Accreditation effects on health service quality: nurse viewpoints

The integration of lean and human resource management practices as an enabler for lean deployment –a systematic literature review

Purpose

The current research aims to map and investigate how human resource management and lean practices can be integrated. This investigation will help identify the HRM aspects critical in the success of lean initiatives while exploring the research gaps in the existing literature. The review also aims to delineate the benefits and challenges of integrating lean with HRM systems to discuss further research and practice areas.

Design/methodology/approach

This study utilizes a systematic literature review method to identify and synthesize the existing literature. As part of the process, a protocol that provided a plan for the review was followed, including the research questions and the data to be extracted.

Findings

The study results indicate that aspects of HRM practice and policies such as training and development, teamwork, motivation, communication, leadership, are key enablers of lean initiative deployment and success. The benefits of the integration of human resources with lean can help in lean training and development, communication of lean initiatives and successes, allocating and hiring continuous improvement personnel, and supporting leadership in lean deployment. Challenges to integrating lean and HRM practices included lack of integration and collaboration between disciplines. Further exploration areas in successful lean deployment would be practical longitudinal case studies on lean deployments with human resource (HR) partnerships and involvement.

Practical implications

This review paper has crucial implications for practice relating to, integration of lean with HRM structures and tailoring HRM initiatives to ensure the success of lean deployment and reduce risks of failure.

Originality/value

The systematic literature review study conducted in this paper is the first of its kind to integrate and map the HRM concepts that can be integrated with Lean to deploy the initiative successfully. This mapping is critical for ensuring the success of lean methodologies within an organization and paves the way for future research. In addition, managers and organizations can find support and guidance from this study to focus on vital areas of partnership between their lean and HR programs.

The impact of hospital accreditation in selected Middle East countries: a scoping review

PURPOSE

There is conflicting evidence concerning the impact of hospital accreditation programmes, including across the Middle East Region, where such programmes have been most recently implemented in Iran, Jordan and Saudi Arabia. This paper maps available evidence regarding the impact of hospital accreditation in these three countries and draws attention to knowledge gaps for consideration.

DESIGN/METHODOLOGY/APPROACH

This scoping review was conducted in 2020, using the Arksey and O'Malley framework. Five research databases were searched, along with five government and accreditation agency websites. Searches were complemented by citation chaining. English and Arabic publications evaluating hospital accreditation in the selected countries were included. Commentaries and articles not based on primary data collection and reviews of existing registry data were excluded. There were no exclusions based on study design or methods. A descriptive numerical summary and thematic analysis were used to synthesise the literature.

FINDINGS

studies were included. The majority (n = 35) were published since 2014 and conducted in Saudi Arabia (n = 16). Four themes emerged: organisational impacts, patient safety, quality of care, and patient satisfaction and experience. The literature generally highlights positive impacts of accreditation, but most studies were based solely on health professionals' subjective perceptions. "Organisational impacts" had the largest, and strongest body of supporting evidence, while "patient safety" had the least and most variable evidence.

ORIGINALITY/VALUE

Opportunities to strengthen the design and evaluation of hospital accreditation programmes in the selected countries are highlighted. Additional experimental, mixed-method research is recommended to strengthen the evidence base and inform practical enhancements to hospital accreditation programmes in the region.

Perceptions and experiences of nurses involved in quality-improvement processes in acute healthcare facilities: a qualitative systematic review protocol

OBJECTIVE

The objective of this review is to understand the perceptions of nurses working in acute healthcare environments in relation to quality-improvement processes.

INTRODUCTION

Quality improvement requirements and processes are firmly embedded in contemporary healthcare practice; however, the evidence is unclear on the extent to which nurses are engaged across the continuum of quality improvement. Nurses are required to consult these processes, but clinical nurses in particular may have limited input into the planning and implementation of quality improvement.

INCLUSION CRITERIA

The population to be reviewed is nurses working in acute healthcare settings. The phenomena of interest is the perceptions and experiences of these nurses in relation to quality-improvement processes.

METHODS

A defined search strategy will be used. PubMed, CINAHL, Embase, and SCOPUS will be searched. Informit, MedNar, and ProQuest will be searched to identify gray literature. The search will be limited to studies published in English. No date limits will be set. After screening the titles and abstracts of identified citations, potentially relevant studies will be retrieved in full. The review will be conducted following the JBI methodology for qualitative evidence. The JBI process of meta-aggregation will be used to identify categories and synthesize findings. The ConQual approach will be used to assess confidence in the findings. Synthesis of the data will be presented in a table with accompanying narrative.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42019146833.

Attitudes Towards Accreditation and Quality Improvement Activities Among Hospital Employees in Iran: A Quantitative Study

Purpose

The hospital accreditation system in Iran is relatively young, having been introduced in 2012. Therefore, there is a real need for research on the status and impact of hospital accreditation in Iran. The purpose of this study was to evaluate and compare attitudes towards accreditation and quality improvement activities among hospital employees, specifically the attitudes towards the impact of accreditation on the quality of healthcare and its benefits in Iran.

Materials and Methods

A cross-sectional survey was carried out at 23 teaching hospitals in three metropolises in Iran, all of which successfully passed national accreditation surveys. Some 1213 hospital managers, administrative staff, nurses, and para-clinical staff participated in the survey. The main outcome measures were quality results, and the activities related to quality improvement include senior managers' commitment and support, strategic quality planning, education and training, rewards and recognition, quality management, use of data, the involvement of professionals in accreditation, and accreditation benefits. The questionnaire was applied using a 5-point Likert scale ranging from 1 “strongly disagree” to 5 “strongly agree”. One-way analysis of variance (ANOVA) was used to compare mean values between respondent groups.

Results

Among nurses and managers, there was low support for accreditation and even less among para-clinical staff who fail to see accreditation having a positive impact on healthcare quality. Also, nurses' attitudes toward the accreditation benefits were more positive compared with the two other groups. Staff stated that the main reasons for low support were a lack of education and training to act upon the accreditation survey results and a lack of management visibility and support for quality improvement.

Conclusion

Improving quality through means of hospital accreditation is a complex process with high demands for management and employees. Questionnaires on employees’ attitudes and perceptions of the impact of accreditation and quality improvement-related activities in the hospitals can provide valuable information on the current problems of a hospital accreditation program.