Development of a framework for evaluation of quality of emergency care services of Indian hospitals.

Healthcare systems are confronted with multiple challenges in the past years due to changes in the political and socio-economic international arena as well as to decreasing quality of healthcare services, decreasing population health status, lack of efficiency of the delivery system, the rigid norms and functioning of the system, lack of competition and of an active role of consumers. These have led to a growing number of healthcare facilities, with overused and outdated medical equipments, with no incentives to provide preventive care, and wide disparities between regions and socio-economic categories regarding access to and quality of hospital services. The scope of the research was to analyze actual methods of resource allocation to hospitals and to develop an improved allocation model, based on optimal costs of delivering services according to standards of actual medical practice in Romanian hospitals. The model suggests a standardization of care per types of patients (ex. Diagnostic Related Groups - DRGs) by means of developing care pathways. Once developed and implemented, care pathways may be the base for calculating the costs of „standard” care, so that they can provide a realistic image of the financial value of resources consumed in the care processes in Romanian hospitals. The model of costing care pathways offers a basis for multiple actions in the areas of financing, cost control, quality of services, adapting to international standards of care, organizational culture, patient safety and patient satisfaction. For the impact it may have on the hospital care system, the implementation of this model may be considered a bottom-up reforming of the system. Keywords: hospital financing, healthcare services costs, management accounting, care pathways, standard costs

Quality healthcare services are a crucial determinant of patient satisfaction, particularly in emergency departments where timely and accurate treatment is essential. This study investigates the influence of the five SERVPERF dimensions Tangibles, Reliability, Responsiveness, Assurance, and Empathy on patient satisfaction in the Emergency Department of Gotong Royong Hospital, Surabaya. Unlike previous studies that often generalize service quality across hospital units, this research specifically focuses on the emergency room context, where service demands and patient expectations are significantly higher. A quantitative survey approach was used, involving 150 respondents who had received ER services. Data were analyzed using Partial Least Squares–Structural Equation Modeling (PLS-SEM) via SmartPLS software. The results reveal that all SERVPERF dimensions significantly affect patient satisfaction, with Empathy showing the strongest positive impact highlighting the importance of personalized care in high-pressure environments. In contrast, Reliability received the lowest rating, indicating critical areas for improvement in consistent and timely service delivery. The study contributes to the literature by offering a focused evaluation of service quality in emergency care using the SERVPERF model and provides actionable insights for hospital management to enhance patient-centered care. Regular implementation of SERVPERF-based evaluations is recommended to ensure continuous service quality improvement guided by real patient experiences.

Quality has taken central stage in contemporary organizations and is one of the key areas of competition. Healthcare organizations, in particular, strive to provide better quality services to their patients in order to gain competitive advantage. Researchers and academicians have yet to agree on how to define and measure quality of service. Attempts have been made to develop standards and measurements to determine the degree of quality of services. However, the literature does not contain a model or standards to measure the quality of health care services. The paper in question presents an inclusive model to measure the quality of service of healthcare organizations. In addition to healthcare services (cure and care) the model encompasses teaching aspect of hospitals as well. This model was developed on the basis of an in-depth and careful study of a large (2400 bedded) public sector teaching hospital spread over a period of two years. Data was collected from 400 patients, 250 employees, 200 general public, and 250 students through questionnaire followed by in-depth interviews. In addition to all this, various processes and interactions among individuals in the hospital were closely observed. Hospital records were studied. Anything that possibly could contribute to the quality of service in hospital was placed under one of the three dimensions of the model. Since the model has been inductively developed through data triangulation, it can safely be used to measure the quality of health care services with a good deal of accuracy.

Patient satisfaction and healthcare service quality are tied together. During Covid-19 pandemic, Lean hospitals have experienced numerous of issues, resulting in drop in service quality and severe impact on patient satisfaction. To understand the patient expectation during the pandemic, service quality of Lean hospitals are further evaluate with employing the SERVQUAL model. 467 questionnaires were collected from the outpatient in the 52 Lean hospitals using non-probability quota sampling method. From the Partial least squares structural equation modelling (PLS-SEM) findings shows that all service quality aspects, reliability, assurance, tangibles, empathy and responsiveness has significant relationship with patient satisfaction. Particularly, patients view empathy as the most significant factor in service quality during the pandemic, whereas the healthcare reliability is discovered to have less influence in explaining the patient satisfaction. A success healthcare system's primary purpose is to ensure all people receive high service quality, respectful treatment and satisfaction to protect their health and well-being. Therefore, the findings provide valuable insights on the perception and expectation of patient towards the healthcare service quality measurement for future improvement. To safeguard the patient satisfaction, Lean hospitals must ensure that (1) sufficient care and attention given to patient to serve patient’s best interests, (2) be responsive to assist and provide prompt services, (3) regularly monitor and ensure the equipment condition and the healthcare environment are clean and appealing, (4) provide professional service throughout interactions to reassure patient with skills and knowledge, and (5) provide timely service with a high accuracy and consistency of medical information.

Service quality is the expected benefits and control over the level of excellence to meet customer desires. Thus the service quality of health care is an effort to fulfill the needs and desires of the customer as well as the accuracy of delivery according to customer expectations. The service quality means the fulfillment of the patient's expectations, and a service provider ability in satisfy­ing the patient's needs and expectations that will result in the customer's positive perception towards the capabilities of the service provider. The aim of the study: Assessing hospital services quality and its relation with patient trust and satisfaction. Research design: Descriptive correlational research design was used. Setting: This study was carried out at Mati Distract Hospital in Minia Governorate. Sample: Convenient sample of all available patients in Mati Hospital with total number (n= 100). Tools: Two tools were used, first tool demographic data, second tool consisted of (service quality, patient trust and patient satisfaction). Results: More than half (58%) of patients assessed the service quality as moderate service. High percent (57%) of patients had a moderate trust. More than half (52%) of patients were dissatisfied. Conclusions: The majority of the patents were dissatisfied about the services provided by the hospital. There were statistical significance relation between (service quality, patient trust and patient satisfaction) and level of education. Recommendation: In service hospital training program for quality and quality management.

PurposeThe purpose of this paper is to explore dimensions of perceived service quality in hospitals and to develop a conceptual framework showing relationship between hospital service quality, patient satisfaction and their behavioural intention.Design/methodology/approachThis paper is based on extensive review of existing literature on hospital service quality, patient satisfaction and behavioural intention. Critical analysis of these literature studies has resulted in determining and defining the dimensions of perceived service quality and establishing relationship between hospital service quality, patient satisfaction and behavioural intention.FindingsThis study has identified six major areas through which patients perceive quality of service in hospitals. These six areas are technical quality, procedural quality, infrastructural quality, interactional quality, personnel quality, social support quality. Further 20 dimensions of hospital service quality are identified under these 6 major areas. These are clinical procedure, quality of outcome, admission, discharge, waiting time, patient safety, billing and price, follow-up, ambience, availability of resources, accessibility, food, staff attitude, personalised attention, information availability, staff competency, trustworthiness, staff diversity, hospital image and social responsibility. The conceptual framework proposes direct relationship between service quality, patient satisfaction and behavioural intention.Originality/valueThough many studies have been conducted on hospital service quality, none of them has been able to project all the possible dimensions to measure the same. The “6-Q framework” developed by this study explores all the possible dimensions of perceived service quality in hospitals.

Quality emergency care (QEC) in resource limited settings: A concept analysis

BackgroundData on emergency and critical care services in Somalia and other countries with fragile and conflict-affected (FCA) situations are limited, although the burden of emergency health conditions remain high. Improving emergency care services could significantly help improve health outcomes and realize the goals of achieving the Universal Health Coverage in these fragile countries.MethodsWe conducted a cross-sectional survey to assess the service availability and readiness for emergency and critical care (ECC) services in the country covering 131 hospitals in Somalia. The survey included both the public and private sector hospitals as well as those at the district, regional and national level hospitals representing the whole organizational structure of emergency health care system in the country. We administered the WHO Hospital Emergency Unit assessment tool which was slightly modified and adapted for this assessment. The survey included questions on the availability of staff, supplies/equipment, services, and systems. The respondents were hospital administrators and clinicians in outpatient departments, emergency departments and inpatient units. An overall median capacity score indicating the service availability and readiness for ECC was calculated for the country as well as for each hospital. Data were collected from December 2020 to March 2021.ResultA total of 524 staff members across 131 hospitals participated in the survey. The median and interquartile range (IQR) ECC readiness score for all health facilities in the country was 0.31 (0.22–0.46) and only 26 (19.8%) facilities assessed had a median readiness score of more than 0.5 (p value = 0.001). Using the cut-off point of 0.5, over 80% of the hospitals assessed were not considered ready to provide ECC services in the country. The third-level hospitals of the private sector including those facilities situated in predominantly urban areas were found to have better readiness to provide ECC services. User fees, lack of equipment and the absence of staff availability around the clock were identified as the most common barriers to emergency and critical care readiness.ConclusionThis is the first study of its kind to be conducted in Somalia using a standardized tool and methodology and provides a comprehensive understanding of emergency and critical care services available in Somalia by facility type and levels of care. The study highlighted that significant capacity gaps exist at all levels in the provision of emergency care services especially in the public sector and at the first-level of care. Investment in emergency care services is urgently needed in the country bringing the primary care into the care continuum for ECC services along with implementing a set of cost-efficient interventions at the first-level of care given the country’s high burden of emergency health conditions.Clinical trial numberNot applicable as this assessment was not a clinical trial.

Quality of care is a key focus of the global healthcare system. It has a major impact on patient satisfaction, costs and the efficiency of service delivery. To ensure that the quality of services meets the expectations of both the patient and the provider, quality is assessed using specific models. Effective quality assessment allows for rational allocation of resources and increased patient satisfaction. This provides the basis for continuous improvement of the system and the public good.The problem of the study is the lack of a unified and objective method to properly assess the quality of health care services, which is due to the subjective perception of the quality of services.The aim is to review scientific literature on the quality of health services and the models used to assess it.Methods. A content analysis of the literature was performed by searching Academic Search Ultimate (EBSCO), National Library of Medicine (PubMed), Emerald Premier Collection and other databases.Results. Evaluation of the quality of health care services covers a variety of aspects, including patient experience, treatment outcomes, quality of infrastructure and organizational processes. The assessment of service quality depends on the method chosen. Assessing quality in healthcare is inseparable from ensuring efficiency, patient safety and access to services. Because of the subjective nature of health care quality assessment, several models have been developed based on research findings.Results and summary. Evaluating the quality of healthcare services covers a wide range of aspects, including patient experience, treatment outcomes, infrastructure quality and organizational processes. Literature review revealed that the process of evaluating the quality of services depends on the method used, which determines the direction and outcomes of the evaluation. Due to the subjective nature of service quality assessment in the healthcare context, various models have been developed to allow for a structured assessment of service delivery. Among them, the SERVQUAL model stands out and is widely recognized as an effective tool for identifying shortcomings in service delivery and identifying areas for improvement. In summary, the concept of quality healthcare services may vary depending on the method of evaluation, but the main objective is to maximize the satisfaction of patients' needs by providing high quality, safe and accessible healthcare services.

The main purpose of this thesis is to research on the satisfaction of the patients with factors of service quality in SERVQUAL model in Hai Duong Children’s Hospital in Vietnam. The research method used in this thesis is quantitative research with some statistical step of data analysis and processing such as: descriptive statistics, scale verification, factor analysis, correlation analysis, and regression analysis. The supporting software is SPSS 20.0. The research results showed that the satisfaction of patients with disease diagnosis and treatment of the hospital was affected by four factors including: (1) assurance, (2) empathy, (3) responsiveness, and (4) tangibles. The factor “reliability” has no impact on general satisfaction of the patients. These factors positively influence the satisfaction of the patients with services. The research results also showed no differences between groups of different age, income, job and education level. In addition, the research also pointed out the limitations and directtions for further researches. Keywords: the satisfaction of patients, healthcare, service quality, SERVQUAL.

Emergency medicine: past, present, and future challenges

Οι συνθήκες που επικρατούν στην υγεία και η ποιότητα της παροχής των υπηρεσιών απασχολούν ολοένα και περισσότερο τους ανθρώπους που εργάζονται και ασχολούνται με τα θέματα διοίκησης και πολιτικών υγείας καθώς είναι ένα πλεονέκτημα το οποίο μπορεί να κάνει έναν οργανισμό υγείας να ξεχωρίσει. Από τη βιβλιογραφική ανασκόπηση που πραγματοποιήθηκε παρατηρήθηκε ενδιαφέρον για περαιτέρω έρευνα όσον αφορά την αξιολόγηση των παρεχόμενων υπηρεσιών από τους ασθενείς. Μέσα από τα αποτελέσματα τέτοιων μελετών ένας οργανισμός υγείας θα μπορέσει να εξελίξει και να αναβαθμίσει τις υπηρεσίες υγείας του κερδίζοντας την εμπιστοσύνη και την ικανοποίηση των ασθενών. Ο σκοπός της παρούσας μελέτης είναι η ανάλυση και η διερεύνηση του επιπέδου ικανοποίησης των ασθενών ως προς την ποιότητα των παρεχόμενων υπηρεσιών υγείας του Π.Γ.Ν. Αττικόν. Η μελέτη είναι περιγραφική και έγινε χρήση ερωτηματολογίου για τη συλλογή των δεδομένων. Το ερωτηματολόγιο που χρησιμοποιήθηκε απεικονίζει πέντε διαστάσεις ποιότητας και συγκεκριμένα την αξιοπιστία, τη διασφάλιση, την υλικοτεχνική υποδομή (απτότητα), την ενσυναίσθηση, και την ανταπόκριση. Η μελέτη πραγματοποιήθηκε στα εξωτερικά ιατρεία του Π.Γ.Ν. Αττικόν με δείγμα 120 άτομα. Σημαντικό γεγονός είναι ότι η μελέτη πραγματοποιήθηκε κατά τη διάρκεια της πανδημίας Covid - 19 και αυτό είχε σαν συνέπεια την περιορισμένη πρόσβαση. Επίσης επηρεάστηκε η επισκεψιμότητα των ασθενών ως προς το νοσοκομείο λόγω φόβου διασποράς του ιού, καθώς ενδέχεται και να επηρεάστηκαν οι προσδοκίες αλλά και οι αντιλήψεις των ασθενών. Συνολικά παρατηρήθηκε ότι οι προσδοκίες του δείγματος ήταν υψηλότερες από τις αντιλήψεις, δηλαδή ήταν υψηλότερες από την υπηρεσία που δέχτηκαν. Ακόμα από τη μελέτη που πραγματοποιήθηκε διακρίνεται ότι η αξιοπιστία και η ασφάλεια ταξινομούνται από τους ασθενείς έως οι πιο σημαντικές διαστάσεις όσον αφορά την αξιολόγηση της ποιότητας των παρεχόμενων υπηρεσιών. Τα αποτελέσματα της μελέτης παρουσιάζουν συνολικά μία σχετικά καλή εντύπωση παρόλα αυτά υπάρχουν τομείς όπου το δείγμα μας έδειξε ότι δεν είναι ικανοποιημένο και οι υπηρεσίες θα μπορούσαν να αναβαθμιστούν. Αυτά τα αποτελέσματα είναι το κλειδί για τους υπεύθυνους της διοίκησης ποιότητας του Π.Γ.Ν. Αττικόν με σκοπό την εξέλιξη της ποιότητας των υπηρεσιών του νοσοκομείου. Φυσικά η μελέτη της ικανοποίησης των ασθενών πρέπει να είναι συνεχής καθώς η ποιότητα που παρέχει ένας οργανισμός πρέπει να συνεχίζεται σε βάθος χρόνου και συνεχώς να αυξάνεται.

The Covid-19 pandemic has forced hospital management need to take quick action in overcoming the crisis while maintaining and improving the relationships with the customers in order to remain satisfied with the quality of service in hospitals. The study’s goal was to use SRVQUAL Scale to describe the impact of service quality on patient satisfaction during the Covid-19 (reliability, tangibles, empathy, assurance, responsiveness). This paper was a literature review sourced from Pubmed and ProQuest articles with keywords ("quality of service" or "service quality" or "quality of health services") AND ("patient satisfaction" OR "patient perspective" OR "patient experience") AND ("covid" OR "pandemic"). Six publications were found to meet the inclusion criteria following a review utilizing the PRISMA flow chart. The findings shown that in the Covid-19 pandemic era, all aspects of service quality (reliability, tangibles, empathy, assurance, responsiveness) have positve and significant impact on patient satisfaction. The study’s findings can helphospital management understand the issues that must be taken into account in order for patients to continue to be happy with the standard of care provided by hospitals, particularly during Covid-19 pandemic.

Background: One of the main services in hospitals are the pharmacy department. Pharmaceutical services are expected to be carried out according to established standards, to provide excellent service to patients.
 Aims: To determine the relationship between the quality of pharmaceutical services and patient satisfaction in the pharmaceutical installation of X Hospital Surabaya
 Methods: Quantitative research with cross sectional study design. The inclusion criteria in this study were patients/patients' families, aged 20-65 years, and willing to fill out a complete questionnaire. The independent variable is the quality of pharmaceutical services at X Hospital, the dependent variable is patient satisfaction at the X Hospital pharmacy installation. The study population was all patients both inpatient and outpatient at X Hospital, with a minimum sample size of 53 people.
 Results: Most of the respondents were female (60.38%), aged > 60 years (49.06%) with polyclinic visits mostly 3-4 times and most were college graduates (PT) (43.40%). There was a relationship between satisfaction of respondents with redemption process of drug prescriptions at the Pharmacy Unit of X Hospital Surabaya (p= 0.000 (α≤0.05) and r = 0.498). This shows that the respondents' expectations of the tangible, reliability, responsiveness, assurance and empathy components were well fulfilled. Satisfaction from several of these dimensions indicates a good match between the quality of service at the X Hospital Pharmacy Unit and the level of patient satisfaction.
 Conclusion: The quality of service at the Pharmacy Installation of X Hospital must be maintained and improved to provide satisfaction to the community. Accuracy in carrying out procedures and supported by the optimization of tangible components, reliability, responsiveness, assurance and empathy can certainly be a form of commitment in maintaining the quality of service in hospitals

Improving the quality of service in hospitals is an important factor to support patient satisfaction. Patient loyalty is determined by the quality of service, so the quality of service must be improved. The purpose of this article is to find out what factors can influence the quality of service in a hospital. The influencing factors are tangible, realistic, responsive, assurance, and empathy. Patient satisfaction is an important component of various health service parameters because patient assessment can be a measure of the quality of health services. Cases of dental and oral disease are high throughout the world, accompanied by an increase in prevalence in Indonesia based on Riskesdas results from 2007 to 2018 and high rates of self-treatment of dental and oral diseases.