Components of teamwork that influence the successful implementation of a total quality management program in a Saudi Arabian healthcare setting

Many health organisations in Saudi Arabia have adopted total quality management (TQM) programs as a strategy to enhance quality and efficiency. Among the many factors that influence the successful implementation of TQM programs are teamwork and its components. This study aimed to investigate the components of teamwork that influence the successful implementation of the TQM program in King Fahad Medical City (KFMC). The study also aimed to explore interactions between teamwork elements and the TQM program that influence employees' engagement in implementation of the program - elements such as task reflexivity, participative trust, team learning behaviour, team efficacy and stability, leadership and decision-making, effective communication and management support. The final aim was to explore KFMC employees' experiences, challenges and opportunities that might influence successful implementation of teamwork within the TQM program

The 100 patient stories project: Patient and family member views on how clinicians (should) enact Open Disclosure - a qualitative study

Objectives To investigate patients’ and family members’ perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure. Design Retrospective qualitative study based on 100 semi-structured, in depth interviews with patients and family members. Setting Nationwide multisite survey across Australia. Participants 39 patients and 80 family members who were involved in high severity healthcare incidents (leading to death, permanent disability, or long term harm) and incident disclosure. Recruitment was via national newspapers (43%), health services where the incidents occurred (28%), two internet marketing companies (27%), and consumer organisations (2%). Main outcome measures Participants’ recurrent experiences and concerns expressed in interviews. Results Most patients and family members felt that the health service incident disclosure rarely met their needs and expectations. They expected better preparation for incident disclosure, more shared dialogue about what went wrong, more follow-up support, input into when the time was ripe for closure, and more information about subsequent improvement in process. This analysis provided the basis for the formulation of a set of principles of effective incident disclosure. Conclusions Despite growing prominence of open disclosure, discussion about healthcare incidents still falls short of patient and family member expectations. Healthcare organisations and providers should strengthen their efforts to meet patients’ (and family members’) needs and expectations

Patients’ and family members’ views on how clinicians enact and how they should enact incident disclosure: the “100 patient stories” qualitative study

Objectives To investigate patients’ and family members’ perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure

MPPUPM Pantau Harga Makanan

Majlis Perwakilan Pelajar Universiti Putra Malaysia (MPPUPM) giat memantau harga makanan yang dikatakan meningkat dengan ketara sehingga menimbulkan kegelisahan mahansiswa

The insurance implications of open disclosure in healthcare

In contrast to as little as a decade ago, open disclosure is now regularly the subject of government policies, professional conferences and academic publications Open disclosure has been advocated since the late 1980s for a variety of reasons, including organisational and legal risk management considerations and, more recently, the need to show respect for the feelings and dignity of victims of adverse events. This article examines the insurance and other legal implications of open disclosure in Australia

Healthcare Rights: Will patients' rights be respected?

A patient-centred health system is known to be associated with safer and higher quality care. Although patient satisfaction with health services in Australia is generally high, recent research suggests that patients' experiences are not always valued and that their expectations are not always met. This does not necessarily lead to poor clinical outcomes for the individuals concerned, however making a strong and consistent effort to respect patients' expectations through a charter of rights is indicative of a patient-centred health system. The Commission has developed the Australian Charter of Healthcare Rights to underpin the provision of safe and high quality care and support a shared understanding of the rights of patients and consumers between those seeking health care and those providing health care

Literature Review: Incident disclosure policy, legal reform and research since 2008

This document provides a literature review of incident disclosure research, policy and legal reform documents published since 2008. The review takes into account Australian as well as international publications. The last four years have seen an explosion of policy and literature on all aspects of incident disclosure. Over this time, three developments are apparent. First, as new policy is issued, implemented and evaluated, the principles for enacting incident disclosure are becoming increasingly detailed and refined. Second, publications increasingly encompass the various inter-disciplinary dimensions of incident disclosure, addressing its legal, ethical, moral, psychological, sociological, communicative and relational dimensions. Third, and most significant perhaps, the literature is becoming increasingly patient-centred and less risk-managerial. These developments have been assisted by policy makers, researchers, practitioners and patients advocating more strategic approaches to quality and safety. Thus, jurisdictions have moved towards developing key performance indicators for implementing quality and safety goals and standards and for measuring quality and safety processes and outcomes. What typifies many of these goals, standards and measures is that they place patients at the centre of the health care system and the health care process. One manifestation of this is the growing support for engaging patients in various aspects of quality and safety improvement. Another is the growing interest in patient rights (viz. the Australian Charter of Patient Health Care Rights and the Perth Declaration 2009 of Patients for Patient Safety)

Council cooperation in New South Wales: Why have some councils not joined joint organisations?

In common with many other municipal systems in Australia and abroad, New South Wales (NSW) local government confronts formidable challenges, not least maintaining a viable level of financial sustainability (Grant and Drew, 2017; Kuhlmann and Bouckaert, 2016). This has led the NSW Government to embark on a sweeping local government reform program, which centred on structural change through a controversial forced amalgamation process over the period 2011–2017. A significant motivation for the compulsory council consolidation program was the quest for ‘adequate scale and capacity’ through the establishment of larger merged municipal entities (Independent Pricing and Regulatory Tribunal IPART, 2015b), notwithstanding the weight of empirical evidence that forced amalgamation has generally failed to reduce operational costs (see, for example, Dollery et al., 2012; Lago-Penas and Martinez-Vazquez, 2013; Allers and Geertsema, 2016). In addition, recent empirical studies have investigated the system-wide effects of municipal mergers, with comparisons of the performance merged and unmerged cohorts of local authorities through time. In this vein, Bell et al. (2016) demonstrated no statistical differences in performance in NSW local government between councils amalgamated in 2004 and their unmerged counterparts after ten years. When the municipal merger program was abruptly abandoned on 27 July 2017, the NSW Government continued its pursuit of scale in local government by establishing a voluntary network of Joint Organisations of Council (JOs) throughout NSW, except for the Greater Sydney region, with councils invited to join a JO. JOs became operational on 1 July 2018 supported by a solid legislative framework and NSW Government seed grants. Additional funding has subsequently been provided to JOs to stimulate regional collaboration between local authorities. With its explicit emphasis on fostering regional cooperation by constellations of councils, including the provision of shared services, the JO program rests on sound evidential foundations, which point inter alia to potentially significant scale economies in service provision (see, for instance, Tomkinson, 2007; Dollery et al., 2012; Henderson, 2015). Council collaboration is ubiquitous across the globe, including Australia (Dollery et al., 2012), Europe (Henderson, 2015), Japan (Jacobs, 2004) and North America (Holzer and Fry, 2011). Moreover, it has a long history in NSW local government (Audit Office of NSW, 2018). Inter-municipal cooperation assumes numerous different institutional forms, including delegation, resource-sharing and shared services (Dollery and Akimov, 2009). However, in contrast to both municipal mergers (Lago-Penas and Martinez-Vazquez, 2013; Allers and Geertsema, 2016) and outsourcing through contracting out, privatisation and other market-orientated methods (Warner and Hefetz, 2008; Bel et al., 2010), significantly less empirical work has examined the impact of council collaboration on local government performance. Furthermore, comparatively little is known about the performance characteristics of alternative models of intermunicipal cooperation (Holzer and Fry, 2011). In addition, while some effort has been directed at the determinants of participation by local authorities in council collaboration programs in the United States and other countries (see, for example, Hawkins, 2009), almost no empirical work has been undertaken in the Australian local government milieu (Dollery et al., 2012), with a single recent exception (Audit Office of NSW, 2018). There is thus an urgent need for empirical research into the rationale for participation in intermunicipal collaboration in Australia, especially the current JO program in NSW local government. The present paper seeks to address this gap in the Australian literature by examining empirically the reasons why some NSW councils have decided not to participate in JOs. While most of the local councils which were at first hesitant in joining a JO have subsequently overcome their initial doubts and assumed membership, it is nonetheless important to consider why this hesitation existed and why a few councils still remain outside the JO network, despite the generous funding offered by the NSW Government to JOs. The paper is divided into six main sections. Section 2 provides a synoptic account of the literature on council collaboration in the local government. Section 3 provides a brief summary of the NSW Fit for the Future policy process which has culminated in the establishment of a network of JOs across NSW. Section 4 considers the nature of the new JO network as well as prior experience with council collaboration in NSW local government leading up to the formation of JOs, especially with regard to participation decision-making by individual councils. Section 5 outlines the empirical research strategy employed in the paper, including a description of councils which have not joined a JO. A discussion of the results is provided in Section 5. The paper ends with some brief comments on its policy implications in Section 6