Selected Private Hospitals Research Articles

Quality of Service as a Predictor of Customer Satisfaction in Healthcare Sector

This study examines role of quality of service as a predictor of customer satisfaction in private hospitals. Using a sample of customers of selected private hospitals in Karachi, this study used reliability statistics, Pearson correlation analysis, and OLS regression techniques to analyse the data. The results show that private hospitals are trying to deliver healthcare service that is at par with the expected standards set by their customers. The findings of this study will help management of these hospitals to develop and implement appropriate and effective strategies that would be helpful in delivering quality healthcare services to the patients.

Status of self-medication among the patients attending outpatient department in selected private hospitals in Dhaka city

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair.
 Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia.
 Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016.
 Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%).
 Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

Staff Turnover and Organizational Performance of Selected Private Hospitals in Kilifi County, Kenya

The performance within most of the private hospitals in Kilifi County has been deteriorating as more of its staff is leaving the private hospitals in search of the county government jobs. The study took a look at the results of personnel turnover on the organizational performance of chosen private hospitals in Kilifi County. The specific goals that assisted the research study were to evaluate the impact of voluntary turnover, involuntary turnover, functional turnover and dysfunctional turnover on the organizational performance. Theories utilized consisted of equity theory, human capital theory expectancy theory and balance score card model. The study embraced the descriptive research study design. The reliability of the survey was tested utilizing a pilot study. Main data was gathered utilizing close-ended questions. The study utilized a population of 53 top and middle-level managers in 6 private hospitals in Kilifi County. The sample size was accomplished using Stratified sampling. The population studied was subdivided into three strata; personnel supervisors, administrators and assistant administrators and departmental heads. SPSS was utilized to examine the information. The findings of the study developed that the four types of turnover under investigation had either a weak or moderate relationship with organizational efficiency. The study, for that reason, concluded that voluntary and practical turnover favorably relates with the organizational efficiency of the personal medical facility while both uncontrolled turnover and inefficient turnover negatively related with the organizational performance of the personal healthcare facilities in Kilifi County. Based on the conclusion, the study recommended that management should improve employee compensation and offer training to their employees as they contribute to employee voluntary exit. Management should put measures in place to reduce cases of indiscipline and fraud which causes involuntary turnover among the employees. Measures should also be implemented to help improve the health of the staff and reduce stress levels. Concerning functional turnover, the study recommended that private hospitals should have a good system of employment that promotes the retention of good performers and the release of poor performers. Finally, the study recommended that dysfunctional turnover should be avoided as it negatively affects organizational performance. Measures should, therefore, be put in place to discourage the departure of competent and high performing employees. 

Vancomycin and florfenicol resistant Enterococcus faecalis and Enterococcus faecium isolated from human urine in an Egyptian urban-rural community

Multidrug resistance is one of the top three threats to global public health. Understanding resistance of bacteria is important to help decrease resistance and improve the development of novel antimicrobial agents or other alternative tools to combat public health challenges. Thus, the goal of this study was to investigate the vancomycin and florfenicol resistance genes of five E. faecalis and 15 E. faecium isolated from patients with urinary tract infections. There were 20 Enterococcus obtained from the library collection of randomly selected private hospitals located in the city of El Qanater El Khayreya; these samples were isolated during 2017. Samples were evaluated for their phenotypic characterization of virulence factors, antimicrobial resistance and PCR was conducted to detect the prescence of the vancomycin vanABC and florfenicol resistance genes encoding the catAB, fexAB and cfu. There were six different antibiotic resistance profiles observed. The 20 isolates showed resistance to clindamycin, oxytetracycline and gentamycin. Resistance was evident to ciprofloxacin, norfloxacin and florfenicol in the absence of the cfr gene in all of the 20 Enterococcus isolates. In addition, all isolates produced biofilms and were classified as extensive drug resistant. MARindices of the isolates were >0.6. The MARindex of human isolates of enterococci suggest these pathogens originate from a high-risk source of contamination where antibiotics are often used. This information highlights a possible public health concern to the Egyptian community. The results also suggest the emergence of a linezolid sensitive-vancomycin resistant E. faecium and E. faecalis in the absence of the cfr gene.

Impact of Service Quality on Customers’ Advocacy; Mediating Role of Customers’ Loyalty: A case of selected Private Hospitals of Peshawar

The aim of the current study is to determine how service quality influence customers’ advocacy directly and indirectly through customers’ loyalty in private sector hospitals of Peshawar. Famous servqual model used for the analysis of service quality of the selected hospitals. Confirmatory factor analysis used to examine the fitness of the model and then with the help of path analysis hypotheses were checked. After analysis it was found that the relationship of service quality and customer advocacy was fully mediated by customer loyalty. The current study would be very useful for the hospital’s management in evaluation of service quality. Furthermore, the findings of the current study would also be useful in getting more customers. Marketing and management personnel of the hospitals would more emphasis on service quality to produce loyal customer, who eventually turns into advocates.

TO EXAMINE LEADER-MEMBER EXCHANGE AS MODERATING VARIABLE ON THE INFLUENCE OF EMPLOYEE PSYCHOLOGICAL UNCERTAINTY TOWARD EMPLOYEES’ JOB SATISFACTION AND TURNOVER INTENTION

The studies revealed that organizational change could create employee’s psychological uncertainty. However, this study argues that the quality of leader-member exchange enables to control the impact of the psychological uncertainty during the change toward employee’s attitude. This study represents job satisfaction and turnover intention as proxy of employee’s attitude for that matter. Based on social exchange theory, quality relationship of leader and employees affects on the relationship of psychological uncertainty and employee’s job satisfaction and turnover intention. This study selected private hospitals experiencing the changes of operational system for complying with national health security system. This study conducted cross-section survey for individual level-analysis. This study produces some findings. Firstly, the LMX has been failed to reduce the negative influence of psychological uncertainty towards employee’s job satisfaction, although the quality of the LMX was good. employee’s job satisfaction is more perceived as personal afective state experienced during the organizational change. Secondly, the LMX has been successfully moderated the positive influence of the psychological uncertainty towards employee’s turnover intention.The data were collected by using questioners, distributed to the employees who worked in hospitals in Yogyakarta Province. There were 193 questioners that could be collected and analyzed by using Moderated Regression Analysis (MRA) to test the hypothesis by using SPSS application version 21. The result of the study shows that psychological uncertainty had negative correlation to employee’s job satisfaction and positive influence to psychological uncertainty toward turnover intention. Besides, LMX was proven to moderate positive influence of psychological uncertainty toward turnover intention, but it could not moderate negative influence of psychological uncertainty toward job satisfaction.

Effectiveness of fenugreek in reducing hyperglycaemia among patients with type II diabetes mellitus in selected private hospital at Madurai, Tamilnadu, India.

Background Diabetes mellitus is a syndrome caused by an imbalance between insulin supply and demand. It is characterized by hyperglycaemia and associated with abnormal carbohydrate fat and protein metabolism. Type II diabetes formerly known as adult onset or Non-insulin dependent diabetes mellitus is the most common form of diabetes. This form of diabetes usually begins with insulin resistance a condition in which muscle and liver cells do not use insulin properly. Diabetes can lead to decreased quality of life increase in mortality and acute metabolic complications. Fenugreek seeds have been well known for its medicinal properties since ancient times. Gel fibre present in fenugreek seeds reduces the rate of glucose absorption and may also delay gastric emptying thereby preventing the rise in blood sugar levels following a meal. Aim The aim of the study was to assess the effectiveness of fenugreek in reducing hyperglycaemia among patients with type II diabetes mellitus in selected private hospital at Madurai Tamilnadu. Materials and methods Quasi experimental research design and purposive or judgemental sampling technique was used to select 60 samples. Data was collected by checking the blood sugar levels using glucometer before and after intervention. Data was analyzed by using descriptive and inferential statistics. Results The study revealed that in the experimental group the mean post test blood sugar level 178.2 is lesser than the mean post test 229.5 blood sugar level 178.2 is lesser than the mean post test 229.5 blood sugar level of control group. The obtained lsquotrsquo value 5.53 is statistically significant at 0.05 level. This indicates that the mean difference of 51.3 is a true difference and has not occurred by chance. So the researcher accepts the research hypothesis and rejects the null hypothesis. Conclusion This study concluded that fenugreek maintains blood sugar level among patients with diabetes mellitus

Reflection of New Graduate Nurses on the Transition Program Conducted in the Selected Malaysian Private Hospitals

Transitions are passages or movements from one state or condition to another, and they can profoundly influence and alter the lives of the individuals involved as well as their significant others such as friends, family, and co-workers. While transitional support programs helps to support the new graduate nurses in their first year of practice, there are unmet needs for clinical, social and emotional support. Understanding new graduate nurses’ (NGNs) experiences and their unmet needs during their first year of practice will enable nurse managers, educators and nurses to better support new graduate nurses’ attain the new graduates’ perception on the Transition Program implemented in three (3) private hospitals. This study is intended to determine the new graduate nurses’ (NGNs) reflection towards the transition program in medical, surgical and multidisciplinary wards in the selected private hospitals. The study used a descriptive, cross-sectional design using purposive sampling technique. Reflections on the transition program implemented were assessed using the instrument which was adopted and modified from previous study questionnaires, Hamad Medical Centre (HMC) questionnaires. The Descriptive statistics were employed to express demographic data and reflections of the NGNs towards the transition program. One hundred new graduate nurses with less than three-year experiences participated in this study. The transition program runs in two stages, two weeks for the orientation program followed by six-month preceptor ship. The researchers used a 5-point Likert scale for data collection. Data were analysed using SPSS version 20. The overall reflection expressed by NGNs on experiences during the transitioning, 70% agreed and 28% had strongly agreed the program conducted was well organized. If both results to be combined, 98% of respondents reflected excellence for the transition program conducted. In conclusion, the transition program which comprised of orientation and preceptor ship program is the most significant approach of helping the adaptation of the NGNs working in the clinical environment. Thus, these programs should be regularly conducted in every hospital which indirectly helps in decreasing the rate of turnover among the NGNs.

Effect of Mentoring on Developing Nursing Competencies among the Newly Joined Staff Nurses in a Selected Private Hospital in Kolkata

Effect of Mentoring on Developing Nursing Competencies among the Newly Joined Staff Nurses in a Selected Private Hospital in Kolkata

Perceptions of Nurse Managers regarding Clinical Relicensing Audits at Private Hospitals

The National Health Insurance (NHI) in South Africa aims to provide access to quality health services for all South Africans. The NHI will only accredit and contract eligible health facilities that meet nationally approved quality standards both in the public and private sector. Detailed tools for measuring compliance with the National Core Standards (NCS) and Batho Pele principles have been developed and implemented in the public sector. To date and since its implementation in the public sector, very little is known about the national audit tool and the method used to evaluate quality and patient safety standards in private hospitals in the eThekwini district, South Africa. The aim of the study was therefore to assess nurse managers’ perceptions regarding the clinical relicensing audits performed at selected private hospitals in the eThekwini district. A qualitative, exploratory, descriptive design using an interview guide was used to conduct the study. The group of hospitals (N = 4) studied has approximately 40 clinical managers who were sampled for the study. A total of 24 nurse managers were interviewed, guided by data saturation. The results of the study showed that the selected private hospitals in the eThekwini district have not fully implemented the approach to clinical practice standards and healthcare audits in relation to the three clinical domains of the NCS, namely patient rights, patient safety and clinical care, and clinical support services, and the Batho Pele principles. Recommendations are for the internal and external factors influencing the national audit process to be dealt with based on the results of the study.

Nurses’ knowledge and practices related to pain assessment in critically ill patients in a selected private hospital in Bangladesh

Background: Most of the time pain is difficult to assess and manage because of being inherently a subjective experience influenced by multiple factors. The perception and tolerance of pain may vary because of different psychological and social influences of the patient. Therefore it is important for health care providers to assess the pain so that individualized management interventions can be provided. This study was aimed to assess the nurses’ knowledge and practices related to pain assessment in critically ill patients.Methods: A descriptive cross-sectional study was carried out among 200 registered nurses working at different ICU in Square Hospital. The study was conducted within April to August 2017. A non-probability purposive sampling technique was used. The data was collected using pre-tested self-administered semi-structured questionnaire and it was analysed using SPSS 22.0 version.Results: About 81% of the respondents were in the age group 22-32 years and the mean age of the respondents was 27.74±12.06 years. About 79.0% of the respondents were female and 59.5% of the respondents had diploma in nursing. The mean monthly income of the respondents’ was 19450.5 taka. The majority (59.5%) of the respondents had less than 2 years’ service experience. About 85.5% of the respondents said it is important to assess the pain and need for analgesia before, during, and after wound care.Conclusions: Our findings reported that the nurses were reasonably knowledgeable about the principles of pain assessment. More than four-fifths of the respondents had adequate knowledge about pain assessment.

An Analysis of Outpatients’ Perceived Service Quality and Satisfaction in Selected Private Hospitals of Kathmandu

<p>Patients’ perceptions about health services, especially about service quality, are becoming increasingly important. It might shape confidence and subsequent behaviors with regard to their choice and usage of the available health care facilities. The study examines the primary satisfaction with a private hospital experience and estimate the effect that each of these construct will have on future behavioral intensions. More specifically, it measures patient’s perceptions of service quality and assesses the dimensions of service quality exert strongest influence on customer satisfaction. The study is based on primary data, which collected from outpatients in the ten selected private hospitals of Kathmandu valley via self-administered and structured questionnaire survey. Convenience sampling method is applied for the study that constituted of 200 outpatients from private hospitals. The present study is based on the SERVPREF model in which independent variables are tangibles, responsiveness, empathy, reliability and assurance whereas the dependent variable is overall satisfaction of the patients. The findings of this study show that 72 percent of the respondents are satisfied with the overall quality of the hospitals; 5 percent are dissatisfied and 18 percent are neutral. It also reveals that satisfaction of the outpatients is irrespective of their genders, age, income level and education. Among all constructs the most positive perceptions are seen in the assurance dimension of the hospitals followed by tangibles, responsiveness, reliability and empathy. Additionally, it is seen that responsiveness dimension is the most strongly correlated dimension with overall satisfaction; while the other dimensions have weak to moderate positive correlation. Overall, a positive relationship is found between patient’s perception of service quality and their satisfaction.</p><p>Journal of Business and Social Sciences Research, Vol. 2, No. 1 & 2, pp. 69-84</p>

Nursing staff perceptions regarding the clinical audit tool used for relicensing inspections within eThekwini private hospitals in South Africa

PurposeThe purpose of this paper is to assess nursing staff perceptions regarding the clinical audit tool used for relicensing inspections within private hospitals in eThekwini district.Design/methodology/approachAn exploratory sequential mixed method research design was used with a qualitative first phase involving a total population of 40 nurse managers through purposive sampling. Nurse managers (n=24) were interviewed. This was followed by a quantitative phase in which a structured questionnaire was administered to nurses (n=270) who were randomly sampled for the study from (n=4) hospitals. Documentation review, a third phase was used to corroborate the findings of the first two phases of the study.FindingsThe results of the study showed that the participants perceptions of the selected private hospitals in eThekwini district is that they have not fully implemented the approach to practice standards and healthcare audits in relation to three clinical domains of the National Core Standards and the Batho Pele principles. These findings were significant and denoted the need for a standardised clinical audit tool for private hospitals in eThekwini district.Research limitations/implicationsThis study was confined to an independent group of hospitals and the findings may not be suitable for generalising across all private hospitals in eThekwini district.Originality/valueThese findings led to the development of a clinical audit tool with measurements representing elements of care that are critical to the provision of safe, quality health care services.

Impact of talent management practices on employee retention with respect to selected private hospitals in Sangli City

Impact of talent management practices on employee retention with respect to selected private hospitals in Sangli City

Perceptions of nursing staff regarding the existence of best practice standards in selected private hospitals in eThekwini district, South Africa

In South Africa, the National Core Standards (NCS) are advocated as the cornerstone for improving quality and patient safety in health care organisations. To align to the Department of Health’s legislative and policy mandates, the Office of Health Standards Compliance developed the NCS for Health Establishments in South Africa that provide a benchmark of quality of care against which the delivery of health services can be monitored. Through the implementation of the NCS, an assessment of a health facility’s compliance to service standards can be measured. The aim of the study was to assess the perceptions of nursing staff regarding the existence of best practice standards in relation to the NCS and Batho Pele Principles. Batho Pele can be viewed as an approach which places the people first. It can be also stated that Batho Pele is a framework which guides healthcare organisations to be more focused on patient needs (Republic of South Africa, 1997). An exploratory descriptive study using a quantitative design was used to conduct the study at a group of four private hospitals in eThekwini district coded as Hospital A, B, C and D. The total population of nurses was 569 of which 270 were sampled for the study. A total of 270 questionnaires were distributed. The total number of questionnaires that were received and included in the data analysis and interpretation was a total of 234 from all four hospitals. The results of the study showed that the overall return rate in the quantitative phase of the study was measured at 86.66%. There was significant agreement by the nursing staff across the four hospitals in the group that best practice standards for patient care existed in selected private hospitals in eThekwini district, related to the Patient Rights, Patient Care and Support Services domains. A follow up phase of documentation review of policies, procedures and directives as identified by the participants was undertaken to validate the findings of the results. The goal now is for ongoing education and training to ensure best practice standards are consistently applied for safe patient care. This requires management commitment and responsibility in the form of education and training, at operational and unit level. It is important that these levels of hierarchy co-operate to implement and sustain best practice standards and processes within the group of hospitals to conform to the National Quality Framework of the NCS and Batho Pele principles.

Effective Communication between Nurses and Doctors: Barriers as Perceived by Nurses

Effective communication among healthcare providers is the key driver for the success of the healthcare system. All the decisions related to patient care depend on effective communication among healthcare providers. Communication and teamwork are the backbones of the organization and helps to safeguard patients’ safety. The study aimed to identify the contributing factors to the communication gap between doctors and nurses at selected private hospitals in Malaysia. The study used a qualitative method with an explorative and descriptive design to elicit the experience of 24 staff nurses from six private hospitals in Kuala Lumpur, Malaysia. A semi-structured interview was conducted to collect the data. The data were analysed using Colaizzi's method for thematic data analysis. The findings of the study suggested three categories as the factors to be responsible for the nurse-physician communication gap as perceived by nurses. The three categories are nurses work readiness; work environment and physician attributes. The respondents also suggested measures to overcome the communication barrier among nurses and physicians. In conclusion, a healthy nurse-physician communication is a vital factor in determining patient safety and quality of care.

Examining the Efficiency of Selected Private Hospitals in Southern Philippines using Data Envelopment Analysis

Objectives: This study aims to evaluate the relative efficiency of selected private hospitals in Southern Philippines using the output-oriented CCR model of data envelopment analysis (DEA). Methods: The output-oriented CCR model of the DEA is applied to analyze efficiency of selected private hospitals in the Philippines using four inputs (namely, doctors, nurses, other staffs and beds) and four outputs (namely, minor operations, major operations, cases treated and patient days) as parameters. Findings: DEA is a management tool commonly used to evaluate the efficiency of service units referred to as the decision-making units (DMUs) working under similar conditions and using the same types of inputs to produce the same kind of output. Unlike typical statistical approaches which compare productivity of a unit with respect to the average, DEA compares each unit with the best units and are classified as either efficient or less efficient. Moreover, the less efficient DMUs need to adopt its efficiency reference set (ERS) or benchmarks for it to improve and become efficient. Results of the study show that 1 out of 10 private hospitals are found to be less efficient using CCR model. Results further provide the magnitude of efficiency of each DMU and also reveal the potential improvements for the private hospital identified as less efficient using the model, on the basis of quantifying the efficiency. Application: This study can provide a way for the hospitals to better enhance their efficiency. Keywords: Data Envelopment Analysis, Efficiency, Private Hospitals

“My hands are tied”: Nurses’ perception of organizational culture in Kenyan private hospitals

It is estimated that by 2030 the global shortage of nurses and midwives will be 7.6 million, with African countries among the most adversely affected. Within this context, it is important to understand the specific organizational factors that contribute to registered nurses (RNs)’ decisions to remain or leave their workplaces in East Africa. The aim of this study was to commence exploration of these factors by exploring nurses’ perceptions of organizational culture of selected private hospitals in Kenya. A small-scale exploratory qualitative approach was employed, with eight nurses undertaking semi-structured interviews. There were five female and three male nurses. All participants were RNs; two held a bachelor’s degree in nursing and the rest held diplomas in nursing. The thematic analysis revealed four major themes and nine sub-themes. The major themes included: restrictive work environment, top-down leadership, normalizing the abnormal in team dynamics and professionalism, and ethical concerns. These findings suggest an urgent need for Kenyan private hospital administrators to create a hospital work environment that provides more autonomy for nurses. There is a need for inclusive leadership styles that target hospital organizational structures and processes in order to address nursing workforce team dynamics. A merit-based salary and progressive reward systems are recommended to empower nurses to remain in the workforce.

Influence of Emotional Labour on Job Satisfaction among Employees of Private Hospitals

Background: With globalization, world has become so competitive that every organization is cracking the hard nut to obtain the reward from this. Service sector has been working on the mantra that customer is the king. Purpose: The objective of this study is to find out the influence of emotional labour on job satisfaction among employees in selected private hospitals of Punjab. The data were collected from 586 employees through stratified random sampling. Methods: Dutch questionnaire on emotional labour (D-QEL) developed and validated by Näring, Briët & Brouwers (2007) and job satisfaction tool by Sharma and Tripathy (2010) were used to collect the data. Descriptive statistics was applied to check the level of emotional labour and job satisfaction, t-test and ANOVA were applied for testing hypothesis. Structural equation modelling was applied to find out the influence of emotional labour on job satisfaction. Conclusions: There was no significant difference in the level of emotional labour and job satisfaction for demographic variables such as age, gender, marital status, designations and years of experience. There was a significant influence of emotional labour on job satisfaction of the employees in selected private hospitals of Punjab. Emotional labour was negatively related with job satisfaction. Out of various dimensions of emotional labour: deep acting and emotional consonance had emerged as major cause of job satisfaction

Medical travellers’ perspectives in selecting in-patient services at selected private hospitals in Sri Lanka

ABSTRACTThe Sri Lankan government has clear plans to develop medical tourism as an industry. Availability of high-quality medical professionals and accredited hospitals has encouraged medical travellers to come to Sri Lanka and to expand the medical tourism industry in the country. The purpose of this cross-sectional study was to describe medical travellers’ perspectives in seeking in-patient services at selected four private hospitals in Sri Lanka. Foreign national in-patients (n = 252) were interviewed using an interviewer-administered questionnaire. The response rate was 93.25%. The majority (68.1%) were Maldivians followed by Indians (20.4%) and 51.1% sought surgical care. Availability of high-quality medical professionals (94.2%) and accredited hospitals (81.3%), easy visa (90.2%) were top reasons to select Sri Lanka. Medical travellers faced difficulties in communication (37.4%), transport (31.9%), accommodation (57%) and finding quality food (41.7%). The study recommends improvement of infrastructure and support services for medical travellers and that private hospitals obtain international accreditation to improve medical tourism potentials.