Healthcare Services: Patient Satisfaction and Loyalty Lessons from Islamic Friendly Hospitals

The Intricate Relationship of Employee Engagement and Lean Approach toward Quality Improvement of the Public Hospitals

The lean approach is a value-added system that reduces cost and waste to continuously improve the quality performance of the healthcare organization. The present study investigates the relationships of the lean approach with top management team and employee engagement toward quality improvement of the public hospitals in Malaysia. This study used stratified random sampling to collect data from the public hospitals' staff who were directly involved with patient services. In this study, PLS-SEM 3.3.4 was applied to measure the research constructs and hypotheses. The research findings indicate that the lean approach has a significant relationship with the top management team and employee engagement to positively impact the quality improvement of the public hospital. However, research findings also indicate that the top management team has no significant influence on quality improvement in public hospitals, but it has an indirect effect through the lean approach and employee engagement. The findings of the study will provide guidelines on how the lean approach contributes to the body of knowledge and practical implications to continuously improve the quality performance of public healthcare system.

Developing a Shariah-compliant medical services framework in Malaysia: an expert system approach using fuzzy Delphi method and interpretive structural modelling

INTRODUCTION

In an increasingly diverse healthcare landscape, addressing the specific needs of Muslim patients has become paramount. The absence of comprehensive frameworks for Shariah-compliant healthcare services often poses challenges for healthcare professionals striving to provide care that aligns with Islamic values.

OBJECTIVE

The objective of this study was to develop a comprehensive framework for Shariah-compliant healthcare services, ensuring alignment with Islamic practices in healthcare.

METHODS, SETTING, PARTICIPANTS

This consensus study employed a key input approach using the fuzzy Delphi method (FDM) and interpretive structural modelling. Conducted in Malaysia, the study involved 10 experts from various regions across the country. These experts were selected based on clear criteria that included professionals with experience in Islamic and/or healthcare, while those lacking relevant expertise were excluded.

RESULTS

The primary outcome was the identification of pertinent elements for the framework, with final elements measured based on expert consensus achieved through FDM. The panel of experts reached consensus on 10 essential elements that form the backbone of the framework for Shariah-compliant healthcare services. These elements include governance, medical ethics, patient care, human resources and professional development, facilities for Islamic worship (ibadah), spiritual care support, end-of-life care, Islamic environment, medicine and drugs, and affordability and accessibility.

CONCLUSION

Ultimately, the development of this comprehensive framework is a crucial step in addressing the specific needs and concerns of Muslim patients worldwide. By incorporating the input and consensus of experts from various relevant fields, the resulting framework provides healthcare professionals with a solid foundation to deliver healthcare services that align with Islamic values, ultimately promoting the well-being of Muslim patients in Malaysia and tourists globally.

The Impact of Medical Risk Perception on Patient Satisfaction: The Moderating Role of Shared Decision-Making

Purpose

The perception of medical risks is ubiquitous, influencing patients' healthcare experiences, yet the "black box" of this influencing process is seldom explored. This study explores the relationship between medical risk perception, trust, and patient satisfaction while taking shared decision-making as a moderator.

Methods

A stratified random sample of 450 inpatients from a tertiary public hospital in Guangzhou was selected for investigation, from June 2023 to September 2023. A moderated mediation model was tested using the PROCESS program, wherein medical risk perception was linked to patient satisfaction through trust, with shared decision-making acting as the moderating variable.

Results

Medical risk perception had a significant negative predictive effect on patient satisfaction (β = -0.383, p < 0.001), and after introducing the mediating variable, the negative predictive effect of medical risk perception on patient satisfaction remained significant (β = -0.237, p < 0.001). Trust partially mediated the relationship between medical risk perception and patient satisfaction, with the mediating effect accounting for 37.86% of the total effect. The interaction term between medical risk perception and shared decision-making (β = 0.211, p < 0.001) significantly predicted trust.

Conclusion

This study confirmed the mediating and moderating effects of trust and shared decision-making on the relationship between medical risk perception and patient satisfaction. The theoretical model constructed based on the theory of information asymmetry provides strategies and methods for healthcare managers to improve the quality of healthcare services and alleviate tensions in doctor-patient relationship.

National income accounting attributes and economic welfare. Evidence from Pakistan

Economic welfare is essential in the modern economy since it directly reflects the standard of living, distribution of resources, and general social satisfaction, which influences individual and social well-being. This study aims to explore the relationship between national income accounting different attributes and the economic welfare in Pakistan. However, this study used data from 1950 to 2022, and data was downloaded from the World Bank data portal. Regression analysis is used to investigate the relationship between them and is very effective in measuring the relationship between endogenous and exogenous variables. Moreover, generalized methods of movement (GMM) are used as the robustness of the regression. Our results show that foreign direct investment outflow, Gross domestic product growth rate, GDP per capita, higher Interest, market capitalization, and population growth have a significant negative on the unemployment rate, indicating the rise in these factors leads to a decrease in the employment rate in Pakistan. Trade and savings have a significant positive impact on the unemployment rate, indicating the rise in these factors leads to an increase in the unemployment rate for various reasons. Moreover, all the factors of national income accounting have a significant positive relationship with life expectancy, indicating that an increase in these factors leads to an increase in economic welfare and life expectancy due to better health facilities, many resources, and correct economic policies. However, foreign direct investment, inflation rate, lending interest rate, and population growth have significant positive effects on age dependency, indicating these factors increase the age dependency. Moreover, GDP growth and GDP per capita negatively impact age dependency. Similarly, all the national income accounting factors have a significant negative relationship with legal rights that leads to decreased legal rights. Moreover, due to better health facilities and health planning, there is a negative significant relationship between national income accounting attributes and motility rate among children. Our study advocated the implications for the policymakers and the government to make policies for the welfare and increase the social factors.

Moderating role of political stability and economic policy uncertainty between country governance practice and stock market performance. A comparative analysis of Pakistan and Kurdistan Region of Iraq

The objective of the study is to explore the relationship between country governance practices along with political stability and Economic policy uncertainty, and stock market performance of two different economies, Pakistan and Kurdistan region of Iraq. To meet our objectives, we used the 25 years past data from 1996 to 2021. Data is collected from the DataStream database. The regression analysis is used as the method of estimation for linear and moderation effect. Our results show that regulatory quality, rules of law and political stability has significant positive relationship with stock market performance of Pakistan, but all the governance indicators have significant positive relationship with stock market performance of the Kurdistan Region of Iraq. Moreover, political stability has significant moderating impact between the governance practices and the performance of the stock markets of both economies indicating that the governance practices perform well with the political stability that leads to rise in the stock market indices of selected countries. Economic policy uncertainty has significant negative moderation impact due to creating the risk in both economies that decrease the performance of the stock markets of the selected economies. Finally, our study advocated some implications for the investors to increase their confidence on the stock of high political stability and low economic policy uncertainty economies. Government can take significant measures to control the uncertainty of the policy and portfolio managers can adjust their risk on the ground of the political stability and efficient governance practices countries.

Environmental and health values, beliefs, norms and compatibility on intention to adopt hydroponic farming among unemployed youth

The objective of this study was to examine the relationships among environmental and health values, ecological worldview, perception of consequences, the ascription of responsibility, and personal norms in the context of the value-belief-norm (VBN) model and how compatibility influences the intentions and behaviors of Chinese youth regarding the use of hydroponic farming technology. The study employed a survey questionnaire to collect data from the target population. The sample size was determined through a power analysis to ensure sufficient statistical power for the analysis. A total of 727 potential respondents' responses were analyzed using SmartPLS (4.0) to perform structural equation modeling. The results confirmed that environmental, emotional, and health values significantly associated with individuals' ecological worldviews. There was an interconnection between ecological worldview, awareness of consequences, and ascription of responsibility, and all three significantly influenced personal norms. The key determinants of the intentions and behaviors to adopt hydroponic farming technology are personal norms and technology compatibility. Therefore, to promote and motivate the interest and intention to use hydroponics among unemployed youth, government agencies, and related companies should focus on providing technology-related and pro-environmental information and training. This is expected to increase the acceptance and awareness of hydroponics among this group, thus increasing the adoption rate of hydroponics.

The relationship between political instability and stock market performance: An analysis of the MSCI index in the case of Pakistan

The stock market is the barometer of the economy that reflects the overall health and direction of the economic development and is affected by different factors including social, environmental and political. It is important to investigate the effect of the political instability on the stock market performance, especially on emerging economies. Therefore, we aim to study the relationship between political instability and stock market performance in Pakistan. To meet our objectives, we used past data from 1996 to 2021. Data are collected from the DataStream data base. MSCI indices are used as the proxy for the Stock market performance of the selected country. World governance six indicators are used in the study as the explanatory variable concentrating the political instability index as the main explanatory variable. Regression analysis is used but two-way robustness analysis was done for the accuracy of the findings through GMM methods and taking GDP as another endogenous variable. Our findings shows that the political stability has significant positive impact on the stock market performance while, political instability has negative impact on stock market performance. Moreover, other governance indicators has a significant positive impact on performance. However, political instability disrupts the operations and economical activities that leads to decrease the investor confidence and also decrease the foreign investment with the increment of the risk in the country. Moreover, our study has some implications for investors to develop the diversified portfolio to minimize the risk and policy makers can increase their foreign direct investment within the economy by controlling the political instability.

Determinants of effectiveness of lean healthcare performance in Malaysian public hospitals

Purpose

This study aims to explore the lean leadership factors influencing the effectiveness of lean healthcare performance at hospitals.

Design/methodology/approach

A total of 217 healthcare professionals’ responses were included for data analysis. The data were analyzed using the partial least square technique.

Findings

The findings revealed that improvement culture, gemba (hands-on approach), hoshin kanri (goal-oriented) and qualification are the crucial lean leadership factors that positively influence the effectiveness of lean healthcare performance at hospitals. The results indicated that the self-development of lean leaders has no significant impact on the effectiveness of lead healthcare performance.

Originality/value

The findings of this study could contribute to the healthcare institutions in Malaysia perceive the benefits of lean healthcare and show a positive intention of using lean leadership principles.

Determinants of patients' satisfaction and trust toward healthcare service environment in general practice clinics

This study aimed to examine the healthcare service environment, patients' experience, and responses toward healthcare services in private general practice (GP) clinics. Self-administered questionnaires were used for collecting data from 367 respondents with prior experience in visiting the general practice clinics in Malaysia. SmartPLS statistical tool was used to test the underlying hypotheses. The results revealed that ambiance, service delivery, interior decor, and cleanliness had a significant influence on patients' trust and satisfaction while the exterior design is neither associated with satisfaction nor trust. Patients' satisfaction and trust had a higher significant effect on their repatronage intention, willingness to pay for a premium healthcare service, and engagement in word-of-mouth for healthcare services. In practice, both the service delivery and ambiance features of the healthcare services environment might be optimized by GP clinics. This research provides significant insights from the patients' perspective toward the GP clinics' healthcare services environment.

Predicting the Willingness and Purchase of Travel Insurance During the COVID-19 Pandemic

This study explored the willingness and purchase of travel insurance during the COVID-19 pandemic amongst working adults to ensure their safety and welfare through the lens of the theory of planned behavior. Primary data were gathered from 1,118 working adults across Malaysia and analyzed using the partial least squares structural equation modeling. The study outcomes revealed that attitude toward travel insurance was significantly influenced by insurance literacy, perceived health risk, and health consciousness. The willingness of working adults to purchase travel insurance was highly influenced by attitudes, subjective norms, and perceived behavioral controls but unaffected by perceived product risks. The purchase of travel insurance was positively influenced by the willingness to purchase travel insurance. In fact, travel insurance literacy and perceived health risk should be emphasized amongst working adults to encourage them to purchase travel insurance policies for traveling abroad.

Predicting Consumer Green Product Purchase Attitudes and Behavioral Intention During COVID-19 Pandemic

This work has aimed to investigate the consumers' green product purchase attitudes and behavioral intention during COVID-19 pandemic. Data was collected through a survey method of 503 consumers in Malaysia. Data were analyzed using the partial least square method. The findings revealed that fear of COVID-19 pandemic has a significant impact on green product behavioral intention. Green product literacy, green product orientation, and social influence have a significant influence on green product purchase attitudes. The results also indicated that consumers' green product purchase attitudes mediate the effect of green product literacy, green product orientation, and social influence on behavioral intention. The findings of this work will provide strategically relevant references to green marketers and retail managers in the understanding of consumers' green product purchase attitudes and green product behavioral intention during the ongoing uncertainty of the COVID-19 pandemic.

The Relationships Between Patient Experience with Nursing Care, Patient Satisfaction and Patient Loyalty: A Structural Equation Modeling

PURPOSE

When creating and managing patient loyalty, medical institutes always focus on medical technicians, overall healthcare quality, and hospital brands, and the role of nursing seems to be underappreciated. Empirical evidence about the relationship between patient experience with nursing care and patient loyalty is limited, especially in the Chinese healthcare system. This study aimed to explore to what extent patient experience with nursing care influences patient loyalty to the hospital and the impact routes.

PATIENTS AND METHODS

This study is a multicenter cross-sectional survey. The STROBE was selected as the checklist in this study. Patient experience with nursing care, patient satisfaction and patient loyalty were collected from 1469 inpatients in three hospitals in China through a paper-based survey. Data were analyzed using SPSS and AMOS software; a structural equation model was established to explore the effect of patient experience with nursing care and satisfaction on patient loyalty using the PROCESS macro.

RESULTS

There were significant direct and indirect effects between patient experience with nursing care and patient loyalty, explaining 32.0% of patient loyalty variance. Patient experience with nursing care had a direct and positive impact on patient loyalty (β=0.298, P<0.01), and better patient experience with nursing care was directly associated with better patient loyalty. In addition, the results also revealed the effect of patient experience with nursing care on patient loyalty was partially mediated by patient satisfaction with nursing care and overall hospital services (β=0.162, P<0.01).

CONCLUSION

This study confirmed the importance of nursing care in creating patient loyalty; improving the patient experience with nursing care would be beneficial to patient loyalty. When creating patient loyalty, hospital administrators and nursing managers should make efforts to develop positive patient experience of nursing care in daily clinical practice through organizational changes, culture shaping and staff education.