The Mediating Effect of Organizational Climate on the Relationship between Transformational Leadership and Patient Safety: A Study on Saudi Hospitals

the main aim of this paper is to investigate the mediation effect of organizational climate on the relationship between Transformational Leadership and perceived patient safety in Saudi Hospitals from the nurses perspective. Patient safety has become a significant topic among health professionals, policy makers, and the public owing to the emphasis on the reported and unreported healthcare errors that result in negative situations. A quantitative research design was employed to collect data from nurses in Saudi hospitals to examine the hypothesized model. Out of 254 questionnaires distributed only 217 questionnaires were usable for analysis. The Partial Least Squares Structural Equation Modeling (PLS-SEM) method was used to test the hypotheses. Based on the statistical results, this study supported the relationship between Transformational Leadership and organizational climate and the relationship between organizational climate and perception of patient safety. Finally, this study confirmed the full mediating effect of organizational climate on the relationship between Transformational Leadership and perception of patient safety. The findings of the study are of a great value to both theory and practice and have important implications for practitioners and policy-makers. DOI: 10.5901/mjss.2015.v6n2s1p11

Artificial Intelligence Will Transform Cardiac Imaging-Opportunities and Challenges

National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Center at BartsSmartHeart EPSRC programme grant (www.nihr.ac.uk; EP/P001009/1)London Medical Imaging and AI Center for Value-Based HealthcareCAP-AI programmeEuropean Union's Horizon 2020 research and innovation programme under grant agreement No 825903

Healthcare finance in the Kingdom of Saudi Arabia:a qualitative study of householders’ attitudes

Background: The public sector healthcare system in Saudi Arabia, essentially financed by oil revenues and ‘free at the point of delivery’, is coming under increasing strain due to escalating expenditure and an increasingly volatile oil market and is likely to be unsustainable in the medium to long term. Objectives: This study examines how satisfied the Saudi people are with their public sector healthcare services and assesses their willingness to contribute to financing the system through a national health insurance scheme. The study also examines public preferences and expectations of a future national health insurance system. Methods: A total of 36 heads of households participated in face-to-face audio-recorded semi-structured interviews. The participants were purposefully selected based on different socio-economic and socio-demographic factors from urban and rural areas to represent the geographical diversity that would presumably influence individual views, expectations, preferences and healthcare experiences. Results: The evidence showed some dissatisfaction with the provision and quality of current public sector healthcare services, including the availability of appointments, waiting times and the availability of drugs. The households indicated a willingness to contribute to a national insurance scheme, conditional upon improvements in the quality of public sector healthcare services. The results also revealed a variety of preferences and expectations regarding the proposed national health insurance scheme. Conclusions: Quality improvement is a key factor that could motivate the Saudi people to contribute to financing the healthcare system. A new authority, consisting of a partnership between the public and private sectors under government supervision, could represent an acceptable option for addressing the variation in public preferences

Investigating the Willingness to Pay for a Contributory National Health Insurance Scheme in Saudi Arabia:A Cross-sectional Stated Preference Approach

Background: The Saudi Healthcare System is universal, financed entirely from government revenue principally derived from oil, and is ‘free at the point of delivery’ (non-contributory). However, this system is unlikely to be sustainable in the medium to long term. This study investigates the feasibility and acceptability of healthcare financing reform by examining households’ willingness to pay (WTP) for a contributory national health insurance scheme. Methods: Using the contingent valuation method, a pre-tested interviewer-administered questionnaire was used to collect data from 1187 heads of household in Jeddah province over a 5-month period. Multi-stage sampling was employed to select the study sample. Using a double-bounded dichotomous choice with the follow-up elicitation method, respondents were asked to state their WTP for a hypothetical contributory national health insurance scheme. Tobit regression analysis was used to examine the factors associated with WTP and assess the construct validity of elicited WTP. Results: Over two-thirds (69.6%) indicated that they were willing to participate in and pay for a contributory national health insurance scheme. The mean WTP was 50 Saudi Riyal (US$13.33) per household member per month. Tobit regression analysis showed that household size, satisfaction with the quality of public healthcare services, perceptions about financing healthcare, education and income were the main determinants of WTP. Conclusions: This study demonstrates a theoretically valid WTP for a contributory national health insurance scheme by Saudi people. The research shows that willingness to participate in and pay for a contributory national health insurance scheme depends on participant characteristics. Identifying and understanding the main influencing factors associated with WTP are important to help facilitate establishing and implementing the national health insurance scheme. The results could assist policy-makers to develop and set insurance premiums, thus providing an additional source of healthcare financing

Report from the Annual Conference of the British Society of Echocardiography, November 2017, Edinburgh International Conference Centre, Edinburgh

No abstract available

A Review of the Implementation of Private Finance Initiatives in UK Hospitals

Since their inception in 1992, Private Finance Initiatives (PFIs) have become the dominant mode of procurement for UK National Health Service (NHS) hospitals.  The private sector initially finances new initiatives which are then repaid through unitary service charges. Despite a great deal of rhetoric around the promise and potential of this funding mechanism, more recently PFIs have been criticized for bringing some NHS trusts to the brink of bankruptcy.  Moving forward, assessing whether PFIs can achieve their intended purpose; the provision of more sustainable and affordable solutions, is critical in determining their future usefulness. The purpose of this paper is to identify past and current benefits of the PFI, and evaluate post implementation problems. Our results suggest reduced labour costs and greater productivity are paramount, as is sharing risk. However, in measuring whether PFIs have delivered these benefits there has been a dearth of quantitative performance measurement. Additionally little research has concentrated on critical analysis and performance of PFIs, hampering attempts to evaluate the affordability and sustainability of this solution

The Impact of Code of Medical Ethics on Health Service Quality among Physicians at Saudi Hospitals of Jeddah

This research aims to determine the scope of applying medical ethics among physicians at Saudi hospitals. This research consists of the independent variables represented by code of medical ethics principles (namely autonomy, beneficence, non-maleficence, and, justice) and dependent variable which represented by health service quality. In order to explore the relationship between independent and dependent variables the quantitative method was applied to collect primary data through a questionnaire, which was administered in the government, and private sector hospitals in Jeddah city. The research population consists of 2871 physicians. The research sample consists of the 287 physicians (10%). The researcher retrieves 176 valid research questionnaires accounted (61%). A purposive sampling strategy was used to choose the participants in this research. The results confirm significant relationship between the codes of medical ethics and health service quality. The result shows that four independent variables are significant (autonomy, beneficence, non- maleficence, and justice) on health service quality. This research contributes to recognizing the vital roles of medical ethics in improving the patient service quality. Regarding the beneficence the physician if consider patient well being and contribute to develop their medical profession by update knowledge and continuous medical education through clinical practice research (randomized control trials) applying evidence based medicine  providing that physician deliver health care in a quality standard  regarding  (attitude ,skills , knowledge, and experience). In turn will lead to increase cure rate, and improve patient well-being. Therefore the medical ethics need to be flexible and open to change and adjust regularly. The medical ethics depends on the future of medicine (e.g. new procedures and techniques)

Telemedicine application and difficulties among Prince Sultan Medical City in Saudi Arabia

The rapid changes in the technological environment in Saudi hospitals sector have exerted significant pressures on the health services provider’s to pay attention to updating medical technology strategies in general and health service delivery strategy/telemedicine in particular. Therefore this research investigates telemedicine application and difficulties among Prince Sultan Military Medical City (PSMMC) in Saudi Arabia. This study proposes and tests a two factors model that explains the considerable variation in telemedicine application and difficulties in PSMMC. In order to explore this issue, a descriptive method was used to collect primary data through a questionnaire, which was administered in the PSMMC in Riyadh the capitals city in Saudi Arabia and, via in-depth semi- structured interviews with hospital managers and experts in the telemedicine. All heads of medical departments, IT department, telemedicine department, and medical education department in (PSMMC)-Riyadh were targeted in this research rather than a representative sample of these hospitals. A purposive sampling strategy was used to choose the participants in this research. In total, 40 senior managers were participated in this study. The results confirm that telemedicine system helps the hospital to minimize the process of referring patients to other hospitals. Furthermore, the results show that telemedicine system helps in increasing the quantity and quality of information available, which reflects positively on the quality of medical service. Regarding the difficulties of applying telemedicine the results also highlight poor training in the utilization of techniques necessary for the application of telemedicine system at the hospital. Because of the contributions made by telemedicine in improving health care services, researchers advocate gradual circulation of a draft of telemedicine at all military and governmental hospitals for capacity building and promotion by users and to avoid the difficulties that might occur