Editorial

Citation

Downey-Ennis, K. (2011), "Editorial", International Journal of Health Care Quality Assurance, Vol. 24 No. 1. https://doi.org/10.1108/ijhcqa.2011.06224aaa.002

Editorial

Article Type: Editorial From: International Journal of Health Care Quality Assurance, Volume 24, Issue 1

When it comes to improving health care at times we appear to be lost in terms of developing some fundamental aspects of the system in which we work. This has never been more crucial with all the changes that are currently occurring and the critical need for a whole team approach.

I include in this editorial some facts that happened to an experienced doctor during the working day which point to the lack of a team and holistic perspective. We use the term holistic frequently when it comes to delivering patient centered care, however working within a hospital system requires a holistic view from all professionals within that system.

The following is a real life scenario from the view of an experienced anesthesiologist:

It was an early start in the operating theatre, doctors and nurses were preparing for a busy day as the schedule was long, however while the case acuity was deemed low each patient presented with individual challenges. All went well for the first case and in preparing the second case the anesthesiologist faced some challenges, the patient’s veins were sparse due to previous complications necessitating three attempts to insert the IV. Coupled with the paucity of veins the doctor had to contend with a new IV system which had been introduced without approval by the frontline users of the system. So here is the first of a catalogue of events, the system was introduced with out proper consultation, highly experienced nurses had difficulty with it, one can ask why their concerns were not taken into consideration. To make things worse the doctor received a needle stick injury in the process of his attempts. As part of the occupational health protocol there was a requirement to examine the patient’s blood to out rule blood borne disease and of course this required yet another blood draw which understandably the patient was not happy with given the recent failed attempts. But still there was work to be done. The next challenge emerged via a malfunctioning anesthetic machine which caused a further delay in the schedule. After successfully completing the case word was received from the Operating Room manager to cancel the last case. This decision was taken solely by the OR manager without any consultation with the team leaving both anesthesiologist and surgeon incensed that a patient would be inconvenienced in this manner and experience further misery and anxiety as the patient was prepared for the surgery on the day. The message from this anecdote is while all healthcare professionals strive to deliver person centered patient care all participants within the system must become part of the team when decisions are made about purchasing, maintenance and scheduling.

You may ask “Why report on the above situation?”, but personally I feel that many professionals working on the frontline are confronted with challenges on a daily basis which with some consideration could be avoided.

There are some interesting papers in this issue all of which are striving to improve the healthcare system from a wide variety of areas.

Jaber, Shaban, Hariri and Smith report on a cross sectional study undertaken to determine healthcare practitioners’ knowledge of oral cancer risk factors and to ascertain if oral cancer risk factors were properly assessed during the diagnostic session with patients in Saudi Arabia. The study also aimed to discover practitioner’s opinions of their knowledge and to identify improvements. The authors concluded that training in oral cancer prevention and early detection is essential for dentists and healthcare practitioners both of whom recognized that they had a deficiency in oral cancer training and that they are interested in taking oral cancer continuous education courses. This led to a re-evaluation of the continuous education strategies in Saudi Arabia with suggestions made to place more emphasis on oral cancer prevention and early detection in further education programs.

Chaiter, Palma, Machluf, Yona, Cohen, Pirogovsky, Shohat, Ytzhak and Ash describe an intervention program that was developed in order to improve the performance and skills of technical medical personnel at military recruitment medical committees. The intervention program increased the perception of the technical medical staff work as part of the medical profiling process and there is an opportunity for the program to be adopted by many others.

Naughton, MacSuibhne, Callanan, Guerandel and Malone’s paper looks at improving the quality of case conferences in the discipline of psychiatry and is essentially “work in progress”. The results provide encouraging evidence that change may be achievable and beneficial, however the multidisciplinary group that attend such conferences held differing views all of which need to be respected and their next step is to listen to all the actors and take on board suggestions on how to improve to ensure that learning is beneficial to participants learning.

Two papers report on studies using the SERVQUAL tool.

Mohd Suki, Chiam Chwee Lian and Mohd Suki investigated whether patients’ perceptions exceeded expectations in private healthcare settings in Malaysia using the five-dimension model to which they added three additional dimensions of the human element of healthcare delivery. They conclude that overall perceptions did not exceed expectations, the responsiveness variable had the lowest service gap score. The authors argue that customers have high expectations and that management need to take cognizance of the fact that customers can be dissatisfied with various aspects of the service delivery process and enact improvements.

Nekoei-Moghadam and Amiresmaili’s research paper hypothesized that while quality orientation is one of the main priorities of any progressive organisation the evaluation of quality is a key challenge and that quality is determined by many intangible factors. The authors undertook a descriptive study using the SERVQUAL tool in a developing country. In all five dimensions gaps were observed between patient perceptions and expectations which give hospitals clear guidance on how to improve services to reduce the gaps identified.

Sooksan Kantabutra’s research paper studied using a case study methodology the fit between the business practices of a social enterprise delivering healthcare services in Thailand with Avery’s 19 sustainable leadership elements derived from Rhineland enterprises. The results indicate that while there was compliance with 15 of the elements this was in varying degrees. The author concludes that the Rhineland practices provide a useful framework for sustaining organizational success together with a means of evaluation on leadership practices.

Sandin-Bojö, Kvist, Berg and Wilde Larsson paper studied the perceptions of how Swedish women perceive the quality of intrapartal care and the subjective importance they ascribe to their care. The study used a quantitative methodology two months post partum and the results revealed that a high percentage of women agreed fully or mostly that the birth of their child was a positive experience women and that they felt in control during the birth of their child and felt themselves to be safe.

Kay Downey-EnnisCo-Editor