Editorial

Citation

Hurst, K. (2013), "Editorial", International Journal of Health Care Quality Assurance, Vol. 26 No. 4. https://doi.org/10.1108/IJHCQA.06226daa.001

Editorial

Article Type: Editorial From: International Journal of Health Care Quality Assurance, Volume 26, Issue 4

Judging from patients’ and relatives’ testimonials, healthcare professionals are excellent technical carers. Service-user complainants, on the other hand, sometimes say that healthcare’s softer side, particularly for patients not overtly showing the turmoil they’re experiencing, falls short. Anything that helps us to underline patients’ psycho-social needs, therefore, is a bonus. In this issue, Eileen O’Donnell assesses cancer patients using the Distress Thermometer (DT – a self-reporting assessment scale) and explains her findings. More than one third of her patients were so distressed (according to their DT results) that were referred to specialist staff. If potential demand among distressed patients is so high and needy patients so readily spotted then shouldn’t the DT be rolled out universally?

Choose and book (or its international equivalent) is rapidly gaining popularity among our authors. However, as we’ve seen in other IJHCQA articles, informing patients about a health service provider characteristics and performance isn’t easy. Makoto Kobayashi and colleagues, in its issues, explore patients’ preferences using triangulation. Readers probably won’t be surprised at what’s on the patient’s shortlist; although one finding (distance from home to hospital) goes against received wisdom, which says that patients are willing to travel distances to their healthcare providers. Unsurprising, on the other hand, is service quality’s importance to patients. Private healthcare, normally assumed to generate higher service quality, wasn’t a critical attribute. Clearly, guiding patients through service providers according to provider attributes, needs careful thought and action.

The professional equivalent to choose and book, evidence-based practice, is explored by Nahid Olfati and colleagues – especially how research is implemented by Iranian general practitioners (GPs). Although GPs were positive about research-based knowledge, only one quarter implemented research-based findings and the reasons why most ignored the evidence, such as rising workload, won’t surprise the readers. The authors explain the pitfalls conducting research among GPs – notoriously poor responders.

The information emerging from service quality-related publications each day is staggering. Consequently, it’s almost impossible for coalface workers to keep abreast; that’s why we’re always pleased to receive manuscripts in which authors take stock and synthesis new intelligence emerging from the literature. In this issue, Yogesh and colleagues take a look at service-quality dimensions in the literature, particularly the dimensions’ underlying theoretical frameworks and their methodological/ psychometric issues. Their literature review is extensive and how their emerging dimensions are applied to health policy and practice generates important insights that inform consumer choice and patient welfare.

How healthcare issues, like choose and book, evidence-practice, etc., shape health services is explored by Yiannis Koumpouros who applies the Balances Scorecard (BSC) to one Greek hospital to explore the organisation’s managerial structures, processes and outcomes/outputs. The author underlines Greece’s healthcare culture and its impact on change management. Perhaps one way to gather intelligence about a service provider, therefore, is to use the Balanced Scorecard (BSC).

How many readers inject significant time and effort into their daily work and decline payment? Unbelievably, claiming reimbursement for patient care from funders’ seems to be an emerging problem in NHS England – to the extent that one article we publish in this issue follows-up a similar article in IJHCQA Volume 22, Issue 4. A relatively new reimbursement system in NHS England called Payment by Results (PbR) relies on service managers billing commissioners for provider services. A cynical person might think that the temptation to bill for fictitious work would be a greater problem than not billing for work legitimately completed; but the latter is exactly what Mohammad Shahid and Alistair Tindall analyse. Even though they study only two surgical procedures, it seems that their hospital’s coders may have failed to bill for procedures worth £118,000. Missed income like this could easily pay for additional clinicians – thereby minimising a vicious cycle (understaffing leads to underperformance leads to falling income leads to …). If miss-coding is a universal problem then it’s staggering what money hospital managers might be losing.

Another article we publish that follows-up a similar article in IJHCQA Volume 25, Issue 1, addresses clinical waste management, which, owing to the healthcare industry’s size and its massive waste’s potentially lethal nature, is another theme we are increasingly publishing. Ghanaian private and public hospital managers have different waste management policies and practices. Efficiency and effectiveness vary. Clearly, hospital managers can learn from waste management practices elsewhere and could benefit from sharing knowledge and skills – perhaps another topic for the healthcare “learning set” movement.

Keith Hurst
Editor