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Background: People with end-of-life chronic obstructive pulmonary disease (COPD) experience debilitating physical limitations, with a high mortality rate. Our research has shown health system design and delivery leads to inequitable outcomes. Enabling people with end-of-life COPD, their support people, and health professionals to partner in setting the agenda for resource allocation may inform health service improvement. Design: Qualitative methodology utilising focus groups including patients, family, friends, informal support people, health care workers and professionals. Methods: The analysis, utilising critical theory and Actor-Network theory, positioned people with severe COPD, their support people and health professionals as experts in end-of-life care. Analyses triangulated these perspectives, and were reviewed by the research investigators and an expert reference group. Results: Participants (n=74) in seven focus groups reported their experiences of inequity within the healthcare system. Equity was an overarching phenomenon identified by participants, with three specific themes being described: policy design, system design, and service design. Conclusion: Experiences of patients, their support people and health professionals as experts in end-of-life COPD care can inform health systems and health service design to address current inequities in funding and delivery of care for end-of-life COPD. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to examine the parallel relationships between the growth rates of patient-reported experiences and hospital-associated infections (HAIs) over time. Data Sources/Study Setting: The study employed five waves (years) of data among hospitals across Norway from the Norwegian Health Directorate website for both patient experience and HAIs. Study Design: The study employed a longitudinal design, testing and comparing different models. A latent growth curve model with autoregressions emerged as the best fit for the data. Data Collection/Extraction Methods: The data extracted from the website included 102 hospitals. However, the study used 61 hospitals after data cleaning, each with 400 patient respondents for each year. Principal Findings: The results showed that for both patient experiences andHAIs, hospitals that recorded higher scores at the starting point experienced a lower growth rate over time compared to hospitals that recorded lower infections at the starting point. Second, it was found that the starting point for patient experience significantly related to the starting point for HAIs, such that the higher the score for patient experience, the lower the score on infections across hospitals. The results also indicated that almost all lagged effects on either patient-reported experience or HAIs were significant. Conclusions: This study shows the significance of patient experience, not only for patient-reported outcomes but also for clinical outcomes. This thus ascertains the relevance of the patient experience pillar for the other pillars of quality health care, namely, clinical effectiveness and safety. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Professional Business Review (JPBReview) is the property of Open Access Publications LLC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background People with end-of-life chronic obstructive pulmonary disease (COPD) experience debilitating physical limitations, with a high mortality rate. Our research has shown health system design and delivery leads to inequitable outcomes. Enabling people with end-of-life COPD, their support people, and health professionals to partner in setting the agenda for resource allocation may inform health service improvement. Design Qualitative methodology utilising focus groups including patients, family, friends, informal support people, health care workers and professionals. Methods The analysis, utilising critical theory and Actor-Network theory, positioned people with severe COPD, their support people and health professionals as experts in end-of-life care. Analyses triangulated these perspectives, and were reviewed by the research investigators and an expert reference group. Results Participants (n=74) in seven focus groups reported their experiences of inequity within the healthcare system. Equity was an overarching phenomenon identified by participants, with three specific themes being described: policy design, system design, and service design. Conclusion Experiences of patients, their support people and health professionals as experts in end-of-life COPD care can inform health systems and health service design to address current inequities in funding and delivery of care for end-of-life COPD.

Background There is a growing concern regarding the quality of care received by patients with malaria. However, the quality of care provided to children under the age of five who have contracted the disease has yet to receive sufficient attention. Accordingly, we evaluated the quality of care provided to children under five diagnosed with malaria at Princess Marie Louis (PML) Children’s Hospital in Accra, Ghana. Methods The objective of this study was to evaluate the quality of care provided to children under 5 years of age diagnosed with malaria through a quantitative approach via a cross-sectional survey. The study randomly selected 74 staff members and 301 parents whose children received malaria treatment at the PML Children’s Hospital. This research encompassed a descriptive statistical summary and regression analysis. Results Healthcare professionals exhibited a relatively high adherence to standard protocols for malaria management. Patient satisfaction was moderate and lower than the national average. Conclusion To improve patient satisfaction, an in-depth investigation of innovative and customer-oriented approaches should be conducted.

Introduction: Worker trust in employer‐provided occupational health services has not been explored in essential industries, such as meatpacking. The purpose of this study was to describe workplace health culture and trust in the occupational health office and highlight meatpacking workers' experiences with the occupational health office. Methods: Meatpacking workers were surveyed between February 2021 and October 2022. Descriptive statistics and nonparametric tests were used to explore trust across demographic variables, including workplace health culture. Thematic analysis was used to examine the short‐answer qualitative data. Results: Among workers who completed surveys (n = 731), health culture was rated low (M = 1.3 (0.73); possible range 0‐3). Trust in the occupational health office was also rated low (M = 8.2 (5.06); possible range 0–20). Workers' descriptions of interactions with the occupational health office were mostly unfavorable (287 negative opinion units; 97 positive opinion units) and primarily focused on quality of care, communication, the supervisor as gatekeeper to health services, and the prioritization of company interests. Conclusion: Meatpacking worker health may be improved by building worker trust in the occupational health office. Suggested strategies include enhanced communication, protection of confidentiality, prioritization of worker well‐being, and promotion of a stronger health culture in plants and throughout the industry. Supporting workers without a regular healthcare provider to establish a relationship with a primary care provider of their choice is also recommended. [ABSTRACT FROM AUTHOR]

Patient safety is an essential component of quality healthcare, which is what the general population is constantly demanding worldwide. Consequently, ensuring quality healthcare should not be a matter of clinical interest only but a public health priority so that all actions planned or implemented may have an impact at all levels and ensure intersectoral support to help the population remain safe when seeking and receiving health services. The definition and implementation of patient safety are currently circumscribed to the institutional setting. This article aims to present data that can help put into perspective the existing gaps pertaining to patient safety definition and fields of action, and conclude that there is room to work in public health in order to close those gaps. This requires understanding the complexities of the interactions between determinants of harm outside the physical setting where care is provided. These include community-level work, incorporation of knowledge from other disciplines in order to account for coverage, access and health outcomes, design strategies to counteract the impact that the absence of effective patient and people safety measures have on the general population and, in particular, on people differentially affected by the social determinants of health. [ABSTRACT FROM AUTHOR]

Patient safety is a crucial element of quality healthcare, and endeavours to enhance it are vital for attaining universal health coverage and improving patient outcomes. This study aimed to evaluate the perception of patient safety culture among staff at the Community Health Centre Ljubljana (CHCL).

Object of this research is South Africa’s healthcare system. South Africa’s healthcare system faces numerous challenges that contribute to inadequate access to quality healthcare for its citizens. These challenges include a scarcity of healthcare workers, insufficient funding and resource allocation, a high burden of communicable and non-communicable diseases, as well as disparities in healthcare access and outcomes driven by socioeconomic status and geographic location. Consequently, many South Africans endure unfavourable health outcomes, limited availability of essential health services, and a prevailing sense of mistrust towards the healthcare system. Concurrently, Ukraine has encountered its own set of healthcare obstacles, including similar shortages of healthcare professionals, funding deficiencies, and disparities in healthcare access exacerbated by armed conflict. This study provides insights into the patient experience, utilizing Kolb’s experiential learning theory. It employs qualitative and quantitative methods, including a questionnaire administered to conveniently sampled participants at Chris Hani Baragwanath hospital’s HIV/AIDS unit. Data analysis using Excel and SPSS reveals a communication gap between healthcare workers and patients, highlighting the need for Department of Health training on communication and diversity. Finally, the implementation of consistent patient feedback mechanisms is essential for healthcare institutions to comprehend evolving patient needs, fostering the adoption of a «people-centred» approach to delivering high-quality healthcare services. By incorporating insights from Ukraine’s challenges, this study not only addresses the specific healthcare obstacles faced by South Africa but also provides a broader perspective on healthcare issues across diverse contexts. These insights enable policymakers and healthcare professionals to identify potential solutions and work towards improving healthcare access and outcomes for all citizens, ensuring the overall health and well-being of the population of South Africa and other countries with similar challenges. [ABSTRACT FROM AUTHOR]

Background: Patient safety (PS) is a global priority for achieving quality healthcare. Although patient engagement (PE) is a crucial risk-reduction strategy, research on this subject in Indonesia is scarce. Aim: This study aims to explore healthcare recipients’ (HCRs’) perspectives and their potential role in PS. Methods: Exploratory qualitative research was conducted with in-depth interviews (IDIs). This study purposively selected fourteen patients and fifteen caretakers in chronic wards. Content analysis was subjected to the IDIs data that has been transcribed verbatim. Results: HCRs showed inadequate knowledge, perception, and willingness to engage in patient safety. Four themes were identified from data analysis: (1) complexity barriers to PE Implementation; (2) enabling factors for PE; (3) HCRs' expectations; and (4) existing and potential HCRs' roles in PS. HCRs' roles were still limited to communication, positive attitude and behavior, aided healthcare process, and error prevention. Conclusion: The limited roles of HCRs resulted from their unreadiness to participate more in PS. For patients to be engaged in safety measures, it was essential to improve the ability of patients and caregivers and eliminate obstacles encountered by healthcare professionals and the broader health system. Keywords: patient engagement, patient safety, quality healthcare

ObjectiveNumber of People Living with Human Immune-deficiency Virus in Ghana is over 300,000 and unmet need for antiretroviral therapy is approximately 60%. This study sought to determine the quality of antiretroviral therapy services in selected ART sites in Ghana using the input-process-outcome approach.MethodsThis is a descriptive cross-sectional case study that employed modified normative evaluation to assess quality of antiretroviral therapy services in the Oti and Volta regions of Ghana among People Living with HIV (n = 384) and healthcare providers (n = 16). The study was conducted from 11 March to 9 May 2019.ResultsResources for managing HIV clients were largely available with the exception of viral load machines, reagents for CD4 counts, and antifungals such as Fluconazole and Cotrimoxazole. Patients enrolled on antiretroviral therapy within 2 weeks was 71% and clients retained in care within 2 weeks of enrolment was 90%. Approximately 26% of enrolled clients recorded viral load suppression; 33% of People Living with HIV who were not insured with the National Health Insurance Scheme paid for some antiretrovirals and cotrimoxazole. Adherence to ART and Cotrimoxazole were 95% and 88%, respectively, using pill count on their last three visits. Time spent with clinical team was among the worst rated (mean = 2.98, standard deviation = 0.54) quality indicators by patients contrary to interpersonal relationship with health provider which was among the best rated (mean = 3.25, standard deviation = 0.41) indicators.ConclusionObserved quality care gaps could potentially reverse gains made in HIV prevention and control in Ghana if not addressed timely; an important value addition of this study is the novel application of input-process-outcome approach in the context of antiretroviral therapy services in Ghana. There is also the need for policy dialogue on inclusion of medications for prophylaxis in antiretroviral therapy on the National Health Insurance Scheme to promote adherence and retention.

Introduction: Delivery of end-of-life care for severe chronic obstructive pulmonary disease (COPD) has been hampered by an unpredictable disease trajectory and poor integration of health care and social services. Objective: To critically explore the perspectives, values, and experiences of stakeholders in COPD end-of-life healthcare services in a large district in Aotearoa New Zealand. Design: Focus groups analysed utilising critical theory and Actor-Network Theory. Methods: Stakeholders in end-of-life COPD healthcare services were purposively sampled from a large healthcare network in Canterbury, Aotearoa New Zealand to participate in seven focus groups (bereaved carers, community-based health professionals, non-Māori, non-Pacific patients, and support people (two groups), Māori patients, supporters and health professionals, Pacific patients, support people and health professionals, and hospital-based health professionals). Participants discussed end-of-life care services for people with COPD. Transcripts were coded utilising descriptive and structural coding to develop themes related to provision of quality care. Participants were positioned as experts. We considered how the themes arising supported and disrupted the healthcare network for end-of-life COPD. Results: Five themes related to quality of care for end-of-life COPD were identified: compassion, competence, community, commitment, and collaboration. The absence of any of these five themes required for quality care led to power imbalances within healthcare systems. Power inequities created disconnection among stakeholders which then disrupted commitment, community, and collaboration. A dysfunctional healthcare network impeded compassion between stakeholders and did not support their competence, leading to lower quality care. All five themes were identified as essential to delivery of high-quality end-of-life care in COPD. Conclusion: Stakeholders' perspectives of end-of-life care for COPD identified of core features of a health system network that enabled or impeded the actions of stakeholders and allocation of resources to provide quality care. [ABSTRACT FROM AUTHOR]

Abstract Background Over the past decade, an industry has emerged around Clinical Practice Guideline (CPG) development in healthcare, which has increased pressure on guideline-producing organisations to develop CPGs at an accelerated rate. These are intended to improve the quality of care provided to patients while containing healthcare costs and reducing variability in clinical practice. However, this has inadvertently led to discrepancies in CPG recommendations between health organisations, also challenging healthcare providers who rely on these for decision-making and to inform clinical care. From a global perspective, although some countries have initiated national protocols regarding developing, appraising and implementing high-quality CPGs, there remains no standardised approach to any aspect of CPG production. Methods A scoping review of the literature and document analysis were conducted according to Joanna Brigg’s Institute methodology for scoping reviews. This comprised two qualitative methods: a comprehensive review of the literature (using CINAHL, Scopus and PubMeD) and a document analysis of all national and international guideline development processes (manual search of health-related websites, national/international organisational health policies and documents). Results A set of clear principles and processes were identified as crucial to CPG development, informing the planning, implementation and dissemination of recommendations. Fundamentally, two common goals were reported: to improve the quality and consistency of clinical practice (patient care) and to reduce the duplication or ratification of low-grade CPGs. Conclusions Consultation and communication between CPG working parties, including a wide range of representatives (including professional organisations, regional and local offices, and relevant national bodies) is essential. Further research is required to establish the feasibility of standardising the approach and disseminating the recommendations.

This editorial discusses the importance of referral systems in achieving quality healthcare and the barriers to effective referrals. It emphasizes the significance of referrals in influencing health outcomes and addresses resource constraints, the impact of referrals on the quality of care, and the barriers to referrals and health system resilience. The document suggests strategies to address these challenges, such as improving transportation facilities, follow-up with patients, and implementing a policy framework for referrals. The authors also highlight the potential benefits of integrating technology into referral systems to improve access to quality healthcare, particularly in rural areas of Maputo Province, Mozambique. [Extracted from the article]

Background: Over the past decade, an industry has emerged around Clinical Practice Guideline (CPG) development in healthcare, which has increased pressure on guideline-producing organisations to develop CPGs at an accelerated rate. These are intended to improve the quality of care provided to patients while containing healthcare costs and reducing variability in clinical practice. However, this has inadvertently led to discrepancies in CPG recommendations between health organisations, also challenging healthcare providers who rely on these for decision-making and to inform clinical care. From a global perspective, although some countries have initiated national protocols regarding developing, appraising and implementing high-quality CPGs, there remains no standardised approach to any aspect of CPG production. Methods: A scoping review of the literature and document analysis were conducted according to Joanna Brigg’s Institute methodology for scoping reviews. This comprised two qualitative methods: a comprehensive review of the literature (using CINAHL, Scopus and PubMeD) and a document analysis of all national and international guideline development processes (manual search of health-related websites, national/international organisational health policies and documents). Results: A set of clear principles and processes were identified as crucial to CPG development, informing the planning, implementation and dissemination of recommendations. Fundamentally, two common goals were reported: to improve the quality and consistency of clinical practice (patient care) and to reduce the duplication or ratification of low-grade CPGs. Conclusions: Consultation and communication between CPG working parties, including a wide range of representatives (including professional organisations, regional and local offices, and relevant national bodies) is essential. Further research is required to establish the feasibility of standardising the approach and disseminating the recommendations. [ABSTRACT FROM AUTHOR]

Introduction: Delivery of end-of-life care for severe chronic obstructive pulmonary disease (COPD) has been hampered by an unpredictable disease trajectory and poor integration of health care and social services. Objective: To critically explore the perspectives, values, and experiences of stakeholders in COPD end-of-life healthcare services in a large district in Aotearoa New Zealand. Design: Focus groups analysed utilising critical theory and Actor-Network Theory. Methods: Stakeholders in end-of-life COPD healthcare services were purposively sampled from a large healthcare network in Canterbury, Aotearoa New Zealand to participate in seven focus groups (bereaved carers, community-based health professionals, non-Māori, non-Pacific patients, and support people (two groups), Māori patients, supporters and health professionals, Pacific patients, support people and health professionals, and hospital-based health professionals). Participants discussed end-of-life care services for people with COPD. Transcripts were coded utilising descriptive and structural coding to develop themes related to provision of quality care. Participants were positioned as experts. We considered how the themes arising supported and disrupted the healthcare network for end-of-life COPD. Results: Five themes related to quality of care for end-of-life COPD were identified: compassion, competence, community, commitment, and collaboration. The absence of any of these five themes required for quality care led to power imbalances within healthcare systems. Power inequities created disconnection among stakeholders which then disrupted commitment, community, and collaboration. A dysfunctional healthcare network impeded compassion between stakeholders and did not support their competence, leading to lower quality care. All five themes were identified as essential to delivery of high-quality end-of-life care in COPD. Conclusion: Stakeholders’ perspectives of end-of-life care for COPD identified of core features of a health system network that enabled or impeded the actions of stakeholders and allocation of resources to provide quality care.

Background: The South African National Accreditation System (SANAS) is the only national body responsible for accreditations in South Africa as mandated by the Accreditation for Conformity Assessment, Calibration and Good Laboratory Practice Act 19 of 2006, which is specifically aimed at illustrating accredited services in medical laboratories. The limited information about accredited medical diagnostic laboratories in South Africa resulted in a lack of awareness on the value of accreditation. This study aimed to ascertain the ratio of the South African population who has access to ISO15189 accredited laboratory services as well as to show the distribution of ISO15189 accredited laboratories throughout the provinces of South Africa. Methods: This was a retrospective cohort study that extracted data on public and private accredited laboratories from 2010-2019. Three databases were used to collect data; namely, the SANAS database to obtain the total number of accredited laboratories in South Africa, the Council of Medical Schemes (CMS) database regarding the populations with medical aid, and the Statistics South Africa (Stats SA) database to obtain the estimated population in South Africa. The collected data were tested for normality using the Shapiro-Wilk test and the Kolmogorov-Smirnov test. Statistical analysis: The data were collected and statistically analysed using the Statistical Package for the Social Sciences (SPSS). The p-value < 0.05 was considered statistically significant and indicated that data were not normally distributed. Results: The results showed that data of South African accredited laboratories were not normally distributed in eight of the nine provinces. Data were normally distributed only in Gauteng province indicating p = 0.474 for public laboratories and p = 0.420 for private laboratories. Conclusion: The findings of this study showed that there was a biased distribution of accredited laboratories in South Africa in favour of private laboratories. There is a need for scaling up SANAS accredited laboratories for public healthcare facilities. The majority of the population who did not have medical aid also had access to unaccredited laboratories. The quality of results in these laboratories is not aligned to international ISO15189 laboratory quality standards. [ABSTRACT FROM AUTHOR]

Background: There is a growing concern regarding the quality of care received by patients with malaria. However, the quality of care provided to children under the age of five who have contracted the disease has yet to receive sufficient attention. Accordingly, we evaluated the quality of care provided to children under five diagnosed with malaria at Princess Marie Louis (PML) Children's Hospital in Accra, Ghana., Methods: The objective of this study was to evaluate the quality of care provided to children under 5 years of age diagnosed with malaria through a quantitative approach via a cross-sectional survey. The study randomly selected 74 staff members and 301 parents whose children received malaria treatment at the PML Children's Hospital. This research encompassed a descriptive statistical summary and regression analysis., Results: Healthcare professionals exhibited a relatively high adherence to standard protocols for malaria management. Patient satisfaction was moderate and lower than the national average., Conclusion: To improve patient satisfaction, an in-depth investigation of innovative and customer-oriented approaches should be conducted., Competing Interests: Sources of Support: None. Conflicts of Interest: None.

Copyright of CES Odontología is the property of Universidad CES and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Business Economics & Management Research is the property of Bayburt University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To learn about the baseline of Oncohematological Pharmacy Units in Spanish hospitals in order to identify areas for improvement. Method: A survey in line with the objectives set in GEDEFO 2020 Strategic Plan of Pharmaceutical Care for oncohematological patients was designed. The survey was hosted on GEDEFO’s website during March and April 2017. Activity data for 2016 was collected. Results: A total of 95 hospitals responded to the survey. Out of which, 76% had an integrated information system of pharmacotherapeutic process management, where a variability in technological and organizational processes were found. The oncohematological pharmacist led the implementation of the principles of medicine, based on evidence and results obtained in routine clinical practice. It was shown that 88% of hospitals had standardized protocols. As for safety practices, in 83% of hospitals, oncohematological pharmacists actively participated in the development and maintenance of risk management program, implemented to prevent errors. Preparation was centralized in 89% of hospitals. Variability was observed in pharmaceutical care depending on where the patient was attended. In 92% of hospitals, pharmacists served as reference for Oncohematology, although with different levels of training. Major deficiencies were observed in training programs and teaching. Of all oncohematological pharmacists, 53% had been a researcher over the past three years. Conclusions: These results mark the starting point for Spanish Oncohematological Pharmacy Units to develop strategies for improving the quality of pharmaceutical care offered to oncohematological patients and led by GEDEFO, heads of service, and oncohematological patients themselves.

Abstract Background Health Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assessed the impact of funded prioritised research and identified research gaps to inform future priority setting initiatives for universal access and quality healthcare in Malaysia. Methods Research impact of universal access and quality healthcare projects funded by the National Institutes of Health Malaysia were assessed based on the modified Payback Framework, addressing categories of informing policy, knowledge production, and benefits to health and health sector. For the HRPS process, the Child Health and Nutrition Research Initiative methodology was adapted and adopted, with the incorporation of stakeholder values using weights and monetary allocation survey. Workshop discussions and interviews with stakeholders and research groups were conducted to identify research gaps, with the use of conceptual frameworks to guide the search. Results Seventeen ongoing and 50 completed projects were identified for research funding impact analysis. Overall, research fund allocation differed from stakeholders’ expectation. For research impact, 48 out of 50 completed projects (96.0%) contributed to some form of policy-making efforts. Almost all completed projects resulted in outputs that contributed to knowledge production and were expected to lead to health and health sector benefits. The HRPS process led to the identification of research priority areas that stemmed from ongoing and new issues identified for universal access and quality healthcare. Conclusion The concerted efforts of evaluation of research funding impact, prioritisation, dissemination and policy-maker involvement were valuable for optimal health research resource utilisation in a resource constrained developing country. Embedding impact evaluation into a priority setting process and funding research based on national needs could facilitate health research investment to reach its potential.

Comprehensive biopsychosocial care for people with gender incongruence (ICD 11) who are transgender (trans) or gender diverse is a complex process in which the quality of the medical transition can only be guaranteed after a multidisciplinary approach, through teams that integrate professionals with training and experience not only in medicine but also in diversity and gender identity. Based on this, the Gonad, Identity and Sexual Differentiation working group of the Spanish Society of Endocrinology and Nutrition (GT-GIDSEEN) has established minimum care requirements that aim to guarantee adequate health care for these people by professionals. A position paper has been produced and is available at https://www.seen.es/portal/documentos/estandares-calidad-gidseen-2024., (Copyright © 2024 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Background The quality of laboratory services is crucial for quality of patient care. Clinical services and physicians’ decisions depend largely on laboratory test results for appropriate patients’ management. Therefore, physicians’ satisfaction with laboratory services is a key measurement of the quality service that stresses impactful laboratory service improvement to benefit patients. Objective To assess physicians’ satisfaction and perspectives on the quality of services in clinical referral laboratories in Rwanda. Methods A cross-sectional survey among physicians from four referral hospitals with closed-ended questionnaire and one general open-ended question. A five-point Likert scale rating was used to measure satisfaction. Descriptive, ordered logistic regression, and thematic analysis were used. Results In total, 462 of 507 physicians (91% response rate) participated in the study. Overall mean satisfaction was 3.2 out of 5, and 36.2% of physicians were satisfied (satisfied and strongly satisfied) with laboratory services. In four service categories out of 17, the physicians’ satisfaction was over 50%. The categories were: reliability of results (69.9%), adequacy of test reports (61.9%), laboratory staff availability (58.4%), and laboratory leadership responsiveness (51.3%). Lowest satisfaction was seen for routine test turnaround time (TAT) (19.3%), in-patient stat (urgent) test TAT (27%), communication of changes such as reagent stock out, new test (29%), and missing outpatient results (31%). Eighty-four percent answered that test TAT was not communicated, and 73.4% lacked virology diagnostics. Pediatricians, internists, and more experienced physicians were less satisfied. While ineffective communication, result delays, and service interruption were perceived as dissatisfying patterns, external audits were appreciated for improving laboratory services. Conclusion Availing continuously laboratory tests, timely result reporting, and effective communication between laboratories and clinicians would increase physicians’ satisfaction and likely improve the quality of health care. Laboratory staff participation in clinical meetings and ward rounds with physicians may address most of the physicians’ concerns.

The implementation of quality management strategies is a global phenomenon, particularly in organizations in developing countries, who have used different quality management systems to improve the quality of their services and to satisfy their customers. In the healthcare sector, the implementation of Total Quality Management (TQM) philosophy can help to enhance patient safety and help healthcare organizations improve performance and adopt cost-effective management practices. This research paper aims to identify and measure the Critical Successful Factors (CSFs) that affecting the implementation of TQM in hospitals. A literature review on TQM was examined to identify the CSFs for its implementation in healthcare between 2010 and 2020. In addition, this study employed quantitative methods to achieve its research objectives. A questionnaire was designed to gather empirical data from senior staff in hospitals adopting a self-administered technique to measure the CSFs that affecting TQM implementation. Of the 600 questionnaires circulated in two public hospitals in Dubai, 356 questionnaires were analyzed, producing a response rate of 59.3%. Descriptive and inferential statistical techniques were applied to analyse the data employing central tendency (Mean), measures of dispersion (Standard Deviation) and Principle Component Analyses (PCA). The findings in this study revealed that an effective TQM implementation in hospitals require abundant top management commitment, employee involvement, training and education, recognition and reward, process management, strategic planning, information analysis, organization culture, continuous improvement, and customer focus. The results in this study further indicated that among the ten TQM implementation CSFs, top management commitment and customer focus were found to be the most CSFs affecting the implementation of TQM in hospitals with highest mean value of 4.8 and 4.7, respectively. This study has contributed to the existing TQM literature concerning the CSFs affecting the implementation of TQM in the healthcare context, particularly in hospitals. In addition, the findings of this research paper provide vital knowledge to hospital managers with a precious understanding of the factors that enable TQM implementation in hospitals. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to determine the level of knowledge of healthcare professionals regarding calibration and their ability to consider device calibration for medical measurements. Methods: Purposive sampling method was used in this cross-sectional descriptive study. The study sample comprised 541 healthcare professionals. The data were collected using personal information form and 'Medical Device Calibration Information Form'. Results: 72.2% of participants did not receive training on calibration, 40.5% indicated that they had no information about the presence of uncalibrated equipment in their units, and 14.3% reported uncalibrated devices in their units. Total knowledge scores of female participants or those at the age of 35 and older, and doctors or laborants were determined to be significantly higher than the other participants (p <0.05). Conclusions: It was determined that healthcare professionals had a low level of knowledge about calibration, used non-calibrated medical devices, and did not receive training on calibration. It is recommended that calibration should be introduced as a subject in both the university curriculum and in-service training programs for healthcare professionals. [ABSTRACT FROM AUTHOR]

The quality of laboratory services is crucial for quality of patient care. Clinical services and physicians’ decisions depend largely on laboratory test results for appropriate patients’ management. Therefore, physicians’ satisfaction with laboratory services is a key measurement of the quality service that stresses impactful laboratory service improvement to benefit patients. To assess physicians’ satisfaction and perspectives on the quality of services in clinical referral laboratories in Rwanda. A cross-sectional survey among physicians from four referral hospitals with closed-ended questionnaire and one general open-ended question. A five-point Likert scale rating was used to measure satisfaction. Descriptive, ordered logistic regression, and thematic analysis were used. In total, 462 of 507 physicians (91% response rate) participated in the study. Overall mean satisfaction was 3.2 out of 5, and 36.2% of physicians were satisfied (satisfied and strongly satisfied) with laboratory services. In four service categories out of 17, the physicians’ satisfaction was over 50%. The categories were: reliability of results (69.9%), adequacy of test reports (61.9%), laboratory staff availability (58.4%), and laboratory leadership responsiveness (51.3%). Lowest satisfaction was seen for routine test turnaround time (TAT) (19.3%), in-patient stat (urgent) test TAT (27%), communication of changes such as reagent stock out, new test (29%), and missing outpatient results (31%). Eighty-four percent answered that test TAT was not communicated, and 73.4% lacked virology diagnostics. Pediatricians, internists, and more experienced physicians were less satisfied. While ineffective communication, result delays, and service interruption were perceived as dissatisfying patterns, external audits were appreciated for improving laboratory services. Availing continuously laboratory tests, timely result reporting, and effective communication between laboratories and clinicians would increase physicians’ satisfaction and likely improve the quality of health care. Laboratory staff participation in clinical meetings and ward rounds with physicians may address most of the physicians’ concerns. [ABSTRACT FROM AUTHOR]