The quest to improve Chinese healthcare: some fundamental issues

A quantitative framework for health‐care service quality assessment in India

Purpose

The present situation of COVID-19 pandemic has put the health-care systems under tremendous stress and stringent tests for their ability to offer expected quality of health-care services, as it decides the sustainability and growth of health-care service providers. This study aims to deliver a quantitative framework for service quality assessment in the health-care industry by classifying the health-care service quality parameters into four balanced scorecard (BSC) perspectives.

Design/methodology/approach

To determine the service quality for the Indian health-care system, decision-making trial and evaluation laboratory and analytical network process are integrated in a fuzzy environment to contemplate the interaction among BSC perspectives and respective performance measures.

Findings

The results indicate “internal processes” perspective assumes the key role within BSC perspectives, while performance measures “nursing staff turnover” and “staff training” play the key roles. The results also signify that “patient satisfaction” is the most vital issue and can be strongly influenced by measures belonging to the “learning and growth” perspective. In “learning and growth” perspective, “staff training” is the most decisive criteria, very highly influencing “patient satisfaction”, highly influencing “profitability,” “change of cost per patient (both in and out patients)” and “outpatient waiting time” while moderately influencing “staff satisfaction,” “bed occupancy” and “nursing staff turnover”. Moreover, “staff training” criteria have a positive influence on “nursing staff turnover.”

Originality/value

The contributions of this study are in two folds in the domain of quantification of service quality for the health-care system. First, it delivers an assessment framework for Indian health-care service quality. Second, it demonstrates an application of the framework for a case situation and validates the proposed framework.

Antecedents and outcomes of patient satisfaction in healthcare: A conceptual model

This study develops a conceptual model and establishes the relationships between the variables, both influencing and affected by patient satisfaction. The authors conducted a thorough search for peer-reviewed articles obtaining a final sample of 64 studies. Service quality was found to be the only antecedent influencing patient satisfaction, while patient satisfaction was found to impact trust, loyalty and word of mouth, also mediating the influence of service quality on these variables. While the study integrates the scattered literature, from a practical standpoint it exhibits how increased patient satisfaction plays a key role in influencing patient trust, loyalty and word-of-mouth.

Development of Balanced Scorecard for healthcare using Interpretive Structural Modeling and Analytic Network Process

Purpose

– The purpose of this paper is to develop a Balanced Scorecard-based performance measurement framework for health care system.

Design/methodology/approach

– An integrated ISM-ANP-based quantitative approach is used for the development of balance scorecard for health care system. The necessary insights are drawn from the secondary literature.

Findings

– This research identifies Key Performance Indicators and their interrelationships for health care system. An integrated approach of ISM and ANP is employed for the development of balance scorecard.

Research limitations/implications

– The findings of the research are based on insights gained from secondary literature and an analysis of five cases in health care segment and hence generalization of proposed framework is limited to the system representing some commonalities with chosen cases.

Practical implications

– Health care is the diagnosis, treatment and prevention of disease, illness, injury and other physical and mental impairments in humans. Access to health care varies across countries, groups and individuals, largely influenced by social and economic conditions as well as the health policies in place. The changing nature of today's health care organizations, including pressure to reduce costs, improve the quality of care and meet stringent guidelines, has forced health care professionals to re-examine how they evaluate their performance.

Originality/value

– The Balanced Scorecard health care expanded organization measures beyond financial analysis. It was first proposed by Robert S. Kaplan and David P. Norton in their book “The Balanced Scorecard (1996, Harvard Business School Press).” This research reports a development of Balanced Scorecard for health care using an integrated approach of Interpretive Structural Modeling and Analytic Network Process is used.

Piercy N, Lal B, Weerakkody V. RFID integrated systems in libraries: extending TAM model for empirically examining the use

Purpose

– The available literature suggest that the research on radio frequency identification (RFID)-related issues is largely concentrated on technical, organizational and implementation aspects, and comparatively lesser attention has been invested in understanding the use aspect of such library management systems. The purpose of this paper is to gain an understanding into the factors that influence the use of RFID systems in the library context by empirically testing the relevant constructs from the extended technology acceptance model (TAM).

Design/methodology/approach

– A questionnaire-based survey approach was employed for collecting the relevant data from 197 respondents. The respondents were the active users of a RFID-based library system.

Findings

– Findings from this study suggested that perceived usefulness and system quality positively influence the user attitude, and user attitude and system quality significantly influence the use of the RFID services. The paper concludes with outlining the salient points, limitations, and future research directions.

Originality/value

– The paper evaluates the role of a set of innovation attributes on the acceptance of RFID integrated systems in libraries. Owing to the scant literature availability in empirical investigations on adoption of RFID systems in libraries, the findings from this paper add value to the existing literature in this field, and also to the literature on the TAM model, with the empirical findings being of use to the aspirant libraries looking toward integrating RFID enabled systems.

The rise and decline of TQM in the NHS

Purpose

– The purpose of this paper is to delineate the factors responsible for the decline of total quality management (TQM) in the National Health Service (NHS). It is suggested that if these factors were initially identified and eliminated prior to implementation, the decline of TQM as a strategy for improving the provision and delivery of quality patient care could have been prevented.

Design/methodology/approach

– The case study approach was chosen because it is the preferred method when “how” or “what” questions are being posed. It is applicable as is evident in this paper where the researcher has little control over events and when the focus is on a contemporary phenomenon within some real-life context. The case study enables the researcher to give an accurate rendition of actual events; it contributes uniquely to the knowledge of individual, organisational, social, and political phenomena. The semi-structured face-to-face interview constituted the main data collection technique of the research. Interviews were held with 23 quality management managers in the British NHS. The central focus of the interview was on “what” factors contributed to the rapid decline of TQM in the NHS. The respondents were chosen because they were directly involved with the implementation of TQM. They were in the vintage position to offer a full insight into the TQM initiative. The analysis of the case is based on Yin's analytic technique of explanation building.

Findings

– The decline of TQM in the NHS could have been prevented if top executives in hospitals had adopted the sequential steps to quality improvement: In the authors opinion, to land a man on the moon needed a belief in the possibility and breakthrough in the attitudes that viewed space travel as pure science fiction as opposed to a practical reality, and so it should have been with TQM in the NHS. However, the attitude of many NHS managers was that TQM was all right for “other institutions” because “they need it” whereas in the NHS, “we don’t”. This negative attitude should have been overcome if TQM was to be accepted as a corporate, all encompassing philosophy.

Research limitations/implications

– The limitation of the research may be the sample size of the respondents, which was limited to 23 quality managers that had hands-on experience and the leadership role to lead and implement TQM in the NHS. Future research may consider a broader sample size. It may also be considered for new research to use surveys to identify a broader set of reasons why TQM declined in the NHS.

Practical implications

– This paper is the first constructive insight to determine reasons for the decline of TQM in the NHS from the individuals who had the sole responsibility for implementation. Any other, group would have amounted to hearsay. Therefore, to constructively delineate the reasons for failure, it was pertinent to learn from the quality managers directly and to ensure that the reasons was representative of their experiences with TQM. The practical implication is to prepare future managers about how to avoid failure.

Originality/value

– The paper clearly suggests the systematic process required for effective implementation of TQM in a healthcare setting by identifying factors that must be avoided to ensure the successful and sustainable implementation of TQM.

What Drives a Successful Technology Implementation?

Radio Frequency Identification (RFID) is revolutionizing item identification and tracking. The technology demonstrates complexities in terms of (a) huge initial capital investment, (b) validating the need for RFID followed by its implementation decisions, (c) risks associated with consumer acceptance and consequences of incorrect implementation, and (d) capability to support enhancements and upgrades in cordial agreement with the individual implementer organizations. This paper explores the extent of RFID implementation at the Swansea University Library, examining the Social, Technological, Economic, and Managerial (STEM) aspects directly associated with implementation. A focused interview approach was resorted to, for data collection purposes. The core implementation team for RFID at Swansea University was interviewed to gain insights into the study’s areas of interest. It was found that self service is the most sought after benefit. It simplifies stock management and enhances security at the libraries. Although the cost of the system remains a concern, varying on the basis of the scale of implementation, vandalism also continues to exist but to a reduced degree. University libraries are public sector organizations, consequently leading these findings to have an insinuation for RFID implementations in other public sector organizations as well.

Best practices of total quality management implementation in health care settings

Due to the growing prominence of total quality management (TQM) in health care, the present study was conducted to identify the set of TQM practices for its successful implementation in healthcare institutions through a systematic review of literature. A research strategy was performed on the selected papers published between 1995 and 2009. An appropriate database was chosen and 15 peer-reviewed research papers were identified through a screening process and were finally reviewed for this study. Eight supporting TQM practices, such as top-management commitment, teamwork and participation, process management, customer focus and satisfaction, resource management, organization behavior and culture, continuous improvement, and training and education were identified as best practices for TQM implementation in any health care setting. The article concludes with a set of recommendations for the future researchers to discuss, develop, and work upon in order to achieve better precision and generalizations.