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  1. Mohamed B, Azizan NA
    Int J Health Care Qual Assur, 2015;28(3):300-14.
    PMID: 25860926 DOI: 10.1108/IJHCQA-06-2014-0074
    PURPOSE: The purpose of this paper is to advance healthcare service quality research using hierarchical component models.
    DESIGN/METHODOLOGY/APPROACH: This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses.
    FINDINGS: The study extends health service quality literature by showing that: patient satisfaction (PS) is dominant, significant and indirect determinant of behavioural compliance (BC); perceived service quality has the strongest effect on BC via PS.
    RESEARCH LIMITATIONS/IMPLICATIONS: Only one hospital was evaluated.
    PRACTICAL IMPLICATIONS: The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design.
    ORIGINALITY/VALUE: Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.
    KEYWORDS: Healthcare; Hierarchical perceived service quality; Population-based sampling
  2. Rahman MS, Osmangani AM
    Int J Health Care Qual Assur, 2015;28(8):841-54.
    PMID: 26440486 DOI: 10.1108/IJHCQA-05-2015-0056
    The purpose of this paper is to examine the five-factor structure of patients' satisfaction constructs toward private healthcare service providers.
  3. Pillay DI, Ghazali RJ, Manaf NH, Abdullah AH, Bakar AA, Salikin F, et al.
    Int J Health Care Qual Assur, 2011;24(7):506-22.
    PMID: 22204085
    This is a national study which aims to determine the average waiting time in Malaysian public hospitals and to gauge the level of patient satisfaction with the waiting time. It also aims to identify factors perceived by healthcare providers which contribute to the waiting time problem.
  4. Awang Kalong N, Yusof M
    Int J Health Care Qual Assur, 2017 May 08;30(4):341-357.
    PMID: 28470137 DOI: 10.1108/IJHCQA-06-2016-0082
    Purpose The purpose of this paper is to discuss a systematic review on waste identification related to health information systems (HIS) in Lean transformation. Design/methodology/approach A systematic review was conducted on 19 studies to evaluate Lean transformation and tools used to remove waste related to HIS in clinical settings. Findings Ten waste categories were identified, along with their relationships and applications of Lean tool types related to HIS. Different Lean tools were used at the early and final stages of Lean transformation; the tool selection depended on the waste characteristic. Nine studies reported a positive impact from Lean transformation in improving daily work processes. The selection of Lean tools should be made based on the timing, purpose and characteristics of waste to be removed. Research limitations/implications Overview of waste and its category within HIS and its analysis from socio-technical perspectives enabled the identification of its root cause in a holistic and rigorous manner. Practical implications Understanding waste types, their root cause and review of Lean tools could subsequently lead to the identification of mitigation approach to prevent future error occurrence. Originality/value Specific waste models for HIS settings are yet to be developed. Hence, the identification of the waste categories could guide future implementation of Lean transformations in HIS settings.
  5. Pahlevan Sharif S
    Int J Health Care Qual Assur, 2017 Oct 09;30(8):717-727.
    PMID: 28958201 DOI: 10.1108/IJHCQA-12-2016-0190
    Purpose The purpose of this paper is to develop and evaluate psychometrically an instrument named the Breast Size Satisfaction Scale (BSSS) to assess breast size satisfaction. Design/methodology/approach The present scale was developed using a set of 16 computer-generated 3D images of breasts to overcome some of the limitations of existing instruments. The images were presented to participants and they were asked to select the figure that most accurately depicted their actual breast size and the figure that most closely represented their ideal breast size. Breast size satisfaction was computed by subtracting the absolute value of the difference between ideal and actual perceived size from 16, such that higher values indicate greater breast size satisfaction. Findings Study 1 ( n=65 female undergraduate students) showed good test-retest reliability and study 2 ( n=1,000 Iranian women, aged 18 years and above) provided support for convergent validity using a nomological network approach. Originality/value The BSSS demonstrated good psychometric properties and thus can be used in future studies to assess breast size satisfaction among women.
  6. Yusof M, Sahroni MN
    Int J Health Care Qual Assur, 2018 Oct 08;31(8):1014-1029.
    PMID: 30415623 DOI: 10.1108/IJHCQA-07-2017-0125
    PURPOSE: The purpose of this paper is to present a review of health information system (HIS)-induced errors and its management. This paper concludes that the occurrence of errors is inevitable but it can be minimised with preventive measures. The review of classifications can be used to evaluate medical errors related to HISs using a socio-technical approach. The evaluation could provide an understanding of errors as a learning process in managing medical errors.

    DESIGN/METHODOLOGY/APPROACH: A literature review was performed on issues, sources, management and approaches to HISs-induced errors. A critical review of selected models was performed in order to identify medical error dimensions and elements based on human, process, technology and organisation factors.

    FINDINGS: Various error classifications have resulted in the difficulty to understand the overall error incidents. Most classifications are based on clinical processes and settings. Medical errors are attributed to human, process, technology and organisation factors that influenced and need to be aligned with each other. Although most medical errors are caused by humans, they also originate from other latent factors such as poor system design and training. Existing evaluation models emphasise different aspects of medical errors and could be combined into a comprehensive evaluation model.

    RESEARCH LIMITATIONS/IMPLICATIONS: Overview of the issues and discourses in HIS-induced errors could divulge its complexity and enable its causal analysis.

    PRACTICAL IMPLICATIONS: This paper helps in understanding various types of HIS-induced errors and promising prevention and management approaches that call for further studies and improvement leading to good practices that help prevent medical errors.

    ORIGINALITY/VALUE: Classification of HIS-induced errors and its management, which incorporates a socio-technical and multi-disciplinary approach, could guide researchers and practitioners to conduct a holistic and systematic evaluation.

  7. Ahmed S, Abd Manaf NH, Islam R
    Int J Health Care Qual Assur, 2018 Oct 08;31(8):973-987.
    PMID: 30415620 DOI: 10.1108/IJHCQA-07-2017-0138
    PURPOSE: The purpose of this paper is to investigate the effects of Lean Six Sigma (LSS) and workforce management on the quality performance of Malaysian hospitals. This paper also investigates the direct and indirect relationships between top management commitment and quality performance of the healthcare organisations in Malaysia.

    DESIGN/METHODOLOGY/APPROACH: This study applied stratified random sampling to collect data from 15 different hospitals in Peninsular Malaysia. The self-administered survey questionnaires were distributed among 673 hospital staff (i.e. doctors, nurses, pharmacists, and medical laboratory technologists) to obtain 335 useful responses with a 49.47 per cent valid response rate. The research data were analysed based on confirmatory factor analysis and structural equation modelling by using AMOS version 23 software.

    FINDINGS: The research findings indicated that LSS and workforce management have a significant impact on quality performance of the Malaysian hospitals, whereas senior management commitment was found to have an insignificant relationship with quality performance. The research findings indicate that senior management commitment has no direct significant relationship with quality performance, but it has an indirect significant relationship with quality performance through the mediating effects of LSS and workforce management.

    RESEARCH LIMITATIONS/IMPLICATIONS: This research focussed solely on healthcare organisations in Malaysia and thus the results might not be applicable for other countries as well as other service organisations.

    ORIGINALITY/VALUE: This research provides theoretical, methodological, and practical contributions for the LSS approach and the research findings are expected to provide guidelines to enhance the level of quality performance in healthcare organisations in Malaysia as well as other countries.

  8. Wijaya MI, Mohamad AR, Hafizurrachman M
    Int J Health Care Qual Assur, 2019 Feb 11;32(1):296-306.
    PMID: 30859877 DOI: 10.1108/IJHCQA-01-2018-0014
    PURPOSE: The purpose of this paper is to improve the Siloam Hospitals' (SHs) patient satisfaction index (PSI) and overcome Indonesia's geographical barriers.

    DESIGN/METHODOLOGY/APPROACH: The topic was selected for reasons guided by the Institute of Healthcare Improvement virtual breakthrough series collaborative (VBSC). Subject matter experts came from existing global quality development in collaboration with sales and marketing, and talent management agencies/departments. Patient satisfaction (PS) was measured using the SH Customer Feedback Form. Data were analysed using Friedman's test.

    FINDINGS: The in-patient (IP) department PSI repeated measures comparison during VBSC, performed using Friedman's test, showed a statistically significant increase in the PSI, χ2 = 44.00, p<0.001. Post hoc analysis with Wilcoxon signed-rank test was conducted with a Bonferroni correction applied, which resulted in a significant increase between the baseline and action phases ( Z=3.317, p=0.003) between the baseline and continuous improvement phases ( Z=6.633, p<0.001), and between the action and continuous improvement phases ( Z=3.317, p=0.003), suggesting that IP PSI was continuously increasing during all VBSC phases. Like IP PSI, the out-patient department PSI was also continuously increasing during all VBSC phases.

    RESEARCH LIMITATIONS/IMPLICATIONS: The VBSC was not implemented using a control group. Factors other than the VBSC may have contributed to increased PS.

    PRACTICAL IMPLICATIONS: The VBSC was conducted using virtual telecommunication. Although conventional breakthrough series might result in better cohesiveness and commitment, Indonesian geographical barriers forced an alternative strategy, which is much more cost-effective.

    ORIGINALITY/VALUE: The VBSC, designed to improve PS, has never been implemented in any Indonesian private hospital group. Other hospital groups might also appreciate knowing about the VBSC to improve their PSI.

  9. Amir Sultan MM, Goh CT, Wan Puteh SE, Mokhtar M
    Int J Health Care Qual Assur, 2019 Feb 11;32(1):34-44.
    PMID: 30859864 DOI: 10.1108/IJHCQA-08-2017-0161
    PURPOSE: Mercury is widely used in medical and healthcare facilities as dental amalgam, mercury-added medical devices, thiomersal-containing vaccines, laboratory analysis and for other general applications despite the hazards. Various agencies consistently promote mercury-free medical facilities through mercury-free alternatives and better management practices, which are in line with the Minamata Convention on Mercury that aims to protect human health and environment from anthropogenic mercury release. The paper aims to discuss these issues.

    DESIGN/METHODOLOGY/APPROACH: The authors conducted a gap analysis on recommended practices gathered from the literature and current practices gathered through semi-structured interviews with Malaysian medical personnel. A life cycle approach was adopted covering mercury use: input, storage, handling, accident, waste disposal and governance phases.

    FINDINGS: The authors found that there are significant gaps between recommended and current mercury management practices. Analysis indicates improper mercury management as the main contributor to these gaps. The authors found from recommended practices that core components needing improvement include: mercury management action plan, mercury use identification team, purchasing policy, proper guidelines and monitoring systems.

    PRACTICAL IMPLICATIONS: This study helps us to understand mercury management practices and suggests essential steps to establish a mercury-free medical facility.

    ORIGINALITY/VALUE: This study explored the gaps between recommended and current mercury management practices in a medical facility and contributes to the Minamata Convention on Mercury aspirations.

  10. Suki NM, Lian JC, Suki NM
    Int J Health Care Qual Assur, 2011;24(1):42-56.
    PMID: 21456497 DOI: 10.1108/09526861111098238
    PURPOSE: The purpose of this paper is to investigate whether patients' perceptions exceed expectations when seeking treatment in private healthcare settings in the Klang Valley Region of Malaysia.
    DESIGN/METHODOLOGY/APPROACH: A survey was conducted among 191 patients in the Klang Valley Region of Malaysia to measure service quality of the private healthcare setting in Malaysia using SERVQUAL 5 dimensions model by Parasuraman et al. and three additional dimensions of the human element, when it comes to rendering good healthcare services, i.e. courtesy, communication and understanding of customers.
    FINDINGS: The results revealed that the customers' perceptions did not exceed their expectations, as they were dissatisfied with the level of healthcare services rendered by private healthcare settings in that they felt that the waiting time of more than an hour to receive the service was excessive and, when there was a problem, the healthcare provider did not provide a response fast enough.
    RESEARCH LIMITATIONS/IMPLICATIONS: Only eight service quality dimensions were studied. The sample investigated is relatively small, where three private healthcare settings were selected.
    PRACTICAL IMPLICATIONS: It is recommended that hospital management should look into highlighted areas for which patients have high expectations.
    ORIGINALITY/VALUE: The paper adds to the existing body of research on healthcare service quality, particularly on patients' perceptions and expectations. Survey results should be useful for continuous quality improvement.
  11. Butt MM, de Run EC
    Int J Health Care Qual Assur, 2010;23(7):658-73.
    PMID: 21125961
    This paper seeks to develop and test the SERVQUAL model scale for measuring Malaysian private health service quality.
  12. Rashid WE, Jusoff HK
    Int J Health Care Qual Assur, 2009;22(5):471-82.
    PMID: 19725368
    This paper attempts to explore the concept of service quality in a health care setting.
  13. Lim YMF, Yusof M, Sivasampu S
    Int J Health Care Qual Assur, 2018 Apr 16;31(3):203-213.
    PMID: 29687760 DOI: 10.1108/IJHCQA-08-2016-0111
    Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.
  14. Pahlevan Sharif S, Abaeian V, Khanekharab J
    Int J Health Care Qual Assur, 2018 Jun 11;31(5):391-399.
    PMID: 29865960 DOI: 10.1108/IJHCQA-02-2017-0026
    Purpose The purpose of this paper is to evaluate the Persian version of the Attitude toward Breast Cancer Screening Procedures Scale (ABCSPS) among Iranian women. Design/methodology/approach In this methodological study, 1,000 Iranian women completed a demographic questionnaire and the 14-item Persian ABCSPS. The scale's construct validity was evaluated using exploratory and confirmatory factor analysis. Internal consistency and reliability were assessed using Cronbach's α and McDonald's coefficient ω. Findings The exploratory factor analysis revealed a two-factor solution accounting for 55.1 percent of the variance. The two-factor measurement model had a good fit with all factor loadings greater than 0.5, which were statistically significant. The results showed good reliability and internally consistency ( α=0.767 and 0.872; ω =0.979 and 0.997). Moreover, model structure was invariant across different income groups. Originality/value The Persian ABCSPS translation demonstrated good validity and reliability among Iranian women. The results also showed that the scale had a multidimensional structure. Regarding proper psychometric properties, the validated scale can be used in future studies as a reliable and relevant breast cancer screening attitude measure.
  15. Rasudin NS, Ahmad MAI, Hussain N, Che Hamah MSS
    Int J Health Care Qual Assur, 2019 Apr 15;32(3):653-658.
    PMID: 31018797 DOI: 10.1108/IJHCQA-07-2018-0169
    PURPOSE: The purpose of this paper is to validate the Press Ganey Questionnaire (PGQ) (Bahasa Melayu version) using Hospital Universiti Sains Malaysia (HUSM) patients.

    DESIGN/METHODOLOGY/APPROACH: This cross-sectional study comprised 252 patients visiting HUSM. Patients were selected using the convenience sampling method. The PGQ (Bahasa Melayu version) had three main factors: during your visit; your care provider and overall assessment. Data were analyzed using the structural equation modeling.

    FINDINGS: The exploratory factor analysis resulted in item reduction from 21 to 17, which contained four factors with eigenvalues greater than 1. Meanwhile, confirmatory factor analysis results showed that data fitted the model: χ2/df at 1.764, comparative fit index at 0.952, Tucker-Lewis index at 0.941 and root mean square error of approximation at 0.073. The average variance extracted value for the four factors was greater than 0.50, which indicated that PGQ convergent validity was met. Overall, PGQ produced good reliability with composite reliability score equals to 0.966. Four factors were reclassified as "during your registration," "hospital staff attitude," "doctor's attitude" and "overall assessment."

    RESEARCH LIMITATIONS/IMPLICATIONS: Patient satisfaction is an important and frequently used indicator for measuring healthcare quality; hence, a validated and reliable instrument is important for measuring patient satisfaction that leads to healthcare service quality assessment.

    PRACTICAL IMPLICATIONS: Validated PGQ provides some useful information for doctors, medical assistants, nurses and staff in the emergency department to help them become more prominent and efficient in their role as healthcare providers.

    SOCIAL IMPLICATIONS: Validated PGQ will help healthcare providers to deliver the best and exceptional care toward emergency patient, and thus improve their quality of work life. The findings in this study can be used as a guide or as baseline data for further research in this area.

    ORIGINALITY/VALUE: The PQG (Bahasa Melayu version) was confirmed as a reliable and valid instrument for measuring patient satisfaction. This research is the first PGQ validation study in Southeast Asia, specifically focusing on Malaysian respondents.

  16. Zolait A, Radhi N, Alhowaishi MM, Sundram VPK, Aldoseri LM
    Int J Health Care Qual Assur, 2019 May 13;32(4):720-730.
    PMID: 31111785 DOI: 10.1108/IJHCQA-05-2018-0106
    PURPOSE: The purpose of this paper is to examine whether Bahraini individuals accept e-health system and the prominent factors affecting e-health system adoption in Bahrain.

    DESIGN/METHODOLOGY/APPROACH: The authors adopted a quantitative and qualitative approach, i.e., a self-administered questionnaire, unstructured and a semi-structured interview, which were used to collect the data. A questionnaire was distributed to Bahraini residents selected randomly. The framework was based on the technology acceptance model (TAM) and theory of reasoned action (TRA). Important variables from both the TAM model and TRA theory were extracted and jointly used to build the research model.

    FINDINGS: The findings indicated that the most factors affecting e-health adoption are trust, health literacy and attitude. Additionally, people in the private and government sectors understand e-health benefits.

    PRACTICAL IMPLICATIONS: If healthcare professionals understand the factors affecting e-health system adoption from an individual and organisational perspective, then nurses, pharmacists and others will be more conscious about e-health and its adoption status.

    ORIGINALITY/VALUE: E-health system adoption has become increasingly important to governments, individuals, and researchers in recent years. A novel research framework, based on TAM and TRA, was used to produce a new integrated model.

  17. Ahmed ES, Ahmad MN, Othman SH
    Int J Health Care Qual Assur, 2019 Jun 10;32(5):887-908.
    PMID: 31195926 DOI: 10.1108/IJHCQA-07-2017-0116
    PURPOSE: According to the literature concerned with this study, less than satisfactory outcomes have been achieved through implementing business process improvements methods (BPIMs) in industries, in general, and in healthcare, in particular. The existing methods used need to be enhanced in order to create more effective outcomes. There has also been a lack of studies documenting gaps or shortfalls in implementing BPIMs, to be presented to the BPI research community. Therefore, researchers of this paper have attempted to fill gaps between theory and practice. On the contrary, there is also a need to link practical outcomes in the healthcare domain with those of the BPI research community. The purpose of this paper is to review popular BPIMs, techniques and tools applied in the healthcare domain; it seeks to examine and highlight their significant roles, clarify their pros and cons, and find opportunities to enhance their impact on the achievement of more sustainable improvements in the healthcare domain.

    DESIGN/METHODOLOGY/APPROACH: This study has been carried out by using a methodology combining an in-depth literature review with a comparison framework, which is called as the "Framework for Comparing Business Process Improvement Methods." The framework is composed of seven dimensions and has been adapted from four recognized, related frameworks. In addition to the in-depth review of related literature and the adapted comparison framework, researchers have conducted several interviews with healthcare BPI practitioners in different hospitals, to attain their opinions of BPI methods and tools used in their practices.

    FINDINGS: The main results have indicated that significant improvements have been achieved by implementing BPIMs in the healthcare domain according to related literature. However, there were some shortfalls in the existing methods that need to be resolved. The most important of these has been the shortfall in representing and analyzing targeted domain knowledge during improvement phases. The tool currently used for representing the domain, specifically flowcharts, is very abstract and does not present the domain in a clear form. The flowchart tool also fails to clearly present the separation of concerns between business processes and the information systems processes that support a business in a given domain.

    PRACTICAL IMPLICATIONS: The findings of this study can be useful for BPI practitioners and researchers, mainly within the healthcare domain. The findings can help these groups to understand BPIMs shortfalls and encourage them to consider how BPIMs can be potentially improved.

    ORIGINALITY/VALUE: This researchers of this paper have proposed a comparison framework for highlighting popular BPIMs in the healthcare domain, along with their uses and shortfalls. In addition, they have conducted a deep literature review based on the practical results obtained from different healthcare institutions implementing unique BPIMs around the world. There has also been valuable interview feedback attained from BPI leaders of specific hospitals in Saudi Arabia. This combination is expected to contribute to knowledge of BPIMs from both theoretical and practical points of view.

  18. Wijaya MI, Mohamad AR, Hafizurrachman M
    Int J Health Care Qual Assur, 2020 Jan 15;ahead-of-print(ahead-of-print).
    PMID: 32012498 DOI: 10.1108/IJHCQA-04-2019-0080
    PURPOSE: The purpose of this paper is to assess the association between shift schedule realignment and patient safety culture.

    DESIGN/METHODOLOGY/APPROACH: Using difference in differences model, BIMC Hospitals and Siloam Hospital Bali were compared before and after shift schedule realignment to test the association between shift schedule realignment and patient safety culture.

    FINDINGS: Shift schedule realignment was associated with a significant improvement in staffing (coefficient 1.272; 95% CI 0.842 - 1.702; p<0.001), teamwork within units (coefficient 1.689; 95% CI 1.206 - 2.171; p<0.001), teamwork across units (coefficient 1.862; 95% CI 1.415 - 2.308; p<0.001), handoffs and transitions (coefficient 0.999; 95% CI 0.616 - 1.382; p<0.001), frequency of error reported (coefficient 1.037; 95% CI 0.581 - 1.493; p<0.001), feedback and communication about error (coefficient 1.412; 95% CI 0.982 - 1.841; p<0.001) and communication openness (coefficient 1.393; 95% CI 0.968 - 1.818; p<0.001).

    PRACTICAL IMPLICATIONS: With positive impact on patient safety culture, shift schedule realignment should be considered as quality improvement initiative. It stretches the compressed workload suffered by staff while maintaining 40 h per week in accordance with applicable laws and regulations.

    ORIGINALITY/VALUE: Shift schedule realignment, designed to improve patient safety culture, has never been implemented in any Indonesian private hospital. Other hospital managers might also appreciate knowing about the shift schedule realignment to improve the patient safety culture.

  19. Poh KW, Ngan CH, Wong JY, Ng TK, Mohd Noor N
    Int J Health Care Qual Assur, 2020 Feb 25;ahead-of-print(ahead-of-print).
    PMID: 32108452 DOI: 10.1108/IJHCQA-11-2019-0195
    PURPOSE: There was limited study available on successful intervention for central-line-associated bloodstream infection (CLABSI) done at nonintensive care unit (ICU) and resources-limited setting. The objective of this study was to design, implement and evaluate a strategy to reduce CLABSI rate in non-ICU settings at general medical wards of Hospital Tuanku Ja'afar Seremban.

    DESIGN/METHODOLOGY/APPROACH: Preinterventional study was conducted in one-month period of January 2019, followed by intervention period from February to March 2019. Postintervention study was conducted from April to July 2019. The CLABSI rates were compared between pre and postintervention periods. A multifaceted intervention bundle was implemented, which comprised (1) educational program for healthcare workers, (2) weekly audit and feedback and (3) implementation of central line bundle of care.

    FINDINGS: There was a significant overall reduction of CLABSI rate between preintervention and postintervention period [incidence rate ratio (IRR) of 0.06 (95 percent CI, 0.01-0.33; P = 0.001)].

    PRACTICAL IMPLICATIONS: CLABSI rates were reduced by a multifaceted intervention bundle, even in non-ICU and resource-limited setting. This includes a preinterventional study to identify the risk factors followed by a local adaption of the recommended care bundles. This study recommends resources-limited hospitals to design a strategy that is suitable for their own local setting to reduce CLABSI.

    ORIGINALITY/VALUE: This study demonstrated the feasibility of a multifaceted intervention bundle that was locally adapted with an evidence-based approach to reduce CLABSI rate in non-ICU and resource-limited setting.

  20. Lee KKS, Silim UA
    Int J Health Care Qual Assur, 2019 Dec 16;ahead-of-print(ahead-of-print).
    PMID: 31886638 DOI: 10.1108/IJHCQA-08-2018-0199
    PURPOSE: The purpose of this paper is to review the findings from an audit of the implementation of a consultation-liaison psychiatry (CLiP) database in all inpatients referred to a CLiP service at the largest hospital in Malaysia with the aim of improving the quality CLiP services.

    DESIGN/METHODOLOGY/APPROACH: All inpatient referrals to the CLiP team were recorded over a three-month period and compared to previous audit data from 2017. Four audit standards were assessed: the reporting of referrals, timeliness of response indication of reason for referral and presence of a management plan.

    FINDINGS: The compliance of reporting using the CLiP form was 70.1 per cent compared to 28 per cent in the audit data from 2017 after interventions were conducted. Analysis of the completed CLiP form reveals that 89 per cent of referrals were seen within the same working day. All referrals included the reason for referral. The most common reason for referral was for depressive disorders, but post-assessment, delirium was the most common diagnosis. In total, 87.8 per cent satisfied the audit criteria for a completed written care plan.

    ORIGINALITY/VALUE: Specialised CLiP services are relatively new in Malaysia and this is the first paper to examine the quality of such services in the country. Interventions were effective in improving the compliance of reporting using the CLiP database. The findings suggest that the CLiP services are on par with international audit standards. Furthermore, data from this clinical audit can serve as a benchmark for the development of national operating policies in similar settings.

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