Assessment of the Quality of Obstetric Services From the Perspective of Maternity Patients and Service Providers in a Tertiary Care Obstetric Unit in Lithuania

Although largely focused on the patient, the provision of healthcare services is a 2-way process and its success hinges on the interactions between patients and physicians. Given the growing role of subjective, patient-dependent assessment of the quality of care received, which is increasingly influenced by the individual aspects of the interaction between patients and care providers, in addition to the explicitly measurable, objective assessment of the quality of care received based on clinical indicators, quality assessment of services should especially consider and explore the attitudes, needs and dynamics of all the parties involved in the healthcare process. This study was designed to assess the attitudes of maternity patients and healthcare providers towards the quality of obstetric care. A quantitative questionnaire survey was conducted in a tertiary level healthcare facility providing obstetric services in Lithuania. Research findings suggested that maternity patients rate both the technical and functional quality of obstetric services higher than the staff providing it. Midwives and obstetricians-gynaecologists view quality assurance as a complex process, rather than focus solely on quantitative indicators. Since midwives were rated slightly higher than physicians in terms of services they provide, it may be appropriate to ensure and encourage a wider use of midwife-only deliveries in low-risk births. A comprehensive assessment of the quality assurance aspects as viewed by the patients and the staff should be included in the regular quality assessments of healthcare facilities as one of the most informative assessment tools on the service quality.

Re-evaluation of the healthcare service quality criteria for the Covid-19 pandemic: Z-number fuzzy cognitive map

Hospitals as healthcare centers have faced many challenges with the Covid-19 spread, which results in a decline in the quality of health care. Because the number of patients referred to hospitals increases dramatically during the pandemic, providing high-quality services and satisfying them is more important than ever to maintain community health and create loyal customers in the future. However, health care quality standards are generally designed for normal circumstances. The SERVPERF standard, which measures customer perceptions of service quality, has also been adjusted for hospital service quality measurement. In this study, the SERVPERF standard criteria for health services are evaluated in the Covid-19 pandemic. For this purpose, by considering the causal relationships between the criteria and using Z-Number theory and Fuzzy Cognitive Maps (FCMs), the importance of these criteria in the prevalence of infectious diseases was analyzed. According to the results, hospital reliability, hospital hygiene, and completeness of the hospital with ratios 0.9559, 0.9305, and 0.9268 are respectively the most influential criteria in improving the quality of health services in the spread of infectious diseases circumstances such as the Covid-19 pandemic. A review of the literature shows that in previous studies, comprehensive research has not been done on prioritizing the criteria for measuring the quality of health services in the context of the spread of infectious diseases.

Assessing healthcare service quality using routinely collected data: Linking information systems in emergency care

Emergency departments need to continuously calculate quality indicators in order to perform structural improvements, improvements in the daily routine, and ad-hoc improvements in everyday life. However, many different actors across multiple disciplines collaborate to provide emergency care. Hence, patient-related data is stored in several information systems, which in turn makes the calculation of quality indicators more difficult. To address this issue, we aim to link and use routinely collected data of the different actors within the emergency care continuum. In order to assess the feasibility of linking and using routinely collected data for quality indicators and whether this approach adds value to the assessment of emergency care quality, we conducted a single case study in a German academic teaching hospital. We analyzed the available data of the existing information systems in the emergency continuum and linked and pre-processed the data. Based on this, we then calculated four quality indicators (Left Without Been Seen, Unplanned Reattendance, Diagnostic Efficiency, and Overload Closure). Lessons learned from the calculation and results of the discussions with staff members that had multiple years of work experience in the emergency department provide a better understanding of the quality of the emergency department, the related challenges during the calculation, and the added value of linking routinely collected data.

Improving healthcare service quality through performance management

PURPOSE

Healthcare service quality in the USA has gained importance under value-based payment models. Providing feedback to front-line staff is a vital component of managing service performance, but complex organizational dynamics can prevent effective communication. This work explored the performance management of appointment desk staff at Mayo Clinic Arizona, identified barriers to effective management and sought to standardize the process for monitoring service performance.

DESIGN/METHODOLOGY/APPROACH

Multiple data sources, including qualitative inquiry with 31 employees from the primary care and surgery departments, were used. The research was conducted in two phases - facilitated roundtable discussions with supervisors and semi-structured interviews with supervisors and staff six months after implementation of service standards. Participants were probed for attitudes about the service standards and supervisor feedback after implementation.

FINDINGS

While all staff indicated a positive work environment, there was an unexpected and pervasive negative stigma surrounding individual feedback from one's supervisor. Half the participants indicated there had been no individual feedback regarding the service standards from the supervisor. Presenting service standards in a simple, one-page format, signed by both supervisor and the patient service representative (PSR), was well received.

ORIGINALITY/VALUE

Combining rapid-cycle quality improvement methodology with qualitative inquiry allowed efficient development of role-specific service standards and quick evaluation of their implementation. This unique approach for improving healthcare service quality and identifying barriers to providing individual feedback may be useful to organizations navigating a more value- and consumer-driven healthcare market.