Aspects Of Service Delivery Research Articles

Impact of a Mandated Accreditation Process on 1,045 Registered Echocardiographic Service Providers in a Previously Unregulated, Publicly Funded Environment

This review was undertaken to examine the impact of a standards-based, mandated accreditation process on several aspects of echocardiographic service delivery in a single-payer, previously unregulated environment. In the province of Ontario, virtually all echocardiographic services are funded by the Ministry of Health and Long Term Care. The Echocardiography Quality Improvement (EQI) process was introduced in 2012 and subsequently linked formally to reimbursement in 2016. Previously, payment for echocardiographic services in Ontario was unregulated. The impact of EQI on the number of facilities, echocardiographic volumes, costs, quality standards, and physician service provision were compared before and after implementation. Of the initial 1,045 registrants, 604 (57.8%) have been accredited or accreditation is expected having successfully resolved identified deficiencies. The remaining registrants were either never functionally operating (323 [30.9%]) or have withdrawn services (118 [11.3%]) since mandatory registration became a requirement for reimbursement. A number of factors identified facilities that were able to most promptly meet EQI standards, including hospital-based, academic, and multiple-physician facilities. The average annual increase in the utilization of echocardiographic services before EQI was 6.7%, decreasing to 2.7% since. The proportion of repeat examinations decreased in community-based facilities. Since 2013, costs for echocardiographic services have totaled about $92.3 million less than predicted by pre-2012 trends. To address standards, some small, more isolated facilities sought out alliances with larger facilities, particularly those affiliated with academic hospitals. EQI is demonstrably a means for improving quality while reducing the rate of growth and repeat examinations.

Public Procurement in the South African Economy: Addressing the Systemic Issues

Public procurement fulfils an important role in the economy and public expenditure of a country and can be regarded as a critical indicator of the effectiveness of a government, because it is a central aspect of public service delivery. Notwithstanding various reforms made to date to public sector procurement in South Africa and the application of Supply Chain Management as a strategic policy strategic instrument, the South African public procurement system still faces several challenges and has been strongly criticised. This paper aims to understand the current public procurement environment in South Africa, its dilemmas and challenges, and to propose that public procurement be refocused towards a strategically placed business process, implemented by well-trained and competent procurement officials. The purpose is to provide a theoretical foundation as well as practical guidance regarding the role of public procurement in the South African public sector. The methodology involved an intensive literature study and document analysis to evaluate various official policy documents and official publications to determine the status of South African public procurement. The study found that the majority of challenges faced by public procurement in South Africa can probably be attributed to the implementation of the system, rather than to the system itself. In the shorter and longer term, the public procurement system in South Africa will have no choice but to emerge as a stronger, more resilient, streamlined and efficient provider of goods and services for the greater good of all.

THE QUALITY OF PUBLIC SERVICE DELIVERY AT MIMOZA MULTIMEDIA GORONTALO

<p><em>The research aims to analyze and describe (1) the quality of service delivery in terms of customers’ satisfaction at Mimoza Multimedia and (2) the factors affecting the quality of service delivery at Mimoza Multimedia. The research method used is qualitative method. The data are the primary data collected through interviews. The data analysis used is Miles and Huberman’s analysis model. The research findings indicate that (1) Mimoza Multimedia Gorontalo has been able to provide public services for society. However, service delivery should be improved through more progressive service polices and evaluations to elevate customers’ satisfaction level. Some aspects of public service delivery that fulfill customers’ satisfaction are adequate facilities and infrastructures, guarantee or compensation to unsatisfactory services, and empathy shown by employees. Meanwhile, responsiveness and reliability are two aspects which need improvement through capacity building in terms of the public service delivery at Mimoza Multimedia Gorontalo and (2) The service delivery at Mimoza Multimedia Gorontalo relies on the quality of human resources, communication between the employees, and communication between the employees and customers. Customers’ satisfaction depends on competent and committed human resources to delivering public services in accordance with service principles. Moreover, the supporting factor is communication. Services without good communication will not satisfy customers. </em></p>

The Impact of Social Servicescape Factors on Customers’ Satisfaction and Repurchase Intentions in Mid-Range Restaurants in Baltic States

The present paper studies the importance of social servicescape factors to customer satisfaction in middle-priced restaurant services. This paper fills the existing literature gap on the importance of social servicescape factors onto customers’ satisfaction in middle-priced services. A survey of 514 respondents from three capitals of the Baltic States was conducted for the purpose of the present study. Descriptive statistics together with an independent samples t-test and partial least squares path analysis were employed for data processing. The results obtained confirmed the hypothesis about the importance of social servicescape attributes to customer satisfaction. The study also highlighted the difference in gender attitudes towards intangible aspects of service delivery. The research confirmed the existence of a relationship between customer satisfaction and repurchase intentions, although to a lesser extent than could have been anticipated from the literature review. The findings of the study covered by the present paper allow us to position middle-priced restaurants closer to luxury ones compared to casual restaurants

Qualitative findings about stigma as a barrier to contraception use: the case of Emergency Hormonal Contraception in Britain and implications for future contraceptive interventions

Background Emergency Hormonal Contraception (EHC) has been underused in Britain and internationally since its introduction. ‘Stigmatisation’ has been identified as one of the barriers to EHC. However, few, if any publications have focussed on the significance of this factor in the British context, the social meanings for women of seeking EHC and the implications for future contraceptive provision and innovation. Method In-depth qualitative material from 27 women across two British studies was analysed. The first, in which 11 young women were interviewed in-depth regarding EHC specifically, was supplemented by material from a multi-stage narrative study of 15 women concerning their life history experiences of using contraception more broadly. Results Stigmatisation of EHC use is a key barrier and derives from associations with irresponsible behaviour. This irresponsibility exists on a continuum with some behaviours and some women more ir/responsible than others. In addition, despite not being an abortifacient, EHC may be closely aligned with abortion meaning users can be perceived as ‘bad women’ in a similar way to abortion seekers. This stigma can deter participants seeking EHC when they may need it. Conclusion Stigma is a powerful barrier to EHC use due to the social significance of responsibility and expectations pertaining to the behaviour of ‘good women.’ Understandings about stigmatisation in the case of EHC should be translated to other aspects of contraceptive service delivery and future innovations, to ensure effective provision of methods and safeguard their uptake.

A Communication for Development Approach to Eradicating Polio: India Succeeds

Communication for development (C4D), has been identified as a major factor in eradication of Polio in India. India has been hailed as a success as it saw innovative use of epidemiological data and application of multiple communication channels, especially for the Polio eradication programme. It has also been perceived that communication for Polio eradication has mostly promoted Polio-vaccine drops whereas the main causal factors such as low rates of routine immunization, poor sanitation, lack of clean drinking water, and poor nutrition that are responsible for spread of Polio virus have not been promoted have not been promoted as the behavior-change content. The research was held in sub-urban clusters around the capital city of Delhi inhabited by migrants from two Indian states. The research documented that the knowledge and perceptions of large number of communities are very low with regard to recalling any causal factors which lead to Polio transmission. Research concludes, for behaviours to change, that cultural taboos, societal norms and structural inequalities need to be taken into consideration, including special emphasis on migrant settlers. Communication strategies have to be cognizant of and in tune with the policy and legislative environment and also linked to the service delivery aspects for the most vulnerable and socially-excluded.

'It is always worth the extra effort': Organizational structures and barriers to collaboration with consumers in mental health research: Perspectives of non-consumer researcher allies.

Consumer collaboration in mental health research has demonstrated significant benefits and reflects both contemporary research practice and policy goals for the expected genuine involvement of consumers in all aspects of mental health service delivery. Notable barriers have been identified as impeding consumer researcher positions that must be better understood and ultimately addressed. The aim of this research was to better understand these barriers from the perspectives of non-consumer researchers who have worked collegially with consumer researchers. We developed a self-report survey, Consumers as Researchers in Mental Health (CaRiMH) and administered it to non-consumer mental health researchers in Australia and New Zealand. Findings suggest a lack of organizational structures to support both consumer research and capacity building of consumer researchers. Most consumer researchers were employed casually with no set hours. Although consumer researchers were typically remunerated, inadequate funding and inflexibility of employment were highlighted as major barriers. There was variation in opinion about token involvement of consumer researchers and some uncertainty about whether these roles, where they existed, were actively resisted. Despite the acknowledged barriers, participants were positive about collaborations with consumer researchers. Overall, findings suggest consumer research is unlikely to proliferate without greater attention to organizational structures. A systematic and strategic approach to advancing mental health consumer research is required, including extra-organizational policy factors.

Delivery of hepato-pancreato-biliary surgery during the COVID-19 pandemic: an European-African Hepato-Pancreato-Biliary Association (E-AHPBA) cross-sectional survey

BackgroundThe extent of the COVID-19 pandemic and the resulting response has varied globally. The European and African Hepato-Pancreato-Biliary Association (E-AHPBA), the premier representative body for practicing HPB surgeons in Europe and Africa, conducted this survey to assess the impact of COVID-19 on HPB surgery. MethodsAn online survey was disseminated to all E-AHPBA members to assess the effects of the pandemic on unit capacity, management of HPB cancers, use of COVID-19 screening and other aspects of service delivery. ResultsOverall, 145 (25%) members responded. Most units, particularly in COVID-high countries (>100,000 cases) reported insufficient critical care capacity and reduced HPB operating sessions compared to COVID-low countries. Delayed access to cancer surgery necessitated alternatives including increased neoadjuvant chemotherapy for pancreatic cancer and colorectal liver metastases, and locoregional treatments for hepatocellular carcinoma. Other aspects of service delivery including COVID-19 screening and personal protective equipment varied between units and countries. ConclusionThis study demonstrates that the COVID-19 pandemic has had a profound adverse impact on the delivery of HPB cancer care across the continents of Europe and Africa. The findings illustrate the need for safe resumption of cancer surgery in a “new” normal world with screening of patients and staff for COVID-19.

Internet Provider Service Value Delivery Index Problem: Case Study of the NetHost

Common problems in service delivery is might related to the issue of timing, marketing cost, user experience, generating lead, identifying prospect, forecasting demand, value proposition, security, privacy, identity management and many more. Unfortunately, company often decided on the wrong context and concept lead to misrepresentation and misinterpretation on the requirement for the service improvement. Thus, the direct intervention through certain criteria in the characteristics and attribute of service delivery should be conducted with judgment assessment. It is done in order to identify the target and examine the policy used to support the outcomes. Thus, this study explore the model used for particular company, which in this case NetHost to provide insights on how the assessment can be fruitful in the long term investment for intangible aspects of service delivery.

Influence of Local Revenue Management on Financial Distress in Selected County Governments, Kenya

The county governments of Kenya have recently encountered difficulties in settling their liability obligations to employees, suppliers, and creditors. Counties ought to act as economic and social transformational tools for the Country's residents, but this is not the case. County governments deliver services to the residents through their own revenue and equitable transfers from the national government. As such, revenue collection and utilization is a vital aspect of service delivery. However, County Governments have continuously failed to meet revenue targets, and some cannot account for the revenue expenditures. This explains their inability to settle the debt and other liabilities as they come due for payment. Therefore, it was necessary to examine the influence of local revenue management on financial distress in County Governments of Kenya. The study was further guided by wrecker's theory of financial distress. The study applied a descriptive survey design to obtain in-depth information from the auditors and accountants from Nairobi, Nakuru, Kakamega, Meru, and Kilifi County Governments. A stratified random sampling technique was applied to obtain a sample of 103 from 212 auditors and accountants. Structured questionnaires were used to collect data that was analysed through descriptive and inferential statistics with the aid of statistical packages for social sciences (SPSS). Study findings were presented by tables. Descriptive and inferential results indicated that revenue management influenced financial distress. The correlation coefficient (R=.613; p=.000) indicated that the relationship between local revenue management and financial distress was positive and statistically significant.The beta coefficient (β=.578; p˂0.01) was significant at 99% confidence level implying that local revenue management influenced financial distress in the county governments of Kenya.The research work will guide departments of finance in National and County Governments on how to effectively utilize financial resources, manage debts, and other liabilities. Corporate organizations will find it important in formulating strategies aimed at combating financial distress in their organizations. Keywords: Local Revenue Management, Financial Distress, County Governments DOI: 10.7176/RJFA/11-12-05 Publication date: June 30th 2020

Continuity of health service delivery during the COVID-19 pandemic: the role of digital health technologies in Uganda.

In response to coronavirus disease-2019 pandemic (COVID-19), the government of Uganda instituted movement restrictions to curb disease spread. However, this affected accessibility to medical services in a setting where the healthcare system is not equipped to handle most healthcare needs of the populace outside hospital premises. This gap led to the prominence and unprecedented rise in the use of digital health technologies to deliver health information and services at a distance (telehealth) during the COVID-19 outbreak. The use of telehealth modalities including tele-consultation, tele-psychiatry, call centers and mobile phone health information dissemination increased. The COVID-19 pandemic augmented the rising role of digital health technologies as a much needed aspect of medical service delivery in our times. However, the efficacy and impact on clinical outcomes across various healthcare thematic areas need to be explored further and more evidence generated.

An ethnic interpretation of mental distress from the perspective of Tongan men and community leaders.

Tongan people living in New Zealand have a high prevalence of mental illness and low uptake of mental health services. Rates of mental illnesses also differ between those born in Tonga and those born in New Zealand. However, little is known about the personalized and culturally shaped meaning and experience of mental distress in this population. Therefore, this research explored the meaning of mental distress for Tongan men and community leaders living in Auckland, New Zealand. The Tongan cultural framework, talanoa (talking, to tell), enabled a culturally congruent and collective approach to examining mental health-related ideologies and ensuing distress. Two talanoa groups were held (one with men and one with community leaders), with a total of 18 participants. The primary research questions focused on tufunga faka-Tonga (Tongan constructions of mental distress). Four themes emerged: fa'unga (reality), hu'unga (directionality), ta'anga (temporality), and tu'unga (positionality). The analytic lens used to define reality was fa'unga, because this concept encompasses the creation/preservation of sino (body), me'a (thing, something), and mo'oni (truth, real). The findings suggested that it is necessary to incorporate tufunga faka-Tonga into all aspects of service delivery to improve mental health services for the Tongan population. The Tongan community will benefit from increased awareness of tufunga faka-paiōsaikosōsiolo (biopsychosocial constructions of mental distress) and tufunga fepaki mo e fetaulaki he vaha'a 'o e tufunga faka-paiōsaikosōsiolo mo e tufunga faka-Tonga (intersections between biopsychosocial and Tongan constructions of mental distress) to support identification of health risks and health service seeking behaviours.

Differences in abortion service-delivery in clinics by state policy context in 2017

Introduction In addition to monitoring the number and location of abortion clinics nationwide, it is important to examine other aspects of service-delivery, such as cost, and number of days abortions are provided, because they influence the accessibility of abortion care. Moreover, state policies can affect the types of care that are provided. This study examines differences in abortion service-delivery in clinics by state policy climate in 2017. Method Data for this study are from the Guttmacher Institute’s 2017 Abortion Provider Census, which collected information from all known abortion-providing facilities in the United States. This analysis focuses on the 808 clinic facilities that provided 95% of abortions that year. Outcomes include the cost of abortion care, maximum gestation at which abortions were offered, number of days clinics provided abortions, and other types of non-abortion services offered. Weights were constructed to account for non-responding facilities. Measures were calculated nationally and according to whether the clinic was in a state with a policy context that we categorized as hostile, middle-ground or supportive of abortion rights. Results In 2017, patients paid an average of $549 for a surgical abortion at 10 weeks gestation; without adjusting for cost-of-living, the amount was highest in middle-ground states ($592) and lowest in hostile states ($534). 64% of clinics offered abortion up to 11 weeks gestation, 22% did so up to 20 weeks, and 13% offered abortion at gestations up to 22 weeks. A slightly higher proportion of clinics in supportive states than hostile offered abortions after 22 weeks. 87% of clinics offered family planning services beyond post-abortion contraception, and the proportion was higher in supportive (93%) than in hostile states (75%). Nationally, clinics provided abortions for a median of 3 days per week. Nearly half of clinics in supportive states provided abortions > =5 days per week (46%), compared to 29% in hostile and middle-ground states. Conclusions Clinics operating in states that are hostile to abortion rights provide abortion services on fewer days and offer fewer non-abortion services. People residing in these states may encounter barriers not just to abortion, but to the wider range of sexual and reproductive health care they need.

A Framework to Inform Protective Support and Supportive Protection in Child Protection and Welfare Practice and Supervision

In this article, our intention is to provide an in-depth framework to inform the management of the inevitable complexity of day-to-day practice and supervision in child protection and welfare. It is based on what is now well evidenced about child protection and welfare literature in relation to risk, relationships, family support, supervision, and professional development. Using Ireland as a case example for illustration and application, we introduce an emerging framework based on a dualism of ‘protective support and supportive protection’ developed in previous work. We avail of Bronfenbrenner’s bio-ecological framework and network theories to progress this ongoing ‘work in progress’ to inform social work and social care practice and supervision in a global context as and where appropriate. We emphasize the importance of context specific approaches, the relevance of range of actors, practitioner and supervisor expertise through experience, and proactive partnership based engagement with children, families, and relevant communities in all aspects of service delivery, including evaluation. We reflect on the challenges and possible obstacles to how such a framework can inform practice and supervision. We argue that practitioners can best activate and apply the framework using a practice research approach.

Intended and unintended effects: community perspectives on a performance-based financing programme in Malawi

BackgroundSeveral performance-based financing (PBF) evaluations have been undertaken in low-income countries, yet few have examined community perspectives of care amid PBF programme implementation. We assessed community members’ perspectives of Support...

What Matters to Potential Patients in Chemotherapy Service Delivery? A Discrete Choice Experiment.

Designing and funding chemotherapy care to meet patient expectations is challenging. Issues including convenience, outcomes, cost, and continuity of care are all potentially important and the appropriate trade-off between them is not clear. Regions with significant geographic spread and concentration of care in metropolitan areas pose a particular problem as ensuring low-cost convenient care is potentially difficult. However, the relative value of different aspects of chemotherapy are as yet unknown. The objective of this work is to quantify the relative value of different aspects of chemotherapy service delivery in an older Australian general population sample. A discrete choice experiment was administered in an older Australian general population sample without cancer. The survey approach asks a series of hypothetical choice tasks and allows estimation of the relative value of different aspects of care. Analysis considered the average respondent, and then also explored the level of preference divergence across the population. One thousand and sixty-two individuals provided data and were included in the analysis. There was a strong population preference for home-based chemotherapy, for follow-up by a specialist, for psycho-social support, and for low cost care. These strong population preferences should be considered when designing chemotherapy care. This poses a significant challenge, both logistically and financially. However, this information can help policy makers identify the components of good value care.

Abortion service delivery in clinics by state policy climate in 2017

ObjectiveThe objective was to examine service delivery in clinics that provided abortions in 2017, including differences by abortion policy climate. Study designUsing data from the Guttmacher Institute's 2017 Abortion Provider Census, we examine amount charged for abortion care, pregnancy gestation at which abortions were offered, number of days per week that clinics provided abortions and types of nonabortion services offered. Our analysis focuses on the 808 clinic facilities that provided 95% of abortions that year. Measures were calculated nationally and according to whether the clinic was in a state we categorized as hostile, middle ground or supportive of abortion rights. ResultsIn 2017, 64% of clinics offered abortion at 11 weeks pregnancy gestation, and 22% did so at 20 weeks gestation. Supportive states had a higher density of clinics that provide abortion for every measured gestation than hostile states. Clinics charged an average of $549 for a surgical abortion at 10 weeks and $551 for medication abortion. Some 46% of clinics in supportive states offered abortion care 5 or more days per week compared to 29% in hostile states. Most clinics offered standalone contraception and family planning (87%) and gynecological care (85%), but the proportion of clinics that provided these services was higher in supportive states (93% and 90%) than in hostile states (75% and 73%). ConclusionsA substantial proportion of abortion facilities provide a range of other health care services. Aspects of service delivery, such as number of days abortions are provided, may vary according to abortion policy climate. Implications statementOnerous policies in states hostile to abortion rights may inhibit some facilities from providing abortion more days per week, and if so, could further burden patients obtaining abortion care in these states.

Implementing 'universal' access to antiretroviral treatment in South Africa: a scoping review on research priorities.

‘Universal’ access to antiretroviral treatment (ART) has become the global standard for treating people living with HIV and achieving epidemic control; yet, findings from numerous ‘test and treat’ trials and implementation studies in sub-Saharan Africa suggest that bringing ‘universal' access to ART to scale is more complex than anticipated. Using South Africa as a case example, we describe the research priorities and foci in the literature on expanded ART access. To do so, we adapted Arksey and O’Malley’s six-stage scoping review framework to describe the peer-reviewed literature and opinion pieces on expanding access to ART in South Africa between 2000 and 2017. Data collection included systematic searches of two databases and hand-searching of a sub-sample of reference lists. We used an adapted socio-ecological thematic framework to categorize data according to where it located the challenges and opportunities of expanded ART eligibility: individual/client, health worker–client relationship, clinic/community context, health systems infrastructure and/or policy context. We included 194 research articles and 23 opinion pieces, of 1512 identified, addressing expanded ART access in South Africa. The peer-reviewed literature focused on the individual and health systems infrastructure; opinion pieces focused on changing roles of individuals, communities and health services implementers. We contextualized our findings through a consultative process with a group of researchers, HIV clinicians and programme managers to consider critical knowledge gaps. Unlike the published literature, the consultative process offered particular insights into the importance of researching and intervening in the relational aspects of HIV service delivery as South Africa’s HIV programme expands. An overwhelming focus on individual and health systems infrastructure factors in the published literature on expanded ART access in South Africa may skew understanding of HIV programme shortfalls away from the relational aspects of HIV services delivery and delay progress with finding ways to leverage non-medical modalities for achieving HIV epidemic control.

A review of challenges and barriers implementing RFID technology in the Healthcare sector

Abstract The healthcare industry is progressively involved in adopting new technologies to provide improved quality of care given to patients. The implementation of RFID technology has globally impacted several industries and this revolution has improved the aspects of service delivery in the healthcare industry as well. The RFID technology has the potential to track medical assets and interact with almost any of the medical devices, pharmaceutical materials, IT equipment, or individual patients, deployed in hospitals all over the world. The motivation behind this paper is to investigate the advantages and obstacles to implement RFID technology in the healthcare sector highlighted in the literature. Further, we highlight the most possible methods or technologies to be adapted to overcome the limitations of implementation.

Products and Services Improvement Through Innovation and Creativity: Case of IT Business Sector

Innovation has become critically important within the today’s business sector as well as in the academic institutions as an underlying and important aspect of the products manufacturing and services delivery. This research is focused on analyzing the impact of innovation in stimulating the improvement process of technological services and its products in competitive markets. By using a descriptive research design and online survey method, qualitative analysis was conducted to observe the innovative outcomes which indicate that innovation is an important aspect of service delivery and products manufacturing. And this were done from the most top ten companies in the world which uses innovation in 2019. This study suggests that, in order to enhance quality service delivery and products manufacturing, companies should be encouraged to have strong and well designed innovation policy and strategy in place. However, the implications of the research findings were discussed, as well as recommendations for the future research were made.