important components of quality Type 1 diabetes healthcare. Allied health services such as psychology, podiatry and dietician services appeared to be underfunded in many parts of the country. While Irish diabetes services lacked funding prior to the recession, the economic decline in Ireland, and the subsequent austerity imposed on the Irish health service as a result of that decline, appears to have additional negative consequences. Despite these difficulties, a number of specialist healthcare services for young adults with diabetes seemed to be providing excellent quality of care. Although young adults and professionals identified many of the same problems with Irish diabetes services, professionals appeared to be more critical of diabetes services than young adults. Young adults generally expressed high levels of satisfaction with services, even where they noted that aspects of those services were sub-optimal. Conclusion Good quality care appears to be unequally distributed throughout Ireland. National austerity measures appear to be negatively impacting health services for young adults with diabetes. There is a need for more Endocrinologist and diabetes nurse specialist posts to be funded in Ireland, as well as allied health professional posts. PMID:24168159

Incorporating elements of social franchising in government health services improves the quality of infant and young child feeding counselling services at commune health centres in Vietnam.

PubMed

Nguyen, Phuong H; Kim, Sunny S; Keithly, Sarah C; Hajeebhoy, Nemat; Tran, Lan M; Ruel, Marie T; Rawat, Rahul; Menon, Purnima

2014-12-01

Although social franchising has been shown to enhance the quality of reproductive health services in developing countries, its effect on nutrition services remains unexamined. This study assessed the effects of incorporating elements of social franchising on shaping the quality of infant and young child feeding (IYCF) counselling facilities and services in Vietnam. Process-related data collected 12 months after the launch of the first franchises were used to compare randomly assigned Alive & Thrive-supported health facilities (AT-F, n = 20) with standard facilities (SF, n = 12) across three dimensions of service quality: 'structure', 'process' and 'outcome' that capture the quality of facilities, service delivery, and client perceptions and use, respectively. Data collection included facility assessments (n = 32), staff surveys (n = 96), counselling observations (n = 137), client exit interviews (n = 137) and in-depth interviews with mothers (n = 48). Structure: AT-F were more likely to have an unshared, well-equipped room for nutrition counselling than SF (65.0% vs 10.0%). Compared with SF providers, AT-F staff had better IYCF knowledge (mean score 9.9 vs 8.8, range 0-11 for breastfeeding; mean score 3.6 vs 3.2, range 0-4 for complementary feeding). AT-F providers also demonstrated significantly better interpersonal communication skills (score 9.6 vs 5.1, range 0-13) and offered more comprehensive counselling sessions. Overall utilization of franchises was low (10%). A higher proportion of pregnant women utilized franchise services (48.9%), compared with mothers with children 6-23.9 months (1.4%). There was no quantitative difference in client satisfaction with counselling services between AT-F and SF, but franchise users praised the AT-F for problem solving related to child feeding. Incorporating elements of social franchising significantly enhances the quality of IYCF counselling services within government primary healthcare facilities, particularly their structural and process attributes. Provided that service utilization is improved through demand generation, this model has the potential to impact IYCF practices and child nutrition. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

[Quality management in implementing specialist pediatric palliative home care in Lower Saxony, Germany].

PubMed

Kremeike, Kerstin; Eulitz, Nina; Sens, Brigitte; Geraedts, Max; Reinhardt, Dirk

2012-01-01

To provide comprehensive high-quality health care is a great challenge in the context of high specialisation and intensive costs. This problem becomes further aggravated in service areas with low patient numbers and low numbers of specialists. Therefore, a multidimensional approach to quality development was chosen in order to optimise the care of children and adolescents with life-limiting conditions in Lower Saxony, a German federal state with a predominantly rural infrastructure. Different service structures were implemented and a classification of service provider's specialisation was defined on the basis of existing references of professional associations. Measures to optimise care were implemented in a process-oriented manner. High-quality health care can be facilitated by carefully worded requirements concerning the quality of structures combined with optimally designed processes. Parts of the newly implemented paediatric palliative care structures are funded by the statutory health insurance. Copyright © 2012. Published by Elsevier GmbH.

Perceptions of Local Health Care Quality in 7 Rural Communities with Telemedicine

ERIC Educational Resources Information Center

Nesbitt, Thomas S.; Marcin, James P.; Daschbach, Martha M.; Cole, Stacey L.

2005-01-01

Rural health services are difficult to maintain because of low patient volumes, limited numbers of providers, and unfavorable economies of scale. Rural patients may perceive poor quality in local health care, directly impacting the sustainability of local health care services. This study examines perceptions of local health care quality in 7…

Service quality perceptions in primary health care centres in Greece

PubMed Central

Papanikolaou, Vicky; Zygiaris, Sotiris

2012-01-01

Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

Service quality perceptions in primary health care centres in Greece.

PubMed

Papanikolaou, Vicky; Zygiaris, Sotiris

2014-04-01

The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

Analysis of NPS Contracting Service Quality

DTIC Science & Technology

2014-12-01

customer expectations is what they “hear from other customers ” or word of mouth communications (Zeithaml et al., 1990). The second factor... satisfaction and customer satisfaction (Hallowell et al., 1996). If a service quality gap exists between the provider and the customer , that gap could...identify a problem with provider job satisfaction , customer satisfaction , or both. In turn, by identifying potential problems in these areas, it could

Data Quality Parameters and Web Services Facilitate User Access to Research-Ready Seismic Data

NASA Astrophysics Data System (ADS)

Trabant, C. M.; Templeton, M. E.; Van Fossen, M.; Weertman, B.; Ahern, T. K.; Casey, R. E.; Keyson, L.; Sharer, G.

2016-12-01

IRIS Data Services has the mission of providing efficient access to a wide variety of seismic and related geoscience data to the user community. With our vast archive of freely available data, we recognize that there is a constant challenge to provide data to scientists and students that are of a consistently useful level of quality. To address this issue, we began by undertaking a comprehensive survey of the data and generating metrics measurements that provide estimates of data quality. These measurements can inform the scientist of the level of suitability of a given set of data for their scientific investigation. They also serve as a quality assurance check for network operators, who can act on this information to improve their current recording or mitigate issues with already recorded data and metadata. Following this effort, IRIS Data Services is moving forward to focus on providing tools for the scientist that make it easier to access data of a quality and characteristic that suits their investigation. Data that fulfill this criterion are termed "research-ready". In addition to filtering data by type, geographic location, proximity to events, and specific time ranges, we will offer the ability to filter data based on specific quality assessments. These include signal-to-noise ratio measurements, data continuity, timing quality, absence of channel cross-talk, and potentially many other factors. Our goal is to ensure that the user receives only the data that meets their specifications and will not require extensive review and culling after delivery. We will present the latest developments of the MUSTANG automated data quality system and introduce the Research-Ready Data Sets (RRDS) service. Together these two technologies serve as a data quality assurance ecosystem that will provide benefit to the scientific community by aiding efforts to readily find appropriate and suitable data for use in any number of objectives.

The Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality Demonstration: a descriptive overview.

PubMed

Reilly, Karen E; Mueller, Christine; Zimmerman, David R

2007-01-01

This paper presents the first comprehensive account of a major national demonstration designed to integrate skilled nursing facilities (SNF) prospective case-mix payment and quality of care. It describes the Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality (NHCMQ) Demonstration-the template for Medicare's SNF Prospective Payment System (PPS) implemented July 1998. The NHCMQ Demonstration provided the basis for one of the most significant changes in SNF reimbursement and quality monitoring policies to date. Prospective reimbursement policies created positive incentive for providers to admit Medicare residents under more equitable payment rates. However, controversy regarding unanticipated perverse provider incentives remains. The quality management system designed under the NHCMQDemonstration is currently used in over 17,000 nursing homes. Furthermore, under the NHCMQ Demonstration, one standardized assessment tool-the MDS-was used to assess a resident's clinical condition, to monitor quality, and to calculate provider reimbursement. Experiences from the NHCMQ Demonstration and continued evaluation of the current national PPS, along with state systems, provide a rich information source regarding prospective, case-mix reimbursement, and provider incentives.

Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya.

PubMed

Keesara, Sirina R; Juma, Pamela A; Harper, Cynthia C

2015-08-20

Nearly 40% of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. We conducted six focus groups discussions and 51 in-depth interviews with postpartum women (n = 61) to explore decision-making about contraceptive use after delivery, including facility choice. When seeking contraceptive services, women in this study preferred private over public facilities due to convenience and timeliness of services. Women avoided public facilities due to long waits and disrespectful providers. Study participants reported, however, that they felt more confident about the technical medical quality in public facilities than in private, and believed that private providers prioritized profit over safe medical practice. Women reported that public facilities offered comprehensive counseling and chose these facilities when they needed contraceptive decision-support. Provision of comprehensive counseling and screening, including side effects counseling and management, determined perception of quality. Women believed private providers offered the advantages of convenience, efficiency and privacy, though they did not consistently offer high-quality care. Quality-improvement of contraceptive care at private facilities could include technical standardization and accreditation. Development of support and training for side effect management may be an important intervention to improve perceived quality of care.

Contribution of ecosystem services to air quality and climate change mitigation policies: the case of urban forests in Barcelona, Spain.

PubMed

Baró, Francesc; Chaparro, Lydia; Gómez-Baggethun, Erik; Langemeyer, Johannes; Nowak, David J; Terradas, Jaume

2014-05-01

Mounting research highlights the contribution of ecosystem services provided by urban forests to quality of life in cities, yet these services are rarely explicitly considered in environmental policy targets. We quantify regulating services provided by urban forests and evaluate their contribution to comply with policy targets of air quality and climate change mitigation in the municipality of Barcelona, Spain. We apply the i-Tree Eco model to quantify in biophysical and monetary terms the ecosystem services "air purification," "global climate regulation," and the ecosystem disservice "air pollution" associated with biogenic emissions. Our results show that the contribution of urban forests regulating services to abate pollution is substantial in absolute terms, yet modest when compared to overall city levels of air pollution and GHG emissions. We conclude that in order to be effective, green infrastructure-based efforts to offset urban pollution at the municipal level have to be coordinated with territorial policies at broader spatial scales.

Quality assessment of dental health services provided at the Faculty of Dentistry, King Abdulaziz University.

PubMed

Hassan, Ali H; Amer, Hala A; Maghrabi, Abdulhamaid A

2005-01-01

The objectives of this research were to assess the quality of dental services delivered in King Abdulaziz University and highlight the necessary recommendations that would improve it. The methods used were live photographs illustrating the structure of dental services of the faculty presented in the clinic buildings, waiting places, equipments, instruments and supplies, as well as the comfort and privacy. Review of official records of the faculty for the number, qualifications and training of the dental staff and auxiliary personnel, as well as the process of care (starting from patient registration until completion of treatment). Records also demonstrated the access and utilization of services delivered in the various departments, the quality of these services and of infection control measures and procedures. The results revealed the high quality of services delivered through evaluating the structure and process of care in the university dental clinics. Dental services of King Abdulaziz University conform to high quality standards, with implementation of some changes for improvement and development.

Improving patient experience in a pediatric ambulatory clinic: a mixed method appraisal of service delivery.

PubMed

Soeteman, Marijn; Peters, Vera; Busari, Jamiu O

2015-01-01

In 2013, customer satisfaction surveys showed that patients were unhappy with the services provided at our ambulatory clinic. In response, we performed an appraisal of our services, which resulted in the development of a strategy to reduce waiting time and improve quality of service. Infrastructural changes to our clinic's waiting room, consultation rooms, and back offices were performed, and schedules were redesigned to reduce wait time to 10 minutes and increase consultation time to 20 minutes. Our objective was to identify if this would improve 1) accessibility to caregivers and 2) quality of service and available amenities. We conducted a multi-method survey using 1) a patient flow analysis to analyze the flow of service and understand the impact of our interventions on patient flow and 2) specially designed questionnaires to investigate patients' perceptions of our wait time and how to improve our services. The results showed that 79% of our respondents were called in to see a doctor within 20 minutes upon arrival. More patients (55%) felt that 10-20 minutes was an acceptable wait time. We also observed a perceived increase in satisfaction with wait time (94%). Finally, a large number of patients (97%) were satisfied with the quality of service and with the accessibility to caregivers (94%). The majority of our patients were satisfied with the accessibility to our ambulatory clinics and with the quality of services provided. The appraisal of our operational processes using a patient flow analysis also demonstrated how this strategy could effectively be applied to investigate and improve quality of service in patients.

An overview of service quality of continuous positive airway pressure services in Australian pharmacies.

PubMed

Hanes, Carissa A; Wong, Keith K H; Saini, Bandana

2014-01-01

Little is known about CPAP services offered in the Australian primary care pharmacy setting, despite the potential influence of service quality on patient adherence. The objective of this study was to provide an overview on a nationwide scale of the range and quality of CPAP and sleep apnoea-related services in Australian pharmacies. A paper-based questionnaire was developed and mailed to all pharmacies in Australia that currently provide CPAP services (as identified by manufacturer's distributor lists or Internet search). A point system was devised to score participants on the quality of their CPAP service. Pharmacies were rated against a list of 23 criteria that were determined by consensus, with one point allocated for each criterion met, allowing for a maximum score of 23. The study response rate was 55% (110/199), and representation was obtained from all eight Australian states and territories. The mean number of criteria met (total score) for pharmacies was 15.7 ± 3.4 (15.7/23 = 68.3%; score range 2-22). Variability was evident in the range of services offered. Eighty-seven per cent of respondents believed that pharmacies supplying CPAP should adhere to a formalized set of professional guidelines. The accessibility of pharmacies may make them a valuable venue for CPAP service provision. However, models of care to guide practice and standardize the variability in services are required. Implementation of such models could improve patient access to quality treatment in the primary care setting. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

Predicting effects of environmental change on river inflows to Tillamook Bay, Oregon

EPA Science Inventory

Estuarine river watersheds provide valued ecosystem services to their surrounding communities including drinking water, fish habitat, and regulation of estuarine water quality. However, the provisioning of these services can be affected by changes in the quantity and quality of ...

Fox Valley Technical College Quality First Process Model.

ERIC Educational Resources Information Center

Fox Valley Technical Coll., Appleton, WI.

An overview is provided of the Quality First Process Model developed by Fox Valley Technical College (FVTC), Wisconsin, to provide guidelines for quality instruction and service consistent with the highest educational standards. The 16-step model involves activities that should be adaptable to any organization. The steps of the quality model are…

Knowledge, attitudes, and practices of private sector immunization service providers in Gujarat, India.

PubMed

Hagan, José E; Gaonkar, Narayan; Doshi, Vikas; Patni, Anas; Vyas, Shailee; Mazumdar, Vihang; Kosambiya, J K; Gupta, Satish; Watkins, Margaret

2018-01-02

India is responsible for 30% of the annual global cohort of unvaccinated children worldwide. Private practitioners provide an estimated 21% of vaccinations in urban centers of India, and are important partners in achieving high vaccination coverage. We used an in-person questionnaire and on-site observation to assess knowledge, attitudes, and practices of private immunization service providers regarding delivery of immunization services in the urban settings of Surat and Baroda, in Gujarat, India. We constructed a comprehensive sampling frame of all private physician providers of immunization services in Surat and Baroda cities, by consulting vaccine distributors, local branches of physician associations, and published lists of private medical practitioners. All providers were contacted and asked to participate in the study if they provided immunization services. Data were collected using an in-person structured questionnaire and directly observing practices; one provider in each practice setting was interviewed. The response rate was 82% (121/147) in Surat, and 91% (137/151) in Baroda. Of 258 participants 195 (76%) were pediatricians, and 63 (24%) were general practitioners. Practices that were potential missed opportunities for vaccination (MOV) included not strictly following vaccination schedules if there were concerns about ability to pay (45% of practitioners), and not administering more than two injections in the same visit (60%). Only 22% of respondents used a vaccination register to record vaccine doses, and 31% reported vaccine doses administered to the government. Of 237 randomly selected vaccine vials, 18% had expired vaccine vial monitors. Quality of immunization services in Gujarat can be strengthened by providing training and support to private immunization service providers to reduce MOVs and improve quality and safety; other more context specific strategies that should be evaluated may involve giving feedback to providers on quality of services delivered and working through professional societies to adopt standards of practice. Published by Elsevier Ltd.

Economic models for prevention: making a system work for patients

PubMed Central

2015-01-01

The purpose of this article is to describe alternative means of providing patient centered, preventive based, services using an alternative non-profit, economic model. Hard to reach, vulnerable groups, including children, adults and elders, often have difficulties accessing traditional dental services for a number of reasons, including economic barriers. By partnering with community organizations that serve these groups, collaborative services and new opportunities for access are provided. The concept of a dental home is well accepted as a means of providing care, and, for these groups, provision of such services within community settings provides a sustainable means of delivery. Dental homes provided through community partnerships can deliver evidence based dental care, focused on a preventive model to achieve and maintain oral health. By using a non-profit model, the entire dental team is provided with incentives to deliver measurable quality improvements in care, rather than a more traditional focus on volume of activity alone. Examples are provided that demonstrate how integrated oral health services can deliver improved health outcomes with the potential to reduce total costs while improving quality. PMID:26391814

Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment.

PubMed

Lehnert, T; Günther, O H; Hajek, A; Riedel-Heller, S G; König, H H

2018-04-06

Most people prefer to "age in place" and to remain in their homes for as long as possible even in case they require long-term care. While informal care is projected to decrease in Germany, the use of home- and community-based services (HCBS) can be expected to increase in the future. Preference-based data on aspects of HCBS is needed to optimize person-centered care. To investigate preferences for home- and community-based long-term care services packages. Discrete choice experiment conducted in mailed survey. Randomly selected sample of the general population aged 45-64 years in Germany (n = 1.209). Preferences and marginal willingness to pay (WTP) for HCBS were assessed with respect to five HCBS attributes (with 2-4 levels): care time per day, service level of the HCBS provider, quality of care, number of different caregivers per month, co-payment. Quality of care was the most important attribute to respondents and small teams of regular caregivers (1-2) were preferred over larger teams. Yet, an extended range of services of the HCBS provider was not preferred over a more narrow range. WTP per hour of HCBS was €8.98. Our findings on preferences for HCBS in the general population in Germany add to the growing international evidence of preferences for LTC. In light of the great importance of high care quality to respondents, reimbursement for services by HCBS providers could be more strongly linked to the quality of services.

Quality in the molecular microbiology laboratory.

PubMed

Wallace, Paul S; MacKay, William G

2013-01-01

In the clinical microbiology laboratory advances in nucleic acid detection, quantification, and sequence analysis have led to considerable improvements in the diagnosis, management, and monitoring of infectious diseases. Molecular diagnostic methods are routinely used to make clinical decisions based on when and how to treat a patient as well as monitor the effectiveness of a therapeutic regime and identify any potential drug resistant strains that may impact on the long term patient treatment program. Therefore, confidence in the reliability of the result provided by the laboratory service to the clinician is essential for patient treatment. Hence, suitable quality assurance and quality control measures are important to ensure that the laboratory methods and service meet the necessary regulatory requirements both at the national and international level. In essence, the modern clinical microbiology laboratory ensures the appropriateness of its services through a quality management system that monitors all aspects of the laboratory service pre- and post-analytical-from patient sample receipt to reporting of results, from checking and upholding staff competency within the laboratory to identifying areas for quality improvements within the service offered. For most European based clinical microbiology laboratories this means following the common International Standard Organization (ISO9001) framework and ISO15189 which sets out the quality management requirements for the medical laboratory (BS EN ISO 15189 (2003) Medical laboratories-particular requirements for quality and competence. British Standards Institute, Bristol, UK). In the United States clinical laboratories performing human diagnostic tests are regulated by the Centers for Medicare and Medicaid Services (CMS) following the requirements within the Clinical Laboratory Improvement Amendments document 1988 (CLIA-88). This chapter focuses on the key quality assurance and quality control requirements within the modern microbiology laboratory providing molecular diagnostics.

Nurse-led hypnotherapy: an innovative approach to Irritable Bowel Syndrome.

PubMed

Bremner, Helen

2013-08-01

Irritable Bowel Syndrome (IBS) is a common, chronic functional illness, which can greatly reduce patients' quality of life, and consumes healthcare resources. Standard treatments include dietary changes and medication, though these are often ineffective. Clinical studies of hypnotherapy demonstrate improvement in symptoms and quality of life in over 80% of subjects with intractable IBS. Our experience of a nurse-led hypnotherapy service for IBS in a community setting provides evidence of comparable efficacy for symptom control, improved quality of life, reduced dependence on medication and improved general health measures. We address the challenges of setting up and maintaining the service in a changing healthcare environment. This model of care could act as a template for providers of gastroenterology and functional disease services wishing to provide IBS care. Copyright © 2013 Elsevier Ltd. All rights reserved.

How size matters: exploring the association between quality of mental health services and catchment area size.

PubMed

Ala-Nikkola, Taina; Sadeniemi, Minna; Kaila, Minna; Saarni, Samuli; Kontio, Raija; Pirkola, Sami; Joffe, Grigori; Oranta, Olli; Wahlbeck, Kristian

2016-08-12

The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known. Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others. The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers' contributions are sensitive to population size. To map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors. The diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services. The third sector and public corporations each provided 44 % of the service units. Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units. Significant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services. Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system.

Improving organizational climate for quality and quality of care: does membership in a collaborative help?

PubMed

Nembhard, Ingrid M; Northrup, Veronika; Shaller, Dale; Cleary, Paul D

2012-11-01

The lack of quality-oriented organizational climates is partly responsible for deficiencies in patient-centered care and poor quality more broadly. To improve their quality-oriented climates, several organizations have joined quality improvement collaboratives. The effectiveness of this approach is unknown. To evaluate the impact of collaborative membership on organizational climate for quality and service quality. Twenty-one clinics, 4 of which participated in a collaborative sponsored by the Institute for Clinical Systems Improvement. Pre-post design. Preassessments occurred 2 months before the collaborative began in January 2009. Postassessments of service quality and climate occurred about 6 months and 1 year, respectively, after the collaborative ended in January 2010. We surveyed clinic employees (eg, physicians, nurses, receptionists, etc.) about the organizational climate and patients about service quality. Prioritization of quality care, high-quality staff relationships, and open communication as indicators of quality-oriented climate and timeliness of care, staff helpfulness, doctor-patient communication, rating of doctor, and willingness to recommend doctor's office as indicators of service quality. There was no significant effect of collaborative membership on quality-oriented climate and mixed effects on service quality. Doctors' ratings improved significantly more in intervention clinics than in control clinics, staff helpfulness improved less, and timeliness of care declined more. Ratings of doctor-patient communication and willingness to recommend doctor were not significantly different between intervention and comparison clinics. Membership in the collaborative provided no significant advantage for improving quality-oriented climate and had equivocal effects on service quality.

Assessment of the Quality of Electronic Administrative Services in a Greek Higher Education Institution: ? Case Study

ERIC Educational Resources Information Center

Papanthymou, Anastasia; Darra, Maria

2018-01-01

The basic aim of this paper is to investigate the perceptions, attitudes and experiences of the students of the Department of Primary Education of University of the Aegean about the quality of the provided services to them by the Secretariat of Administrative Electronic Services. The survey was conducted during the second semester of the academic…

Transforming Data into Practical Information: Using Consumer Input to Improve Home-Care Services

ERIC Educational Resources Information Center

Applebaum, Robert; Kunkel, Suzanne; Wilson, Ken

2007-01-01

Purpose: As funds have increased for the provision of in-home care, so too have concerns about the quality of services. In response, care management agencies and home-care providers have developed an array of monitoring activities designed to ensure the quality of services. In this article, we show how an area agency on aging both collected and…

Observations on quality senior health business: success patterns and policy implications.

PubMed

Yang, Ya-Ting; Hsu, Yi-Hsin Elsa; Chen, Ya-Mei; Su, Shyi; Chang, Yao-Mao; Iqbal, Usman; Yujiro, Handa; Lin, Neng-Pai

2016-04-01

Population ageing is a global issue that affects almost every country. Most ageing researches focused on demand side and studies related to supply side were relatively scarce. This study selected quality enterprises focus on ageing health and analysed their patterns on providing quality services successfully. Our study selected quality senior health enterprises and explored their success patterns through face-to-face semi-structured in-depth interviews with CEO of each enterprise in 2013. Thirty-three quality senior health enterprises in Taiwan. Thirty-three CEO's of enterprises were interviewed individually. None. Core values and vision, historical development, organization structure, services/products provided, delivering channels, customer relationships and further development strategies. Our results indicated success patterns for senior enterprises that there were meeting diversified lifestyles and substitutive needs for the elderly and their caregivers, providing a total solution for actual/virtual integration and flexible one-stop shopping services. We classified these enterprises by used degree of clicks-and-mortar of services and residing situation of the elderly. Industry characteristics and policy implications were summarized. Our observations will serve as a primary evidenced base for enterprises developing their senior market, and also for opening dialogue between customers and enterprises to facilitate valuable opportunities for co-creation between the supply and demand sides. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Exploring the Effect of Autism Waiver Services on Family Outcomes

ERIC Educational Resources Information Center

Eskow, Karen; Pineles, Lisa; Summers, Jean Ann

2011-01-01

This study examined the effect of services provided through Maryland's Home and Community-Based Services Medicaid waiver for children with autism on several outcomes related to families, specifically family quality of life (FQoL) and employment. The purpose of this study was to assess the impact of the services provided through the Maryland autism…

Alabama Public Library Service, 1987 Annual Report.

ERIC Educational Resources Information Center

Alabama Public Library Service, Montgomery.

Designed to provide an overview of the range and quality of services provided by the Alabama Public Library Service (APLS), this annual report focuses on the 1987 activities of APLS. A report on the activities of the Library Development Division shows the allocation of state aid and Library Services and Construction Act (LCSA) Titles I and III…

Evaluation of products and services of a nursing library: user satisfaction.

PubMed

Cozin, Sheila Kátia; Turrini, Ruth Natalia Teresa

2008-01-01

The goal of the study was to evaluate the quality of the services provided by the library at the Nursing School of the University of São Paulo. A questionnaire evaluating users' satisfaction with the service was employed, covering five quality components: tangibles, reliability, responsiveness, assurance and empathy. The Satisfaction Rate was calculated through the degree of importance in relation to satisfaction. The analysis of the open-ended answers was quanti-qualitative. For Reliability and Empathy, the users showed dissatisfaction with the training for bibliographic research and the librarian's willingness to meet the clients' information needs, respectively. Responsiveness did not fully satisfy the users, disagreeing with the providers. However, both agreed that the archives are outdated. Among the tangible aspects, equipment and noise were criticized most often. The results show that the library offers good service quality to its users.

222-S Laboratory Quality Assurance Plan. Revision 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meznarich, H.K.

1995-07-31

This Quality Assurance Plan provides,quality assurance (QA) guidance, regulatory QA requirements (e.g., 10 CFR 830.120), and quality control (QC) specifications for analytical service. This document follows the U.S Department of Energy (DOE) issued Hanford Analytical Services Quality Assurance Plan (HASQAP). In addition, this document meets the objectives of the Quality Assurance Program provided in the WHC-CM-4-2, Section 2.1. Quality assurance elements required in the Guidelines and Specifications for Preparing Quality Assurance Program Plans (QAMS-004) and Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans (QAMS-005) from the US Environmental Protection Agency (EPA) are covered throughout this document. A qualitymore » assurance index is provided in the Appendix A. This document also provides and/or identifies the procedural information that governs laboratory operations. The personnel of the 222-S Laboratory and the Standards Laboratory including managers, analysts, QA/QC staff, auditors, and support staff shall use this document as guidance and instructions for their operational and quality assurance activities. Other organizations that conduct activities described in this document for the 222-S Laboratory shall follow this QA/QC document.« less

Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

PubMed Central

Shrestha, Khadka Narayan; Homer, Caroline S. E.

2017-01-01

Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987

In Urban And Rural India, A Standardized Patient Study Showed Low Levels Of Provider Training And Huge Quality Gaps

PubMed Central

Das, Jishnu; Holla, Alaka; Das, Veena; Mohanan, Manoj; Tabak, Diana; Chan, Brian

2013-01-01

This article reports on the quality of care delivered by private and public providers of primary health care services in rural and urban India. To measure quality, the study used standardized patients recruited from the local community and trained to present consistent cases of illness to providers. We found low overall levels of medical training among health care providers; in rural Madhya Pradesh, for example, 67 percent of health care providers who were sampled reported no medical qualifications at all. What’s more, we found only small differences between trained and untrained doctors in such areas as adherence to clinical checklists. Correct diagnoses were rare, incorrect treatments were widely prescribed, and adherence to clinical checklists was higher in private than in public clinics. Our results suggest an urgent need to measure the quality of health care services systematically and to improve the quality of medical education and continuing education programs, among other policy changes. PMID:23213162

Managing Vocabulary Mapping Services

PubMed Central

Che, Chengjian; Monson, Kent; Poon, Kasey B.; Shakib, Shaun C.; Lau, Lee Min

2005-01-01

The efficient management and maintenance of large-scale and high-quality vocabulary mapping is an operational challenge. The 3M Health Information Systems (HIS) Healthcare Data Dictionary (HDD) group developed an information management system to provide controlled mapping services, resulting in improved efficiency and quality maintenance. PMID:16779203

The Australian radiation protection and nuclear safety agency megavoltage photon thermoluminescence dosimetry postal audit service 2007-2010.

PubMed

Oliver, C P; Butler, D J; Webb, D V

2012-03-01

The Australian radiation protection and nuclear safety agency (ARPANSA) has continuously provided a level 1 mailed thermoluminescence dosimetry audit service for megavoltage photons since 2007. The purpose of the audit is to provide an independent verification of the reference dose output of a radiotherapy linear accelerator in a clinical environment. Photon beam quality measurements can also be made as part of the audit in addition to the output measurements. The results of all audits performed between 2007 and 2010 are presented. The average of all reference beam output measurements calculated as a clinically stated dose divided by an ARPANSA measured dose is 0.9993. The results of all beam quality measurements calculated as a clinically stated quality divided by an ARPANSA measured quality is 1.0087. Since 2011 the provision of all auditing services has been transferred from the Ionizing Radiation Standards section to the Australian Clinical Dosimetry Service (ACDS) which is currently housed within ARPANSA.

Improving Aboriginal maternal and infant health services in the 'Top End' of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change.

PubMed

Barclay, Lesley; Kruske, Sue; Bar-Zeev, Sarah; Steenkamp, Malinda; Josif, Cathryn; Narjic, Concepta Wulili; Wardaguga, Molly; Belton, Suzanne; Gao, Yu; Dunbar, Terry; Kildea, Sue

2014-06-02

Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia. A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of 'out of hospital' or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated. Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the required skills for providing care for infants, and an 'outpatient' model of care. Services were also characterised by absent Aboriginal leadership and inadequate coordination between remote and tertiary services that is essential to improve quality of care and reduce 'system-introduced' risk. Evidence-informed redesign of maternity services and delivery of care has improved clinical effectiveness and quality for women. However, more work is needed to address substandard care provided for infants and their parents.

The cost of service quality improvements: tracking the flow of funds in social franchise networks in Myanmar

PubMed Central

2013-01-01

Introduction This paper examines the cost of quality improvements in Population Services International (PSI) Myanmar’s social franchise operations from 2007 to 2009. Methods The social franchise commodities studied were products for reproductive health, malaria, STIs, pneumonia, and diarrhea. This project applied ingredients based costing for labor, supplies, transport, and overhead. Data were gathered seven during key informant interviews with staff in the central Yangon office, examination of 3 years of payroll data, examination of a time motion study conducted by PSI, and spreadsheets recording the costs of acquiring and transporting supplies. Results In 2009 PSI Myanmar’s social franchise devoted $2.02 million towards a 94% reduction in commodity prices offered to its network of over 1700 primary care providers. These providers retained 1/3 of the subsidy as revenue and passed along the other 2/3 to their patients in the course of offering subsidized care for 1.5 million health episodes. In addition, PSI Myanmar devoted $2.09 million to support a team of franchise officers who conducted quality assurance for the private providers overseeing service quality and to distributing medical commodities. Conclusion In Myanmar, the social franchise operated by PSI spends roughly $1.00 in quality management and retailing for every $1.00 spent subsidizing medical commodities. Some services are free, but patients also pay fees for other lines of service. Overall patients contribute 1/6 as much as PSI does. Unlike other NGO’s, health services in social franchises like PSI are not all free to the patients, nor are the discounts uniformly applied. Discounts and subsidies evolve in response to public health concerns, market demand, providers’ cost structures as well as strategic objectives in maintaining the network and its portfolio of services. PMID:23826743

A framework for improving access and customer service times in health care: application and analysis at the UCLA Medical Center.

PubMed

Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas

2013-01-01

There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics.

Assessing uncertain human exposure to ambient air pollution using environmental models in the Web

NASA Astrophysics Data System (ADS)

Gerharz, L. E.; Pebesma, E.; Denby, B.

2012-04-01

Ambient air quality can have significant impact on human health by causing respiratory and cardio-vascular diseases. Thereby, the pollutant concentration a person is exposed to can differ considerably between individuals depending on their daily routine and movement patterns. Using a straight forward approach this exposure can be estimated by integration of individual space-time paths and spatio-temporally resolved ambient air quality data. To allow a realistic exposure assessment, it is furthermore important to consider uncertainties due to input and model errors. In this work, we present a generic, web-based approach for estimating individual exposure by integration of uncertain position and air quality information implemented as a web service. Following the Model Web initiative envisioning an infrastructure for deploying, executing and chaining environmental models as services, existing models and data sources for e.g. air quality, can be used to assess exposure. Therefore, the service needs to deal with different formats, resolutions and uncertainty representations provided by model or data services. Potential mismatch can be accounted for by transformation of uncertainties and (dis-)aggregation of data under consideration of changes in the uncertainties using components developed in the UncertWeb project. In UncertWeb, the Model Web vision is extended to an Uncertainty-enabled Model Web, where services can process and communicate uncertainties in the data and models. The propagation of uncertainty to the exposure results is quantified using Monte Carlo simulation by combining different realisations of positions and ambient concentrations. Two case studies were used to evaluate the developed exposure assessment service. In a first study, GPS tracks with a positional uncertainty of a few meters, collected in the urban area of Münster, Germany were used to assess exposure to PM10 (particulate matter smaller 10 µm). Air quality data was provided by an uncertainty-enabled air quality model system which provided realisations of concentrations per hour on a 250 m x 250 m resolved grid over Münster. The second case study uses modelled human trajectories in Rotterdam, The Netherlands. The trajectories were provided as realisations in 15 min resolution per 4 digit postal code from an activity model. Air quality estimates were provided for different pollutants as ensembles by a coupled meteorology and air quality model system on a 1 km x 1 km grid with hourly resolution. Both case studies show the successful application of the service to different resolutions and uncertainty representations.

Measuring the performance of maintenance service outsourcing.

PubMed

Cruz, Antonio Miguel; Rincon, Adriana Maria Rios; Haugan, Gregory L

2013-01-01

The aims of this paper are (1) to identify the characteristics of maintenance service providers that directly impact maintenance service quality, using 18 independent covariables; (2) to quantify the change in risk these covariables present to service quality, measured in terms of equipment turnaround time (TAT). A survey was applied to every maintenance service provider (n = 19) for characterization purposes. The equipment inventory was characterized, and the TAT variable recorded and monitored for every work order of each service provider (N = 1,025). Finally, the research team conducted a statistical analysis to accomplish the research objectives. The results of this study offer strong empirical evidence that the most influential variables affecting the quality of maintenance service performance are the following: type of maintenance, availability of spare parts in the country, user training, technological complexity of the equipment, distance between the company and the hospital, and the number of maintenance visits performed by the company. The strength of the results obtained by the Cox model built are supported by the measure of the Rp,e(2) = 0.57 with a value of Rp,e= 0.75. Thus, the model explained 57% of the variation in equipment TAT, with moderate high positive correlation between the dependent variable (TAT) and independent variables.

Improving the Quality of Postabortion Care Services in Togo Increased Uptake of Contraception

PubMed Central

Mugore, Stembile; Kassouta, Ntapi Tchiguiri K; Sebikali, Boniface; Lundstrom, Laurel; Saad, Abdulmumin

2016-01-01

ABSTRACT High-quality postabortion care (PAC) services that include family planning counseling and a full range of contraceptives at point of treatment for abortion complications have great potential to break the cycle of repeat unintended pregnancies and demand for abortions. We describe the first application of a systematic approach to quality improvement of PAC services in a West African country. This approach—IntraHealth International’s Optimizing Performance and Quality (OPQ) approach—was applied at 5 health care facilities in Togo starting in November 2014. A baseline assessment identified the following needs: reorganizing services to ensure that contraceptives are provided at point of treatment for abortion complications, before PAC clients are discharged; improving provider competencies in family planning services, including in providing long-acting reversible contraceptive implants and intrauterine devices; ensuring that contraceptive methods are available to all PAC clients free of charge; standardizing PAC registers and enhancing data collection and reporting systems; enhancing internal supervision systems at facilities and teamwork among PAC providers; and engaging PAC providers in community talks. Solutions devised and applied at the facilities during OPQ resulted in significant increases in contraceptive counseling and uptake among PAC clients: During the 5-month baseline period, 31% of PAC clients were counseled, while during the 13-month intervention period, 91% were counseled. Of all PAC clients counseled during the baseline period, 37% accepted a contraceptive, compared with 60% of those counseled during the intervention period. Oral contraceptive pills remained the most popular method during both periods, yet uptake of implants increased significantly during the intervention period—from 4% to 27% of those accepting contraceptives. This result demonstrates that the solutions applied maintained method choice while expanding access to underused long-acting reversible contraceptives. OPQ shows great potential for sustainability and scale in Togo and for application in similar contexts where the health system struggles to offer safe, high-quality, accessible PAC services. PMID:27688719

Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape.

PubMed

Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline

2015-01-01

With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers need to work closely with the compensation and rehabilitation sector as well as governments to establish robust evidence of the benefits and costs of payment models, from the perspectives of clients/consumers, funders, service providers and rehabilitation professionals.

Can there be mutual support between hospital marketing and continuous quality improvement?

PubMed

Weiland, D E

1992-01-01

Marketing the results of continuous quality improvement in hospitals builds a growing bank of loyal customers in an increasingly competitive and quality-oriented environment: If healthcare institutions want to survive and flourish, they must develop a lasting relationship with their customers. The long-term goal of CQI is to provide quality products and services. If marketing managers can sell these improved services, hospitals will build a solid client foundation.

End of Life: An Overview

ERIC Educational Resources Information Center

Toner, Mary Ann; Shadden, Barbara B.

2012-01-01

Speech-language pathologists (SLPs) provide services to patients confronting the end of life (EOL) in a variety of settings. Instead of targeting improvement of health or sustaining life, EOL services focus primarily on quality of life. Although SLPs may not consider themselves core members of the health care team providing EOL services, the…

Healthcare service quality: towards a broad definition.

PubMed

Mosadeghrad, Ali Mohammad

2013-01-01

The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

The quality of free antenatal and delivery services in Northern Sierra Leone.

PubMed

Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou

2017-07-12

The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of consumables, non-functional basic emergency obstetric care facilities, and geographic inequities in access to CEOC facilities. These findings suggest that the health sector needs to urgently investigate continuing inequities adversely influencing the uptake of these services, and explore more sustainable funding mechanisms. Without this, the country is unlikely to achieve its goal of reducing maternal deaths.

An Automated End-To Multi-Agent Qos Based Architecture for Selection of Geospatial Web Services

NASA Astrophysics Data System (ADS)

Shah, M.; Verma, Y.; Nandakumar, R.

2012-07-01

Over the past decade, Service-Oriented Architecture (SOA) and Web services have gained wide popularity and acceptance from researchers and industries all over the world. SOA makes it easy to build business applications with common services, and it provides like: reduced integration expense, better asset reuse, higher business agility, and reduction of business risk. Building of framework for acquiring useful geospatial information for potential users is a crucial problem faced by the GIS domain. Geospatial Web services solve this problem. With the help of web service technology, geospatial web services can provide useful geospatial information to potential users in a better way than traditional geographic information system (GIS). A geospatial Web service is a modular application designed to enable the discovery, access, and chaining of geospatial information and services across the web that are often both computation and data-intensive that involve diverse sources of data and complex processing functions. With the proliferation of web services published over the internet, multiple web services may provide similar functionality, but with different non-functional properties. Thus, Quality of Service (QoS) offers a metric to differentiate the services and their service providers. In a quality-driven selection of web services, it is important to consider non-functional properties of the web service so as to satisfy the constraints or requirements of the end users. The main intent of this paper is to build an automated end-to-end multi-agent based solution to provide the best-fit web service to service requester based on QoS.

Development of a questionnaire to measure consumers' perceptions of service quality in Australian community pharmacies.

PubMed

Mirzaei, Ardalan; Carter, Stephen R; Chen, Jenny Yimin; Rittsteuer, Claudia; Schneider, Carl R

2018-06-11

Recent changes within community pharmacy have seen a shift towards some pharmacies providing "value-added" services. However, providing high levels of service is resource intensive yet revenues from dispensing are declining. Of significance therefore, is how consumers perceive service quality (SQ). However, at present there are no validated and reliable instruments to measure consumers' perceptions of SQ in Australian community pharmacies. The aim of this study was to build a theory-grounded model of service quality (SQ) in community pharmacies and to create a valid survey instrument to measure consumers' perceptions of service quality. Stage 1 dealt with item generation using theory, prior research and qualitative interviews with pharmacy consumers. Selected items were then subjected to content validity and face validity. Stages 2 and 3 included psychometric testing among English-speaking adult consumers of Australian pharmacies. Exploratory factor analysis was used for item reduction and to explain the domains of SQ. In stage 1, item generation for SQ initially generated 113 items which were then refined, through content and face validity, down to 61 items. In stage 2, after subjecting the questionnaire to psychometric testing on the data from the first pharmacy (n = 374), the use of the primary dimensions of SQ was abandoned leaving 32 items representing 5 domains of SQ. In stage 3, the questionnaire was subject to further testing and item reduction in 3 other pharmacies (n = 320). SQ was best described using 23 items representing 6 domains: 'health and medicines advice', 'relationship quality', 'technical quality', 'environmental quality', 'non-prescription service', and 'health outcomes'. This research presents a theoretically-grounded and robust measurement scale developed for consumer perceptions of SQ in a community pharmacy. Copyright © 2018. Published by Elsevier Inc.

Is patient satisfaction and perceived service quality with musculoskeletal rehabilitation determined by patient experiences?

PubMed

Medina-Mirapeix, Francesc; Jimeno-Serrano, Francisco J; Escolar-Reina, Pilar; Del Baño-Aledo, M Elena

2013-06-01

To assess the relationships between patient experiences and two overall evaluations - satisfaction and service quality - in outpatient rehabilitation settings. A cross-sectional, self-reported survey carried out in the year 2009. Three outpatient rehabilitation units belonging to Spanish hospitals located in Barcelona, Madrid and Seville. Four hundred and sixty-five outpatients (response rate 90%) mean age 39.4 (SD = 11.9) years. Self-reported experiences on aspects of care, participants' perception of service quality, satisfaction with care, socio-demographic and health characteristics. Satisfaction and service quality were highly correlated (rho = 0.72, P< 0.001). Two multivariate logistic regression models using satisfaction and service quality (with adjusted R(2) 31.5% and 37.1%, respectively) indicated that patients' experiences and global rating of health improvement have more effect on those evaluations than socio-demographic characteristics. Mean satisfaction was 8.9 (SD = 1.2), and 88% of respondents described high service quality. However, nearly 25% of the respondents who reported high-quality evaluations also indicated a problem score of more than 50% in almost all aspects of care studied. Satisfaction and service quality provide a poor indicator of patients' experiences. Both are two proxies but distinct constructs in rehabilitation care. Besides, not all problems encountered by patients are equally important to them.

Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers.

PubMed

Hasegawa, Aya; Yasuoka, Junko; Ly, Po; Nguon, Chea; Jimba, Masamine

2013-08-23

Malaria and other communicable diseases remain major threats in developing countries. In Cambodia, village malaria workers (VMWs) have been providing malaria control services in remote villages to cope with the disease threats. In 2009, the VMW project integrated child health services into the original malaria control services. However, little has been studied about the utilization of VMWs' child health services. This study aimed to identify determinants of caregivers' VMW service utilization for childhood illness and caregivers' knowledge of malaria management. A cross-sectional study was conducted in 36 VMW villages of Kampot and Kampong Thom provinces in July-September 2012. An equal number of VMW villages with malaria control services only (M) and those with malaria control plus child health services (M+C) were selected from each province. Using structured questionnaires, 800 caregivers of children under five and 36 VMWs, one of the two VMWs who was providing VMW services in each study village were interviewed. Among the caregivers, 23% in M villages and 52% in M+C villages utilized VMW services for childhood illnesses. Determinants of caregivers' utilization of VMWs in M villages included their VMWs' length of experience (AOR = 11.80, 95% confidence interval [CI] = 4.46-31.19) and VMWs' service quality (AOR = 2.04, CI = 1.01-4.11). In M+C villages, VMWs' length of experience (AOR = 2.44, CI = 1.52-3.94) and caregivers' wealth index (AOR = 0.35, CI = 0.18-0.68) were associated with VMW service utilization. Meanwhile, better service quality of VMWs (AOR = 3.21, CI = 1.34-7.66) and caregivers' literacy (AOR = 9.91, CI = 4.66-21.05) were positively associated with caregivers' knowledge of malaria management. VMWs' service quality and length of experience are important determinants of caregivers' utilization of VMWs' child health services and their knowledge of malaria management. Caregivers are seeking VMWs' support for childhood illnesses even if they are providing only malaria control services. This underlines the importance of scaling-up VMWs' capacity by adding child health services of good quality, which will result in improving child health status in remote Cambodia.

A survey of assistive technology service providers in the USA.

PubMed

Arthanat, Sajay; Elsaesser, Linda-Jeanne; Bauer, Stephen

2017-11-01

This study investigates perspectives of assistive technology service (ATS) providers regarding their education and training, interdisciplinary standards of practice, use of a common language framework, funding policies, utilization of evidence and outcomes measurement. A survey underpinned by AT legislations and established guidelines for practice was completed by 318 certified AT providers. More than 30% of the providers reported their education and training as inadequate to fulfil four of the seven primary roles of ATS. Nearly 90% of providers expressed awareness of the International Classification of Functioning, Disability and Health (ICF) domains for interdisciplinary communication. However, only 45% felt that they could effectively utilize the ICF in their documentation. About 75% of the providers acknowledged the lack of a recognized standard for the provision of services. Prevailing inadequacies in funding were negatively impacting the quality of ATS, as expressed by 88% of respondents. Translation of evidence to practice was identified as a major challenge by 41% of service providers. Providers were predominantly documenting outcomes through informal interviews (54%) or non-standard instruments (26%). Findings support the need for strengthening professional curriculum, pre-service and in-service training and an established standard to support effective, interdisciplinary AT services and data collection to support public policy decisions. Implications for Rehabilitation This study validates the need to strengthen education and training of AT service providers by enhancing professional curriculum as well as their engagement in pre-service and in-service training activities. This study draws attention to health care funding policies and practices that critically impact the quality of AT services. This study signifies the need for an established interdisciplinary standard among AT professionals to support effective communication, service coordination and outcomes measurement.

Perceived Quality of In-Service Communication and Counseling Among Adolescents Undergoing Voluntary Medical Male Circumcision.

PubMed

Van Lith, Lynn M; Mallalieu, Elizabeth C; Patel, Eshan U; Dam, Kim H; Kaufman, Michelle R; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

2018-04-03

Experience with providers shapes the quality of adolescent health services, including voluntary medical male circumcision (VMMC). This study examined the perceived quality of in-service communication and counseling during adolescent VMMC services. A postprocedure quantitative survey measuring overall satisfaction, comfort, perceived quality of in-service communication and counseling, and perceived quality of facility-level factors was administered across 14 VMMC sites in South Africa, Tanzania, and Zimbabwe. Participants were adolescent male clients aged 10-14 years (n = 836) and 15-19 years (n = 457) and completed the survey 7 to 10 days following VMMC. Adjusted prevalence ratios (aPRs) were estimated by multivariable modified Poisson regression with generalized estimating equations and robust variance estimation to account for site-level clustering. Of 10- to 14-year-olds and 15- to 19-year-olds, 97.7% and 98.7%, respectively, reported they were either satisfied or very satisfied with their VMMC counseling experience. Most were also very likely or somewhat likely (93.6% of 10- to 14-year olds and 94.7% of 15- to 19-year olds) to recommend VMMC to their peers. On a 9-point scale, the median perceived quality of in-service (counselor) communication was 9 (interquartile range [IQR], 8-9) among 15- to 19-year-olds and 8 (IQR, 7-9) among 10- to 14-year-olds. The 10- to 14-year-olds were more likely than 15- to 19-year-olds to perceive a lower quality of in-service (counselor) communication (score <7; 21.5% vs. 8.2%; aPR, 1.61 [95% confidence interval, 1.33-1.95]). Most adolescents were more comfortable with a male rather than female counselor and provider. Adolescents of all ages wanted more discussion about pain, wound care, and healing time. Adolescents perceive the quality of in-service communication as high and recommend VMMC to their peers; however, many adolescents desire more discussion about key topics outlined in World Health Organization guidance.

32 CFR 861.6 - DOD review of foreign air carriers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... DEPARTMENT OF DEFENSE COMMERCIAL AIR TRANSPORTATION QUALITY AND SAFETY REVIEW PROGRAM § 861.6 DOD review of... carriers seeking to provide or providing air transportation services under a contract or Military Air.... Foreign air carriers seeking to provide or providing air transportation services under a contract or...

Value for money of changing healthcare services? Economic evaluation of quality improvement

PubMed Central

Severens, J

2003-01-01



 There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369

Contract management using cause-effect clues in service worksheets.

PubMed

Chen, J H

1996-01-01

Sophisticated equipment often needs intensive technical resources to maintain its system availability. Service contracts can be an easy channel to outside technical resources. Usually, a service contract purchaser only sees its cost instead of its maintenance quality. A system's needs, however, depend on the trade-off between the cost paid and the quality received. If a clinical engineer can actively interpret and integrate the cause-effect consequences on the compiled service worksheets, those clues can serve as a criterion to justify the quality and the cost-effectiveness of a service contract. Through the analysis of the service labor consumed, the justification of the parts replaced, and the assessment of the "fit" to system availability, this paper provides a cost-effective tool for equipment management.

Identifying Continuous Quality Improvement Priorities in Maternal, Infant, and Early Childhood Home Visiting.

PubMed

Preskitt, Julie; Fifolt, Matthew; Ginter, Peter M; Rucks, Andrew; Wingate, Martha S

2016-01-01

The purpose of this article was to describe a methodology to identify continuous quality improvement (CQI) priorities for one state's Maternal, Infant, and Early Childhood Home Visiting program from among the 40 required constructs associated with 6 program benchmarks. The authors discuss how the methodology provided consensus on system CQI quality measure priorities and describe variation among the 3 service delivery models used within the state. Q-sort methodology was used by home visiting (HV) service delivery providers (home visitors) to prioritize HV quality measures for the overall state HV system as well as their service delivery model. There was general consensus overall and among the service delivery models on CQI quality measure priorities, although some variation was observed. Measures associated with Maternal, Infant, and Early Childhood Home Visiting benchmark 1, Improved Maternal and Newborn Health, and benchmark 3, Improvement in School Readiness and Achievement, were the highest ranked. The Q-sort exercise allowed home visitors an opportunity to examine priorities within their service delivery model as well as for the overall First Teacher HV system. Participants engaged in meaningful discussions regarding how and why they selected specific quality measures and developed a greater awareness and understanding of a systems approach to HV within the state. The Q-sort methodology presented in this article can easily be replicated by other states to identify CQI priorities at the local and state levels and can be used effectively in states that use a single HV service delivery model or those that implement multiple evidence-based models for HV service delivery.

Total quality management: It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

Today we are in the midst of information and 'total quality' revolutions. At the NASA STI Program's Center for AeroSpace Information (CASI), we are focused on using continuous improvements techniques to enrich today's services and products and to ensure that tomorrow's technology supports the TQM-based improvement of future STI program products and services. The Continuous Improvements Program at CASI is the foundation for Total Quality Management in products and services. The focus is customer-driven; its goal, to identify processes and procedures that can be improved and new technologies that can be integrated with the processes to gain efficiencies, provide effectiveness, and promote customer satisfaction. This Program seeks to establish quality through an iterative defect prevention approach that is based on the incorporation of standards and measurements into the processing cycle. Four projects are described that utilize cross-functional, problem-solving teams for identifying requirements and defining tasks and task standards, management participation, attention to critical processes, and measurable long-term goals. The implementation of these projects provides the customer with measurably improved access to information that is provided through several channels: the NASA STI Database, document requests for microfiche and hardcopy, and the Centralized Help Desk.

[Analysis of public quality reports for home care and long-term care with respect to their usefulness for the customer].

PubMed

Sünderkamp, Susanne; Weiß, Christian; Rothgang, Heinz

2014-10-01

Public quality reports, based on new legislative regulations of 2008, were supposed to offer potential customers the possibility to make a well-informed choice of a care provider. This empirical study on marks for long-term care is based on the public quality reports of the Medical Service of the Health Insurance Companies (MDK), of 11 884 home care services and 10 310 nursing homes, which corresponds to a comprehensive survey of almost all care providers in Germany. Descriptive statistical methods and discussion of the results concerning the customer benefit. The analysis of transparency reports reveals a limited value for customers, which is particularly caused by very good quality results with low scattering. In addition, a high amount of missing data - especially in the area of home care providers - leads to a growing influence of service criteria on the final grade. Though deficits in nursing might be compensated by good marks in service criteria, it rarely occurs. At present, a more detailed look at risk criteria hardly improves the customer benefit. The marks for nursing need to be improved to increase their informative value for the customer.

The role of the Standard Days Method in modern family planning services in developing countries.

PubMed

Lundgren, Rebecka I; Karra, Mihira V; Yam, Eileen A

2012-08-01

The mere availability of family planning (FP) services is not sufficient to improve reproductive health; services must also be of adequate quality. The introduction of new contraceptive methods is a means of improving quality of care. The Standard Days Method (SDM) is a new fertility-awareness-based contraceptive method that has been successfully added to reproductive health care services around the world. Framed by the Bruce-Jain quality-of-care paradigm, this paper describes how the introduction of SDM in developing country settings can improve the six elements of quality while contributing to the intrinsic variety of available methods. SDM meets the needs of women and couples who opt not to use other modern methods. SDM providers are sensitised to the potential of fertility-awareness-based contraception as an appropriate choice for these clients. SDM requires the involvement of both partners and thus offers a natural entry point for providers to further explore partner communication, intimate partner violence, condoms, and HIV/STIs. SDM introduction broadens the range of FP methods available to couples in developing countries. SDM counselling presents an opportunity for FP providers to discuss important interpersonal and reproductive health issues with potential users.

Improving Care And Research Electronic Data Trust Antwerp (iCAREdata): a research database of linked data on out-of-hours primary care.

PubMed

Colliers, Annelies; Bartholomeeusen, Stefaan; Remmen, Roy; Coenen, Samuel; Michiels, Barbara; Bastiaens, Hilde; Van Royen, Paul; Verhoeven, Veronique; Holmgren, Philip; De Ruyck, Bernard; Philips, Hilde

2016-05-04

Primary out-of-hours care is developing throughout Europe. High-quality databases with linked data from primary health services can help to improve research and future health services. In 2014, a central clinical research database infrastructure was established (iCAREdata: Improving Care And Research Electronic Data Trust Antwerp, www.icaredata.eu ) for primary and interdisciplinary health care at the University of Antwerp, linking data from General Practice Cooperatives, Emergency Departments and Pharmacies during out-of-hours care. Medical data are pseudonymised using the services of a Trusted Third Party, which encodes private information about patients and physicians before data is sent to iCAREdata. iCAREdata provides many new research opportunities in the fields of clinical epidemiology, health care management and quality of care. A key aspect will be to ensure the quality of data registration by all health care providers. This article describes the establishment of a research database and the possibilities of linking data from different primary out-of-hours care providers, with the potential to help to improve research and the quality of health care services.

Identifying influence of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

PubMed

Karim, R M; Abdullah, M S; Rahman, A M; Alam, A M

2015-04-01

Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Discussion (FGD), key informants interview and data for measuring the utilization status were collected by an interviewer administered pretested semi-structured questionnaire. About 95% of the respondents were Muslims and 5% were Hindus. The average age of the respondents was 23.38 (SD ± 4.15) years and almost all of them are home makers. The average monthly expenditure of their family was 7462.92 (SD ± 2545) BDT equivalent to 95 (SD ± 32) US$. To measure lay peoples' perception and satisfaction regarding primary health care service quality two scales e.g. Slim Haddad's 20-item scale for measuring perceived quality of primary health care services (PQPCS) validated in Guinea and Burkina Fuso and primary care satisfaction survey for women (PCSSW) developed by Scholle and colleagues 2004; is a 24-item survey tool validated in Turkey were chosen as a reference tools. Based on those, two psychometric research instruments; 24 items PQPCS scale (chronbach's α =0.89) and 22-items Community Clinic Service Satisfaction (CCSS) scale (chronbach's α = 0.97), were constructed and validated for measuring perceived service quality and satisfaction in Bangladesh context. This study showed mothers with preprimary education [(χ2 = 4.20, p = 0.04), AOR with 95% CI = 1.89 (1.03, 3.53)] utilized the limited curative care services more than educated mothers. On the contrary, higher income families [for income group 5000-10,000 BDT χ2 = 8.83, p = 0.003 and AOR with 95% CI = 0.37(0.19, 0.71)] and [for income group above 10,000 BDT χ2 = 5.02, p = 0.025 and AOR with 95% CI = 0.40 (0.18, 0.89)] and families having cultivable lands [for 5-10 decimal group χ2 = 5.51, p = 0.19, and AOR with 95% CI = 0.56 (0.35, 0.91)] and [for > 10 decimal group χ2 = 6.70, p = 0.010, and AOR with 95% CI = 0.50 (0.29, 0.84)] utilized the limited curative care services less than their poorer and landless counterpart. The same relationship was observed in case of health education and Antenatal Care (ANC) and Postnatal Care (PNC) services. Women who lived in their own residence used health education services more frequently than those who lived in a rental house [χ2 = 24.00, p = 0.000 and AOR with 95% CI = 1.21, (1.12, 1.30)] and they also increasingly used maternal and child health services χ2 = 27.49, p = 0.000 and AOR with 95% CI 1.61, (1.35, 1.93)]. Perceptions concerning skill and competence of the health care provider [χ2 = 16.90, p = 0.000 and AOR with 95% CI = 1.14, (1.07, 1.22)] and satisfaction indicating interpersonal communication and attitude of the care provider [χ2 = 7.07, p = 0.008 AOR with 95% CI = 1.08, (1.02, 1.15)] were found significant predictors for limited curative care service utilization of CC. Perception related to the quality of management, administration, physical environment of the service point and satisfaction addressing health promotion and women health issues also played significant role on CC's services utilization. Besides parental education and income, client's perception and satisfaction played significant role in CC service utilization. Provider's perception of service quality should be studied. The study findings will enable policy-makers .to improve quality of primary health care services, realizing providers' and patients' ideas of CC service quality.

14 CFR 234.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS AIRLINE SERVICE QUALITY PERFORMANCE REPORTS § 234.1 Purpose. The purpose of this part is to set... system vendors in computerized form, except as otherwise provided, so that information on air carriers' quality of service can be made available to consumers of air transportation. This part also requires that...

14 CFR 234.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS AIRLINE SERVICE QUALITY PERFORMANCE REPORTS § 234.1 Purpose. The purpose of this part is to set... system vendors in computerized form, except as otherwise provided, so that information on air carriers' quality of service can be made available to consumers of air transportation. This part also requires that...

14 CFR 234.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS AIRLINE SERVICE QUALITY PERFORMANCE REPORTS § 234.1 Purpose. The purpose of this part is to set... system vendors in computerized form, except as otherwise provided, so that information on air carriers' quality of service can be made available to consumers of air transportation. This part also requires that...

14 CFR 234.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATIONS AIRLINE SERVICE QUALITY PERFORMANCE REPORTS § 234.1 Purpose. The purpose of this part is to set... system vendors in computerized form, except as otherwise provided, so that information on air carriers' quality of service can be made available to consumers of air transportation. This part also requires that...

QoS measurement of workflow-based web service compositions using Colored Petri net.

PubMed

Nematzadeh, Hossein; Motameni, Homayun; Mohamad, Radziah; Nematzadeh, Zahra

2014-01-01

Workflow-based web service compositions (WB-WSCs) is one of the main composition categories in service oriented architecture (SOA). Eflow, polymorphic process model (PPM), and business process execution language (BPEL) are the main techniques of the category of WB-WSCs. Due to maturity of web services, measuring the quality of composite web services being developed by different techniques becomes one of the most important challenges in today's web environments. Business should try to provide good quality regarding the customers' requirements to a composed web service. Thus, quality of service (QoS) which refers to nonfunctional parameters is important to be measured since the quality degree of a certain web service composition could be achieved. This paper tried to find a deterministic analytical method for dependability and performance measurement using Colored Petri net (CPN) with explicit routing constructs and application of theory of probability. A computer tool called WSET was also developed for modeling and supporting QoS measurement through simulation.

47 CFR 22.1005 - Priority of service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES... central stations. However, they may also be used to render private leased line communication service, provided that such usage does not reduce or impair the extent or quality of communication service which...

A systematic composite service design modeling method using graph-based theory.

PubMed

Elhag, Arafat Abdulgader Mohammed; Mohamad, Radziah; Aziz, Muhammad Waqar; Zeshan, Furkh

2015-01-01

The composite service design modeling is an essential process of the service-oriented software development life cycle, where the candidate services, composite services, operations and their dependencies are required to be identified and specified before their design. However, a systematic service-oriented design modeling method for composite services is still in its infancy as most of the existing approaches provide the modeling of atomic services only. For these reasons, a new method (ComSDM) is proposed in this work for modeling the concept of service-oriented design to increase the reusability and decrease the complexity of system while keeping the service composition considerations in mind. Furthermore, the ComSDM method provides the mathematical representation of the components of service-oriented design using the graph-based theoryto facilitate the design quality measurement. To demonstrate that the ComSDM method is also suitable for composite service design modeling of distributed embedded real-time systems along with enterprise software development, it is implemented in the case study of a smart home. The results of the case study not only check the applicability of ComSDM, but can also be used to validate the complexity and reusability of ComSDM. This also guides the future research towards the design quality measurement such as using the ComSDM method to measure the quality of composite service design in service-oriented software system.

A Systematic Composite Service Design Modeling Method Using Graph-Based Theory

PubMed Central

Elhag, Arafat Abdulgader Mohammed; Mohamad, Radziah; Aziz, Muhammad Waqar; Zeshan, Furkh

2015-01-01

The composite service design modeling is an essential process of the service-oriented software development life cycle, where the candidate services, composite services, operations and their dependencies are required to be identified and specified before their design. However, a systematic service-oriented design modeling method for composite services is still in its infancy as most of the existing approaches provide the modeling of atomic services only. For these reasons, a new method (ComSDM) is proposed in this work for modeling the concept of service-oriented design to increase the reusability and decrease the complexity of system while keeping the service composition considerations in mind. Furthermore, the ComSDM method provides the mathematical representation of the components of service-oriented design using the graph-based theoryto facilitate the design quality measurement. To demonstrate that the ComSDM method is also suitable for composite service design modeling of distributed embedded real-time systems along with enterprise software development, it is implemented in the case study of a smart home. The results of the case study not only check the applicability of ComSDM, but can also be used to validate the complexity and reusability of ComSDM. This also guides the future research towards the design quality measurement such as using the ComSDM method to measure the quality of composite service design in service-oriented software system. PMID:25928358

Competition and quality in a physiotherapy market with fixed prices.

PubMed

Pekola, Piia; Linnosmaa, Ismo; Mikkola, Hennamari

2017-01-01

Our study focuses on competition and quality in physiotherapy organized and regulated by the Social Insurance Institution of Finland (Kela). We first derive a hypothesis with a theoretical model and then perform empirical analyses of the data. Within the physiotherapy market, prices are regulated by Kela, and after registration eligible firms are accepted to join a pool of firms from which patients choose service providers based on their individual preferences. By using 2SLS estimation techniques, we analyzed the relationship among quality, competition and regulated price. According to the results, competition has a statistically significant (yet weak) negative effect (p = 0.019) on quality. The outcome for quality is likely caused by imperfect information. It seems that Kela has provided too little information for patients about the quality of the service.

Differentiated strategies for improving streaming service quality

NASA Astrophysics Data System (ADS)

An, Hui; Chen, Xin-Meng

2005-02-01

With the explosive growth of streaming services, users are becoming more and more sensitive to its quality of service. To handle these problems, the research community focuses of the application of caching and replication techniques. But most approaches try to find specific strategies of caching of replication that suit for streaming service characteristics and to design some kind of universal policy to deal with all streaming objects. This paper explores the combination of caching and replication for improving streaming service quality and demonstrates that it makes sense to incorporate two technologies. It provides a system model and discusses some related issues of how to determining a refreshable streaming object and which refreshment policies a refreshable object should use.

Integration of legal aspects and human rights approach in palliative care delivery-the Nyeri Hospice model.

PubMed

Musyoki, David; Gichohi, Sarafina; Ritho, Johnson; Ali, Zipporah; Kinyanjui, Asaph; Muinga, Esther

2016-01-01

Palliative care is patient and family-centred care that optimises quality of life by anticipating, preventing, and treating suffering. Open Society Foundation public health program (2011) notes that people facing life-threatening illnesses are deeply vulnerable: often in severe physical pain, worried about death, incapacitation, or the fate of their loved ones. Legal issues can increase stress for patients and families and make coping harder, impacting on the quality of care. In the absence of a clear legal provision expressly recognising palliative care in Kenya, providers may face numerous legal and ethical dilemmas that affect the availability, accessibility, and delivery of palliative care services and commodities. In order to ensure positive outcomes from patients, their families, and providers, palliative care services should be prioritised by all and includes advocating for the integration of legal support into those services. Palliative care service providers should be able to identify the various needs of patients and their families including specific issues requiring legal advice and interventions. Access to legal services remains a big challenge in Kenya, with limited availability of specialised legal services for health-related legal issues. An increased awareness of the benefits of legal services in palliative care will drive demand for easily accessible and more affordable direct legal services to address legal issues for a more holistic approach to quality palliative care.

A cluster randomised controlled trial of a staff-training intervention in residential units for people with long-term mental illness in Portugal: the PromQual trial.

PubMed

Cardoso, Graça; Papoila, Ana; Tomé, Gina; Killaspy, Helen; King, Michael; Caldas-de-Almeida, José Miguel

2017-11-01

This study aimed to assess the efficacy of a staff-training intervention to improve service users' engagement in activities and quality of care, by means of a cluster randomised controlled trial. All residential units with at least 12-h a day staff support (n = 23) were invited to participate. Quality of care was assessed with the Quality Indicator for Rehabilitative Care (QuIRC) filled online by the unit's manager. Half the units (n = 12) were randomly assigned to continue providing treatment as usual, and half (n = 11) received a staff-training intervention that focused on skills for engaging service users in activities, with trainers working alongside staff to embed this learning in the service. The primary outcome was service users' level of activity (measured with the Time Use Diary), reassessed at 4 and 8 months. Secondary outcomes were the quality of care provided (QuIRC), and service users' quality of life (Manchester Short Assessment of Quality of Life) reassessed at 8 months. Generalized linear mixed effect models were used to assess the difference in outcomes between units in the two trial arms. The trial was registered with Current Controlled Trials (Ref NCT02366117). Knowledge acquired by the staff during the initial workshops increased significantly (p ≤ 0.01). However, the intervention and comparison units did not differ significantly in primary and secondary outcomes at either follow-up. The intervention increased the level of knowledge of staff without leading to an improvement in service users' engagement in activities, quality of life, or quality of care in the units.

Improving patient experience in a pediatric ambulatory clinic: a mixed method appraisal of service delivery

PubMed Central

Soeteman, Marijn; Peters, Vera; Busari, Jamiu O

2015-01-01

Objective In 2013, customer satisfaction surveys showed that patients were unhappy with the services provided at our ambulatory clinic. In response, we performed an appraisal of our services, which resulted in the development of a strategy to reduce waiting time and improve quality of service. Infrastructural changes to our clinic’s waiting room, consultation rooms, and back offices were performed, and schedules were redesigned to reduce wait time to 10 minutes and increase consultation time to 20 minutes. Our objective was to identify if this would improve 1) accessibility to caregivers and 2) quality of service and available amenities. Design We conducted a multi-method survey using 1) a patient flow analysis to analyze the flow of service and understand the impact of our interventions on patient flow and 2) specially designed questionnaires to investigate patients’ perceptions of our wait time and how to improve our services. Results The results showed that 79% of our respondents were called in to see a doctor within 20 minutes upon arrival. More patients (55%) felt that 10–20 minutes was an acceptable wait time. We also observed a perceived increase in satisfaction with wait time (94%). Finally, a large number of patients (97%) were satisfied with the quality of service and with the accessibility to caregivers (94%). Conclusion The majority of our patients were satisfied with the accessibility to our ambulatory clinics and with the quality of services provided. The appraisal of our operational processes using a patient flow analysis also demonstrated how this strategy could effectively be applied to investigate and improve quality of service in patients. PMID:25848303

The attendees' view of quality in community-based day centre services for people with psychiatric disabilities.

PubMed

Lundqvist, Lars-Olov; Ivarsson, Ann-Britt; Rask, Mikael; Brunt, David; Schröder, Agneta

2018-05-01

Community-based day centres in Sweden are well-established arenas for psychiatric rehabilitation, but little is known of the attendees' perception of the quality of the service provided. The aim of the study was thus to describe and investigate the quality of the services in community-based day centre for people with psychiatric disabilities. A sample of 218 attendees in 14 community-based day centre services in Sweden completed the Quality in Psychiatric Care - Daily Activities (QPC-DA). The results showed that people with psychiatric disabilities perceived the quality of community-based day centre services as high. Most notably, quality of service was rated higher by those with lower educational level, had waited shorter time to attend the centre, and had better mental and physical health. However, particularly aspects of a secluded environment and participation (information) may be areas with potential for improvement. From an occupational science perspective, the results adhere to the importance of occupational balance, with periods of rest/privacy during the time at the centre.

[Evaluation of quality of service in Early Intervention: A systematic review].

PubMed

Jemes Campaña, Inmaculada Concepción; Romero-Galisteo, Rita Pilar; Labajos Manzanares, María Teresa; Moreno Morales, Noelia

2018-06-07

Early Intervention (EI), as a paediatric service, has the duty of quantifying the results and the quality of its services provided. The accessibility of valid and reliable tools allows professionals to evaluate the quality of these services. The aim of this study is to review the scientific literature on tools used to measure the methodological and service quality in EI. A search was made in different databases: Medline (from PubMed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC and Scielo. The methodological quality of the studies was tested using the COSMIN scale. A total of 13 manuscripts met the criteria to be included in this review. Ten of them received a "good" or "reasonable" score based on the COSMIN scale. Despite its importance, there is no consensus among authors on the measurement of service quality in EI. It is often the family of the children attended in EI that are considered the target to study, although the opinion of professionals carries more weight and completes the information. Copyright © 2018. Publicado por Elsevier España, S.L.U.

[Validating an instrument for measuring the perceived quality of services received by people using hospitals in Colombia].

PubMed

Cabrera-Arana, Gustavo A; Londoño-Pimienta, Jaime L; Bello-Parías, León D

2008-01-01

Validating an instrument for measuring the perceived quality of services received by people using hospitals forming part of the Colombian Ministry of Social Protection's restructuring, redesigning and modernisation programme for health-service providing networks. Sánchez and Echeverri's guidelines for validating health quality measurement scales were followed due to the lack of a valid instrument for doing this in Colombia. Conceptual synthesis led to identifying a structure of constituent indicators, domains and sub-domains regarding the perception of health service quality. A list of reactions (having a scale for categorising the replies) was analysed according to the validity of appearance, construct, criteria and utility as criteria for sensitivity and usefulness. Successive revisions and three rounds of field-trials led to producing PECASUSS, an acronym given to the instrument for measuring users' perception of health service quality (Percepción de Calidad Según Usuarios de Servicios de Salud). The guidelines effectively orientated the validation of the instrument required for measuring the perceived quality of health services received by people using hospitals forming part of the programme.

Service models and realization of differentiated services networks

NASA Astrophysics Data System (ADS)

Elizondo, Antonio J.; Garcia Osma, Maria L.; Einsiedler, Hans J.; Roth, Rudolf; Smirnov, Michael I.; Bartoli, Maurizio; Castelli, Paolo; Varga, Balazs; Krampell, Magnus

2001-07-01

Internet Service Providers need to offer Quality of Service (QoS) to fulfil the requirements of applications of their customers. Moreover, in a competitive market environment costs must be low. The selected service model must be effective and low in complexity, but it should still provide high quality and service differentiation, that the current Internet is not yet capable to support. The Differentiated Services (DiffServ) Architecture has been proposed for enabling a range of different Classes of Service (CoS). In the EURESCOM project P1006 several European service providers co-operated to examine various aspects involved in the introduction of service differentiation using the DiffServ approach. The project explored a set of service models for Expedited Forwarding (EF) and Assured Forwarding (AF) and identified requirements for network nodes. Besides, we addressed also measurement issues, charging and accounting issues. Special attention has been devoted to requirements of elastic traffic that adapts its sending rate to congestion state and available bandwidth. QoS mechanisms must prove Transmission Control Protocol (TCP) friendliness. TCP performance degrades under multiple losses. Since RED based queue management may still cause multiple discards, a modified marking scheme called Capped Leaky Bucket is proposed to improve the performance of elastic applications.

Linguistic and Cultural Barriers to Care

PubMed Central

Ngo-Metzger, Quyen; Massagli, Michael P; Clarridge, Brian R; Manocchia, Michael; Davis, Roger B; Iezzoni, Lisa I; Phillips, Russell S

2003-01-01

CONTEXT Primarily because of immigration, Asian Americans are one of the fastest growing and most ethnically diverse minority groups in the United States. However, little is known about their perspectives on health care quality. OBJECTIVE To examine factors contributing to quality of care from the perspective of Chinese- and Vietnamese-American patients with limited English language skills. DESIGN Qualitative study using focus groups and content analysis to determine domains of quality of care. SETTING Four community health centers in Massachusetts. PARTICIPANTS A total of 122 Chinese- and Vietnamese-American patients were interviewed in focus groups by bilingual interviewers using a standardized, translated moderator guide. MAIN OUTCOME MEASURES Domains of quality of care mentioned by patients in verbatim transcripts. RESULTS In addition to dimensions of health care quality commonly expressed by Caucasian, English-speaking patients in the United States, Chinese- and Vietnamese-American patients with limited English proficiency wanted to discuss the use of non-Western medical practices with their providers, but encountered significant barriers. They viewed providers' knowledge, inquiry, and nonjudgmental acceptance of traditional Asian medical beliefs and practices as part of quality care. Patients also considered the quality of interpreter services to be very important. They preferred using professional interpreters rather than family members, and preferred gender-concordant translators. Furthermore, they expressed the need for help in navigating health care systems and obtaining support services. CONCLUSIONS Cultural and linguistically appropriate health care services may lead to improved health care quality for Asian-American patients who have limited English language skills. Important aspects of quality include providers' respect for traditional health beliefs and practices, access to professional interpreters, and assistance in obtaining social services. PMID:12534763

Factors influencing private health providers' technical quality of care for acute respiratory infections among under-five children in rural West Bengal, India.

PubMed

Chakraborty, Sarbani; Frick, Kevin

2002-11-01

In many developing countries, private health practitioners provide a significant portion of curative care for diseases which are of public health importance. Currently, health sector reform efforts in these countries are fostering increased participation of private providers in the delivery of health services, including those of public health importance. Guaranteeing good technical quality of care is critical to the process. However, little is known about private providers' technical quality of care (disease management practices) and the factors influencing these services. The purpose of this study was to contribute information on this topic. The study was conducted among private providers in rural West Bengal, India and focused on providers' disease management practices for acute respiratory infections (ARI) among under-five children. World Health Organization (WHO) guidelines for ARI case management were used as the expected standard of care. Observations of patient-provider encounters and interviews with the providers and mothers were the main sources of data. The study found that private health providers in rural West Bengal have inadequate technical quality of care. The problem was related both to low levels of performance (limited potential) and inconsistency in performance (within-provider variation). Limited potential for good technical quality for ARI among the providers was related to lack of knowledge (technical incompetence). One of the important factors influencing within-provider variation was patient load. Since rural private providers operate on a fee-for-service payment system, there are incentives related to seeing many patients. The study concluded that to bring about sustainable improvements in private providers' ARI disease management practices, training programs and interventions that improved compliance were necessary.

Determination of Appropriate Service Delivery Level for Quantitative Attributes of Household Toilets in Rural Settlements of India from Users' Perspective

NASA Astrophysics Data System (ADS)

Rashid, Mohammad; Pandit, Debapratim

2018-04-01

Improvement of quality of sanitation services in rural settlements is an important development goal in developing countries including India and accordingly several strategies are adopted which promote the demand and use of household toilets through creating awareness and providing subsidies to poor people for construction of household toilets with service-level standards specified from experts' perspective. In many cases, users are unsatisfied with the quality of toilets constructed using subsidies and the same remain unused. Users' satisfaction depends on their perceptions of service quality of individual attributes and overall service quality of the household toilets, which is an important determinant of sustainability and sustained use of toilets. This study aims to assess and benchmark the appropriate service delivery level for quantitative attributes of rural household toilets based on user perception. The service quality is determined with the help of level of service (LOS) scales developed using successive interval scaling technique, the zone of tolerance (ZOT), and users satisfaction level (USL) which relates service delivery levels with user satisfaction directly. The study finds that the service quality of most of the attributes of household toilets constructed using subsidies is perceived as poor. The results also suggest that most of the users expect to have a toilet with the service level of attributes ranging between LOS A and LOS B.

Determination of Appropriate Service Delivery Level for Quantitative Attributes of Household Toilets in Rural Settlements of India from Users' Perspective.

PubMed

Rashid, Mohammad; Pandit, Debapratim

2018-04-01

Improvement of quality of sanitation services in rural settlements is an important development goal in developing countries including India and accordingly several strategies are adopted which promote the demand and use of household toilets through creating awareness and providing subsidies to poor people for construction of household toilets with service-level standards specified from experts' perspective. In many cases, users are unsatisfied with the quality of toilets constructed using subsidies and the same remain unused. Users' satisfaction depends on their perceptions of service quality of individual attributes and overall service quality of the household toilets, which is an important determinant of sustainability and sustained use of toilets. This study aims to assess and benchmark the appropriate service delivery level for quantitative attributes of rural household toilets based on user perception. The service quality is determined with the help of level of service (LOS) scales developed using successive interval scaling technique, the zone of tolerance (ZOT), and users satisfaction level (USL) which relates service delivery levels with user satisfaction directly. The study finds that the service quality of most of the attributes of household toilets constructed using subsidies is perceived as poor. The results also suggest that most of the users expect to have a toilet with the service level of attributes ranging between LOS A and LOS B.

Quality Assurance Framework for Mini-Grids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baring-Gould, Ian; Burman, Kari; Singh, Mohit

Providing clean and affordable energy services to the more than 1 billion people globally who lack access to electricity is a critical driver for poverty reduction, economic development, improved health, and social outcomes. More than 84% of populations without electricity are located in rural areas where traditional grid extension may not be cost-effective; therefore, distributed energy solutions such as mini-grids are critical. To address some of the root challenges of providing safe, quality, and financially viable mini-grid power systems to remote customers, the U.S. Department of Energy (DOE) teamed with the National Renewable Energy Laboratory (NREL) to develop a Qualitymore » Assurance Framework (QAF) for isolated mini-grids. The QAF for mini-grids aims to address some root challenges of providing safe, quality, and affordable power to remote customers via financially viable mini-grids through two key components: (1) Levels of service: Defines a standard set of tiers of end-user service and links them to technical parameters of power quality, power availability, and power reliability. These levels of service span the entire energy ladder, from basic energy service to high-quality, high-reliability, and high-availability service (often considered 'grid parity'); (2) Accountability and performance reporting framework: Provides a clear process of validating power delivery by providing trusted information to customers, funders, and/or regulators. The performance reporting protocol can also serve as a robust monitoring and evaluation tool for mini-grid operators and funding organizations. The QAF will provide a flexible alternative to rigid top-down standards for mini-grids in energy access contexts, outlining tiers of end-user service and linking them to relevant technical parameters. In addition, data generated through implementation of the QAF will provide the foundation for comparisons across projects, assessment of impacts, and greater confidence that will drive investment and scale-up in this sector. The QAF implementation process also defines a set of implementation guidelines that help the deployment of mini-grids on a regional or national scale, helping to insure successful rapid deployment of these relatively new remote energy options. Note that the QAF is technology agnostic, addressing both alternating current (AC) and direct current (DC) mini-grids, and is also applicable to renewable, fossil-fuel, and hybrid systems.« less

Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh

PubMed Central

Saha, Kuntal Kumar; Chowdhury, Ashfaqul Haq; Garnett, Sarah P.; Arifeen, Shams El; Menon, Purnima

2017-01-01

Background In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS) by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC) and management of sick children younger than five years. Methods Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children. Results Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19%) healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average. Conclusions Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should be considered to identify alternative and appropriate service delivery platforms before nationwide scale up. PMID:28542530

Influence of Security Mechanisms on the Quality of Service of VoIP

NASA Astrophysics Data System (ADS)

Backs, Peter; Pohlmann, Norbert

While Voice over IP (VoIP) is advancing rapidly in the telecommunications market, the interest to protect the data transmitted by this new service is also rising. However, in contrast to other internet services such as email or HTTP, VoIP is real-time media, and therefore must meet a special requirement referred to as Quality-of-Service to provide a comfortable flow of speech. Speech quality is worsened when transmitted over the network due to delays in transmission or loss of packets. Often, voice quality is at a level that even prevents comprehensive dialog. Therefore, an administrator who is to setup a VoIP infrastructure might consider avoiding additional decreases in voice quality resulting from security mechanisms, and might leave internet telephony unprotected as a result. The inspiration for this paper is to illustrate that security mechanisms have negligible impact on speech quality and should in fact be encouraged.

Convenience, quality and choice: Patient and service-provider perspectives for treating primary care complaints in urgent care settings.

PubMed

Sturgeon, David

2017-11-01

To investigate why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice. Since the 1980's, healthcare organisations in the UK and elsewhere have implemented an increasingly consumer-orientated model of healthcare provision. As a result, patients with non-urgent presentations are attending Emergency Departments (EDs) and other urgent care facilities in growing numbers. A comparative case study approach was adopted and between October 2014 and May 2015 the researcher was embedded as a participant observer as part of the emergency nurse practitioner team at two, nurse-led, MIUs (site A and B). During this time, 40 patients, 17 service-providers and 1 senior manager were interviewed. Patients and service-providers at both sites identified convenience and quality of care as the principle reasons patients presented for primary healthcare services at MIUs rather than their GP practice. Service-providers were aware that by providing treatment, they established a precedent and a sense of expectation for future care. Patients are acting rationally and predictably in response to healthcare policy promises regarding choice, expectation created by service-providers, and local demographic factors. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Measuring quality in services for children with an intellectual disability.

PubMed

Koornneef, Erik

2006-01-01

To evaluate the application of one particular quality measurement tool, the SERVQUAL instrument, as a potential mechanism to measure quality in services for children with disabilities Staff and family of children with an intellectual disability in two organisations providing specialist therapy and day completed an adapted SERVQUAL questionnaire. A total of 81 SERVQUAL questionnaires were distributed and 59 questionnaires were returned (response rate of 73 per cent). The SERVQUAL instrument can be considered as a useful diagnostic tool to identify particular strengths and areas for improvement in services for people with disabilities as the instrument lends itself for the monitoring of the effectiveness of quality improvement initiatives over time. The findings also showed relatively high customer expectations and the organisations involved in this research are currently not meeting all of these high expectations as significant quality gaps were found in the areas of reliability and responsiveness. The sample size was relatively small and the measurement of quality using the SERVQUAL instrument remains a challenge, due to the conceptual and empirical difficulties. The SERVQUAL instrument is probably most be attractive to service managers and funding organisations because of its ability to identify gaps in the quality of the service. The tool had been used to measure quality in services for people with disabilities and the research has shown that this tool might be an important additional quality measurement tool for services.

Towards quality indicators for assertive outreach programmes for severely impaired substance abusers: concept mapping with Dutch experts.

PubMed

Roeg, Diana; van de Goor, Ien; Garretsen, Henk

2005-06-01

We investigated the concept of 'quality of assertive outreach programmes for severely impaired substance abusers' with the aim of developing a conceptual framework as the basis for an assessment instrument. We held a concept-mapping session with 13 experts in 2003. Fifty measurable elements of quality were mentioned and rated in terms of relative importance on a Likert-type response scale. Subsequently, the experts grouped the statements that were similar in content. The resulting concept map and additional interpretation made up the final quality framework. SETTING/STUDY PARTICIPANTS: Theoretical sampling was used to select Dutch managers, team leaders, and service providers from different assertive outreach delivery systems for substance abusers. Variation in both perspective and region was reflected in the sample. Nine aspects of quality were formulated: preconditions for care, preconditions for service providers' work, relationship to regular care, service providers' activities and goals, service providers' skills, the role of repression, optimal care for the client, goals of assertive outreach, and nuisance reduction to society. Each aspect was presented using a selection of measurable elements. According to the experts, optimal assertive outreach depends on a broad range of aspects that were later classified in three regions: structure, process, and outcomes. Saturation of the elements has not been proved so far. Nevertheless, it is promising that the framework's regions are supported by theory and that it is largely in accordance with clients' perspectives on assertive community treatment.

Leveraging the real value of laboratory medicine with the value proposition.

PubMed

Price, Christopher P; John, Andrew St; Christenson, Robert; Scharnhorst, Volker; Oellerich, Michael; Jones, Patricia; Morris, Howard A

2016-11-01

Improving quality and patient safety, containing costs and delivering value-for-money are the key drivers of change in the delivery of healthcare and have stimulated a shift from an activity-based service to a service based on patient-outcomes. The delivery of an outcomes-based healthcare agenda requires that the real value of laboratory medicine to all stakeholders be understood, effectively defined and communicated. The value proposition of any product or service is the link between the provider and the needs of the customer describing the utility of the product or service in terms of benefit to the customer. The framework of a value proposition for laboratory medicine provides the core business case that drives key activities in the evolution and maintenance of high quality healthcare from research through to adoption and quality improvement in an established service. The framework of a value proposition for laboratory medicine is described. The content is endorsed by IFCC and WASPaLM. Copyright © 2016 Elsevier B.V. All rights reserved.

Quality improvement in physiotherapy services.

PubMed

Boak, George; Sephton, Ruth; Hough, Elaine; Ten Hove, Ruth

2017-06-12

Purpose The purpose of this paper is to evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes. Design/methodology/approach This is a multiple case study and information was gathered from eight physiotherapy teams over 24 months. Findings The process change was successfully implemented in six teams. It had a clear, positive effect on service quality provided to patients in three teams. Whilst quality also improved in three other teams, other issues make changes difficult to assess. Factors that enabled process change to be effective are suggested. Research limitations/implications The findings are based on results achieved by only eight English teams. Practical implications This process change may be appropriate for other teams providing therapy services if attention is paid to potential enabling factors, and a learning approach is adopted to designing and introducing the change. Originality/value To the best of the authors' knowledge, no other longitudinal process change study in therapy services has been published.

Quality of Service in Networks Supporting Cultural Multimedia Applications

ERIC Educational Resources Information Center

Kanellopoulos, Dimitris N.

2011-01-01

Purpose: This paper aims to provide an overview of representative multimedia applications in the cultural heritage sector, as well as research results on quality of service (QoS) mechanisms in internet protocol (IP) networks that support such applications. Design/methodology/approach: The paper's approach is a literature review. Findings: Cultural…

The Technical Writer in the Global Marketplace.

ERIC Educational Resources Information Center

Ronayne, Deborah Washburn

The International Standards Organization (ISO) has developed standards to provide a uniform framework for quality assurance in organizations' products and services. Commonly referred to as ISO 9000, these standards focus on achieving and sustaining the quality of the product or service produced to continuously meet purchasers' needs, and give…

76 FR 21746 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Agency... of Qualitative Feedback on Agency Service Delivery AGENCY: Agency for Healthcare Research and Quality... quantitative results that can be generalized to the population of study. This feedback will provide insights...

76 FR 30715 - Information Collection Being Reviewed by the Federal Communications Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-26

... technology; and (e) ways to further reduce the information collection burden on small business concerns with...: Business or other for-profit. Number of Respondents and Responses: 48 respondents; 63 responses. Estimated... designed to capture trends in service quality under price cap regulation. It provides service quality...

[Comment on "La Calidad de Atencion en la Provision de Servicios Clinicos" of Juan Diaz and Hans Halbe].

PubMed

Trias, M

1990-12-01

Rather than a commentary on a specific article, this work contains reflections on the concept of quality in provision of family planning services and its possible use to deflect family planning efforts. Quality is a difficult concept to define precisely. Applied to family planning, it may be defined as the totality of attributes possessed by a program that does not place impediments in the way of comfortable adoption of a contraceptive method. Another definition of quality, achievable only by a long list of ideal characteristics which are often expensive and sometimes unattainable, has been and continues to be used by enemies of family planning to slow its diffusion; they hold that if perfect quality is not offered, it is better to offer nothing. A specific tactic of this group is to oppose the quantity of services with their quality. The hard-fought campaign to discredit the measurement of concrete goals and results is part of this strategy. But it is apparent that without a reasonably satisfactory quality of service, no program would achieve significant growth. People would not continue to come, and in growing numbers, to a program where they received poor quality service. Each goal, each statistic, each percentage represents human problems confronted and resolved by programs and personnel. Profamilia has become 1 of the largest nongovernmental family planning organizations. Profamilia has always paid attention to the quality of its services and has conducted numerous studies to assess results and identify shortcomings. The high percentage of positive results attests to the quality of Profamilia programs. In an age of scarce resources and tight budgets, the objective of family planning programs is to provide an austere but acceptable quality of attention so that the quantity of services will be sufficient to meet demand. Program elements that have a real cost without offering a measurable benefit should be avoided. Another problem is that integrated programs that aim to combine family planning with maternal-child health or other services often end by neglecting the family planning component. Profamilia believes that good information should be provided with services, but it is limited to what is needed for proper and safe use of each method. And integration is not presently needed to disguise or dress up family planning programs. It is justifiable only when for political reasons there is no alternative or when it can provide other resources to subsidize family planning programs.

Regional and supraregional biochemistry services in Scotland: a survey of hospital laboratory users.

PubMed Central

Murphy, M J; Dryburgh, F J; Shepherd, J

1994-01-01

AIM--To ascertain the views of Scottish hospital laboratory users on aspects of regional and supraregional biochemical services offered by the Institute of Biochemistry at Glasgow Royal Infirmary. METHODS--A questionnaire was circulated asking questions or inviting opinions under various headings, including current patterns of usage of the services provided, availability of information on specimen collection requirements and reference ranges, current arrangements for transport of specimens, turnaround times for delivery of reports, layout and content of request and report forms, quantity and quality of interpretive advice, potential changes in laboratory services, and overall impression of the services provided. Opportunities were provided for free text comment. The questionnaire was circulated in 1992 to heads of department in 23 Scottish hospital biochemistry laboratories. RESULTS--Twenty one replies were received. Services used widely included trace metals/vitamins (n = 20) and specialised endocrine tests (n = 19). Other services also used included specialised lipid tests (n = 13), toxicology (n = 12), thyroid function tests (n = nine), and tumour markers (n = eight). Fifteen laboratories used one or more of the services at least weekly. Most (n = 20) welcomed the idea of a handbook providing information on specimen collection and reference ranges. Nine identified loss of specimens as a problem. Other perceived problems included the absence of reference ranges from report forms, quantity and quality of interpretive advice, and turnaround times of some tests. Overall impressions of the service(s) offered were very good (n = 12); adequate (n = seven); poor (n = one). CONCLUSIONS--Useful information was obtained about patterns of use and transport arrangements. Areas identified as requiring follow up included provision of information, alternative ways of communicating reports, and improvement in quantity and quality of interpretive advice. PMID:8027390

Evaluating Service Quality from Patients' Perceptions: Application of Importance-performance Analysis Method.

PubMed

Mohebifar, Rafat; Hasani, Hana; Barikani, Ameneh; Rafiei, Sima

2016-08-01

Providing high service quality is one of the main functions of health systems. Measuring service quality is the basic prerequisite for improving quality. The aim of this study was to evaluate the quality of service in teaching hospitals using importance-performance analysis matrix. A descriptive-analytic study was conducted through a cross-sectional method in six academic hospitals of Qazvin, Iran, in 2012. A total of 360 patients contributed to the study. The sampling technique was stratified random sampling. Required data were collected based on a standard questionnaire (SERVQUAL). Data analysis was done through SPSS version 18 statistical software and importance-performance analysis matrix. The results showed a significant gap between importance and performance in all five dimensions of service quality (p < 0.05). In reviewing the gap, "reliability" (2.36) and "assurance" (2.24) dimensions had the highest quality gap and "responsiveness" had the lowest gap (1.97). Also, according to findings, reliability and assurance were in Quadrant (I), empathy was in Quadrant (II), and tangibles and responsiveness were in Quadrant (IV) of the importance-performance matrix. The negative gap in all dimensions of quality shows that quality improvement is necessary in all dimensions. Using quality and diagnosis measurement instruments such as importance-performance analysis will help hospital managers with planning of service quality improvement and achieving long-term goals.

Family-centred service coordination in childhood health and disability services: the search for meaningful service outcome measures.

PubMed

Trute, B; Hiebert-Murphy, D; Wright, A

2008-05-01

Potential service outcome measures were tested for their utility in the assessment of the quality of 'family centred' service coordination in the provincial network of children's disability services in Manitoba, Canada. This study is based on in-home survey data provided by 103 mothers at 6 and 18 months following assignment of a 'dedicated' service coordinator. Service outcome indicators included measures of parent self-esteem, parenting stress, family functioning and the need for family support resources. Hierarchical regression analyses showed no relationship between level of quality of family-centred service coordination and standardized psychosocial measures of parent and family functioning. However, family centredness of service coordination was found to predict significant reduction in level of family need for psychosocial support resources after 18 months of contact with a service coordinator. Outcome measures that are focused on specific and tangible results of service coordination appear to be of higher utility in service quality assessment than are more global, standardized measures of parent and family functioning.

CSI Index Of Customer's Satisfaction Applied In The Area Of Public Transport

NASA Astrophysics Data System (ADS)

Poliaková, Adela

2015-06-01

In Western countries, the new visions are applied in quality control for an integrated public transport system. Public transport puts the customer at the centre of our decision making in achieving customer satisfaction with provided service. Sustainable surveys are kept among customers. A lot of companies are collecting huge databases containing over 30,000 voices of customers, which demonstrates the current satisfaction levels across the public transport service. Customer satisfaction with a provided service is a difficult task. In this service, the quality criteria are not clearly defined, and it is therefore difficult to define customer satisfaction. The paper introduces a possibility of CSI index application in conditions of the Slovak Republic transport area.

Quality in Family Child Care Networks: An Evaluation of All Our Kin Provider Quality

ERIC Educational Resources Information Center

Porter, Toni; Reiman, Kayla; Nelson, Christina; Sager, Jessica; Wagner, Janna

2016-01-01

This article presents findings from a quasi-experimental evaluation of quality with a sample of 28 family child care providers in the All Our Kin Family Child Care Network, a staffed family child care network which offers a range of services including relationship-based intensive consultation, and 20 family child care providers who had no…

Value-Based Payment Reform and the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015: A Primer for Plastic Surgeons.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.

Measuring service quality and its relationship to future consumer behavior.

PubMed

Headley, D E; Miller, S J

1993-01-01

The authors adapt the SERVQUAL scale for medical care services and examine it for reliability, dimensionality, and validity in a primary care clinic setting. In addition, they explore the possibility of a link between perceived service quality--and its various dimensions--and a patient's future intent to complain, compliment, repeat purchase, and switch providers. Findings from 159 matched-pair responses indicate that the SERVQUAL scale can be adapted reliably to a clinic setting and that the dimensions of reliability, dependability, and empathy are most predictive of a patient's intent to complain, compliment, repeat purchase, and switch providers.

Capacity and readiness for quality improvement among home and community-based service providers.

PubMed

Abrahamson, Kathleen; Myers, Jaclyn; Arling, Greg; Davila, Heather; Mueller, Christine; Abery, Brian; Cai, Yun

2016-01-01

The objective of this study was to explore home and community-based service (HCBS) providers' perspectives of organizational readiness for quality improvement (QI). Data were obtained from a survey of participants (N = 56) in a state-sponsored HCBS QI initiative. Quality improvement challenges included lack of time and resources, staff apprehension or resistance, resistance from consumers and families, and project sustainability. Support from leadership was viewed as an important factor in participating organizations' decision to engage in QI. Internal resources available to support QI varied widely between participating organizations, with differences observed between smaller and larger agencies, as well as between provider types and populations served.

Multi-Agent Architecture with Support to Quality of Service and Quality of Control

NASA Astrophysics Data System (ADS)

Poza-Luján, Jose-Luis; Posadas-Yagüe, Juan-Luis; Simó-Ten, Jose-Enrique

Multi Agent Systems (MAS) are one of the most suitable frameworks for the implementation of intelligent distributed control system. Agents provide suitable flexibility to give support to implied heterogeneity in cyber-physical systems. Quality of Service (QoS) and Quality of Control (QoC) parameters are commonly utilized to evaluate the efficiency of the communications and the control loop. Agents can use the quality measures to take a wide range of decisions, like suitable placement on the control node or to change the workload to save energy. This article describes the architecture of a multi agent system that provides support to QoS and QoC parameters to optimize de system. The architecture uses a Publish-Subscriber model, based on Data Distribution Service (DDS) to send the control messages. Due to the nature of the Publish-Subscribe model, the architecture is suitable to implement event-based control (EBC) systems. The architecture has been called FSACtrl.

Perceived Self-Efficacy of Licensed Counselors to Provide Substance Abuse Counseling

ERIC Educational Resources Information Center

Chandler, Nichelle; Balkin, Richard S.; Perepiczka, Michelle

2011-01-01

This nationwide, quantitative study documented licensed counselors' perceived self-efficacy of adequately providing substance abuse services. Despite their lack of substance abuse training, counselors were highly confident in their ability to provide quality substance abuse services. Counselor training implications are discussed. (Contains 3…

An evaluation of the quality of Emergency Nurse Practitioner services for patients presenting with minor injuries to one rural urgent care centre in the UK: a descriptive study.

PubMed

McDevitt, Joe; Melby, Vidar

2015-02-01

To evaluate the quality of the emergency nurse practitioner service provided to people presenting to a rural urgent care centre with minor injuries. The three objectives that were focused were an evaluation of the safety and effectiveness of the emergency nurse practitioner service, an assessment of patients' satisfaction with the emergency nurse practitioner service and a determination of factors that may enhance the quality of the emergency nurse practitioner service. Urgent care centres have become increasingly prevalent across the UK. Emergency nurse practitioner services at these rural urgent care centres remain largely unevaluated. This study attempts to redress this deficit by evaluating the quality of an emergency nurse practitioner service in relation to the care of patients presenting with minor injuries to a rural urgent care centre. This descriptive study used a case-note review and a survey design with one open-ended exploratory question. Patient views were collected using a self-completed questionnaire and a data extraction tool to survey patients' case notes retrospectively. Despite comparatively low total length-of-stay times, most patients felt they had enough time to discuss things fully with the emergency nurse practitioner. Although emergency nurse practitioners routinely impart injury advice, feedback from some patients suggests a need for the provision of more in-depth information regarding their injury. The vast majority (97·3%) of patients felt that the quality of the emergency nurse practitioner service was of a high standard. Contrary to some other studies, the findings in this study indicate that patient satisfaction is not influenced by waiting times. Emergency nurse practitioners in rural urgent care centres have the potential to deliver a safe and effective quality service that is reflected in high levels of patient satisfaction. This study provides some evidence to support the continued expansion of the emergency nurse practitioner service in rural settings in the UK. © 2014 John Wiley & Sons Ltd.

Provider and service-user perspectives of volunteer health-worker service provision in Ayeyarwady Region, Myanmar: a qualitative study.

PubMed

Watt, Nicola; Yupar, Aye; Sender, Paul; Campbell, Fiona; Legido-Quigley, Helena; Howard, Natasha

2016-12-09

To explore perspectives and reported experiences of service users, community providers and policymakers related to volunteer health-worker services provision in a rural area of Myanmar. A qualitative interview study was conducted in rural communities with 54 service users and 17 community providers in Ayeyarwady Region, Myanmar, and with 14 national managers and policymakers in Yangon Myanmar. Topics included reasons for seeking health services, views and experiences, and comparison with experiences of other services. Data were analysed thematically using deductive and inductive coding. Accessibility and affordability were important to all participants. Service users described the particular relevance of trust, familiarity and acceptability in choosing a provider. Perceived quality and effectiveness were necessary for trust to develop. Perceived value of volunteers was a cross-cutting dimension, which was interpreted differently by different participants. Results suggest that volunteers are appropriate and valued, and support 'availability', 'accessibility' and 'acceptability' as dimensions of health services access in this setting. However, social complexities should be considered to ensure effective service delivery. Further research into trust-building, developing quality perceptions and resulting service-user choices would be useful to inform effective policy and planning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Assessing and changing organizational social contexts for effective mental health services.

PubMed

Glisson, Charles; Williams, Nathaniel J

2015-03-18

Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness.

Determining Level of Service for Multilane Median Opening Zone

NASA Astrophysics Data System (ADS)

Ali, Paydar; Johnnie, Ben-Edigbe

2017-08-01

The road system is a capital-intensive investment, requiring thorough schematic framework and funding. Roads are built to provide an intrinsic quality of service which satisfies the road users. Roads that provide good services are expected to deliver operational performance that is consistent with their design specifications. Level of service and cumulative percentile speed distribution methods have been used in previous studies to estimate the quality of multilane highway service. Whilst the level of service approach relies on speed/flow curve, the cumulative percentile speed distribution is based solely speed. These estimation methods were used in studies carried out in Johor Malaysia. The aim of the studies is to ascertain the extent of speed reduction caused by midblock U-turn facilities as well as verify which estimation method is more reliable. At selected sites, road segments for both directional flows were divided into free-flow and midblock zones. Traffic volume, speed and vehicle type data for each zone were collected continuously for six weeks. Both estimation methods confirmed that speed reduction would be caused by midblock u-turn facilities. However level of service methods suggested that the quality of service would improve from level F to E or D at midblock zone in spite of speed reduction. Level of service was responding to traffic volume reduction at midblock u-turn facility not travel speed reduction. The studies concluded that since level of service was more responsive to traffic volume reduction than travel speed, it cannot be solely relied upon when assessing the quality of multilane highway service.

The quality of service in passenger transport terminals

NASA Astrophysics Data System (ADS)

Oprea, C.; Roşca, E.; Popa, M.; Ilie, A.; Dinu, O.; Roşca, M.

2016-11-01

The quality of service in transport terminals is differently perceived by engineers, economists, transport operators and sociologists. The traveler's perception is nevertheless decisive. The quality of service is well connected with the inside design of terminals, with the facilities in terminals and with the provided service standards. In order to provide a high level of service, the activities taking place in the public transport terminal and the maximum travelers flow size must be carefully analyzed and dimensioned. The purpose of modelling is to find the best route for each traveler from origin (entrance) to destination (exit) through all the intermediate service points, taking into consideration the instant network conditions. In developing the model we consider the walking, the waiting and the serving time. Using a simulation program written in ARENA we determine the waiting time. For validation, the model is used to evaluate the performance level in Bucharest Basarab station. By comparing the total walking distance for the possible routes and the utility function that describes the utility of all activities from entrance to exit we can find the optimal route.

Development of service-oriented products based on the inverse manufacturing concept.

PubMed

Fujimoto, Jun; Umeda, Yasushi; Tamura, Tetsuya; Tomiyama, Tetsuo; Kimura, Fumihiko

2003-12-01

To achieve sustainability, resource consumption and waste generation must be drastically decreased. For societal acceptance, preservation of both quality of life and corporate profits are essential. One promising approach is to shift the source of value from the amount of product sold to the quality of services the product provides. This paper describes the need for redesigning recycling systems from a manufacturing perspective and then discusses the possibility of this "servicification" of products, describing our experience with prototype development. We discuss development of product prototypes and their business, using consumer facsimile machines as an example of "service-oriented products". Traditional thought presumes that only products comprising new materials and components are valuable. Consideration of a service-oriented product can serve as a stimulus to revise this mode of thought and to control delivery and quality of disposed products. This paper also provides a life cycle simulation of the developed service-oriented business. Simulation results indicate that service-oriented business can potentially reduce environmental impact while extending business opportunities from the viewpoint of whole product life cycles.

How the Kano model contributes to Kansei engineering in services.

PubMed

Hartono, Markus; Chuan, Tan Kay

2011-11-01

Recent studies show that products and services hold great appeal if they are attractively designed to elicit emotional feelings from customers. Kansei engineering (KE) has good potential to provide a competitive advantage to those able to read and translate customer affect and emotion in actual product and services. This study introduces an integrative framework of the Kano model and KE, applied to services. The Kano model was used and inserted into KE to exhibit the relationship between service attribute performance and customer emotional response. Essentially, the Kano model categorises service attribute quality into three major groups (must-be [M], one-dimensional [O] and attractive [A]). The findings of a case study that involved 100 tourists who stayed in luxury 4- and 5-star hotels are presented. As a practical matter, this research provides insight on which service attributes deserve more attention with regard to their significant impact on customer emotional needs. STATEMENT OF RELEVANCE: Apart from cognitive evaluation, emotions and hedonism play a big role in service encounters. Through a focus on delighting qualities of service attributes, this research enables service providers and managers to establish the extent to which they prioritise their improvement efforts and to always satisfy their customer emotions beyond expectation.

Does public reporting influence quality, patient and provider's perspective, market share and disparities? A review.

PubMed

Vukovic, Vladimir; Parente, Paolo; Campanella, Paolo; Sulejmani, Adela; Ricciardi, Walter; Specchia, Maria Lucia

2017-12-01

Public reporting (PR) of healthcare (HC) provider's quality was proposed as a public health instrument for providing transparency and accountability in HC. Our aim was to assess the impact of PR on five main domains: quality improvement; patient choice, service utilization and market share; provider's perspective; patient experience; and unintended consequences. PubMed, Scopus, ISI WOS, and EconLit databases were searched to identify studies investigating relationships between PR and five main domains, published up to April 1, 2016. Sixty-two papers published between 1988 and 2015 were included. Nineteen studies investigated quality improvement, 19 studies explored the unintended consequences of PR, 10 explored the effects on market share, 10 on patients' choice, 7 evaluated the provider's perspective, 4 economic outcome, 4 service utilization, 2 purchasers' use of PR and 2 studies explored patient experiences. The effect of PR was diverse throughout the studies-mostly positive on: patient experience (100%), quality improvement (63%), patient choice, service utilization and market share (46%); mixed on provider's perspective and economic outcome (27%) and mainly negative on unintended consequences (68%). Our research covering different outcomes and settings reported that PR is associated with changes in HC provider's behavior and can influence market share. Unintended consequences are a concern of PR and should be taken into account when allocating HC resources. The experiences collected in this paper could give a snapshot about the impact of PR on a HC user's perception of the providers' quality of care, helping them to make empowered choices. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

"Tag you're it!"--providing flawless customer service in the healthcare security environment.

PubMed

Hogan, Michael V

2012-01-01

An adaptation of a childhood game as a means of providing flawless service to customers will allow security departments to increase their scope and quality of service, the author points out. Teaching our officers the concept of playing "tag, " embracing being "it" and finishing the game will provide a significant return on investment by expanding the value of our departments, he says.

The Effects of Korean Medical Service Quality and Satisfaction on Revisit Intention of the United Arab Emirates Government Sponsored Patients.

PubMed

Lee, Seoyoung; Kim, Eun-Kyung

2017-06-01

The purpose of this study was to investigate medical service quality, satisfaction and to examine factors influencing hospital revisit intention of the United Arab Emirates government sponsored patients in Korea. A total of 152 UAE government sponsored patients who visited Korean hospitals participated in the questionnaire survey from August to November 2016. Stepwise multiple regression was used to identify the factors that affected the revisit intention of the participants. The mean scores of medical service quality, satisfaction, and revisit intention were 5.72 out of 7, 88.88 out of 100, 4.59 out of 5, respectively. Medical service quality and satisfaction, Medical service quality and revisit intention, satisfaction and revisit intention were positively correlated. Medical service of physician, visiting routes and responsiveness of medical service quality explained about 23.8% of revisit intention. There are needs for physicians to communicate with patients while ensuring sufficient consultation time based on excellent medical skills and nurses to respond immediately for the patients' needs through an empathic encounter in order to improve medical service quality and patient satisfaction so that to increase the revisit intention of the United Arab Emirates government sponsored patients. Further, it is necessary for the hospitals to have support plans for providing country specialized services in consideration of the UAE culture to ensure that physicians' and nurses' competencies are not undervalued by non-medical service elements such as interpreters and meals. Copyright © 2017. Published by Elsevier B.V.

National pilot audit of intermediate care.

PubMed

Hutchinson, Tom; Young, John; Forsyth, Duncan

2011-04-01

The National Service Framework for Older People resulted in the widespread introduction of intermediate care (IC) services. However, although these services have shared common aims, there has been considerable diversity in their staffing, organisation and delivery. Concerns have been raised regarding the clinical governance of IC with a paucity of data to evaluate the effectiveness, quality and safety of these services. This paper presents the results of a national pilot audit of IC services focusing particularly on clinical governance issues. The results confirm these concerns and provide support for a larger scale national audit of IC services to monitor and improve care quality.

Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.

PubMed

Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk

2017-03-28

Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and we hope that these findings may contribute to future studies.

Performance Evaluation of Resource Management in Cloud Computing Environments.

PubMed

Batista, Bruno Guazzelli; Estrella, Julio Cezar; Ferreira, Carlos Henrique Gomes; Filho, Dionisio Machado Leite; Nakamura, Luis Hideo Vasconcelos; Reiff-Marganiec, Stephan; Santana, Marcos José; Santana, Regina Helena Carlucci

2015-01-01

Cloud computing is a computational model in which resource providers can offer on-demand services to clients in a transparent way. However, to be able to guarantee quality of service without limiting the number of accepted requests, providers must be able to dynamically manage the available resources so that they can be optimized. This dynamic resource management is not a trivial task, since it involves meeting several challenges related to workload modeling, virtualization, performance modeling, deployment and monitoring of applications on virtualized resources. This paper carries out a performance evaluation of a module for resource management in a cloud environment that includes handling available resources during execution time and ensuring the quality of service defined in the service level agreement. An analysis was conducted of different resource configurations to define which dimension of resource scaling has a real influence on client requests. The results were used to model and implement a simulated cloud system, in which the allocated resource can be changed on-the-fly, with a corresponding change in price. In this way, the proposed module seeks to satisfy both the client by ensuring quality of service, and the provider by ensuring the best use of resources at a fair price.

Performance Evaluation of Resource Management in Cloud Computing Environments

PubMed Central

Batista, Bruno Guazzelli; Estrella, Julio Cezar; Ferreira, Carlos Henrique Gomes; Filho, Dionisio Machado Leite; Nakamura, Luis Hideo Vasconcelos; Reiff-Marganiec, Stephan; Santana, Marcos José; Santana, Regina Helena Carlucci

2015-01-01

Cloud computing is a computational model in which resource providers can offer on-demand services to clients in a transparent way. However, to be able to guarantee quality of service without limiting the number of accepted requests, providers must be able to dynamically manage the available resources so that they can be optimized. This dynamic resource management is not a trivial task, since it involves meeting several challenges related to workload modeling, virtualization, performance modeling, deployment and monitoring of applications on virtualized resources. This paper carries out a performance evaluation of a module for resource management in a cloud environment that includes handling available resources during execution time and ensuring the quality of service defined in the service level agreement. An analysis was conducted of different resource configurations to define which dimension of resource scaling has a real influence on client requests. The results were used to model and implement a simulated cloud system, in which the allocated resource can be changed on-the-fly, with a corresponding change in price. In this way, the proposed module seeks to satisfy both the client by ensuring quality of service, and the provider by ensuring the best use of resources at a fair price. PMID:26555730

Adapting the SERVQUAL scale to hospital services: an empirical investigation.

PubMed Central

Babakus, E; Mangold, W G

1992-01-01

Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified. PMID:1737708

Social franchising primary healthcare clinics--a model for South African National Health Insurance?

PubMed

Robinson, Andrew Ken Lacey

2015-09-21

This article describes the first government social franchise initiative in the world to deliver a 'brand' of quality primary healthcare (PHC) clinic services. Quality and standards of care are not uniformly and reliably delivered across government PHC clinics in North West Province, South Africa, despite government support, numerous policies, guidelines and in-service training sessions provided to staff. Currently the strongest predictor of good-quality service is the skill and dedication of the facility manager. A project utilising the social franchising business model, harvesting best practices, has been implemented with the aim of developing a system to ensure reliably excellent healthcare service provision in every facility in North West. The services of social franchising consultants have been procured to develop the business model to drive this initiative. Best practices have been benchmarked, and policies, guidelines and clinic support systems have been reviewed, evaluated and assessed, and incorporated into the business plan. A pilot clinic has been selected to refine and develop a working social franchise model. This will then be replicated in one clinic to confirm proof of concept before further scale-up. The social franchise business model can provide solutions to a reliable and recognisable 'brand' of quality universal coverage of healthcare services.

Non-linear assessment and deficiency of linear relationship for healthcare industry

NASA Astrophysics Data System (ADS)

Nordin, N.; Abdullah, M. M. A. B.; Razak, R. C.

2017-09-01

This paper presents the development of the non-linear service satisfaction model that assumes patients are not necessarily satisfied or dissatisfied with good or poor service delivery. With that, compliment and compliant assessment is considered, simultaneously. Non-linear service satisfaction instrument called Kano-Q and Kano-SS is developed based on Kano model and Theory of Quality Attributes (TQA) to define the unexpected, hidden and unspoken patient satisfaction and dissatisfaction into service quality attribute. A new Kano-Q and Kano-SS algorithm for quality attribute assessment is developed based satisfaction impact theories and found instrumentally fit the reliability and validity test. The results were also validated based on standard Kano model procedure before Kano model and Quality Function Deployment (QFD) is integrated for patient attribute and service attribute prioritization. An algorithm of Kano-QFD matrix operation is developed to compose the prioritized complaint and compliment indexes. Finally, the results of prioritized service attributes are mapped to service delivery category to determine the most prioritized service delivery that need to be improved at the first place by healthcare service provider.

Effects of Ethnic Attributes on the Quality of Family Planning Services in Lima, Peru: A Randomized Crossover Trial

PubMed Central

Planas, Maria-Elena; García, Patricia J.; Bustelo, Monserrat; Carcamo, Cesar P.; Martinez, Sebastian; Nopo, Hugo; Rodriguez, Julio; Merino, Maria-Fernanda; Morrison, Andrew

2015-01-01

Most studies reporting ethnic disparities in the quality of healthcare come from developed countries and rely on observational methods. We conducted the first experimental study to evaluate whether health providers in Peru provide differential quality of care for family planning services, based on the indigenous or mestizo (mixed ethnoracial ancestry) profile of the patient. In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian family planning clinical guidelines. Providers and data analysts were kept blinded to the allocation. We found a non-significant mean difference of -0·7% (p = 0·23) between ethnic profiles in the percentage of technical tasks performed by providers. However we report large deficiencies in the compliance with quality standards of care for both profiles. Differential provider behaviour based on the patient's ethnic profiles compared in the study did not contribute to deficiencies in family planning outcomes observed. The study highlights the need to explore other determinants for poor compliance with quality standards, including demand and supply side factors, and calls for interventions to improve the quality of care for family planning services in Metropolitan Lima. PMID:25671664

Effects of ethnic attributes on the quality of family planning services in Lima, Peru: a randomized crossover trial.

PubMed

Planas, Maria-Elena; García, Patricia J; Bustelo, Monserrat; Carcamo, Cesar P; Martinez, Sebastian; Nopo, Hugo; Rodriguez, Julio; Merino, Maria-Fernanda; Morrison, Andrew

2015-01-01

Most studies reporting ethnic disparities in the quality of healthcare come from developed countries and rely on observational methods. We conducted the first experimental study to evaluate whether health providers in Peru provide differential quality of care for family planning services, based on the indigenous or mestizo (mixed ethnoracial ancestry) profile of the patient. In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian family planning clinical guidelines. Providers and data analysts were kept blinded to the allocation. We found a non-significant mean difference of -0.7% (p = 0.23) between ethnic profiles in the percentage of technical tasks performed by providers. However we report large deficiencies in the compliance with quality standards of care for both profiles. Differential provider behaviour based on the patient's ethnic profiles compared in the study did not contribute to deficiencies in family planning outcomes observed. The study highlights the need to explore other determinants for poor compliance with quality standards, including demand and supply side factors, and calls for interventions to improve the quality of care for family planning services in Metropolitan Lima.

Undermining the rules in home care services for the elderly in Norway: flexibility and cooperation.

PubMed

Wollscheid, Sabine; Eriksen, John; Hallvik, Jørgen

2013-06-01

This study explores the provision of home care services (home nursing and domiciliary help) for the elderly in Norwegian municipalities with purchaser-provider split model. The study draws on the assumption that flexibility in adjusting services to the care receivers' needs, and cooperation between provider and purchasers are indicators of good quality of care. Data were collected through semi-structured telephone interviews with 22 team leaders of provider units in nine municipalities. Data were collected in 2008-2009. The study has been approved by the Norwegian Social Science Data Services. We identified four different ways of organising home care services under a purchaser-provider split model: Provider empowerment, New Public Management, Vague instructions and undermining the rules. High flexibility in providing care and cooperation with the purchaser unit were identified by the team leaders as characteristics for good care. Our findings suggest that the care providers use individual strategies that allow flexibility and cooperation rather than rigidly abiding to the regulations the purchaser-provider split models implies. Ironically, in provider units where the 'rules were undermined', the informants (team leaders of provider units) seemed to be most satisfied with the quality of home care that they delivered. © 2012 Nordic College of Caring Science.

Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysis.

PubMed

Barden-O'Fallon, Janine

2017-05-08

Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. Results show that FBOs are less likely to offer FP services than other managing authorities (p < 0.05). For example, 69% of FBOs in Kenya offer FP services compared to 97% of public facilities and 83% of other private facilities. Offering long-acting or permanent methods in faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). Results from this analysis indicate that there is room for improvement in the availability of FP services by FBOs in these countries. Quality of counseling should be improved by all managing authorities in the three countries, as indicated by low overall coverage for practices such as ensuring confidentiality (22% in Malawi, 47% in Kenya and 12% in Haiti), discussion of sexually transmitted infections (18%, 25%, 17%, respectively), and providing services to youth (53%, 27%, 32%, respectively).

Challenges in the delivery of public HIV testing and counselling (HTC) in Douala, Cameroon: providers perspectives and implications on quality of HTC services.

PubMed

Ngangue, Patrice; Gagnon, Marie-Pierre; Bedard, Emmanuelle

2017-04-08

The Cameroon government has made HIV testing and counselling (HTC) a priority in its HIV/AIDS strategic plan. However, there is a dearth of literature on the perspectives of providers on the quality of HTC services. The aim of this study was to explore challenges in the provision of HTC services and their implications on quality of HTC services in Douala's district hospitals. Two primary data collection methods supported by the Donabedian's model of healthcare were used to explain the challenges in the provision of HTC services and their implications on quality of HTC services. This consisted of semi-structured individual interviews with 6 nurses and 16 lay counsellors and a non-participant observation of the physical environment for HTC by site. The study sites were the prevention and voluntary testing and counselling centre (PVTCC) of the six district hospitals of the city of Douala. The study reveals concerns about confidentiality and privacy during the counselling sessions due to inadequate and limited space. An absence of consent, even verbal, was reported in one PVTCC. There is no specific accredited training curriculum that leads to a formal registration as a PVTCC staff, and some lay counsellors work without training. Lay counsellors carry the burden of HIV counselling, but the majority of them work for many years without remuneration and recognition. Another quality challenge is the high workload in the district hospitals' lab, which leads to long waiting times for HIV test results, thus contributing to failure to return for results. The findings of this study highlighted some issues such as lack of adequate space and equipment for HIV testing and counselling that hinder the quality of HTC services and should challenge the health authorities of Cameroon on the need to reorganize HTC services and create a national HIV quality assurance program.

[Clinical trial data management and quality metrics system].

PubMed

Chen, Zhao-hua; Huang, Qin; Deng, Ya-zhong; Zhang, Yue; Xu, Yu; Yu, Hao; Liu, Zong-fan

2015-11-01

Data quality management system is essential to ensure accurate, complete, consistent, and reliable data collection in clinical research. This paper is devoted to various choices of data quality metrics. They are categorized by study status, e.g. study start up, conduct, and close-out. In each category, metrics for different purposes are listed according to ALCOA+ principles such us completeness, accuracy, timeliness, traceability, etc. Some general quality metrics frequently used are also introduced. This paper contains detail information as much as possible to each metric by providing definition, purpose, evaluation, referenced benchmark, and recommended targets in favor of real practice. It is important that sponsors and data management service providers establish a robust integrated clinical trial data quality management system to ensure sustainable high quality of clinical trial deliverables. It will also support enterprise level of data evaluation and bench marking the quality of data across projects, sponsors, data management service providers by using objective metrics from the real clinical trials. We hope this will be a significant input to accelerate the improvement of clinical trial data quality in the industry.

Performance of new alternative providers of primary care services in England: an observational study.

PubMed

Greaves, Felix; Laverty, Anthony A; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem; Millett, Christopher

2015-05-01

Health system reforms in England are opening broad areas of clinical practice to new providers of care. As part of these reforms, new entrants--including private companies--have been allowed into the primary care market under 'alternative provider of medical services' contracting mechanisms since 2004. The characteristics and performance of general practices working under new alternative provider contracts are not well described. We sought to compare the quality of care provided by new entrant providers to that provided by the traditional model of general practice. Open cohort study of English general practices. We used linear regression in cross-sectional and time series analyses, adjusting for practice and population characteristics, to compare quality in practices using alternative provider contracts to traditional practices. We created regression models using practice fixed effects to estimate the impact of practices changing to the new contract type. The English National Health Service. All general practices open from 2008/2009 to 2012/2013. Seventeen established quality indicators--covering clinical effectiveness, efficiency, access and patient experience. In total, 4.1% (347 of 8300) of general practices in England were run by alternative contract providers. These practices tended to be smaller, and serve younger, more diverse and more deprived populations than traditional providers. Practices run by alternative providers performed worse than traditional providers on 15 of 17 indicators after adjusting for practice and population characteristics (p < 0.01 for all). Switching to a new alternative provider contract did not result in improved performance. The introduction of new alternative providers to deliver primary care services in England has not led to improvements in quality and may have resulted in worse care. Regulators should ensure that new entrants to clinical provider markets are performing to adequate standards and at least as well as traditional providers. © The Royal Society of Medicine.

Funneling Child Welfare Consumers into and through the Mental Health System: Assessment, Referral, and Quality Issues

PubMed Central

Fedoravicius, Nicole; McMillen, J. Curtis; Rowe, Jill E.; Kagotho, Njeri; Ware, Norma C.

2012-01-01

This qualitative study explores how consumers of child welfare services reach nonpsychiatric mental health providers and the perceived quality of these services. It relies on iterative interviews with individuals and groups, as well as on court observations from one metropolitan area. Results suggest that, consistent with theories of street-level bureaucracy, efficiency issues drive mental health service use, as clients are routinely subjected to psychological evaluations and funneled into mental health services as a matter of course. Referral practices are shaped by child welfare professionals' routines, discretion, and desire to meet such system objectives as providing short turnaround times for reports. The results suggest that, despite stakeholders' best intentions, maltreated children are not benefiting from thoughtful processes geared to screen for, assess, and provide targeted treatment for unmet mental health needs. PMID:22740722

Information Technology and the Baldrige Quality Award: The Role and Impact of Information, Systems, and Service Quality at a Community College

ERIC Educational Resources Information Center

Noble Burak, Deborah

2010-01-01

Educational institutions, especially community colleges, are facing challenges to provide accessible, affordable, and quality learning opportunities to a growing number of both traditional and nontraditional students. Enterprise resource planning (ERP) systems facilitate institutional operations and provide an integrated platform for information…

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia

PubMed Central

Ron Levey, Ilana; Wang, Wenjuan

2014-01-01

Background Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. Methods The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. Results The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. Conclusion The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. PMID:25012796

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia.

PubMed

Ron Levey, Ilana; Wang, Wenjuan

2014-07-01

Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Group Family Day Care Provider Handbook

ERIC Educational Resources Information Center

New York State Office of Children and Family Services, 2006

2006-01-01

Group family day care providers need to create high-quality programs where children have opportunities to grow, learn and thrive. Part of providing high-quality child care includes complying with the group family day care regulations from the New York State Office of Children and Family Services (OCFS). This Handbook will help day care providers:…

So You're Going To Have a Fund Raiser.

ERIC Educational Resources Information Center

Lemieux, Russ

1997-01-01

Provides a fundraising checklist for preschools and centers to use as a tool for evaluating companies which provide services and goods, to help providers make informed solicitation decisions. The checklist assists in evaluating product quality and cost, company professionalism, educational value, company history, organization of services, and…

32 CFR 861.5 - DOD Commercial Airlift Review Board procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AIRCRAFT DEPARTMENT OF DEFENSE COMMERCIAL AIR TRANSPORTATION QUALITY AND SAFETY REVIEW PROGRAM § 861.5 DOD... procedures apply to air carriers seeking to provide or already providing air transportation services to DOD... provide air transportation service to DOD; the review and approval or disapproval of air carriers in the...

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China.

PubMed

Jiang, Hong; Xu, Jieshuang; Richards, Esther; Qian, Xu; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.

Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

PubMed

Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

2015-12-01

We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

Quality and provider choice: a multinomial logit-least-squares model with selectivity.

PubMed Central

Haas-Wilson, D; Savoca, E

1990-01-01

A Federal Trade Commission survey of contact lens wearers is used to estimate a multinomial logit-least-squares model of the joint determination of provider choice and quality of care in the contact lens industry. The effect of personal and industry characteristics on a consumer's choice among three types of providers--opticians, ophthalmologists, and optometrists--is estimated via multinomial logit. The regression model of the quality of care has two features that distinguish it from previous work in the area. First, it uses an outcome rather than a structural or process measure of quality. Quality is measured as an index of the presence of seven potentially pathological eye conditions caused by poorly fitted lenses. Second, the model controls for possible selection bias that may arise from the fact that the sample observations on quality are generated by consumers' nonrandom choices of providers. The multinomial logit estimates of provider choice indicate that professional regulations limiting the commercial practices of optometrists shift demand for contact lens services away from optometrists toward ophthalmologists. Further, consumers are more likely to have their lenses fitted by opticians in states that require the licensing of opticians. The regression analysis of variations in quality across provider types shows a strong positive selection bias in the estimate of the quality of care received by consumers of ophthalmologists' services. Failure to control for this selection bias results in an overestimate of the quality of care provided by ophthalmologists. PMID:2312308

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

PubMed

Hanna, Timothy P; Kangolle, Alfred C T

2010-10-13

Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

Perceived Quality of Care of Community Health Worker and Facility-Based Health Worker Management of Pneumonia in Children Under 5 Years in Western Kenya: A Cross-Sectional Multidimensional Study

PubMed Central

Shaw, Brian I.; Asadhi, Elijah; Owuor, Kevin; Okoth, Peter; Abdi, Mohammed; Cohen, Craig R.; Onono, Maricianah

2016-01-01

Integrated community case management (iCCM) programs that train lay community health workers (CHWs) in the diagnosis and treatment of diarrhea, malaria, and pneumonia have been increasingly adopted throughout sub-Saharan Africa to provide services in areas where accessibility to formal public sector health services is low. One important aspect of successful iCCM programs is the acceptability and utilization of services provided by CHWs. To understand community perceptions of the quality of care in an iCCM intervention in western Kenya, we used the Primary Care Assessment Survey to compare caregiver attitudes about the diagnosis and treatment of childhood pneumonia as provided by CHWs and facility-based health workers (FBHWs). Overall, caregivers rated CHWs more highly than FBHWs across a set of 10 domains that capture multiple dimensions of the care process. Caregivers perceived CHWs to provide higher quality care in terms of accessibility and patient relationship and equal quality care on clinical aspects. These results argue for the continued implementation and scale-up of iCCM programs as an acceptable intervention for increasing access to treatment of childhood pneumonia. PMID:26976883

Implementation of a quality assurance process for non-therapeutic infant male circumcision providers in North West England.

PubMed

Whittaker, P J; Gollins, H J; Roaf, E J

2014-03-01

Infant male circumcision is practised by many groups for religious and cultural reasons. Prompted by a desire to minimize the complication rate and to help parents identify good quality providers, a quality assurance (QA) process for infant male circumcision providers has been developed in Greater Manchester. Local stakeholders agreed a set of minimum standards, and providers were invited to submit evidence of their practice in relation to these standards. In participation with parents, community groups, faith groups, healthcare staff and safeguarding partners, an information leaflet for parents was produced. Engagement work with local community groups, faith groups, providers and healthcare staff was vital to ensure that the resources are accessible to parents and that providers continue to engage in the process. Providers that met the QA standards have been listed on a local website. Details of the website are included in the information leaflet distributed by maternity services, health visitors, primary care and community and faith groups. The leaflet is available in seven languages. Local QA processes can be used to encourage and identify good practice and to support parents who need to access services outside the remit of the National Health Service.

Improving the Quality of Voluntary Medical Male Circumcision through Use of the Continuous Quality Improvement Approach: A Pilot in 30 PEPFAR-Supported Sites in Uganda

PubMed Central

Opio, Alex; Calnan, Jacqueline; Njeuhmeli, Emmanuel

2015-01-01

Background Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality. Methods and Findings Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the “good” range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring “good” rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events. Conclusion Public sector providers can be engaged to address the quality of VMMC using a continuous quality improvement approach. PMID:26207986

The influence of involvement and outcome messages on consumer reference prices

Treesearch

Gerard Kyle; Ercan Sirakaya

1998-01-01

As public leisure and recreation services become more accountable for their service's fiscal independence, service providers dependence on user fees continues to be a contentious issue. Annually, service managers are required to recommend price changes for services offered the following year in order to maintain existing service quality. Despite the emergent role...

Providing animal health services to the poor in Northern Ghana: rethinking the role of community animal health workers?

PubMed

Mockshell, Jonathan; Ilukor, John; Birner, Regina

2014-02-01

The Community Animal Health Workers (CAHWs) system has been promoted as an alternative solution to providing animal health services in marginal areas. Yet, access to quality animal health services still remains a fundamental problem for livestock dependent communities. This paper uses the concepts of accessibility, affordability, and transaction costs to examine the perceptions of livestock keepers about the various animal health service providers. The empirical analysis is based on a survey of 120 livestock-keeping households in the Tolon-Kumbungu and Savelugu-Nanton districts in the Northern Region of Ghana. A multinomial logit model was used to determine the factors that influence households' choice of alternative animal health service providers. The results show that the government para-vets are the most preferred type of animal health service providers while CAHWs are the least preferred. Reasons for this observation include high transaction costs and low performance resulting from limited training. In areas with few or no government para-vets, farmers have resorted to self-treatment or to selling sick animals for consumption, which has undesirable health implications. These practices also result in significant financial losses for farmers. This paper finds that the CAHWs' system is insufficient for providing quality animal health services to the rural poor in marginal areas. Therefore, market-smart alternative solutions requiring strong public sector engagement to support livestock farmers in marginal areas and setting minimum training standards for animal health service providers merit policy consideration.

Guide to Improving Parenting Education in Even Start Family Literacy Programs.

ERIC Educational Resources Information Center

Powell, Douglas R.; D'Angelo, Diane

This guide provides a framework and suggestions for strengthening the quality and impact of parenting education services in Even Start. It is aimed at Even Start state coordinators and local program administrators responsible for supporting and monitoring the quality of parenting education services in Even Start, and at local program staff…

Measuring Perceptual (In) Congruence between Information Service Providers and Users

ERIC Educational Resources Information Center

Boyce, Crystal

2017-01-01

Library quality is no longer evaluated solely on the value of its collections, as user perceptions of service quality play an increasingly important role in defining overall library value. This paper presents a retooling of the LibQUAL+ survey instrument, blending the gap measurement model with perceptual congruence model studies from information…

British standard (BS) 5750--quality assurance?

PubMed

Pratt, D J

1995-04-01

BS5750 is the British Standard on "Quality Systems". Its equivalent in European Standards is EN29000 and in the International Standards Organisation ISO9000. This paper points out that these standards lay down formalised procedures and require documentation but do not ipso facto lead to quality assurance. The author points to the Japanese post-war industrial success as being an example of Total Quality Management within the framework provided by the philosophy of Dr. W. Edwards Deming (1988 and 1993). This philosophy on the management of "systems" to provide high quality products and services is briefly outlined. The author argues that improvement in prosthetic and orthotic services will not be reached through implementation of BS5750 but rather through radical rethinking and the adoption and application of the Deming philosophy.

Developing Federal Clinical Care Recommendations for Women.

PubMed

Godfrey, Emily M; Tepper, Naomi K; Curtis, Kathryn M; Moskosky, Susan B; Gavin, Loretta E

2015-08-01

The provision of family planning services has important health benefits for the U.S. Approximately 25 million women in the U.S. receive contraceptive services annually and 44 million make at least one family planning-related clinical visit each year. These services are provided by private clinicians, as well as publicly funded clinics, including specialty family planning clinics, health departments, Planned Parenthoods, community health centers, and primary care clinics. Recommendations for providing quality family planning services have been published by CDC and the Office of Population Affairs of the DHHS. This paper describes the process used to develop the women's clinical services portion of the new recommendations and the rationale underpinning them. The recommendations define family planning services as contraceptive care, pregnancy testing and counseling, achieving pregnancy, basic infertility care, sexually transmitted disease services, and preconception health. Because many women who seek family planning services have no other source of care, the recommendations also include additional screening services related to women's health, such as cervical cancer screening. These clinical guidelines are aimed at providing the highest-quality care and are designed to establish a national standard for family planning in the U.S. Published by Elsevier Inc.

Reference Service Policy Statement.

ERIC Educational Resources Information Center

Young, William F.

This reference service policy manual provides general guidelines to encourage reference service of the highest possible quality and to insure uniform practice. The policy refers only to reference service in the University Libraries and is intended for use in conjunction with other policies and procedures issued by the Reference Services Division.…

Family Day Care Provider Handbook

ERIC Educational Resources Information Center

New York State Office of Children and Family Services, 2006

2006-01-01

Family day care providers are responsible for creating a high-quality program where children have opportunities to grow, learn and thrive. Part of providing high-quality child care includes complying with the family day care regulations from the New York State Office of Children and Family Services (OCFS). This Handbook will help day care…

Alabama Public Library Service, The State Library Agency. 1986 Annual Report.

ERIC Educational Resources Information Center

Alabama Public Library Service, Montgomery.

Designed to provide an overview of the range and quality of services provided by the Alabama Public Library Service (APLS), this annual report focuses on the 1986 activities of APLS; the state's public library directory and statistical report will be published separately. A discussion of the activities of the Library Development Division includes…

EIDA Next Generation: ongoing and future developments

NASA Astrophysics Data System (ADS)

Strollo, Angelo; Quinteros, Javier; Sleeman, Reinoud; Trani, Luca; Clinton, John; Stammler, Klaus; Danecek, Peter; Pedersen, Helle; Ionescu, Constantin

2015-04-01

The European Integrated Data Archive (EIDA; http://www.orfeus-eu.org/eida/eida.html) is the distributed Data Centre system within ORFEUS, providing transparent access and services to high quality, seismic data across (currently) 9 large data archives in Europe. EIDA is growing, in terms of the number of participating data centres, the size of the archives, the variability of the data in the archives, the number of users, and the volume of downloads. The on-going success of EIDA is thus providing challenges that are the driving force behind the design of the next generation (NG) of EIDA, which is expected to be implemented within EPOS IP. EIDA ORFEUS must cope with further expansion of the system and more complex user requirements by developing new techniques and extended services. The EIDA NG is being designed to work on standard FDSN web services and two additional new web services: Routing Service and QC (quality controlled) service. This presentation highlights the challenges EIDA needs to address during the EPOS IP and focuses on these 2 new services. The Routing Service can be considered as the core of EIDA NG. It was designed to assist users and clients to locate data within a federated, decentralized data centre (e.g. EIDA). A detailed, FDSN-compliant specification of the service has been developed. Our implementation of this service will run at every EIDA node, but is also capable of running on a user's computer, allowing anyone to define virtual or integrate existing data centres. This (meta)service needs to be queried in order to locate the data. Some smart clients (in a beta status) have been also provided to offer the user an integrated view of the whole EIDA, hiding the complexity of its internal structure. The service is open and able to be queried by anyone without the need of credentials or authentication. The QC Service is developed to cope with user requirements to query for relevant data only. The web service provides detailed information on the contents of the waveform data in an archive and in particular the following features and quality parameters are provided: gaps, statistical values, availability, overlaps, quality flags and more. It is a tool to be used for quickly exploring the contents of the waveform files before downloading them, or by clients to fulfill user specific requirements. The API reflects almost identically the FDSN dataselect service with some additional features. The characteristics are computed on fixed daily intervals (day boundaries) and in case of gaps the service can additionally provide the above features for each continuous data segment in the day interval. The newly developed services and the mediator service being designed and implemented in the near future, will facilitate interoperability and sustainability of the EIDA system and ensure a smooth integration with other Thematic (TCS) and Integrated (ICS) Core Services within EPOS.

Total quality management - It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

Today we are in the midst of information and 'total quality' revolutions. At the NASA STI Program's Center for AeroSpace Information (CASI), we are focused on using continuous improvements techniques to enrich today's services and products and to ensure that tomorrow's technology supports the TQM-based improvement of future STI program products and services. The Continuous Improvements Program at CASI is the foundation for Total Quality Management in products and services. The focus is customer-driven; its goal, to identify processes and procedures that can be improved and new technologies that can be integrated with the processes to gain efficiencies, provide effectiveness, and promote customer satisfaction. This Program seeks to establish quality through an iterative defect prevention approach that is based on the incorporation of standards and measurements into the processing cycle.

Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change

PubMed Central

2014-01-01

Background Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia. Methods A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of ‘out of hospital’ or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated. Results Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the required skills for providing care for infants, and an ‘outpatient’ model of care. Services were also characterised by absent Aboriginal leadership and inadequate coordination between remote and tertiary services that is essential to improve quality of care and reduce ‘system-introduced’ risk. Conclusion Evidence-informed redesign of maternity services and delivery of care has improved clinical effectiveness and quality for women. However, more work is needed to address substandard care provided for infants and their parents. PMID:24890910

CMEMS (Copernicus Marine Environment Monitoring Service) In Situ Thematic Assembly Centre: A service for operational Oceanography

NASA Astrophysics Data System (ADS)

Manzano Muñoz, Fernando; Pouliquen, Sylvie; Petit de la Villeon, Loic; Carval, Thierry; Loubrieu, Thomas; Wedhe, Henning; Sjur Ringheim, Lid; Hammarklint, Thomas; Tamm, Susanne; De Alfonso, Marta; Perivoliotis, Leonidas; Chalkiopoulos, Antonis; Marinova, Veselka; Tintore, Joaquin; Troupin, Charles

2016-04-01

Copernicus, previously known as GMES (Global Monitoring for Environment and Security), is the European Programme for the establishment of a European capacity for Earth Observation and Monitoring. Copernicus aims to provide a sustainable service for Ocean Monitoring and Forecasting validated and commissioned by users. From May 2015, the Copernicus Marine Environment Monitoring Service (CMEMS) is working on an operational mode through a contract with services engagement (result is regular data provision). Within CMEMS, the In Situ Thematic Assembly Centre (INSTAC) distributed service integrates in situ data from different sources for operational oceanography needs. CMEMS INSTAC is collecting and carrying out quality control in a homogeneous manner on data from providers outside Copernicus (national and international networks), to fit the needs of internal and external users. CMEMS INSTAC has been organized in 7 regional Dissemination Units (DUs) to rely on the EuroGOOS ROOSes. Each DU aggregates data and metadata provided by a series of Production Units (PUs) acting as an interface for providers. Homogeneity and standardization are key features to ensure coherent and efficient service. All DUs provide data in the OceanSITES NetCDF format 1.2 (based on NetCDF 3.6), which is CF compliant, relies on SeaDataNet vocabularies and is able to handle profile and time-series measurements. All the products, both near real-time (NRT) and multi-year (REP), are available online for every CMEMS registered user through an FTP service. On top of the FTP service, INSTAC products are available through Oceanotron, an open-source data server dedicated to marine observations dissemination. It provides services such as aggregation on spatio-temporal coordinates and observed parameters, and subsetting on observed parameters and metadata. The accuracy of the data is checked on various levels. Quality control procedures are applied for the validity of the data and correctness tests for the metadata of each NetCDF file. The quality control procedures for the data include different routines for NRT and REP products. Key Performance Indicators (KPI) for monitoring purposes are also used in Copernicus. They allow a periodic monitoring of the availability, quantity and quality of the INSTAC data integrated in the NRT products. Statistical reports are generated on quarterly and yearly basis to provide more visibility on the coverage in space and time of the INSTAC NRT and REP products, as well as information on their quality. These reports are generated using Java and Python procedures developed within the INSTAC group. One of the most critical tasks for the DUs is to generate NetCDF files compliant with the agreed format. Many tools and programming libraries have been developed for that purpose, for instance Unidata Java Library. These tools provide NetCDF data management capabilities including creation, reading and modification. Some DUs have also developed regional data portals which offer useful information for the users including data charts, platforms availability through interactive maps, KPI and statistical figures and direct access to the FTP service. The proposed presentation will detail Copernicus in situ data service and the monitoring tools that have been developed by the INSTAC group.

Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures

PubMed Central

Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

2016-01-01

Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of performance suggest that efficiency may be achieved without sacrificing quality. PMID:26803655

Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures.

PubMed

Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

2016-02-01

Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of performance suggest that efficiency may be achieved without sacrificing quality. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

DataFed: A Federated Data System for Visualization and Analysis of Spatio-Temporal Air Quality Data

NASA Astrophysics Data System (ADS)

Husar, R. B.; Hoijarvi, K.

2017-12-01

DataFed is a distributed web-services-based computing environment for accessing, processing, and visualizing atmospheric data in support of air quality science and management. The flexible, adaptive environment facilitates the access and flow of atmospheric data from provider to users by enabling the creation of user-driven data processing/visualization applications. DataFed `wrapper' components, non-intrusively wrap heterogeneous, distributed datasets for access by standards-based GIS web services. The mediator components (also web services) map the heterogeneous data into a spatio-temporal data model. Chained web services provide homogeneous data views (e.g., geospatial, time views) using a global multi-dimensional data model. In addition to data access and rendering, the data processing component services can be programmed for filtering, aggregation, and fusion of multidimensional data. A complete application software is written in a custom made data flow language. Currently, the federated data pool consists of over 50 datasets originating from globally distributed data providers delivering surface-based air quality measurements, satellite observations, emissions data as well as regional and global-scale air quality models. The web browser-based user interface allows point and click navigation and browsing the XYZT multi-dimensional data space. The key applications of DataFed are for exploring spatial pattern of pollutants, seasonal, weekly, diurnal cycles and frequency distributions for exploratory air quality research. Since 2008, DataFed has been used to support EPA in the implementation of the Exceptional Event Rule. The data system is also used at universities in the US, Europe and Asia.

Service quality in healthcare institutions: establishing the gaps for policy action.

PubMed

Abuosi, Aaron A; Atinga, Roger A

2013-01-01

The authors seek to examine two key issues: to assess patients' hospital service quality perceptions and expectation using SERVQUAL; and to outline the distinct concepts used to assess patient perceptions. Questionnaires were administered to 250 patients on admission and follow-up visits. The 22 paired SERVQUAL expectation and perception items were adopted. Repeated t-measures and factor analysis with Varimax rotation were used to analyse data. Results showed that patient expectations were not being met during medical treatment. Perceived service quality was rated lower than expectations for all variables. The mean difference between perceptions and expectations was statistically significant. Contrary to the SERVQUAL five-factor model, four service-quality factors were identified in the study. Findings have practical implications for hospital managers who should consider stepping up staffing levels backed by client-centred training programmes to help clinicians deliver care to patients' expectations. Limited studies are tailored towards patients' service-quality perception and expectation in Ghanaian hospitals. The findings therefore provide valuable information for policy and practice.

[Theoretical grounds of a structural and functional model for quality assurance of radiation diagnostics under conditions of development of the modern health care system in Ukraine].

PubMed

Korop, Oleg A; Lenskykh, Sergiy V

2018-01-01

Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population. The aim of the work is to provide theoretical grounds for a structural and functional model of quality assurance of radiation diagnostics at all levels of medical care given to the population under the current health care reform in Ukraine. Materials and methods: The object of the study is organizing the operation of the radiation diagnostic service; the information is based on the actual data on the characteristics of radiation diagnosis at different levels of medical care provision. Methods of systematic approach, system analysis and structural and functional analysis of the operating system of radiation diagnostics are used. Review: The basis of the quality assurance model is the cyclical process, which includes the stages of the problem identifition, planning of its solution, organization of the system for implementation of decisions, monitoring the quality management process of the radiation diagnostics, and factors influencing the quality of the radiation diagnostics service. These factors include the quality of the structure, process, results, organization of management and control of current processes and the results of radiation diagnostics management. Conclusions: The advantages of the proposed model for ensuring the quality of the radiation diagnostics service are its systemacy and complexity, elimination of identified defects and deficiencies, and achievement of profitability through modern redistribution and use of existing resources of the health care system. The results of adequate service quality management activities in radiation diagnostics are the improvement of organizational and economic principles along with legislative regulation, the implementation of a modern system of radiation diagnostics in the state health care at the national and regional levels, the increase of the accessibility, quality and efficiency of the radiation diagnostics service.

Improving access to services and interactions with clients in Guatemala: the value of distance learning.

PubMed

Brambila, Carlos; Lopez, Felipe; Garcia-Colindres, Julio; Donis, Marco Vinicio

2005-04-01

To develop and test a distance-learning programme to improve the quality and efficiency of family planning services in Guatemala. The setting was rural family planning services in Guatemala. The study design was quasi-experimental with one intervention and one control group and with pre- and post-intervention measures. Two staff members from each of 20 randomly selected health districts were trained as leaders of the training programme. In turn, the 40 trainers trained a total of 240 service providers, under the supervision of four health area facilitators. The results were compared with 20 randomly selected control health districts. The intervention was a distance-learning programme including 40 in-class hours followed by 120 inservice practice hours spread over a 4-month period. Distinctively, the programme used a cascade approach to training, intensive supervision, and close monitoring and evaluation. Patient flow analysis was used to determine number of contacts, waiting times, and the interaction time between service providers and clients. Consultation observations were used to assess the quality and completeness of reproductive health information and services received by clients. The intervention showed a positive impact on reducing the number of contacts before the consultation and client waiting times. More complete services and better quality services were provided at intervention clinics. Some, but not all, of the study objectives were attained. The long-term impact of the intervention is as yet unknown. Distance-learning programmes are an effective methodology for training health professionals in rural areas.

An examination of the role of perceived support and employee commitment in employee-customer encounters.

PubMed

Vandenberghe, Christian; Bentein, Kathleen; Michon, Richard; Chebat, Jean-Charles; Tremblay, Michel; Fils, Jean-François

2007-07-01

The authors examined the relationships between perceived organizational support, organizational commitment, commitment to customers, and service quality in a fast-food firm. The research design matched customer responses with individual employees' attitudes, making this study a true test of the service provider-customer encounter. On the basis of a sample of matched employee-customer data (N = 133), hierarchical linear modeling analyses revealed that perceived organizational support had both a unit-level and an employee-level effect on 1 dimension of service quality: helping behavior. Contrary to affective organizational commitment, affective commitment to customers enhanced service quality. The 2 sub-dimensions of continuance commitment to the organization--perceived high sacrifice and perceived lack of alternatives--exerted effects opposite in sign: The former fostered service quality, whereas the latter reduced it. The implications of these findings are discussed within the context of research on employee-customer encounters.

Progress and gaps in reproductive health services in three humanitarian settings: mixed-methods case studies

PubMed Central

2015-01-01

Background Reproductive health (RH) care is an essential component of humanitarian response. Women and girls living in humanitarian settings often face high maternal mortality and are vulnerable to unwanted pregnancy, unsafe abortion, and sexual violence. This study explored the availability and quality of, and access barriers to RH services in three humanitarian settings in Burkina Faso, Democratic Republic of the Congo (DRC), and South Sudan. Methods Data collection was conducted between July and October 2013. In total, 63 purposively selected health facilities were assessed: 28 in Burkina Faso, 25 in DRC, and nine in South Sudan, and 42 providers completed a questionnaire to assess RH knowledge and attitudes. Thirty-four focus group discussions were conducted with 29 members of the host communities and 273 displaced married and unmarried women and men to understand access barriers. Results All facilities reported providing some RH services in the prior three months. Five health facilities in Burkina Faso, six in DRC, and none in South Sudan met the criteria as a family planning service delivery point. Two health facilities in Burkina Faso, one in DRC, and two in South Sudan met the criteria as an emergency obstetric and newborn care service delivery point. Across settings, three facilities in DRC adequately provided selected elements of clinical management of rape. Safe abortion was unavailable. Many providers lacked essential knowledge and skills. Focus groups revealed limited knowledge of available RH services and socio-cultural barriers to accessing them, although participants reported a remarkable increase in use of facility-based delivery services. Conclusion Although RH services are being provided, the availability of good quality RH services was inconsistent across settings. Commodity management and security must be prioritized to ensure consistent availability of essential supplies. It is critical to improve the attitudes, managerial and technical capacity of providers to ensure that RH services are delivered respectfully and efficiently. In addition to ensuring systematic implementation of good quality RH services, humanitarian health actors should meaningfully engage crisis-affected communities in RH programming to increase understanding and use of this life-saving care. PMID:25798189

Quality control in linen and laundry service at a tertiary care teaching hospital in India.

PubMed

Singh, Dara; Qadri, Gj; Kotwal, Monica; Syed, At; Jan, Farooq

2009-01-01

The clean bedding and clean clothes installs psychological confidence in the patients and the public and enhances their faith in the services rendered by the hospital. Being an important Component in the management of the patients, a study was carried out to find out the current quality status and its conformity with the known standards and identify the areas of intervention in order to further increase the patient and staff satisfaction regarding the services provided by linen and laundry department Quality control practised in the Linen and Laundry Service was studied by conducting a prospective study on the concept of Donabedian model of structure, process and outcome. Study was done by pre-designed Proforma along with observation / Interviews / Questionnaire and study of records. The input studied included physical facilities, manpower, materials, equipments and environmental factors. The various elements of manpower studied consisted of number of staff working, their qualification, training, promotion avenues, motivation and job satisfaction. Process was studied by carrying out observations in linen and laundry service through a predesigned flow chart which was supplemented by interviews with different category of staff. Patient satisfaction, staff satisfaction and microbial count of laundered linen (quality dimensions) were studied in the outcome. The current study found that in spite of certain deficiencies in the equipment, manpower and process, the linen and laundry service is providing a satisfactory service to its users. However the services can be further improved by removing the present deficiencies both at structure and process level.

Factors affecting success of an integrated community-based telehealth system.

PubMed

Hsieh, Hui-Lung; Tsai, Chung-Hung; Chih, Wen-Hai; Lin, Huei-Hsieh

2015-01-01

The rise of chronic and degenerative diseases in developed countries has become one critical epidemiologic issue. Telehealth can provide one viable way to enhance health care, public health, and health education delivery and support. The study aims to empirically examine and evaluate the success factors of community-based telehealth system adoption. The valid 336 respondents are the residents of a rural community in Taiwan. The structural equation modeling (SEM) was used to assess the proposed model applied to telehealth. The findings showed the research model had good explanatory power and fitness. Also, the findings indicated that system quality exerted the strongest overall effect on intention to use. Furthermore, service quality exerted the strongest overall effect on user satisfaction. The findings also illustrated that the joint effects of three intrinsic qualities (system quality, information quality, and service quality) on use were mediated by user satisfaction and intention to use. The study implies that community-based telehealth service providers should improve three intrinsic qualities to enhance user satisfaction and intention to use, which in turn can lead to increase the usage of the telehealth equipment. The integrated community-based telehealth system may become an innovative and suitable way to deliver better care to the residents of communities.

Reliability and utility of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour.

PubMed

McVilly, K; Webber, L; Paris, M; Sharp, G

2013-08-01

Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II (BSP-QEII) was developed to monitor and assess BSPs prepared by teachers to support children with disability in the school system. This study investigated the application of the BSP-QEII to the assessment of BSPs for adults with ID in community support services. The inter-rater reliability of the BSP-QEII was assessed. The utility of the BPS-QEII was then investigated with reference to a time series study of matched pairs of BSPs, developed for the same clients over a period of approximately 3 years. Differences in plan quality measured across a number of service and systemic variables were also investigated. The BSP-QEII was found to have good inter-rater reliability and good utility for audit purposes. It was able to discriminate changes in plan quality over time. Differences in plan quality were also evident across different service types, where specialist staff had or had not been involved, and in some instances where a statutory format for the plan had or had not been used. There were no differences between plans developed by government and community sector agencies, nor were there any regional differences across the jurisdiction. The BSP-QEII could usefully be adopted as an audit tool for measuring the quality of BSPs for adults with ID. In addition to being used for research and administrative auditing, the principles underpinning the BSP-QEII could also be useful to guide policy and educational activities for staff in community based services for adults with ID. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

Blending Key Ingredients to Assure Quality in Home Health Care.

ERIC Educational Resources Information Center

Griffith, Deloris G.

1986-01-01

Careful staff selection, training, and review are among the methods the author recommends to home care agencies striving to provide top-notch services. Discusses measuring the quality of care employees are providing, accreditation, and the benefits of accreditation. (CT)

[Between the public and the private. New incentives in health care].

PubMed

Abel-Smith, B

1992-01-01

This paper discusses some of the proposals regarding the improvement of the efficiency in the delivery of health care services. Several countries have implemented different strategies based on the experience of the Health Maintenance Organizations, which have used the market to stimulate competition between providers and insurance companies. One of the proposals includes the creation of agencies that would compete in quality and in price. Another one implies the creation of a National Health Service capable of hiring public or private services from local agencies. The ideal strategy would enable a consumer to choose between insurance companies and public and private providers, and would hopefully create cost conditions reasonably correlated with the efficiency and quality of the rendered services.

Women’s perspectives on quality of maternal health care services in Malawi

PubMed Central

Machira, Kennedy; Palamuleni, Martin

2018-01-01

Despite promotion by many stakeholders to improve maternal health outcome in many developing countries including Malawi, many analysts agree that the utmost success in maternal health will arise if maternal health care services are an unparallel led source for women’s health care solutions for any problem related to childbirth. Health advocates worldwide claim that even though maternal services are provided, women’s utilization of such services has not been ascertained. The objective of this study was to explore women’s perspectives on the quality of health care service delivery in Malawi. This article therefore investigates women’s perspectives on the quality of maternal health care services in Malawi. We used six focus group discussions in six health facilities that were selected across Malawi. We found that erratic availability of medical resources and unethical practices among health workers adversely affected quality of maternal health care service delivery. We concluded that the expensive routine operational audits of medical resources and service delivery across health facilities are imperative if women’s health outcomes are to be enhanced in Malawi. PMID:29386917

Gap between the Expectations and Perceptions of Students regarding the Educational Services Offered in a School of Nursing and Midwifery.

PubMed

Asefi, Fariba; Delaram, Masoumeh; Deris, Fatemeh

2017-04-01

Awareness of students' opinions about the various aspects of training provided is an essential factor to evaluate the quality of education. The aim of this study was to determine the gap between the students' expectations and perceptions from the educational services provided to them in the School of Nursing and Midwifery in Shahrekord University of Medical Sciences. In this cross-sectional study, 320 students were selected by stratified random sampling method and data were collected by SERVQUAL questionnaire to examine the areas of assurance, responsiveness, empathy, tangibles and confidence. Data analysis was conducted by descriptive (frequency, percentage, mean±SD) and analytical (paired t-test, independent t-test and One-Way ANOVA) statistics in SPSS 20. The mean scores of the students' expectations and perceptions of the educational services delivered to them were 4.34±0.63 and 3.56±0.68, respectively, with a significant, negative gap (-0.77±0.77, p<0.001). The lowest gap of quality was derived for assurance (-0.65) followed by reliability (-0.69), accountability (-0.74), and empathy (-0.81), and the greatest gap observed in tangibles (-0.96). A negative gap was observed between the students' expectations and perceptions of the quality of educational services delivered to them. This means that the quality of services delivered to students was less than what they expected. The highest gap was related to the tangibles. In order to improve the educational services, paying attention to different areas of quality of educational services, especially, the tangibles, is necessary.

Are patients in Western Turkey contented with healthcare services?: a quality assessment study.

PubMed

Kuguoglu, Sema; Aslan, Fatma Eti; Icli, Gülnur

2006-01-01

The purpose of this study was to describe service quality as perceived by 1200 patients who had inpatient treatment at 3 hospitals in Istanbul: university, social security administration, and government. Patients were most satisfied with the helpful attitudes of personnel during check-in procedures, promptness and skill of nurses, overall service provided by physicians, speedy and skilled work of personnel in laboratories and X-ray rooms, and hospitals in general.

Quality gap in primary health care services in Isfahan: women's perspective

PubMed Central

Sharifirad, Gholam R.; Shamsi, Mohsen; Pirzadeh, Asiyeh; Farzanegan, Parvin D.

2012-01-01

Background: Quality gap is the gap between client's understanding and expectations. The first step in removing this gap is to recognize client's understanding and expectations of the services. This study aimed to determine women's viewpoint of quality gap in primary health care centers of Isfahan. Materials and Methods: This cross-sectional study was conducted on women who came to primary health care centers in Isfahan city. Sample size was 1280 people. Service Quality was used to collect data including tangible dimensions, confidence, responsiveness, assurance and sympathy in providing services. Data were analyzed by t test and chi square test. Results: The results showed that women had controversy over all 5 dimensions. The least mean quality gap was seen in assurance (-11.08) and the highest mean quality gap was seen in tangible dimension (-14.41). The difference between women's viewpoint in all 5 dimensions was significant. (P < 0.05) Conclusion: Negative difference means clients’ expectations are much higher than their understanding of the current situation, so there is a large space to improve services and satisfy clients. PMID:23555148

Evaluation of health care service quality in Poland with the use of SERVQUAL method at the specialist ambulatory health care center.

PubMed

Manulik, Stanisław; Rosińczuk, Joanna; Karniej, Piotr

2016-01-01

Service quality and customer satisfaction are very important components of competitive advantage in the health care sector. The SERVQUAL method is widely used for assessing the quality expected by patients and the quality of actually provided services. The main purpose of this study was to determine if patients from state and private health care facilities differed in terms of their qualitative priorities and assessments of received services. The study included a total of 412 patients: 211 treated at a state facility and 201 treated at a private facility. Each of the respondents completed a 5-domain, 22-item SERVQUAL questionnaire. The actual quality of health care services in both types of facilities proved significantly lower than expected. All the patients gave the highest scores to the domains constituting the core aspects of health care services. The private facility respondents had the highest expectations with regard to equipment, and the state facility ones regarding contacts with the medical personnel. Health care quality management should be oriented toward comprehensive optimization in all domains, rather than only within the domain identified as the qualitative priority for patients of a given facility.

Identifying positive deviants in healthcare quality and safety: a mixed methods study.

PubMed

O'Hara, Jane K; Grasic, Katja; Gutacker, Nils; Street, Andrew; Foy, Robbie; Thompson, Carl; Wright, John; Lawton, Rebecca

2018-01-01

Objective Solutions to quality and safety problems exist within healthcare organisations, but to maximise the learning from these positive deviants, we first need to identify them. This study explores using routinely collected, publicly available data in England to identify positively deviant services in one region of the country. Design A mixed methods study undertaken July 2014 to February 2015, employing expert discussion, consensus and statistical modelling to identify indicators of quality and safety, establish a set of criteria to inform decisions about which indicators were robust and useful measures, and whether these could be used to identify positive deviants. Setting Yorkshire and Humber, England. Participants None - analysis based on routinely collected, administrative English hospital data. Main outcome measures We identified 49 indicators of quality and safety from acute care settings across eight data sources. Twenty-six indicators did not allow comparison of quality at the sub-hospital level. Of the 23 remaining indicators, 12 met all criteria and were possible candidates for identifying positive deviants. Results Four indicators (readmission and patient reported outcomes for hip and knee surgery) offered indicators of the same service. These were selected by an expert group as the basis for statistical modelling, which supported identification of one service in Yorkshire and Humber showing a 50% positive deviation from the national average. Conclusion Relatively few indicators of quality and safety relate to a service level, making meaningful comparisons and local improvement based on the measures difficult. It was possible, however, to identify a set of indicators that provided robust measurement of the quality and safety of services providing hip and knee surgery.

Quality of the ophthalmological service to outpatients of the public and private healthcare systems.

PubMed

Hercos, Benigno Vicente Santos; Berezovsky, Adriana

2017-01-01

To compare perceptions of the quality of ophthalmological services offered to outpatients from the public healthcare system to those from the private healthcare system, and to determine which measures are seen as necessary and a priority for improving the quality of care. This was a prospective observational study on 200 patients, 101 and 99 of whom were from the public and private healthcare systems, respectively. All patients underwent an ophthalmological examination at an ophthalmology hospital in Belo Horizonte, Minas Gerais, Brazil. Personal interviews were conducted using two structured questionnaires adapted from the modified SERVQUAL scale. Overall, patients from the private healthcare system were significantly more dissatisfied than those from the public healthcare system. In both systems, reliability was considered to be the most important determinant of quality, and it presented the highest level of dissatisfaction. Satisfaction with the public healthcare system was significantly greater than that with the private healthcare system in terms of the tangibles, reliability, responsiveness, and assurance determinants of the SERVQUAL scale. Institutions must plan, execute, evaluate, and monitor measures that seek to improve the overall patient satisfaction with the quality of services provided, particularly in the private healthcare system, and special attention must be paid to reliability in both healthcare systems. The identification and monitoring of the quality of healthcare services through the periodic use of the SERVQUAL scale may provide healthcare managers with information so that they can identify, plan, and monitor necessary and priority measures. This could be a key strategy for improving the quality of outpatient health services in the public and private systems.

Rural Child Sexual Abuse Prevention and Treatment.

ERIC Educational Resources Information Center

Ray, JoAnn; Murty, Susan A.

1990-01-01

Reviews literature on rural child sexual abuse and treatment. Surveys providers in rural Washington treatment programs. Responses describe agency characteristics, services, delivery problems, and suggested solutions. Reports providers' perceptions of service quality and interagency cooperation. Cites as problems heavy caseloads, lack of staff, and…

Quality Program Provisions for Aeronautical and Space System Contractors

NASA Technical Reports Server (NTRS)

1969-01-01

This publication sets forth quality program requirements for NASA aeronautical and space programs, systems, subsystems, and related services. These requirements provide for the effective operation of a quality program which ensures that quality criteria and requirements are recognized, definitized, and performed satisfactorily.

Is There a Trade-off Between Quality and Profitability in United States Nursing Homes?

PubMed

Godby, Tyler; Saldanha, Sarah; Valle, Jazmine; Paul, David P; Coustasse, Alberto

Nursing home residents across the United States rely on quality care and effective services. Nursing homes provide skilled nurses and nursing aides who can provide services 24 hours a day for individuals who could not perform these tasks for themselves. Not-for-profit (NFP) versus for-profit (FP) nursing homes have been examined for utilization and efficacy; however, it has been shown that NFP nursing homes generally offer higher quality care and generate greater profit margins compared with FP nursing homes. The purpose of this research was to determine if NFP nursing homes provide enhanced quality care and a larger profit margin compared with FP nursing homes. Benefits and barriers in regard to financial stability and quality of care exist for both FP and NFP homes. Based on the findings of this review, it is suggested that NFP nursing homes have achieved higher quality of care because of a more effective balance of business aspects, as well as prioritizing resident well-being, and care quality over profit maximization in NFP homes.

Is quality of care a key predictor of perinatal health care utilization and patient satisfaction in Malawi?

PubMed

Creanga, Andreea A; Gullo, Sara; Kuhlmann, Anne K Sebert; Msiska, Thumbiko W; Galavotti, Christine

2017-05-22

The Malawi government encourages early antenatal care, delivery in health facilities, and timely postnatal care. Efforts to sustain or increase current levels of perinatal service utilization may not achieve desired gains if the quality of care provided is neglected. This study examined predictors of perinatal service utilization and patients' satisfaction with these services with a focus on quality of care. We used baseline, two-stage cluster sampling household survey data collected between November and December, 2012 before implementation of CARE's Community Score Card© intervention in Ntcheu district, Malawi. Women with a birth during the last year (N = 1301) were asked about seeking: 1) family planning, 2) antenatal, 3) delivery, and 4) postnatal care; the quality of care received; and their overall satisfaction with the care received. Specific quality of care items were assessed for each type of service, and up to five such items per type of service were used in analyses. Separate logistic regression models were fitted to examine predictors of family planning, antenatal, delivery, and postnatal service utilization and of complete satisfaction with each of these services; all models were adjusted for women's socio-demographic characteristics, perceptions of the closest facility to their homes, service use indicators, and quality of care items. We found higher levels of perinatal service use than previously documented in Malawi (baseline antenatal care 99.4%; skilled birth attendance 97.3%; postnatal care 77.5%; current family planning use 52.8%). Almost 73% of quality of perinatal care items assessed were favorably reported by > 90% of women. Women reported high overall satisfaction (≥85%) with all types of services examined, higher for antenatal and postnatal care than for family planning and delivery care. We found significant associations between perceived and actual quality of care and both women's use and satisfaction with the perinatal health services received. Quality of care is a key predictor of perinatal health service utilization and complete patient satisfaction with such services in Malawi. The current heightened attention toward perinatal health services and outcomes should be coupled with efforts to improve the actual quality of care offered to women in this country.

Implementing Quality Assurance at Royal University of Phnom Penh, Cambodia: Perceptions, Practices and Challenges

ERIC Educational Resources Information Center

Ros, Soveacha

2010-01-01

Quality Assurance in higher education has been an ongoing international issue for discussion. As higher education institutions move toward an era of accountability and accreditation, groups of stakeholders require proof of high-quality academic programs and services from higher education providers. Since the mid-1990s, most providers have strived…

Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

PubMed

Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

2015-09-01

The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Significant components of service brand equity in healthcare sector.

PubMed

Chahal, Hardeep; Bala, Madhu

2012-01-01

The purpose of the study is to examine three significant components of service brand equity--i.e. perceived service quality, brand loyalty, and brand image--and analyze relationships among the components of brand equity and also their relationship with brand equity, which is still to be theorized and developed in the healthcare literature. Effective responses were received from 206 respondents, selected conveniently from the localities of Jammu city. After scale item analysis, the data were analyzed using factor analysis, correlations, t-tests, multiple regression analysis and path modeling using SEM. The findings of the study support that service brand equity in the healthcare sector is greatly influenced by brand loyalty and perceived quality. However, brand image has an indirect effect on service brand equity through brand loyalty (mediating variable). The research can be criticized on the ground that data were selected conveniently from respondents residing in the city of Jammu, India. But at the same time the respondents were appropriate for the study as they have adequate knowledge about the hospitals, and were associated with the selected hospital for more than four years. Furthermore, the validity and reliability of the data are strong enough to take care of the limitations of the convenience sampling selection method. The study has unique value addition to the service marketing vis-à-vis healthcare literature, from both theoretical and managerial perspectives. The study establishes a direct and significant relationship between service brand equity and its two components, i.e. perceived service quality and brand loyalty in the healthcare sector. It also provides directions to healthcare service providers in creating, enhancing, and maintaining service brand equity through service quality and brand loyalty, to sustain competitive advantage.

How to assess quality in your sexual health service.

PubMed

Hathorn, Emma; Land, Lucy; Ross, Jonathan D C

2011-10-01

Previous improvements in NHS have largely focused on increasing service capacity to ensure the provision of universal, comprehensive healthcare at the point of need in the UK. However, public expectations of the NHS are changing, triggered by increased access to information and media coverage of a series of lapses in quality and geographical inequity of care. The NHS also faces the challenges posed by a changing family structure, an ageing population, advancing technology and economic uncertainty. To meet these challenges, improvements in quality rather than just quantity have become a focus of the new NHS. This article provides an overview of quality and how to measure it in sexual health services.

The role of complaint management in the service recovery process.

PubMed

Bendall-Lyon, D; Powers, T L

2001-05-01

Patient satisfaction and retention can be influenced by the development of an effective service recovery program that can identify complaints and remedy failure points in the service system. Patient complaints provide organizations with an opportunity to resolve unsatisfactory situations and to track complaint data for quality improvement purposes. Service recovery is an important and effective customer retention tool. One way an organization can ensure repeat business is by developing a strong customer service program that includes service recovery as an essential component. The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied customers and convert them into satisfied customers. Service recovery has proven to be cost-effective in other service industries. The complaint management process involves six steps that organizations can use to influence effective service recovery: (1) encourage complaints as a quality improvement tool; (2) establish a team of representatives to handle complaints; (3) resolve customer problems quickly and effectively; (4) develop a complaint database; (5) commit to identifying failure points in the service system; and (6) track trends and use information to improve service processes. Customer retention is enhanced when an organization can reclaim disgruntled patients through the development of effective service recovery programs. Health care organizations can become more customer oriented by taking advantage of the information provided by patient complaints, increasing patient satisfaction and retention in the process.

Planning and Implementing total Quality Management in an Air Force Service Organization: A Case Study

DTIC Science & Technology

1988-09-01

Quality Management (TQM). Documentation of such implementation methods can provide useful crossfeed to other services organizations attempting similiar efforts. The following research questions were addressed to present the case in a useful context for interpretation: (1) What is TQM and how will it be implemented in AFALC; (2) How can the quality of service organizations be improved and what techniques may be useful for this purpose; (3) How does the environment at AFALC differ from most Air Force organizations implementing TQM and what obstacles must it overcome; (4) How

Gap Analysis between Perceptions and Expectations of Medical-Surgical Patients in a Public Hospital in Saudi Arabia.

PubMed

Al-Momani, Mohammed Mahmoud

2016-01-01

To investigate patients' satisfaction with nursing care by measuring the gap between patients' expectations of care and perceptions of the actual care provided and to identify the areas of nursing care that need improvement. A cross-sectional survey was conducted among patients who were admitted to the Departments of Medicine and Surgery at King Saud Medical City, Riyadh, Saudi Arabia. A modified Service Quality (SERVQUAL) instrument was adapted to collect information from a convenience sample of 432 patients from November 25, 2012, to February 3, 2013. The instrument comprised 22 pairs of questions assessing 5 dimensions of the nursing care provided to patients during hospitalizations. The mean patient expectations and perceptions as well as the gap score values for each dimension of nursing service were tested for differences between the mean scores of the sample at a level of significance of 0.05 using a t test. The gap score for all of the 5 dimensions of nursing services were: responsiveness, -1.71; reliability, -1.48; tangibles, -1.36; assurance, -1.26, and empathy, -0.96. Service quality across the dimensions of responsiveness and reliability was statistically significant (p < 0.05). This result indicated that patients were not satisfied with the nursing service quality in relation to all dimensions. Our study showed negative gaps for the 5 nursing service quality dimensions evaluated. This could provide nurses with information about the aspects of nursing care that promote more positive patient outcomes and satisfaction. © 2015 S. Karger AG, Basel.

Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

PubMed

Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

2017-10-01

Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia

PubMed Central

Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

2017-01-01

Background Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. Methodology A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. Results A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). Conclusion In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system. PMID:29075171

Development of a cloud-based application for the Fracture Liaison Service model of care.

PubMed

Holzmueller, C G; Karp, S; Zeldow, D; Lee, D B; Thompson, D A

2016-02-01

The aims of this study are to develop a cloud-based application of the Fracture Liaison Service for practitioners to coordinate the care of osteoporotic patients after suffering primary fractures and provide a performance feedback portal for practitioners to determine quality of care. The application provides continuity of care, improved patient outcomes, and reduced medical costs. The purpose of this study is to describe the content development and functionality of a cloud-based application to broadly deploy the Fracture Liaison Service (FLS) to coordinate post-fracture care for osteoporotic patients. The Bone Health Collaborative developed the FLS application in 2013 to support practitioners' access to information and management of patients and provide a feedback portal for practitioners to track their performance in providing quality care. A five-step protocol (identify, inform, initiate, investigate, and iterate) organized osteoporotic post-fracture care-related tasks and timelines for the application. A range of descriptive data about the patient, their medical condition, therapies and care, and current providers can be collected. Seven quality of care measures from the National Quality Forum, The Joint Commission, and the Centers for Medicare and Medicaid Services can be tracked through the application. There are five functional areas including home, tasks, measures, improvement, and data. The home, tasks, and data pages are used to enter patient information and coordinate care using the five-step protocol. Measures and improvement pages are used to enter quality measures and provide practitioners with continuous performance feedback. The application resides within a portal, running on a multitenant, private cloud-based Avedis enterprise registry platform. All data are encrypted in transit and users access the application using a password from any common web browser. The application could spread the FLS model of care across the US health care system, provide continuity of care, effectively manage osteoporotic patients, improve outcomes, and reduce medical costs.

[Satisfaction survey of CatSalut-PLAENSA(©). Strategies to incorporate citizens' perception of the quality of the service in health policies].

PubMed

Aguado-Blázquez, Hortensia; Cerdà-Calafat, Ismael; Argimon-Pallàs, Josep Maria; Murillo-Fort, Carles; Canela-Soler, Jaume

2011-12-01

The aim of this work is to present the strategies, activities and results of satisfaction surveys Plan CatSalut- PLAENSA(©) 2003-2010 that are making progress in improving the quality of health services. Since 2003, CatSalut has at its disposal the plan known as PLAENSA(©) Satisfaction Surveys, a tool for assessment and improvement proposals addressed to the insurance services provided by contracted public entities. The plan follows 3 key strategies: systematic and objective policyholders' satisfaction measurement, related to the services received; release of improvement proposals according to a standardized model, including standardized monitoring, and promotion of equity through propagation among health centres and territories. Current assessment provided by the insured about most health services has been already collected, leading to more tan 2,500 projects of improvement which are being developed by the providers of the 7 health regions of Catalonia. Copyright © 2011 Elsevier España S.L. All rights reserved.

Experience with Health Coach-Mediated Physician Referral in an Employed Insured Population

PubMed Central

Rao, Sowmya R.; Rogers, Robert S.; Mailhot, Johanna R.; Galvin, Robert

2010-01-01

BACKGROUND Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic “health coach” — a registered nurse who assists with identifying appropriate and available providers. OBJECTIVE To evaluate the health coach’s influence on provider choice and the quality of the user experience in the early introduction of this service. DESIGN Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered health coach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users. PARTICIPANTS Insured adults (ages 21–64) employed by a large national firm or covered dependents of employees. MEASUREMENTS Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction. MAIN RESULTS The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%. CONCLUSIONS Customers largely follow the provider recommendation of the health coach. Users express general satisfaction with existing health coach services, but differences in performance between vendors highlight the need for the services to be well implemented. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1428-4) contains supplementary material, which is available to authorized users. PMID:20556533

Transportation Service Center Analysis Using GIS Technology

DOT National Transportation Integrated Search

1997-01-01

The Transportation Service Center (TSC) concept originated as a result of the department's evaluation of its key business processes and its commitment to improve the quality of the goods and services it provides. TSCs are local Michigan Department of...

Designing and implementing a trust-wide quality assurance programme.

PubMed

Coope, Sally-Ann

2018-04-02

Derbyshire Community Health Services (DCHS) NHS Foundation Trust provides a wide range of community-based health services. After the Care Quality Commission (CQC) found gaps in the trust's assurance process, its board decided to develop a method of continuous quality improvements that could be used as a basis for the trust's quality assurance system. The trust adapted and built on an acute model so it was suitable for community services. The final assurance system, Quality Always, has four elements: the clinical assessment and accreditation scheme; leadership development; 'champions' within clinical teams to support and promote the scheme; and dashboards to record and monitor progress. A system to recognise and reward achievement was essential for success. Quality Always has resulted in better care quality, an improved CQC rating, a sense of achievement among staff, the development of support networks, learning (especially among support staff) and good practice being shared.

Service provision and quality outcomes in home health for rural Medicare beneficiaries at high risk for unplanned care.

PubMed

Mroz, Tracy M; Andrilla, C Holly A; Garberson, Lisa A; Skillman, Susan M; Patterson, Davis G; Larson, Eric H

2018-06-11

Multiple barriers exist to providing home health care in rural areas. This study examined relationships between service provision and quality outcomes among rural, fee-for-service Medicare beneficiaries who received home health care between 2011 and 2013 for conditions associated with high-risk for unplanned care. More skilled nursing visits, visits by more types of providers, more timely care, and shorter lengths of stay were associated with significantly higher odds of hospital readmission and emergency department use and significantly lower odds of community discharge. Results may indicate unmeasured clinical severity and care needs among this population. Additional research regarding the accuracy of current severity measures and adequacy of case-mix adjustment for quality metrics is warranted, especially given the continued focus on value-based payment policies.

PDQ: Planning and Development of Quality Services in the Schools, Instructional Guide, Student Manual and Reference Materials.

ERIC Educational Resources Information Center

Wright, Sandra Raymore

The instructional guide, student manual, and reference materials were developed by the PDQ Project, Planning and Development of Quality Services in the Schools, an effort by the American Speech-Language-Hearing Association to provide public school personnel working with communication disordered children with information and training related to…

The Bottom Line: Quality/Consumer-Oriented Child Care.

ERIC Educational Resources Information Center

Jackson, Cheryl D.

Arguing that the provision of child care services is consistent with the role of the community college, this paper provides an overview of the current demand for and delivery of child care services and briefly discusses ways in which community colleges can assist in the development and provision of consumer-oriented, high-quality child care.…

Where Are We Headed with Center Accreditation? Trends in Quality Assurance

ERIC Educational Resources Information Center

Neugebauer, Roger

2009-01-01

With a new administration in Washington, DC poised to expand federal support for early childhood services, it is important that those in the early childhood education profession take a close look at how they can assure parents that they are providing the high quality early childhood services the parents need and deserve. In this article, the…

Developing a Scale for Perceptions of Competency in Teaching Quality

ERIC Educational Resources Information Center

Tasci, Guntay; Atar, Burcu

2016-01-01

The purpose of this study was to develop a measurement instrument for determining pre-service teachers' perceptions of competency in providing quality teaching. The initial phase of the instrument was consisted of 54 items that were composed based on theory and literature. The initial form was applied to 232 pre-service teachers. An exploratory…

Self-Service Charge Systems: Current Technological Applications and Their Implications for the Future Library.

ERIC Educational Resources Information Center

Mardikian, Jackie

1995-01-01

Discusses a possible shift to self-service check-out systems for academic library patrons. Provides an annotated bibliography of 51 items that discuss the impact of self-service technology on the quality of service and customer satisfaction in libraries, service sectors, banking, and the vending industry. (LRW)

Understand, Identify, and Respond: The New Focus of Access Services

ERIC Educational Resources Information Center

Rodriguez, Juan Carlos; Meyer, Kristin; Merry, Brian

2017-01-01

Library public services staff have primarily focused on providing services through interactions with their users. Although service quality and customer satisfaction are important in the delivery of these services, the emphasis and nature of the work have often been influenced by a library-centric philosophy rather than a user-centric philosophy.…

Lean in service industries: A literature review

NASA Astrophysics Data System (ADS)

V, Vignesh; Suresh, M.; Aramvalarthan, S.

2016-09-01

Lean service is an amalgamation of tools and practices which, if applied appropriately, would definitely improve the existing quality of operations and ensure the generation of a large amount of favourable financial and economic outcomes and improve the behaviour of the workforce. As a result, it assumes of great significance in the fiercely competitive modern world. This article presents a comprehensive bibliographic study about the various lean service practices through a variety of approaches like service improvement, manufacturing, supply chain, market and retailing approaches, etc. Thus it gives a clear view on how the lean services are implemented in various sectors and the contribution of lean service towards improving the quality in the services provided while reducing the costs.

Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples.

PubMed

Bailie, Ross; Si, Damin; Shannon, Cindy; Semmens, James; Rowley, Kevin; Scrimgeour, David J; Nagel, Tricia; Anderson, Ian; Connors, Christine; Weeramanthri, Tarun; Thompson, Sandra; McDermott, Robyn; Burke, Hugh; Moore, Elizabeth; Leon, Dallas; Weston, Richard; Grogan, Haylene; Stanley, Andrew; Gardner, Karen

2010-05-19

Strengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE) project has facilitated the implementation of modern Continuous Quality Improvement (CQI) approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1) explore the factors associated with variation in clinical performance; 2) examine specific strategies that have been effective in improving primary care clinical performance; and 3) work with health service staff, management and policy makers to enhance the effective implementation of successful strategies. The study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria) over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management. By linking researchers directly to users of research (service providers, managers and policy makers), the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary health care and fostering effective and efficient exchange and use of data and information among service providers and policy makers to achieve evidence-based resource allocation, service planning, system development, and improvements of service delivery and Indigenous health outcomes.

Accuracy of Health and Wellness Messages Provided by "ChaCha", the Mobile Answers Text Message Service

ERIC Educational Resources Information Center

Bliss, Kadi; Lodyga, Marc; Bochantin, Shelley; Null, Dawn

2010-01-01

A relatively new mobile text message service, "ChaCha," describes itself as "a smart search engine powered by human intelligence." The service claims to provide high-quality, accurate information, yet there is no research published to date substantiating this claim. The purpose of this study was to assess the extent to which health and…

7 CFR 981.42 - Quality control.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 8 2012-01-01 2012-01-01 false Quality control. 981.42 Section 981.42 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Quality Control § 981.42 Quality control. (a) Incoming. Except as provided in this...

7 CFR 981.42 - Quality control.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Quality control. 981.42 Section 981.42 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Regulating Handling Quality Control § 981.42 Quality control. (a) Incoming. Except as provided in this...

7 CFR 981.42 - Quality control.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Quality control. 981.42 Section 981.42 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Quality Control § 981.42 Quality control. (a) Incoming. Except as provided in this...

7 CFR 981.42 - Quality control.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Quality control. 981.42 Section 981.42 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Quality Control § 981.42 Quality control. (a) Incoming. Except as provided in this...

13 CFR 130.330 - Operating requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... assessment and evaluation, and internal quality control. (c) The Lead Center shall be open to the public... provide administrative services and coordination for the SBDC network, including program development... Project Officer as soon as is feasible. Other SBDC service providers shall be open during the normal...

Measuring Outcomes in Children's Services.

ERIC Educational Resources Information Center

Christner, Anne Marshall, Ed.

Outcomes evaluation can provide program managers and clinical directors in child welfare, juvenile justice, child mental health, and child protective services the necessary tools for program quality assurance and accountability. This guide describes the outcomes evaluation process and provides a summary of articles and reports detailing current…

Approaches to Mapping Nitrogen Removal: Examples at a Landscape Scale

EPA Science Inventory

Wetlands can provide the ecosystem service of improved water quality via nitrogen removal, providing clean drinking water and reducing the eutrophication of aquatic resources. Within the ESRP, mapping nitrogen removal by wetlands is a service that incorporates the goals of the ni...

Addressing the Needs of Diverse Distributed Students

ERIC Educational Resources Information Center

Shimoni, Rena; Barrington, Gail; Wilde, Russ; Henwood, Scott

2013-01-01

Two interrelated studies were undertaken to assist Alberta post-secondary institutions with meeting challenges associated with providing services to diverse distributed students that are of similar quality to services provided to traditional classroom students. The first study identified and assessed best practices in distributed learning; the…

Reimbursement for school nursing health care services: position statement.

PubMed

Lowe, Janet; Cagginello, Joan; Compton, Linda

2014-09-01

Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and reduce costs. The goal is to promote a comprehensive and cost-effective health care delivery model that integrates schools, families, providers, and communities.

Effects of a performance and quality improvement intervention on the work environment in HIV-related care: a quasi-experimental evaluation in Zambia.

PubMed

Bazant, Eva; Sarkar, Supriya; Banda, Joseph; Kanjipite, Webby; Reinhardt, Stephanie; Shasulwe, Hildah; Mulilo, Joyce Monica Chongo; Kim, Young Mi

2014-12-20

Human resource shortages and reforms in HIV-related care make it challenging for frontline health care providers in southern Africa to deliver high-quality services. At health facilities of the Zambian Defence Forces, a performance and quality improvement approach was implemented to improve HIV-related care and was evaluated in 2010/2011. Changes in providers' work environment and perceived quality of HIV-related care were assessed to complement data of provider performance. The intervention involved on-site training, supportive supervision, and action planning focusing on detailed service delivery standards. The quasi-experimental evaluation collected pre- and post-intervention data from eight intervention and comparison facilities matched on defence force branch and baseline client volume. Overall, 101 providers responded to a 24-item questionnaire on the work environment, covering topics of drugs, supplies, and equipment; training, feedback, and supervision; compensation; staffing; safety; fulfilment; and HIV services quality. In bivariate analysis and multivariate analyses, we assessed changes within each study group and between the two groups. In the bivariate analysis, the intervention group providers reported improvements in the work environment on adequacy of equipment, feeling safe from harm, confidence in clinical skills, and reduced isolation, while the comparison group reported worsening of the work environment on supplies, training, safety, and departmental morale.In the multivariate analysis, the intervention group's improvement and the comparison group's decline were significant on perceived adequacy of drugs, supplies, and equipment; constructive feedback received from supervisor and co-workers; and feeling safe from physical harm (all P <0.01, except P <0.04 for equipment). Further, the item "provider lacks confidence in some clinical skills" declined in the intervention group but increased in the comparison group (P = -0.005). In multivariate analysis, changes in perceived quality of HIV care did not differ between study groups. Provider perceptions were congruent with observations of preparing drugs, supplies, equipment, and in service delivery of prevention of mother-to-child transmission of HIV and antiretroviral therapy follow-up care. The performance and quality improvement intervention implemented at Zambian Defence Forces' health facilities was associated with improvements in providers' perceptions of work environment consistent with the intervention's focus on commodities, skills acquisition, and receipt of constructive feedback.

Cost containment: strategies and responsibilities of the laboratory manager.

PubMed

Martin, B G

1985-12-01

In these difficult times we must not lose the sense of purpose and the personal drive that makes it possible to achieve excellence. We can be exasperated with reduced funding, burdened with excuses, debilitated with confusion about budgetary cuts, and even be stubborn about alternatives, but we must be serious about excellence and quality. It is natural that during these times we will face those with conflicting views, negative ideas, and erratic long-term goals, but that in itself should rouse us, as professionals, toward the pursuit of quality health care services. With better scheduling of tests and procedure, improved discharge planning, more careful review of the need for patient hospitalization, and a more careful examination of the number, mix, and quality of services furnished during a patient's hospital stay, we, as a health care team, can and will reduce unnecessary utilization of all services. Well-managed laboratories must operate around a return on investment threshold, from which all products, services, and expenditures are ranked. On this basis, management decisions will be made to add to service, reduce service, improve or sustain quality, change technology, or discontinue the business altogether. Given the mandate embodied in the DRG regulations, laboratories have become cost centers. New ideas, new technology, and creative efforts must now be used to improve laboratory productivity while sustaining quality health care services. It is argued philosophically that the DRGs or other major measures to reduce funding adversely affect quality of service. This may be true under the traditional definition of services, but there must be "a new order of things." Today's complex problems indicate that orthodox solutions no longer apply, and in our quest to answer who should pay versus who should receive, and how much is enough, we must ensure quality of all services offered. This new order of doing things could result in far greater savings than has previously been predicted. The patient's length of stay in the hospital has already been reduced. There will continue to be decreases in laboratory utilization and consumption of resources necessary to provide laboratory services. Cost competitiveness coupled with the laboratory's need for increased productivity will further expand savings. To summarize, the laboratory manager in the mid-1980's will have the following goals. To provide quality, cost-efficient, and timely laboratory services. To sustain and nurture the growth of the clinical laboratory profession as dictated by the needs of society and new scientific trends and discoveries.(ABSTRACT TRUNCATED AT 400 WORDS)

Overview of harm reduction in prisons in seven European countries.

PubMed

Sander, Gen; Scandurra, Alessio; Kamenska, Anhelita; MacNamara, Catherine; Kalpaki, Christina; Bessa, Cristina Fernandez; Laso, Gemma Nicolás; Parisi, Grazia; Varley, Lorraine; Wolny, Marcin; Moudatsou, Maria; Pontes, Nuno Henrique; Mannix-McNamara, Patricia; Libianchi, Sandro; Antypas, Tzanetos

2016-10-07

While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.

Factors Influencing Utilization of Primary Health Care Services in Patients with Chronic Respiratory Diseases.

PubMed

Kurpas, D; Bujnowska-Fedak, M M; Athanasiadou, A; Mroczek, B

2015-01-01

The purpose of our study was to determine the factors affecting the level of services provided in primary health care among patients with chronic respiratory diseases. The study group consisted of 299 adults (median age: 65, min-max: 18-92 years) with mixed chronic respiratory diseases, recruited from patients of 135 general practitioners. In the analysis, in addition to the assessment of the provided medical services, the following were used: Patient Satisfaction Questionnaire, Camberwell Assessment of Needs Short Appraisal Schedule, Acceptance of Illness Scale, and WHO Quality of Life Instrument Short Form. Variables that determined the level of services were the following: age, place of residence, marital status, number of chronic diseases, and level of disease acceptance, quality of life, and health behaviors. The level of provided services correlated with variables such as gender, severity of somatic symptoms, level of satisfied needs, and satisfaction with health care. We concluded that in patients with mixed chronic respiratory diseases a higher level of health care utilization should be expected in younger patients, those living in the countryside, those having a partner, with multimorbidity, a low level of disease acceptance, those satisfied with their current quality of life, with positive mental attitudes, and maintaining health practices.

Improving service quality in primary care.

PubMed

Kennedy, Denise M; Nordrum, Jon T; Edwards, Frederick D; Caselli, Richard J; Berry, Leonard L

2015-01-01

A framework for improving health care service quality was implemented at a 12-provider family medicine practice in 2010. A national patient satisfaction research vendor conducted weekly telephone surveys of 840 patients served by that practice: 280 patients served in 2009, and 560 served during 2010 and 2011. After the framework was implemented, the proportion of "excellent" ratings of provider service (the highest rating on a 5-point scale) increased by 5% to 9%, most notably thoroughness (P = .04), listening (P = .04), and explaining (P = .04). Other improvements included prompt test result notification and telephone staff courtesy (each by 10%, P = .02), as well as teamwork (by 8%, P = .04). Overall quality increased by 10% (P = .01), moving the practice from the 68th to the 91st percentile of medical practices in the research vendor's database. Improvements in patient satisfaction suggest that this framework may be useful in value-based payment models. © 2014 by the American College of Medical Quality.

Quality of antenatal care in Zambia: a national assessment

PubMed Central

2012-01-01

Background Antenatal care (ANC) is one of the recommended interventions to reduce maternal and neonatal mortality. Yet in most Sub-Saharan African countries, high rates of ANC coverage coexist with high maternal and neonatal mortality. This disconnect has fueled calls to focus on the quality of ANC services. However, little conceptual or empirical work exists on the measurement of ANC quality at health facilities in low-income countries. We developed a classification tool and assessed the level of ANC service provision at health facilities in Zambia on a national scale and compared this to the quality of ANC received by expectant mothers. Methods We analysed two national datasets with detailed antenatal provider and user information, the 2005 Zambia Health Facility Census and the 2007 Zambia Demographic and Health Survey (DHS), to describe the level of ANC service provision at 1,299 antenatal facilities in 2005 and the quality of ANC received by 4,148 mothers between 2002 and 2007. Results We found that only 45 antenatal facilities (3%) fulfilled our developed criteria for optimum ANC service, while 47% of facilities provided adequate service, and the remaining 50% offered inadequate service. Although 94% of mothers reported at least one ANC visit with a skilled health worker and 60% attended at least four visits, only 29% of mothers received good quality ANC, and only 8% of mothers received good quality ANC and attended in the first trimester. Conclusions DHS data can be used to monitor “effective ANC coverage” which can be far below ANC coverage as estimated by current indicators. This “quality gap” indicates missed opportunities at ANC for delivering effective interventions. Evaluating the level of ANC provision at health facilities is an efficient way to detect where deficiencies are located in the system and could serve as a monitoring tool to evaluate country progress. PMID:23237601

An Artificial Intelligence System to Predict Quality of Service in Banking Organizations

PubMed Central

Popovič, Aleš

2016-01-01

Quality of service, that is, the waiting time that customers must endure in order to receive a service, is a critical performance aspect in private and public service organizations. Providing good service quality is particularly important in highly competitive sectors where similar services exist. In this paper, focusing on banking sector, we propose an artificial intelligence system for building a model for the prediction of service quality. While the traditional approach used for building analytical models relies on theories and assumptions about the problem at hand, we propose a novel approach for learning models from actual data. Thus, the proposed approach is not biased by the knowledge that experts may have about the problem, but it is completely based on the available data. The system is based on a recently defined variant of genetic programming that allows practitioners to include the concept of semantics in the search process. This will have beneficial effects on the search process and will produce analytical models that are based only on the data and not on domain-dependent knowledge. PMID:27313604

An Artificial Intelligence System to Predict Quality of Service in Banking Organizations.

PubMed

Castelli, Mauro; Manzoni, Luca; Popovič, Aleš

2016-01-01

Quality of service, that is, the waiting time that customers must endure in order to receive a service, is a critical performance aspect in private and public service organizations. Providing good service quality is particularly important in highly competitive sectors where similar services exist. In this paper, focusing on banking sector, we propose an artificial intelligence system for building a model for the prediction of service quality. While the traditional approach used for building analytical models relies on theories and assumptions about the problem at hand, we propose a novel approach for learning models from actual data. Thus, the proposed approach is not biased by the knowledge that experts may have about the problem, but it is completely based on the available data. The system is based on a recently defined variant of genetic programming that allows practitioners to include the concept of semantics in the search process. This will have beneficial effects on the search process and will produce analytical models that are based only on the data and not on domain-dependent knowledge.

Vouchers for primary healthcare services in an ageing world? The perspectives of elderly voucher recipients in Hong Kong.

PubMed

Lai, Angel Hor-Yan; Kuang, Zoey; Yam, Carrie Ho-Kwan; Ayub, Shereen; Yeoh, Eng-Kiong

2018-05-01

Considering the ageing population in economically advanced regions across the world, measures are necessary to enhance the health of the older population as well as contain public healthcare spending. Hong Kong implements the Elderly Health Care Voucher Scheme (EHCVS), providing older people aged 65 or above an annual subsidy of visiting private healthcare service providers for chronic disease prevention and management. The services also aim at reallocating demand from the public to private sector as well as improve quality of services. This qualitative study explored the experiences of EHCVS recipients (n = 55, aged 61-94) with eight focus group interviews in Hong Kong in the year 2016. Convenience sampling was used. Research questions were: (1) Why do older people choose not to use EHCVS for preventive as well as disease management services among older people in Hong Kong? (2) What are the barriers to reallocating demand from the public to private sector? (3) In what ways did EHCVS improve the quality of primary care services for older people? Using a deductive and inductive approach, eight qualitative themes were identified. Findings suggested that the non-targeted services and inadequate knowledge on EHCVS deterred older people from using the vouchers for disease management and prevention. The relatively expensive private services, lack of trust in the private sector, low public clinic fees and good services quality of the public sector, together with inadequate private practitioners in the healthcare market were barriers that hinder demand reallocation. Nevertheless, the quality of primary care services had been improved after the implementation of EHCVS with shortened wait times and opportunities to discuss health-related issues with private practitioners. Findings were discussed with practice, policy and research implications. © 2017 John Wiley & Sons Ltd.

Qualitative assessment of the dental health services provided at a dental school in Kerman, Iran.

PubMed

Rad, Maryam; Haghani, Jahangir; Shahravan, Arash; Khosravifar, Ali

2009-01-01

Increasing the quality of the services provided in a Dental School can raise the satisfaction level of patients and consequently increase the level of their oral health. This study was conducted to evaluate the quality of dental care and services provided to patients referred to a Dental School in Kerman, Iran. In this qualitative study, face-to-face, in-depth interviews were conducted with 41 participants [25 patients (P), 5 nurses (N), 6 dental academic staff (AS), and 5 dental students (S)]. Then, the interviews were transcribed and analyzed, using content analysis of data. Data analysis in qualitative research involves breaking down the data and searching for codes and categories that are then reassembled to form themes. Both positive and negative themes emerged. Positive themes included: good infection control, service accessibility, patient appointments and visits were not assigned on merit, precise examinations, and comprehensive treatment plans. Negative themes included: long wait time, lack of options to pass waiting time, such as newspapers and television, an insufficient number of nurses, and not enough professors for supervision. In addition, the results of this study show that the patients and dental staff have high expectations in relation to dental services, and that implementation of these expectations would increase the overall satisfaction with and the quality of the level of services. Finally, some recommendations for improving services in the Kerman Dental School were given to the managing team of the Dental School.

1990 National Water Quality Laboratory Services Catalog

USGS Publications Warehouse

Pritt, Jeffrey; Jones, Berwyn E.

1989-01-01

PREFACE This catalog provides information about analytical services available from the National Water Quality Laboratory (NWQL) to support programs of the Water Resources Division of the U.S. Geological Survey. To assist personnel in the selection of analytical services, the catalog lists cost, sample volume, applicable concentration range, detection level, precision of analysis, and preservation techniques for samples to be submitted for analysis. Prices for services reflect operationa1 costs, the complexity of each analytical procedure, and the costs to ensure analytical quality control. The catalog consists of five parts. Part 1 is a glossary of terminology; Part 2 lists the bottles, containers, solutions, and other materials that are available through the NWQL; Part 3 describes the field processing of samples to be submitted for analysis; Part 4 describes analytical services that are available; and Part 5 contains indices of analytical methodology and Chemical Abstract Services (CAS) numbers. Nomenclature used in the catalog is consistent with WATSTORE and STORET. The user is provided with laboratory codes and schedules that consist of groupings of parameters which are measured together in the NWQL. In cases where more than one analytical range is offered for a single element or compound, different laboratory codes are given. Book 5 of the series 'Techniques of Water Resources Investigations of the U.S. Geological Survey' should be consulted for more information about the analytical procedures included in the tabulations. This catalog supersedes U.S. Geological Survey Open-File Report 86-232 '1986-87-88 National Water Quality Laboratory Services Catalog', October 1985.

A site-based approach to delivering rangeland ecosystem services

USDA-ARS?s Scientific Manuscript database

Rangeland ecosystems are capable of providing an array of ecosystem services important to the wellbeing of society. Some of these services (e.g. meat, fibre) are transported to markets and their quantity, quality and value are established via a set of widely accepted standards. Other services (e.g. ...

An Evaluation of Alert Services: Quantity versus Quality

ERIC Educational Resources Information Center

Zandian, Fatemeh; Riahinia, Nosrat; Azimi, Ali; Poursalehi, Nastaran

2010-01-01

Purpose: Online information vendors currently offer a variety of additional services; among these are alert services which present requested information on recent publications to registered users. This paper aims to investigate a variety of alert services provided by four online information vendors. Design/methodology/approach: A comparison of the…

Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

PubMed

Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

2015-01-01

Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (p< 0.001). The overall perceived service quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

You Can Make Your Facilities Services Provider Part of the College Community.

ERIC Educational Resources Information Center

Ledbetter, Randy

2002-01-01

Discusses five attributes that, when well implemented, form the framework for successful relationships between college administration and services companies: reporting relationships, Quality of Service (QoS) measures, formal reports and reviews, employee relations, and subcontractor relations. (EV)

The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

PubMed

Rutter, Matthew D; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

2016-02-01

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision. ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients.

The fee-for-service shift to bundled payments: financial considerations for hospitals.

PubMed

Scamperle, Keely

2013-01-01

Skyrocketing health care costs are forcing payers to demand delivery efficiencies that preserve and promote quality care while reducing costs. Hospitals are challenged to meet the pressure from payers to deliver value and outcome-based health care while preserving sufficient financial margins. The fee-for-service (FFS) model with its perverse incentives to incur high-volume services is no longer, if ever, sufficient to ensure quality, cost-efficient health care. In response, payers have sought to force the issue through accelerated efforts to bundle payments to providers. It is theorized that by tying together providers throughout the continuum or episode of care for a patient, efficiencies in delivery inclusive of cost reductions will be obtained. This article examines the bundled payment models and the financial considerations for hospital facility providers.

48 CFR 408.711 - Quality complaints.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Quality complaints. 408... People Who Are Blind or Severely Disabled 408.711 Quality complaints. Prior to attempting to resolve a complaint regarding the quality of goods or services provided by participating nonprofit agency with the...

Use of speech-to-text technology for documentation by healthcare providers.

PubMed

Ajami, Sima

2016-01-01

Medical records are a critical component of a patient's treatment. However, documentation of patient-related information is considered a secondary activity in the provision of healthcare services, often leading to incomplete medical records and patient data of low quality. Advances in information technology (IT) in the health system and registration of information in electronic health records (EHR) using speechto- text conversion software have facilitated service delivery. This narrative review is a literature search with the help of libraries, books, conference proceedings, databases of Science Direct, PubMed, Proquest, Springer, SID (Scientific Information Database), and search engines such as Yahoo, and Google. I used the following keywords and their combinations: speech recognition, automatic report documentation, voice to text software, healthcare, information, and voice recognition. Due to lack of knowledge of other languages, I searched all texts in English or Persian with no time limits. Of a total of 70, only 42 articles were selected. Speech-to-text conversion technology offers opportunities to improve the documentation process of medical records, reduce cost and time of recording information, enhance the quality of documentation, improve the quality of services provided to patients, and support healthcare providers in legal matters. Healthcare providers should recognize the impact of this technology on service delivery.

Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries.

PubMed

Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

2018-06-01

Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities "ready to provide obstetric services" had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and "ready to provide obstetric services" were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and "ready to provide obstetric services", respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities "ready to provide obstetric services". Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities "ready to provide obstetric services" (≥30% of facility deliveries) were only found in three countries. The low levels of availability, readiness and coverage of obstetric services documented represent substantial missed opportunities within health systems. Global and national efforts need to prioritize upgrading EmOC functionality and improving readiness to deliver obstetric service, particularly in rural areas. The approach of linking health facility and household surveys described here could facilitate the tracking of progress towards quality obstetric care.

Variations in the Availability and Quality of Early Childhood Education and Care by Socioeconomic Status of Neighborhoods

ERIC Educational Resources Information Center

Cloney, Dan; Cleveland, Gordon; Hattie, John; Tayler, Collette

2016-01-01

Research Findings: This article provides Australian evidence of the availability and quality of early childhood education and care (ECEC) services in low-socioeconomic status (SES) neighborhoods. There is less availability of ECEC in low-SES areas in Australia, and these programs provide a lower average quality of care than in more advantaged…

Forest Inventory and Analysis National Data Quality Assessment Report for 2000 to 2003

Treesearch

James E. Pollard; James A. Westfall; Paul L. Patterson; David L. Gartner; Mark Hansen; Olaf Kuegler

2006-01-01

The Forest Inventory and Analysis program (FIA) is the key USDA Forest Service (USFS) program that provides the information needed to assess the status and trends in the environmental quality of the Nation's forests. The goal of the FIA Quality Assurance (QA) program is to provide a framework to assure the production of complete, accurate and unbiased forest...

An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa.

PubMed

Magasana, Vuyolwethu; Zembe, Wanga; Tabana, Hanani; Naik, Reshma; Jackson, Debra; Swanevelder, Sonja; Doherty, Tanya

2016-12-01

HIV counseling and testing (HCT) has been prioritized as one of the prevention strategies for HIV/AIDS, and promoted as an essential tool in scaling up and improving access to treatment, care and support especially in community settings. Home-based HCT (HBHCT) is a model that has consistently been found to be highly acceptable and has improved HCT coverage and uptake in low- and middle-income countries since 2002. It involves trained lay counselors going door-to-door offering pre-test counseling and providing HCT services to consenting eligible household members. Currently, there are few studies reporting on the quality of HBHCT services offered by lay counselors especially in Sub-Saharan Africa, including South Africa. This is a quantitative descriptive sub-study of a community randomized trial (Good Start HBHCT trial) which describes the quality of HBHCT provided by lay counselors. Quality of HBHCT was measured as scores comparing observed practice to prescribed protocols using direct observation. Data were collected through periodic observations of HCT sessions and exit interviews with clients. Counselor quality scores for pre-test counseling and post-test counseling sessions were created to determine the level of quality. For the client exit interviews a continuous score was created to assess how satisfied the clients were with the counseling session. A total of 196 (3%) observational assessments and 406 (6%) client exit interviews were completed. Overall, median scores for quality of counseling and testing were high for both HIV-negative and HIV-positive clients. For exit interviews all 406 (100%) clients had overall satisfaction with the counseling and testing services they received, however 11% were concerned about the counselor keeping their discussion confidential. Of all 406 clients, 393 (96.8%) intended to recommend the service to other people. In ensuring good quality HCT services, ongoing quality assessments are important to monitor quality of HCT after training.

A profile of women at the highest risk of maternal death in Pakistan.

PubMed

Agha, Sohail

2015-09-01

Traditionally, health interventions implemented in Pakistan have been designed to increase the supply of maternal health services, but have not focused on reaching the poorest women or on providing high-quality services. Demand-side barriers to the utilization of health services are substantial in Pakistan, as are supply-side constraints to the provision of quality health care. This study uses data from the Pakistan Demographic and Health Survey 2006-07 to develop a profile of the poorest women in Pakistan in order to understand demand-side barriers to accessing maternal health care. The study shows stark differences in human capital, material and demographic resources between the poorest women and other women. It illustrates how these differences translate into low levels of service utilization among the poorest women. The purpose of the study is to stimulate a discussion of both the difficulty and the importance of reaching the poorest women with high-quality maternal health interventions. The findings from several pilot projects in Pakistan suggest that the poorest women can be reached at disproportionately higher rates than non-poor women through targeted, community-based, interventions. There is little demonstrable evidence, however, that high-quality care has been provided through these interventions. Evidence-based approaches, which have the potential to overcome financial and sociocultural barriers to service utilization, should be scaled up as soon as possible. However, measures should be taken to ensure that the quality of care provided through these interventions is adequate and able to lead to significant reductions in mortality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Provider Perspectives on School-Based Mental Health for Urban Minority Youth: Access and Services

ERIC Educational Resources Information Center

Gamble, Brandon E.; Lambros, Katina M.

2014-01-01

This article provides results from a qualitative study on the efforts of school-based mental health providers (SBMHPs) who serve students in urban, suburban, and ethnically diverse settings to help families access quality mental health services. School-based mental health plays a key role in the provision of direct and indirect intervention…

Feasibility of Expanding Services for Very Young Children in the Public Mental Health Setting

ERIC Educational Resources Information Center

Knapp, Penelope K.; Ammen, Sue; Arstein-Kerslake, Cindy; Poulsen, Marie Kanne; Mastergeorge, Ann

2007-01-01

Objective: A quality-improvement study evaluated the feasibility of training mental health providers to provide mental health screening and relationship-based intervention to expand services for children 0 to 5 years of age in eight California county mental health systems from November 2002 to June 2003. State-level training was provided to more…

High-Price And Low-Price Physician Practices Do Not Differ Significantly On Care Quality Or Efficiency

PubMed Central

Roberts, Eric T.; Mehrotra, Ateev; McWilliams, J. Michael

2017-01-01

Provider consolidation has intensified concerns that providers with market power may be able to charge higher prices without having to deliver better care. Providers have argued that higher prices cover the costs of delivering higher-quality care. We examined the relationship between physician practice prices for outpatient services and the quality and efficiency of care provided to their patients. Using commercial claims, we classified practices as high-priced or low-priced. We compared care quality, utilization, and spending between high-priced and low-priced practices in the same areas using data from the Consumer Assessment of Health Care Providers and Systems survey and linked claims for Medicare beneficiaries. Compared with low-priced practices, high-priced practices were much larger and received 36% higher prices. Patients of high-priced practices reported significantly higher scores on some measures of care coordination and management, but did not differ meaningfully in their overall care ratings, other domains of patient experiences (including physician ratings and access to care), receipt of mammography, vaccinations, or diabetes services, acute care use, or total Medicare spending. These findings suggest an overall weak relationship between practices’ prices and the quality and efficiency of care they provide, calling into question claims that high-priced providers deliver substantially higher-value care. PMID:28461352

Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries.

PubMed

Stepurko, Tetiana; Pavlova, Milena; Groot, Wim

2016-08-02

The measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with the quality of and access to health care services. The study focuses on six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). We use data on past experience with health care use collected in 2010 through uniform national surveys in these countries. Based on these data, we carry out a multi-country analysis to investigate factors associated with the satisfaction of health care users in the six countries. The results indicate that about 10-14 % of the service users are not satisfied with the quality of, or access to health care services they used in the preceding year. However, significant differences across countries and services are observed, e.g. the highest level of dissatisfaction with access to outpatient services (16.4 %) is observed among patients in Lithuania, while in Poland, the level of dissatisfaction with quality of outpatient and inpatient services are much lower than dissatisfaction with access. The study also analyses the association of users' satisfaction with factors such as making informal payments, inability to pay and relative importance of service attributes stated by the service users. These multi-country findings provide evidence for health policy making in the Central and Eastern European countries. Although the average rates of satisfactions per country are relatively high, the results suggest that there is ample room for improvements. Specifically, many service-users still report dissatisfaction especially those who pay informally and those unable to pay. The high shares of informal payments and inability of users to deal with the health expenditures lead to doubts about the fairness of the health care provision in Central and Eastern Europe. There is an urgent need for policy makers in the region to not only acknowledge but also to effectively address this key problem.

Measuring Provider Performance for Physicians Participating in the Merit-Based Incentive Payment System.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.

Moving towards Universal Health Coverage through the Development of Integrated Service Delivery Packages for Primary Health Care in the Solomon Islands

PubMed Central

Whiting, Stephen; Postma, Sjoerd; Jamshaid de Lorenzo, Ayesha; Aumua, Audrey

2016-01-01

The Solomon Islands Government is pursuing integrated care with the goal of improving the quality of health service delivery to rural populations. Under the auspices of Universal Health Coverage, integrated service delivery packages were developed which defined the clinical and public health services that should be provided at different levels of the health system. The process of developing integrated service delivery packages helped to identify key policy decisions the government needed to make in order to improve service quality and efficiency. The integrated service delivery packages have instigated the revision of job descriptions and are feeding into the development of a human resource plan for health. They are also being used to guide infrastructure development and health system planning and should lead to better management of resources. The integrated service delivery packages have become a key tool to operationalise the government’s policy to move towards a more efficient, equitable, quality and sustainable health system. PMID:28321177

Reforming funding for chronic illness: Medicare-CDM.

PubMed

Swerissen, Hal; Taylor, Michael J

2008-02-01

Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.

Quality Control in Linen and Laundry Service at A Tertiary Care Teaching Hospital in India

PubMed Central

Singh, Dara; Qadri, GJ; Kotwal, Monica; Syed, AT; Jan, Farooq

2009-01-01

Introduction: The clean bedding and clean clothes installs psychological confidence in the patients and the public and enhances their faith in the services rendered by the hospital. Being an important Component in the management of the patients, a study was carried out to find out the current quality status and its conformity with the known standards and identify the areas of intervention in order to further increase the patient and staff satisfaction regarding the services provided by linen and laundry department Methods: Quality control practised in the Linen and Laundry Service was studied by conducting a prospective study on the concept of Donabedian model of structure, process and outcome. Study was done by pre-designed Proforma along with observation / Interviews / Questionnaire and study of records. The input studied included physical facilities, manpower, materials, equipments and environmental factors. The various elements of manpower studied consisted of number of staff working, their qualification, training, promotion avenues, motivation and job satisfaction. Process was studied by carrying out observations in linen and laundry service through a predesigned flow chart which was supplemented by interviews with different category of staff. Patient satisfaction, staff satisfaction and microbial count of laundered linen (quality dimensions) were studied in the outcome. Results: The current study found that in spite of certain deficiencies in the equipment, manpower and process, the linen and laundry service is providing a satisfactory service to its users. However the services can be further improved by removing the present deficiencies both at structure and process level. PMID:21475509

A community hospital acute pain service.

PubMed

Musclow, Shirley L

2005-11-01

This article provides readers with a guide to developing and implementing an acute pain service in a community hospital. Kanter's theory of innovative diffusion is used to frame the author's experiences as a lead nurse in two community hospital acute pain services. Health-care providers recognize the importance of quality pain assessment and management. One initiative for improving pain management has been the implementation of an acute pain service (APS). In Canada, most university-affiliated teaching hospitals have now developed an APS to improve pain management. Community hospitals, however, have only recently begun to adopt the concept. Improving pain management through an APS provides an excellent opportunity for nursing leadership at all levels. Nursing administration may take the lead in proposing the idea and benefits of acquiring an APS. An advanced practice nurse can provide leadership through the coordination and provision of enhanced pain management as a lead nurse in an APS. Staff nurses can provide leadership in improving pain management on a daily basis and ensuring that quality pain care reaches the bedside, Nursing practice is at the core of making a difference in pain management.

Improving the provision of language services at an academic medical center: ensuring high-quality health communication for limited-English-proficient patients.

PubMed

Standiford, Connie J; Nolan, Elizabeth; Harris, Michelle; Bernstein, Steven J

2009-12-01

To evaluate and improve the provision of language services at an academic medicine center caring for a diverse population including many limited-English-proficient (LEP) patients. The authors performed a prospective observational study between November 2006 and December 2008 evaluating the provision of language services at the University of Michigan Health System. The primary performance measures were (1) screening patients for their preferred language for health care, (2) assessing the proportion of LEP patients receiving language services from a qualified language services provider, and (3) assessing whether there were any disparities in diabetes care for LEP patients compared with English-speaking patients. The proportion of patients screened for preferred language increased from 59% to 96% with targeted inventions, such as training staff to capture preferred language for health care and correcting prior inaccurate primary language data entry. The proportion of LEP outpatients with a qualified language services provider increased from 19% to 83% through the use of staff and contract interpreters, over-the-phone interpreting and bilingual providers. There were no systematic differences in diabetes quality performance measures between LEP and English-proficient patients. Academic medical centers should measure their provision of language services and compare quality and safety data (e.g., performance measures and adverse events) between LEP and English-speaking patients to identify disparities in care. Leadership support and ongoing training are needed to ensure language-specific services are embedded into clinical care to meet the needs of our diverse patient populations.

Conjoint Analysis for New Service Development on Electricity Distribution in Indonesia

NASA Astrophysics Data System (ADS)

Widaningrum, D. L.; Chynthia; Astuti, L. D.; Seran, M. A. B.

2017-07-01

Many cases of illegal use of electricity in Indonesia is still rampant, especially for activities where the power source is not available, such as in the location of street vendors. It is not only detrimental to the state, but also harm the perpetrators of theft of electricity and the surrounding communities. The purpose of this study is to create New Service Development (NSD) to provide a new electricity source for street vendors' activity based on their preferences. The methods applied in NSD is Conjoint Analysis, Cluster Analysis, Quality Function Deployment (QFD), Service Blueprint, Process Flow Diagrams and Quality Control Plan. The results of this study are the attributes and their importance in the new electricity’s service based on street vendors’ preferences as customers, customer segmentation, service design for new service, designing technical response, designing operational procedures, the quality control plan of any existing operational procedures.

A social marketing approach to quality improvement in family planning services: a case study from Rawalpindi, Pakistan.

PubMed

Gulzar, Jamshaid; Ali, Moazzam; Kuroiwa, Chushi

2008-02-01

In the 1990s, social marketing approach was introduced in Pakistan to improve the quality and accessibility of family planning methods involving private practitioners. This study measured six quality elements using a Bruce-Jain framework. Cross-sectional survey data were collected from 29 randomly selected Green Star clinics. The study's four components were 1) an inventory of each outlet (infrastructure, equipment, and supplies); 2) an observation guide for interaction between family planning clients and service providers; 3) exit interviews with clients attending the outlet; and 4) interviews with providers at the outlet. Of the 29 clients participating in the exit interviews, 72% were new users of family planning. The clients' mean age was 32 years; all clients were married; 93% had received formal education. Housework was the principal activity of 93% of clients. The mean number of children reported was three. Both hormonal and intrauterine contraceptives (IUCDs) were available in all facilities; 86% of the clients reported being able to obtain their contraceptive of choice. Most facilities had the equipment and supplies needed to deliver services; service personnel were trained and regularly supervised; the service outlets emphasized mechanisms to ensure continuity of use. Notable shortcomings included a shortage of information on alternative methods, contraindications, and side-effect management, as well as a dearth of registration records. In conclusion, this is a good example of public-private partnership involving private practitioners using a social marketing approach. The quality components of a Bruce-Jain framework were achieved, resulting in a satisfied clientele. Involvement of private service outlets increased the accessibility and enhanced the use of services. Social marketing may be expanded to improve quality and access by involving further components of health care.