Quality Of Healthcare Services Research Articles

Relationship between patient safety culture and patient experience in hospital settings: a scoping review

BackgroundMeasures of patient safety culture and patient experience are both commonly utilised to evaluate the quality of healthcare services, including hospitals, but the relationship between these two domains remains uncertain. In this study, we aimed to explore and synthesise published literature regarding the relationships between these topics in hospital settings.MethodsThis study was performed using the five stages of Arksey and O’Malley’s Framework, refined by the Joanna Briggs Institute. Searches were conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, SciELO and Scopus databases. Further online search on the websites of pertinent organisations in Australia and globally was conducted. Data were extracted against predetermined criteria.Results4512 studies were initially identified; 15 studies met the inclusion criteria. Several positive statistical relationships between patient safety culture and patient experience domains were identified. Communication and teamwork were the most influential factors in the relationship between patient safety culture and patient experience. Managers and clinicians had a positive view of safety and a positive relationship with patient experience, but this was not the case when managers alone held such views. Qualitative methods offered further insights into patient safety culture from patients’ and families’ perspectives.ConclusionThe findings indicate that the patient can recognise safety-related issues that the hospital team may miss. However, studies mostly measured staff perspectives on patient safety culture and did not always include patient experiences of patient safety culture. Further, the relationship between patient safety culture and patient experience is generally identified as a statistical relationship, using quantitative methods. Further research assessing patient safety culture alongside patient experience is essential for providing a more comprehensive picture of safety. This will help to uncover issues and other factors that may have an indirect effect on patient safety culture and patient experience.

Post‐road traffic injury experiences and challenges faced by college students: A qualitative study in Madurai district, Tamil Nadu, India

AbstractRoad traffic injuries (RTIs) are a pressing public health concern in India, leading to a rise in injury‐related deaths, hospitalizations, and disabilities. India accounts for a significant portion of the world's fatal traffic accidents, with two‐wheelers being involved in the majority of these accidents. The impact of non‐fatal injuries on individuals extends beyond the bodily consequences of the injury and includes both the physical and psychological dimensions of the injury. The literature indicates the need for policy cascades and implementation framework for the prevention of road traffic injury. This study aimed to investigate the post‐RTI experiences and challenges faced by college students who experienced road traffic injury during their college life by using a qualitative research approach in Madurai district, Tamil Nadu, India. The study found that college students who experienced RTIs faced a wide range of physical, emotional, and social difficulties. The study highlights the need for a more comprehensive and holistic approach to RTI prevention that takes into account the complex interplay of individual, environmental, and societal factors that contribute to RTIs. The study also underscores the urgent need to improve the quality and availability of healthcare and rehabilitation services for RTI survivors.

Complementary and Alternative Medicine (CAM) Practices: A Narrative Review Elucidating the Impact on Healthcare Systems, Mechanisms and Paediatric Applications.

While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM's applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.

Sustainable medical tourism in the global competitive environment: The case of Cyprus.

The aim of this study is to examine the perceptions of Cypriot medical tourism experts regarding the phenomenon of medical tourism, as well as to emphasise the benefits and opportunities for Cyprus to become a highly competitive global healthcare destination. A Delphi study was conducted in Cyprus, with the participation of 20 experts in the field of medical tourism. At first, 20 experts took part in semi-structured interviews. Based on their feedback provided during that phase, a structured questionnaire was drawn up and completed, addressing a wide variety of medical tourism-related issues, such as benefits and losses from the development of medical tourism in Cyprus, advantages and disadvantages of Cyprus in attracting international patients, the key elements of a medium- to long-term strategic plan for the development of medical tourism in Cyprus, the role of the public and private sector and the importance of international accreditation of private and public hospitals. Cyprus appears to have some very favourable qualities when it comes to its listing as a competitive destination for medical travellers. Undeniably, the growth of medical tourism improves all sectors of the economy and society, but the healthcare industry is the one that benefits most. On the opposite end, medical tourism could potentially impact the access of local people to healthcare services. No clear answers were given by the expert respondents on the need for international accreditation of healthcare providers in Cyprus. The competent authorities should promote Cyprus to international markets as a medical tourism destination of choice, upgrading the quality of healthcare services it provides having due regard in parallel to any potential impacts to the access of local population to the healthcare system.

Analysis of the National Formulary Drug Supply Chain with Its Availability in the Pharmacy Installation of the Government General Hospital (RSUD) Dr. Sitanala Tangerang City

This study explores the pharmaceutical supply chain management of the National Formulary at RSUP Dr. Sitanala in Tangerang City, aiming to identify obstacles to drug availability and formulate effective and efficient solutions. Acknowledging quality healthcare as a fundamental human right and a critical investment for a nation's future, this research emphasizes the importance of high-quality healthcare services. These services encompass not only treatment but also health promotion and disease prevention through the adoption of clean and healthy living habits. Drug availability is a major pillar in the provision of quality healthcare services. Effective and efficient management of the pharmaceutical supply chain, particularly regarding National Formulary drugs, is crucial in ensuring the availability of medications at healthcare facilities. This research employs a comprehensive analysis of the supply chain processes at RSUP Dr. Sitanala, examining stages such as drug selection, demand planning, procurement, receipt, storage, distribution, drug control, therapy monitoring, prescription preparation, drug dispensation, and medication administration. The study's methodology involves a case study approach, integrating theoretical management principles and interdisciplinary pharmacy management with compliance to regulations, as outlined in Permenkes No. 76 of 2016. Findings from RSUP Dr. Sitanala indicate that the hospital's pharmaceutical management practices align with contemporary health and pharmacy management theories, emphasizing structured systems, stringent verification, and effective interprofessional communication to ensure medication safety and efficacy. The study identifies challenges in information technology and interdisciplinary coordination as areas needing improvement. Nonetheless, a commitment to continuous improvement and adherence to regulatory standards reflects RSUP Dr. Sitanala's dedication to enhancing the quality of pharmaceutical management and healthcare services. The implications of this research extend beyond RSUP Dr. Sitanala, offering valuable recommendations for improving drug supply chain management in other healthcare institutions in Indonesia. By enhancing access to and the quality of healthcare services, this study contributes to the broader goal of achieving the highest possible level of health for individuals, reflecting the perspective of human rights and investment in the nation's future health.

LEGAL LIABILITY OF A PHYSICIAN FOR PROVIDING INADEQUATE MEDICAL CARE TO A PATIENT: ANALYSIS OF APPROACHES BASED ON THE EXAMPLES OF KAZAKHSTAN AND THE UNITED STATES

Background: This research focuses on the determination of liability for medical professionals causing harm to patients, using the criminal legislation of the Republic of Kazakhstan as a foundation. Criminal liability for medical offences is stipulated in Chapter 12 of the Criminal Code. By identifying the mandatory characteristics or elements of a medical criminal offence according to the criminal legislation of Kazakhstan, parallels are drawn with the types of culpability provided for in developed countries worldwide. The authors reviewed scholarly works examining the effectiveness of handling cases involving harm to patients and decisions regarding the satisfaction or dismissal of the patient's claims in Kazakhstan. Attention has been given to empirical data collected within the territory of the Republic of Kazakhstan. The results of sociological research conducted by the authors over a period of 3 months among healthcare professionals from different regions of the country have been utilised. Special attention has been devoted to international experiences in implementing measures to improve patient safety, reducing citizen complaints regarding the quality of healthcare services, and enhancing the legal protection of medical personnel. The research selects provisions from scholarly works that reduce the risk of harm to patients and thereby contribute to reducing medical crime levels. Methods: In this research, the authors employed a number of methods of scientific research to achieve their goals and solve their tasks, in particular legal analysis, comparative legal analysis, survey, questionnaire, and interviewing. Legal analysis of the Criminal Legislation of the Republic of Kazakhstan, including Chapter 12 of the Criminal Code, was conducted to identify the specifics of criminal liability for medical offences, exemplified by Article 317. This analysis highlighted the nuances of criminal liability for medical offences in Kazakhstan. Comparative legal analysis made it possible to compare the responsibilities of doctors in the USA and Kazakhstan. Attention was drawn to the similarity of the concepts of guilt in the form of negligence, with a specific emphasis on the American approach, which offers valuable insights for Kazakhstan. These aspects could be adapted to improve Kazakhstan's legal system. The specific cases of harm to patients considered by the courts of the Republic of Kazakhstan were studied, and court decisions concerning the satisfaction of patients' claims and their rejection were analysed, which allowed the authors to identify the main arguments and trends in judicial practice. Surveys and questionnaires were conducted among medical workers from various regions of Kazakhstan to gather empirical data on their perceptions of duties and responsibilities. Additionally, in-depth interviews were also conducted with experts in the field of medicine and law, as well as patients, and representatives of health authorities, providing high-quality data on the problems and challenges faced by medical workers. Statistical data collected during sociological research were processed and analysed. This included data on citizen complaints about the quality of medical care, cases of harm to patients and other relevant statistical indicators. The study of the problem at various levels revealed the level of patient safety and legal protection of medical personnel. Results and Conclusion: Creating conditions for medicine and ensuring effective social and professional medical insurance are some factors that provide opportunities for medical practice as a whole and the healthcare system. These facts also facilitate a proper legal assessment of a doctor's performance

Global prevalence of overweight and obesity among healthcare workers: a systematic review.

This systematic review aims to determine the global pooled prevalence of overweight and obesity among health care workers in the 6 World Health Organization (WHO) regions. The escalating prevalence of overweight and obesity among health care workers significantly affects both individual health and the quality of health care services. Understanding this global prevalence is crucial to be able to implement informed interventions, policies, and for the overall optimization of health care delivery. Systematic reviews with prevalence data for overweight and obesity among health care workers in both private and public health care facilities will be considered for inclusion. Transparent documentation of anthropometric measurements and adherence to established overweight and obesity criteria by the WHO, Asia Pacific standards, or Asian criteria are required to be eligible for inclusion. The review will focus on observational study designs, including cross-sectional, survey, case-control, and cohort studies. MEDLINE (PubMed), Scopus, and Web of Science will be searched for records with predefined keywords, including MeSH terms. Records found through hand-searching and reference lists will be added. Two researchers will independently screen studies, resolving any discrepancies with a third researcher. Standardized critical appraisal and data extraction forms will be used. If suitable, pooled prevalence for overweight and obesity based on the 6 WHO regions will be calculated using the DerSimonian-Laird random-effects model. Statistical analysis will be performed and publication bias will be assessed through funnel plot analysis and Egger's test. PROSPERO CRD42023452330.

Understanding the barriers and facilitators of healthcare services for brain injury and concurrent mental health and substance use issues: a qualitative study

BackgroundPeople with acquired brain injury (ABI) may experience concurrent conditions such as, mental health and substance use concerns, that require specialized care. There are services that aim to support people with ABI and these conditions separately; however, little is known about the facilitators and barriers of these services. Therefore, the purpose of this study was to engage stakeholders to investigate the facilitators and barriers of healthcare services for ABI and concurrent issues.MethodsSemi-structured focus groups were conducted in-person and virtually with people with ABI, caregivers, healthcare professionals, and policy makers during a one-day event in British Columbia, Canada. Manifest content analysis was used with a constructivist perspective to analyze data.Results90 participants (including 34 people with ABI) provided insights during 15 simultaneous focus groups. Three categories were identified: (1) complexity of ABI, (2) supports, (3) structure of care. Complexity of ABI outlined the ongoing basic needs after ABI and highlighted the need for public awareness of ABI. Supports outlined healthcare professional and community-based supports. Structure of care described people with ABI needing to meet criteria for support, experiences of navigating through the system and necessity of integrated services.ConclusionsThese findings highlight the facilitators and barriers of healthcare services for ABI and concurrent conditions and provide insights into the changes that may be needed. Doing so can improve the accessibility and quality of ABI healthcare services.

Can the digital transformation of pharmaceutical enterprises' finance improve healthcare equity?

Using big data, cloud computing, and blockchain technologies, enterprise finance is gradually transitioning towards digital transformation. Academia has already researched the motivations, efficiency improvements, and ethical impacts of the digital transformation of enterprises' finances. However, there is little research from the social equity perspective to explore the impact of enterprise financial digitization transformation on regional social welfare. As important entities for improving residents' health conditions, pharmaceutical enterprises have not fully studied whether their financial digitization transformation can improve the quality and efficiency of healthcare services and enhance regional healthcare equity. Therefore, this study focuses on listed Chinese pharmaceutical enterprises from 2018 to 2022, empirically examining the impact of pharmaceutical enterprises' digital transformation on regional healthcare equity. Using A Hospital in China as a case study, the process of its financial digitization transformation is deeply analyzed. The results show that the financial digitization transformation of pharmaceutical enterprises has a significant positive impact on regional healthcare equity, and it can be further enhanced by improving financial flexibility and increasing data assets. These findings contribute to accurately assessing the social responsibilities of pharmaceutical enterprises and provide new perspectives and evidence for improving regional social welfare levels.

Quality of Care in the Last Two Years of Life for Children With Complex Chronic Conditions

ContextLimited data exists about care received by children with complex chronic conditions (CCCs) in the final years of their disease and end-of-life (EOL). ObjectiveTo examine hospital performance on EOL quality measures and to describe healthcare services during the last two years of life for children with CCCs who died in-hospital. MethodsRetrospective automated electronic health record review of children with ≥1 CCC ICD-10 diagnosis code, who died inpatient between October 2020 and March 2023 at a single quaternary U.S. children's hospital. Quality was assessed based on performance on 15 measures across five domains: healthcare utilization, interprofessional supports, medical intensity, symptom management, and communication. Quality EOL care and healthcare services in the last two years of life were determined overall by age group and per patient. Descriptive statistics were used to evaluate demographic differences by age. Results266 children with CCCs died in the study timeframe; 45% were infants (n = 120), 52% (n = 137) were male, 42% (n = 113) were white, 64% (n = 170) were non-Hispanic, and 59% (n=156) had public insurance. Children had a median of three CCCs (IQR 2.4; range 1–8). On average, children met 69% (SD 13%) of EOL quality measures for which they were eligible. In the two years prior to death, 98% (n = 261) had an ICU admission, 75% (n = 200) had a procedure requiring sedation, and 29% (n = 79) had received cardiopulmonary resuscitation. 86% (n = 229) died in the ICU. ConclusionIn this study, children with CCCs met 69% of quality measures and received high-intensity healthcare in the last two years of life.

The Effect of Health Literacy on Health Status in Patients with Heart Failure: A Path Analysis.

Managing heart failure (HF) is challenging because of its complexity and high rates of hospitalization, morbidity, and mortality. Effective management requires coordination between patients' abilities and healthcare services; however, low health literacy among patients with heart failure can adversely affect their health status. Therefore, the understanding relationship between health literacy and health status would provide the evidence for developing future intervention. This analytical study explored multilevel factors influencing health literacy and health status in patients with heart failure (HF) who underwent health service delivery at outpatient clinics. The sample consisted of 453 patients with HF from 12 hospitals located in five regional areas (north, south, east, northeast, central, and Bangkok) in Thailand. A hypothetical model was used to test the association between comorbidity, social support, patient-centered care, health service delivery, health literacy, and health status. Path analysis was used to analyze the data. The results indicated that 40.8% of patients with HF exhibited low or inadequate levels of health literacy, yet perceived their health status as good, with an average of 25.2±19.8 points. Health service delivery by a cardiologist and nurse case manager directly influences health literacy. Comorbidity had a direct impact on health status, whereas social support, patient-centered care, and the aforementioned health service delivery indirectly affected health status through health literacy. Importantly, health literacy status directly influences health status. Comorbidity, social support, patient-centered care, and health service delivery were related with health literacy and high level of health literacy could influence the better health status. To increase the quality of health care services, health care providers should promote health literacy and integrate the concept of patient-centered care for HF patients at outpatient clinics. Recommendations include the training of nurses as case managers.

Advancing evidence-based practice through the Knowledge Translation Challenge: Nurses' important roles in research, implementation science and practice change.

To describe a knowledge translation capacity-building initiative and illustrate the roles of nurses in practice change using an exemplar case study. The report uses observational methods and reflection. The Knowledge Translation Challenge program involves a multi-component intervention across several sites. The advisory committee invited eligible teams to attend capacity-building workshops. Implementation plans were developed, and successful teams receive funding for a 2 year period. Evaluation involved collecting data on program uptake and impact on practice change. Data has been collected from five cohorts. The exemplar case study employed an action-research framework. Four nurse-led teams have demonstrated successful implementation of their practice change. The case study on implementing a clinical toolkit for clozapine management further illustrates a thoughtful planning process, and implementation journey and learnings by a team of nurses. The Knowledge Translation Challenge program empowers nurses to use implementation science practices to enhance the quality and effectiveness of healthcare services. Success of this initiative serves as a model for addressing the persistent gap between knowledge and practice in clinical settings and the value of activating nurses to help close this gap. As the most trusted and numerous profession, it is vital that nurses contribute to efforts to translate research evidence into clinical practice. The Knowledge Translation Challenge program supports nurses to lead practice change. The Knowledge Translation Challenge program successfully equips nurses and other health care providers with the knowledge, skills and resources to implement practice improvements which enhance the quality and effectiveness of healthcare services and nursing practice. The Knowledge Translation Challenge advisory committee has three patient-public partners that support teams to develop a patient-oriented approach for their projects by providing feedback on the implementation plans. Each team was also supported to include patient-public partners on their project.

Assessment of Patient Satisfaction Regarding Clinic Visits in Riyadh, Kingdom of Saudi Arabia: A Cross-Sectional Study.

Background Understanding patient experiences and opinions is crucial to improving the quality of treatment given as healthcare services in Riyadh continue to expand. This study attempts to evaluate various aspects of patient satisfaction with clinic visits. Objectives To assess and analyze patient satisfaction with clinic visits in Riyadh, Kingdom of Saudi Arabia, in order to identify areas for improvement and enhance the overall quality of healthcare services in the region. Methods This cross-sectional study collected data from 350 adults aged 18 and above in Riyadh, Kingdom of Saudi Arabia. A paper-based questionnaire was distributed using a snowball convenience sampling technique at various locations. The survey assessed different aspects of patient satisfaction, including demographics, accessibility, quality of care, and patient experience. Ethical approval was obtained, and informed consent was acquired from all participants. Results The study's demographic distribution revealed that the majority of participants were female (77.4%), with the largest age group being 24-35 years old (34.9%). Saudi nationals constituted the majority (72.6%). Regarding accessibility and convenience of healthcare services, a significant proportion of participants agreed that the distance between their residence and the health center was reasonable (73.4%). However, opinions were mixed regarding waiting times, with some considering it reasonable (47.4%) and others disagreeing (25.4%). Participants also had varying views on appointment availability, with a notable percentage finding it difficult (33.7%). In terms of continuity of care and communication, most participants agreed that the clinic proactively contacts them for appointments (67.4%), but there were mixed responses regarding the ease of transferring patients to a hospital (37.7% agreed, 13.1% disagreed). The agreement on seeing the same doctor at each visit was moderate (41.1%), and a majority agreed that doctors had easy access to medical records (74.9%). Regarding the quality of care and patient experience, most participants agreed that doctors treated them with respect (83.7%) and that nurses and staff members were respectful and cooperative (54.3%). The majority agreed that health centers provided services during emergencies (78%). In terms of evaluating the quality of medical services and facilities, most participants agreed that vital signs were checked during each visit (78.6%), while satisfaction with laboratory facilities was moderate (60.3%). When it came to doctor-patient communication and counseling, most participants agreed that doctors provided detailed information about their disease and medications (73.4%) and addressed patients' queries (74.9%). However, some participants said that doctors did not inform them well about their disease (23.4%). Most participants agreed that doctors showed empathy and friendliness (73.7%) and allocated adequate time during visits (71.7%). However, satisfaction with post-visit accessibility to the doctor was mixed (35.1% agreed it was easy). Conclusion The findings revealed that while participants expressed satisfaction with certain aspects of care, there were areas requiring improvement. These areas included reducing waiting times, enhancing appointment availability, improving transfer procedures, ensuring consistency in doctor-patient relationships, and enhancing communication and counselling.

Using Behavioral Insights to Strengthen Strategies for Change. Practical Applications for Quality Improvement in Healthcare.

For over 30 years, quality improvement (QI) methods have been used as a means of increasing the quality and safety of healthcare services, but with mixed success. One explanation highlighted in the literature for this outcome is the overemphasis on technical elements of change, and a failure to fully appreciate the human side of change. Behavioral insights (BI) is an approach that utilizes knowledge and tools from a broad range of scientific disciplines, such as neuroscience and behavioral psychology, to support behavior change. The aim of this paper is to explore the possibility of supplementing QI methods with tools and understanding from BI. We outline a practical case that involved applying aspects BI methods into a QI program aimed at reducing the use of intravenous antibiotics in patients accessing services at a busy university hospital in Copenhagen, Denmark. We exemplify how to use BI tools to guide the analysis of staff behaviors during standard clinical processes and develop targeted interventions aimed at increasing actions and behaviors more aligned to best clinical practice. Outcomes suggest that it is possible to combine the models and methods from BI and QI in a way that is helpful in focusing attention on the human side of change when developing strategies for change. Potential psychological barriers identified from the analysis included the following: 'default inertia,' 'decision complexity,' 'risk aversion,' and biases related to confidence, confirmation, and omission. Future quality improvement projects could benefit from integrating models and tools from BI to guide and support behavior change.

Impact Assessment of Patient Experience Capacity-Building Program Using Kirkpatrick Model for Program Evaluation at a Regional Healthcare System.

The patient experience (PX) is central to improving the quality of healthcare services. We launched a PX capacity- and capability-building program at the Armed Forces Hospitals Taif Region, which is integral to our regional healthcare cluster transformation plans and is an initial step toward developing a culture of improvement in human experience in healthcare. A multidisciplinary PX committee recruited five frontline interprofessional PX heads, one from each of our regional healthcare hospitals. The Kirkpatrick model for program evaluation was used to assess the impact on four key levels: reaction, learning, behavior, and results. A pre-program competency assessment was conducted to evaluate the level of expertise across various PX competencies, and a program curriculum was developed accordingly. Participants underwent an intensive workshop-based PX capacity-building training program. A post-program competency assessment was performed along with a post-program survey. The PX-related activities led by interprofessional frontline PX heads at their respective hospitals' post-programs were tracked. The impact on the regional PX mean score across various settings, including inpatient, outpatient, and emergency settings, was measured using Press Ganey PX surveys. Our work is reported in accordance with the SQUIRE-EDU guidelines of the EQUATOR network. The PX capacity-building program led to a significant improvement in participants' expertise across various PX competencies. Significant improvements beyond the strategic targets were observed in the PX mean score in inpatient departments pre-program (83.31) vs. post-program (86.34), with a p-value of < 0.001 across the regional healthcare system. The PX capacity-building program is a first step toward major cultural change amid the healthcare cluster transformation in our regional healthcare system. The Kirkpatrick model helps evaluate the impact of PX capacity- and capability-building training programs comprehensively through an organizational approach. Sustainable improvements in PX over a long period through a capacity-building program alone remain challenging.

Nursing managers' perceptions of teamwork and collaboration in mining primary healthcare clinics in Gauteng.

Teamwork and collaboration among nursing managers, nurses, doctors and peripheral hospitals treating mining patients is pivotal. A case study of specific mining primary healthcare clinics revealed a lack of teamwork among the doctors and nursing managers, even on decisions that show productivity. The aim of this study was to explore and describe nursing managers' perceptions of teamwork and collaboration in mining primary healthcare clinics in Gauteng. A qualitative, exploratory, descriptive and contextual research design was adopted to conduct this study. Data were collected by conducting semi-structured individual interviews with 10 participants and thematically analysed. Data saturation was reached by the seventh participant and confirmed with three more interviews. Trustworthiness measures and ethical considerations were preserved as protocols because of the nature of the study. Three themes emanated from the study: (1) team coordination and support improve teamwork and collaboration in primary healthcare clinics, (2) there is a lack of involvement from the nursing team, negatively influencing teamwork and collaboration and (3) collaboration can improve the quality of healthcare services rendered in mining primary healthcare clinics. All mining primary healthcare clinic team members should be involved in operational activities to foster teamwork and collaboration.Contribution:This study revealed that teamwork and collaboration should be facilitated to improve the quality of healthcare service in mining primary healthcare clinics.

When and What: Family Physicians' Perspective on Clinical Communication Skills and Professionalism Education during the Medical Training Program in Riyadh, Saudi Arabia

Background: Effective communication skills are crucial for health professionals in order to build a favorable rapport with their patients, so enhancing their overall well-being and quality of life. From this standpoint, the implementation of communication skills training may serve as effective techniques to enhance the care delivered by healthcare personnel and the overall quality of healthcare services. Aim: To investigate the perspectives of family physicians, on the necessary communication and professionalism skills for medical students, as well as the best time during medical training programs to attain these competencies in Riyadh, Saudi Arabia. Methods: A cross-sectional survey-based study was conducted among family medicine physicians in different hospitals, Riyadh, Saudi Arabia. Participants responded to inquiries on the communication abilities and professionalism competencies while discussing the timing of competency achievement. An online questionnaire was sent to all the physicians. The questionnaire consisted of three sections: Gathering demographic information, Questionnaire on professional engagements, and a timeline estimation of each doctor's acquisition of communication skills and professionalism competencies. The data analysis was performed using SPSS, Version 26.0. Prior to analysis, data cleaning and entering were conducted. A test is considered significant if the P-value is below 0.05. Results: A total of 301 participants, aged between 30 and 41 years old, took part in the current research. Approximately 51.5% of the participants were family physician specialists, whereas around 25.9% were residents and 4% were students. A majority of FM respondents (56.5%) said that FM residency is the most opportune period in the medical training program to include the bio-psycho-social context. Respondents (50.5%) felt that it is during this time that they get a better understanding of the patient's viewpoint and that of their family. Approximately 48.5% of FM participants believe that the FM residency is the most favorable period of medical training to take into account the beliefs, needs, and perspectives of patients and their families. However, 58.5% of participants feel that this residency provides an opportunity to develop strong critical thinking skills. Furthermore, 50.2% of participants believe that the FM residency equips them with the ability to handle uncertainty effectively and adapt to various situations and contexts. The majority of FM participants were doing clinical activities at different stages; After Residency (93.8%), Residency (80.8%), or Undergraduate (86.8%). In addition, teaching practice was significantly related to the stages of communication training (P&lt;0.001); most of FM participants practice teaching after Residency (90.6%), and 53% of them practice teaching in their Residency. there is a significant relation between the clinical activity done and the stage of professionalism training (P=0.005), the majority of FM participants were doing clinical activities at different stages; After Residency (93.9%), Residency (83.6%), or Undergraduate (76.3%). In addition, the preceptor was significantly related to the stages of professionalismtraining (P=0.010); 45.5% of FM participants after residency were preceptors. Conclusion: The perspectives of these family doctors' medical educators may aid in formulating the necessary objectives for medical training, which might influence the structure of medical curricula and promote lifelong learning initiatives. Future research should focus on certifying these key competencies and enhancing evaluation methodologies, with a particular emphasis on evaluating their effect on healthcare. Keywords: Family Physicians, Perspectives, Clinical Communication Skills, Professionalism, Medical Training

Does participation in sports competitions enhance interprofessional teamwork among medical students? Evidence from a medical school curriculum experiment

BackgroundEffective interprofessional teamwork is essential for the efficiency, safety and quality of healthcare system services and requires interprofessional education for medical students. Physical education is a simple and easy way to teach teamwork, which translates into team performance in the work environment. This study was conducted to examine the effectiveness of the physical education competition model, instead of the exams model, for improving teamwork skills among medical students.MethodsA quasiexperimental intervention design was used to measure the effect of a 16-week cheerleading programme on subjects' teamwork skills by completing a teamwork scale comprising four subdimensions, namely, personal characteristics, teamwork, leadership, and conflict management, before the start and at the end of the programme, and by comparing nonwinning to winning students to measure the effect of teamwork skills on team performance.ResultsA total of 179 students completed the valid baseline and posttest (effective rate = 95.21%). The teamwork scale scores (B M = 4.81, R M = 5.05, p < 0.001) and 4 subdimension scores (personal characteristics p = 0.002, teamwork p = 0.028, leadership p < 0.001, conflict management p < 0.001) were statistically significant. Twenty-two of the 44 items in the scale improved significantly. The differences between students who won the competition and those who did not (N M=4.86, W M=5.14, p<0.01) were statistically significant, with no significant differences in personal characteristics p = 0.183; significant differences in the 3 subdimensions of teamwork p < 0.01, leadership p = 0.024, and conflict management p = 0.037; and a significant increase in 13 out of 44 self-efficacy items on the scale.ConclusionsThe "race for exams" physical education programme improved teamwork among medical students, and increased teamwork improved team performance. The "competition instead of examination" physical education programme provides a quantifiable method for improving interprofessional teamwork among medical students.

Effect of community-based public health service on health-related quality of life among middle-aged and older adults with chronic diseases in China

BackgroundThe growing prevalence of non-communicable chronic diseases poses a significant public health challenge globally, particularly impacting the well-being of aging populations. This study aims to assess the impact of community-based public health service (PHS) on the health-related quality of life (HRQoL) among middle-aged and older adults with chronic diseases in China.MethodsUtilizing data from the China Health and Retirement Longitudinal Study, we constructed a novel scale based on the 36-Item Short Form Health Survey (SF-36) to measure the HRQoL of middle-aged and older patients with hypertension and/or type-2 diabetes. Multivariate linear regression models with Instrument Variables and Propensity Score Matching techniques were applied to examine the effect of PHS on the HRQoL of identified chronic disease patients.ResultsAmong 8,403 hypertensive and/or diabetic patients, only 10.98% had received PHS. After adjusting for covariates, PHS exhibited a significant association with an elevated overall SF-36 score (β = 3.539, p < 0.001). Similar effects were observed in the physical and mental component summary scores, with increases of 1.982 (p < 0.001) and 5.095 (p < 0.001), respectively. Sensitive analysis affirmed the robustness of these findings. Heterogeneity analysis revealed significant HRQoL improvements among males, females, those aged 70 and older, patients with comorbidities, and urban residents, while the effect was less pronounced in the middle-aged, those without comorbidities, or rural dwellers.ConclusionCommunity-based PHS has exerted a positive impact on both the physiological and psychological aspects of HRQoL among middle-aged and older chronic disease patients, with effects varying among individuals with different characteristics. Our findings advocate for enhancing the delivery and utilization of government-funded PHS, increasing health literacy, and promoting early prevention strategies for chronic diseases. Furthermore, targeted health management initiatives for patients with comorbidities and enhancements in the quality of community healthcare services, particularly in rural areas, are deemed necessary.

The Role Of Information Technology In Improving The Quality Of Health Services In Hospitals

This study aims to identify, analyze, and provide recommendations for the effective implementation of information technology to improve the quality of health services in hospitals as well as to find out how the IT process has become an integral component in various sectors, including business, education, government, and health. The methodology used in this study is a literature study and secondary data analysis as well as interviews with health practitioners and information technology experts with a review of scientific articles, research reports, and other publications, data from the Ministry of Health, and relevant national surveys. This will help in identifying current trends, challenges, and opportunities in the application of information technology in hospitals. Information technology has a positive impact on the quality of health services through operational efficiency, accuracy and security of patient data, increased patient satisfaction, and improved accessibility of services. There are challenges and barriers in the implementation of information technology such as implementation costs, training and human resources, data security and privacy, and resistance to change. The implementation of information technology in hospitals has great potential to improve the quality of healthcare services. However, challenges and barriers such as implementation costs, training needs, data security, and resistance to change must be overcome to achieve success.