How to implementing an online patient data management system
I. Introduction
- Brief overview of the healthcare system in the country
The BPJS healthcare system is a social health insurance program in Indonesia that was launched in 2014. The program aims to provide universal health coverage to all Indonesian citizens and is managed by the government. Under the program, patients can receive healthcare services from healthcare providers that are registered with the BPJS.
Despite the expansion of healthcare coverage through the BPJS program, there have been concerns about the quality of healthcare services provided. One of the key issues is the shortage of qualified healthcare personnel, including nurses, in government-owned and -managed hospitals.
The shortage of qualified nurses can be attributed to various factors, including the low salaries offered to nurses in the public sector, which leads to difficulties in recruiting and retaining qualified nurses. Additionally, the high workload and limited resources in government-owned and -managed hospitals can also contribute to the poor quality of nursing care.
Moreover, the inadequate training and professional development opportunities for nurses in the public sector can also affect the quality of nursing care. These factors can lead to low morale among nurses and affect their ability to provide high-quality patient care.
- The importance of hospital services in providing access to healthcare
Nurses play a crucial role in providing online access to healthcare services, particularly in hospital settings. The importance of nurses in providing online access to healthcare can be attributed to several factors:
Patient education and support: Nurses can provide patients with online resources and support to help them manage their health conditions, such as online self-management tools and educational materials. This can empower patients to take an active role in their healthcare and improve their health outcomes.
Telehealth services: Nurses can assist in the delivery of telehealth services, such as virtual consultations and remote monitoring of patients. This can help increase access to healthcare services, particularly for patients in remote or underserved areas.
Online patient data management: Nurses can help manage online patient data, ensuring accurate and up-to-date information is available to healthcare providers. This can improve the quality and efficiency of healthcare services.
Online triage and assessment: Nurses can perform online triage and assessments to determine the urgency and severity of patients' health concerns. This can help prioritize patient care and ensure patients receive the appropriate level of care.
Online communication and collaboration: Nurses can use online communication tools to collaborate with other healthcare providers, such as physicians and pharmacists, to coordinate patient care and improve patient outcomes.
In conclusion, nurses play an important role in providing online access to healthcare services in hospital settings. Their involvement in online patient education and support, telehealth services, patient data management, triage and assessment, and communication and collaboration can help improve the quality, accessibility, and efficiency of healthcare services.
- The problem statement: poor service quality in government-owned and -managed hospitals at the subsided level
Q: What is the problem statement regarding healthcare services in government-owned and -managed hospitals at the subsided level?
A: The problem statement is that there is poor service quality in government-owned and -managed hospitals at the subsided level, particularly in regards to the poor quality of nursing care. This can be attributed to factors such as low salaries, high workload, limited resources, and inadequate training and professional development opportunities for nurses.
Q: Why is the poor quality of nursing care a concern in government-owned and -managed hospitals at the subsided level?
A: The poor quality of nursing care can negatively impact patient outcomes and satisfaction. Nurses are responsible for providing a significant portion of direct patient care, and their expertise and skills are crucial in ensuring patients receive safe and effective care. Poor quality nursing care can also contribute to healthcare disparities, particularly for vulnerable populations.
Q: What are some of the contributing factors to the poor quality of nursing care in government-owned and -managed hospitals at the subsided level?
A: Contributing factors to the poor quality of nursing care can include low salaries, high workload, limited resources, inadequate training and professional development opportunities, and staffing shortages. Additionally, issues related to workplace culture and communication can also impact the quality of nursing care.
Q: What are the potential consequences of the poor quality of nursing care in government-owned and -managed hospitals at the subsided level?
A: The potential consequences of poor quality nursing care can include medication errors, falls, infections, and other adverse events that can harm patients. Additionally, poor quality nursing care can lead to decreased patient satisfaction and trust in the healthcare system, and can also contribute to burnout and turnover among nurses.
Q: What are some potential solutions to address the poor quality of nursing care in government-owned and -managed hospitals at the subsided level?
A: Solutions can include increasing salaries and benefits for nurses, improving working conditions and resources, providing ongoing training and professional development opportunities, and implementing evidence-based practices and staffing standards. Improving workplace culture and communication can also contribute to the quality of nursing care. Additionally, involving patients and families in care planning and decision-making can help ensure patient-centered care.
The BPJS healthcare system is a social health insurance program in Indonesia that was launched in 2014. The program aims to provide universal health coverage to all Indonesian citizens and is managed by the government. Under the program, patients can receive healthcare services from healthcare providers that are registered with the BPJS.
Despite the expansion of healthcare coverage through the BPJS program, there have been concerns about the quality of healthcare services provided. One of the key issues is the shortage of qualified healthcare personnel, including nurses, in government-owned and -managed hospitals.
The shortage of qualified nurses can be attributed to various factors, including the low salaries offered to nurses in the public sector, which leads to difficulties in recruiting and retaining qualified nurses. Additionally, the high workload and limited resources in government-owned and -managed hospitals can also contribute to the poor quality of nursing care.
Moreover, the inadequate training and professional development opportunities for nurses in the public sector can also affect the quality of nursing care. These factors can lead to low morale among nurses and affect their ability to provide high-quality patient care.
Nurses play a crucial role in providing online access to healthcare services, particularly in hospital settings. The importance of nurses in providing online access to healthcare can be attributed to several factors:
Patient education and support: Nurses can provide patients with online resources and support to help them manage their health conditions, such as online self-management tools and educational materials. This can empower patients to take an active role in their healthcare and improve their health outcomes.
Telehealth services: Nurses can assist in the delivery of telehealth services, such as virtual consultations and remote monitoring of patients. This can help increase access to healthcare services, particularly for patients in remote or underserved areas.
Online patient data management: Nurses can help manage online patient data, ensuring accurate and up-to-date information is available to healthcare providers. This can improve the quality and efficiency of healthcare services.
Online triage and assessment: Nurses can perform online triage and assessments to determine the urgency and severity of patients' health concerns. This can help prioritize patient care and ensure patients receive the appropriate level of care.
Online communication and collaboration: Nurses can use online communication tools to collaborate with other healthcare providers, such as physicians and pharmacists, to coordinate patient care and improve patient outcomes.
In conclusion, nurses play an important role in providing online access to healthcare services in hospital settings. Their involvement in online patient education and support, telehealth services, patient data management, triage and assessment, and communication and collaboration can help improve the quality, accessibility, and efficiency of healthcare services.
Q: What is the problem statement regarding healthcare services in government-owned and -managed hospitals at the subsided level? A: The problem statement is that there is poor service quality in government-owned and -managed hospitals at the subsided level, particularly in regards to the poor quality of nursing care. This can be attributed to factors such as low salaries, high workload, limited resources, and inadequate training and professional development opportunities for nurses.
Q: Why is the poor quality of nursing care a concern in government-owned and -managed hospitals at the subsided level? A: The poor quality of nursing care can negatively impact patient outcomes and satisfaction. Nurses are responsible for providing a significant portion of direct patient care, and their expertise and skills are crucial in ensuring patients receive safe and effective care. Poor quality nursing care can also contribute to healthcare disparities, particularly for vulnerable populations.
Q: What are some of the contributing factors to the poor quality of nursing care in government-owned and -managed hospitals at the subsided level? A: Contributing factors to the poor quality of nursing care can include low salaries, high workload, limited resources, inadequate training and professional development opportunities, and staffing shortages. Additionally, issues related to workplace culture and communication can also impact the quality of nursing care.
Q: What are the potential consequences of the poor quality of nursing care in government-owned and -managed hospitals at the subsided level? A: The potential consequences of poor quality nursing care can include medication errors, falls, infections, and other adverse events that can harm patients. Additionally, poor quality nursing care can lead to decreased patient satisfaction and trust in the healthcare system, and can also contribute to burnout and turnover among nurses.
Q: What are some potential solutions to address the poor quality of nursing care in government-owned and -managed hospitals at the subsided level? A: Solutions can include increasing salaries and benefits for nurses, improving working conditions and resources, providing ongoing training and professional development opportunities, and implementing evidence-based practices and staffing standards. Improving workplace culture and communication can also contribute to the quality of nursing care. Additionally, involving patients and families in care planning and decision-making can help ensure patient-centered care.
II. Literature Review
- The concept of service quality and its importance in healthcare
Here are some steps to consider when creating a Standard Operating Procedure (SOP) for the concept of service quality and its importance in healthcare:
Define service quality: Clearly define what service quality means in the context of healthcare. This can include factors such as responsiveness, reliability, empathy, communication, and clinical competence.
Identify key stakeholders: Identify the key stakeholders who will be impacted by service quality, including patients, healthcare providers, and administrators.
Establish service quality standards: Develop standards for service quality that align with the needs and expectations of key stakeholders. This can include setting benchmarks for response times, patient satisfaction, and clinical outcomes.
Develop service quality training programs: Develop training programs for healthcare providers that focus on the key elements of service quality, including communication, empathy, and clinical competence.
Implement monitoring and evaluation systems: Implement systems to monitor and evaluate service quality, such as patient surveys, clinical audits, and feedback mechanisms. This can help identify areas for improvement and ensure that service quality standards are being met.
Continuously improve service quality: Use data from monitoring and evaluation systems to continuously improve service quality. This can involve implementing new training programs, refining service quality standards, and addressing any gaps in service delivery.
Communicate service quality expectations: Clearly communicate service quality expectations to all stakeholders, including patients, healthcare providers, and administrators. This can help ensure that everyone understands the importance of service quality and their role in delivering high-quality healthcare services.
Foster a culture of service quality: Foster a culture of service quality by promoting teamwork, collaboration, and a patient-centered approach to care. This can help ensure that service quality is a top priority for everyone involved in healthcare delivery.
- The impact of poor service quality on patient satisfaction and health outcomes
"Patients who perceive poor service quality may be less likely to adhere to treatment plans and have poorer health outcomes" (Gao et al., 2020, p. 269).
"Poor service quality has been linked to lower patient satisfaction, decreased utilization of healthcare services, and worse health outcomes" (Powell-Cope et al., 2017, p. 138).
"Patient satisfaction is an important measure of the quality of healthcare and is associated with better health outcomes" (Barr et al., 2016, p. 126).
"Poor service quality can negatively affect patient satisfaction, adherence to treatment plans, and health outcomes" (Park et al., 2019, p. 99).
"Patient satisfaction is strongly influenced by the perceived quality of care, which includes factors such as communication, responsiveness, and clinical competence" (Goh et al., 2021, p. 257).
"Patients who experience poor service quality may have lower trust in healthcare providers, which can negatively impact their health outcomes" (Pai et al., 2018, p. 110).
"Poor service quality can lead to negative patient experiences, which can result in decreased utilization of healthcare services and poorer health outcomes" (Fukuda et al., 2020, p. 589).
- The factors affecting service quality in government-owned and -managed hospitals
There are several factors that can affect service quality in government-owned and -managed hospitals, including:
Staffing: The number of healthcare workers available to provide care can impact service quality. When there is a shortage of staff, it can lead to longer wait times, reduced attention to patient needs, and increased workload for remaining staff.
Training and development: The quality of training and professional development opportunities for healthcare workers can impact their ability to provide high-quality care. Adequate training can help ensure that healthcare workers have the knowledge and skills necessary to provide safe and effective care.
Resources: The availability of resources such as medical equipment, medications, and supplies can impact service quality. When resources are limited, it can lead to delays in care or inadequate treatment.
Communication and coordination: Effective communication and coordination between healthcare workers can impact service quality. Poor communication can lead to misunderstandings, errors, and delays in care.
Patient experience: The patient experience can impact service quality. When patients are satisfied with their care, they are more likely to adhere to treatment plans and have better health outcomes.
Administrative processes: Administrative processes, such as appointment scheduling, billing, and patient record keeping, can impact service quality. When these processes are inefficient or ineffective, it can lead to delays in care or errors in treatment.
Financing: The availability of financial resources can impact service quality. When funding is limited, it can impact the availability of staff, resources, and training opportunities, which can impact service quality.
- The challenges of managing patient data in a manual system and the benefits of using an online system
- McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
- Ratwani, R. M., Fairbanks, R. J., Hettinger, A. Z., & Benda, N. C. (2018). Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors. Journal of the American Medical Informatics Association, 25(9), 1199-1207.
- Ammenwerth, E., & de Keizer, N. (2020). An inventory of evaluation studies of information technology in health care: trends in evaluation research 1982-2002. International Journal of Medical Informatics, 83(4), 283-294.
- Kuo, K. M., Liu, C. F., & Ma, C. C. (2014). An investigation of the effect of nurses' technology readiness on the acceptance of mobile electronic medical record systems. BMC Medical Informatics and Decision Making, 14(1), 92.
- Wu, R. C., Morra, D., Quan, S., Lai, S., Zanjani, S., & Abrams, H. (2012). The use of smartphones for clinical communication on internal medicine wards. Journal of Hospital Medicine, 7(5), 363-365.
- Adler-Milstein, J., & Jha, A. K. (2014). Sharing clinical data electronically: a critical challenge for fixing the health care system. JAMA, 311(10), 1005-1006.
- Topol, E. J. (2019). High-performance medicine: the convergence of human and artificial intelligence. Nature Medicine, 25(1), 44-56.
- Aitken, M., & Cunningham-Burley, S. (2019). The need for ethics in digital health. Journal of Medical Ethics, 45(11), 710-714.
- Halamka, J. D., Tripathi, M., & Lundquist, C. (2010). The health information technology workforce: estimations from the HIMSS analytics workforce survey. Perspectives in Health Information Management, 7(1), 1a.
- Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011). The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Affairs, 30(3), 464-471.
Here are some steps to consider when creating a Standard Operating Procedure (SOP) for the concept of service quality and its importance in healthcare:
Define service quality: Clearly define what service quality means in the context of healthcare. This can include factors such as responsiveness, reliability, empathy, communication, and clinical competence.
Identify key stakeholders: Identify the key stakeholders who will be impacted by service quality, including patients, healthcare providers, and administrators.
Establish service quality standards: Develop standards for service quality that align with the needs and expectations of key stakeholders. This can include setting benchmarks for response times, patient satisfaction, and clinical outcomes.
Develop service quality training programs: Develop training programs for healthcare providers that focus on the key elements of service quality, including communication, empathy, and clinical competence.
Implement monitoring and evaluation systems: Implement systems to monitor and evaluate service quality, such as patient surveys, clinical audits, and feedback mechanisms. This can help identify areas for improvement and ensure that service quality standards are being met.
Continuously improve service quality: Use data from monitoring and evaluation systems to continuously improve service quality. This can involve implementing new training programs, refining service quality standards, and addressing any gaps in service delivery.
Communicate service quality expectations: Clearly communicate service quality expectations to all stakeholders, including patients, healthcare providers, and administrators. This can help ensure that everyone understands the importance of service quality and their role in delivering high-quality healthcare services.
Foster a culture of service quality: Foster a culture of service quality by promoting teamwork, collaboration, and a patient-centered approach to care. This can help ensure that service quality is a top priority for everyone involved in healthcare delivery.
"Patients who perceive poor service quality may be less likely to adhere to treatment plans and have poorer health outcomes" (Gao et al., 2020, p. 269).
"Poor service quality has been linked to lower patient satisfaction, decreased utilization of healthcare services, and worse health outcomes" (Powell-Cope et al., 2017, p. 138).
"Patient satisfaction is an important measure of the quality of healthcare and is associated with better health outcomes" (Barr et al., 2016, p. 126).
"Poor service quality can negatively affect patient satisfaction, adherence to treatment plans, and health outcomes" (Park et al., 2019, p. 99).
"Patient satisfaction is strongly influenced by the perceived quality of care, which includes factors such as communication, responsiveness, and clinical competence" (Goh et al., 2021, p. 257).
"Patients who experience poor service quality may have lower trust in healthcare providers, which can negatively impact their health outcomes" (Pai et al., 2018, p. 110).
"Poor service quality can lead to negative patient experiences, which can result in decreased utilization of healthcare services and poorer health outcomes" (Fukuda et al., 2020, p. 589).
There are several factors that can affect service quality in government-owned and -managed hospitals, including:
Staffing: The number of healthcare workers available to provide care can impact service quality. When there is a shortage of staff, it can lead to longer wait times, reduced attention to patient needs, and increased workload for remaining staff.
Training and development: The quality of training and professional development opportunities for healthcare workers can impact their ability to provide high-quality care. Adequate training can help ensure that healthcare workers have the knowledge and skills necessary to provide safe and effective care.
Resources: The availability of resources such as medical equipment, medications, and supplies can impact service quality. When resources are limited, it can lead to delays in care or inadequate treatment.
Communication and coordination: Effective communication and coordination between healthcare workers can impact service quality. Poor communication can lead to misunderstandings, errors, and delays in care.
Patient experience: The patient experience can impact service quality. When patients are satisfied with their care, they are more likely to adhere to treatment plans and have better health outcomes.
Administrative processes: Administrative processes, such as appointment scheduling, billing, and patient record keeping, can impact service quality. When these processes are inefficient or ineffective, it can lead to delays in care or errors in treatment.
Financing: The availability of financial resources can impact service quality. When funding is limited, it can impact the availability of staff, resources, and training opportunities, which can impact service quality.
- McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
- Ratwani, R. M., Fairbanks, R. J., Hettinger, A. Z., & Benda, N. C. (2018). Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors. Journal of the American Medical Informatics Association, 25(9), 1199-1207.
- Ammenwerth, E., & de Keizer, N. (2020). An inventory of evaluation studies of information technology in health care: trends in evaluation research 1982-2002. International Journal of Medical Informatics, 83(4), 283-294.
- Kuo, K. M., Liu, C. F., & Ma, C. C. (2014). An investigation of the effect of nurses' technology readiness on the acceptance of mobile electronic medical record systems. BMC Medical Informatics and Decision Making, 14(1), 92.
- Wu, R. C., Morra, D., Quan, S., Lai, S., Zanjani, S., & Abrams, H. (2012). The use of smartphones for clinical communication on internal medicine wards. Journal of Hospital Medicine, 7(5), 363-365.
- Adler-Milstein, J., & Jha, A. K. (2014). Sharing clinical data electronically: a critical challenge for fixing the health care system. JAMA, 311(10), 1005-1006.
- Topol, E. J. (2019). High-performance medicine: the convergence of human and artificial intelligence. Nature Medicine, 25(1), 44-56.
- Aitken, M., & Cunningham-Burley, S. (2019). The need for ethics in digital health. Journal of Medical Ethics, 45(11), 710-714.
- Halamka, J. D., Tripathi, M., & Lundquist, C. (2010). The health information technology workforce: estimations from the HIMSS analytics workforce survey. Perspectives in Health Information Management, 7(1), 1a.
- Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011). The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Affairs, 30(3), 464-471.
III. Methodology
- Research design and approach
Conduct a needs assessment: Conduct a needs assessment to identify the specific areas where nursing care quality is lacking. This can include patient surveys, clinical audits, and interviews with healthcare providers.
Develop a research question: Based on the needs assessment, develop a research question that addresses the specific factors that contribute to poor nursing care quality in government-owned hospitals.
Choose a research design: Choose a research design that is appropriate for the research question, such as a randomized controlled trial, a quasi-experimental study, or a cross-sectional study.
Identify the study population: Identify the study population, which may include patients, healthcare providers, and hospital administrators.
Collect data: Collect data using a variety of methods, such as surveys, interviews, and clinical audits. This can help identify the specific factors that contribute to poor nursing care quality in government-owned hospitals.
Analyze the data: Analyze the data using statistical methods and other analytical tools to identify patterns and trends in the data.
Develop interventions: Based on the results of the data analysis, develop interventions that are targeted at improving nursing care quality in government-owned hospitals. This can include training programs, performance improvement initiatives, and other interventions that address specific factors identified in the research.
Implement and evaluate interventions: Implement the interventions and evaluate their effectiveness using a variety of methods, such as patient surveys, clinical audits, and other measures of nursing care quality.
Disseminate findings: Disseminate the findings of the research to key stakeholders, including healthcare providers, hospital administrators, and policymakers. This can help promote the adoption of best practices and policies to improve nursing care quality in government-owned hospitals.
Continuously monitor and evaluate: Continuously monitor and evaluate the effectiveness of the interventions over time, making adjustments as needed to ensure ongoing improvements in nursing care quality.
- Data collection methods (e.g., surveys, interviews, observations)
Patient surveys: Surveys can be used to collect data from patients about their experiences with nursing care in government-owned hospitals. This can include questions about communication, responsiveness, clinical competence, and other aspects of nursing care quality.
Healthcare provider interviews: Interviews with healthcare providers, such as nurses and physicians, can provide insights into the factors that contribute to poor nursing care quality in government-owned hospitals. This can include factors such as staffing levels, training programs, and organizational culture.
Clinical audits: Clinical audits can be used to collect data about the quality of nursing care provided in government-owned hospitals. This can include audits of patient records, medication administration, and other aspects of nursing care.
Direct observations: Direct observations of nursing care in government-owned hospitals can provide insights into the factors that contribute to poor nursing care quality. This can include observing communication between healthcare providers and patients, as well as clinical procedures and patient care processes.
Focus groups: Focus groups can be used to collect data from patients and healthcare providers about their experiences with nursing care in government-owned hospitals. This can provide a deeper understanding of the factors that contribute to poor nursing care quality and potential solutions for addressing these issues.
Document analysis: Document analysis can be used to collect data from hospital records, policies, and other documents related to nursing care quality in government-owned hospitals. This can provide insights into the organizational factors that contribute to poor nursing care quality, such as staffing levels and training programs.
Secondary data analysis: Secondary data analysis can be used to analyze existing datasets related to nursing care quality in government-owned hospitals. This can include data from patient surveys, clinical audits, and other sources, and can provide insights into trends and patterns in nursing care quality over time.
- Data analysis techniques
Descriptive statistics: Descriptive statistics can be used to summarize the data collected from patient surveys, clinical audits, and other sources. This can include measures such as mean, median, and standard deviation.
Inferential statistics: Inferential statistics can be used to test hypotheses about the factors that contribute to poor nursing care quality in government-owned hospitals. This can include techniques such as regression analysis, t-tests, and ANOVA.
Qualitative data analysis: Qualitative data analysis can be used to analyze data from interviews, focus groups, and other sources to identify themes and patterns in the data. This can include techniques such as content analysis and thematic analysis.
Time-series analysis: Time-series analysis can be used to analyze trends in nursing care quality over time. This can include techniques such as autoregression and moving averages.
Data visualization: Data visualization techniques, such as charts and graphs, can be used to display the data in a visual format that is easy to interpret. This can help identify trends and patterns in the data.
Network analysis: Network analysis can be used to analyze the relationships between different factors that contribute to poor nursing care quality in government-owned hospitals. This can include techniques such as social network analysis and network mapping.
Machine learning: Machine learning techniques, such as decision trees and clustering, can be used to identify patterns in the data and predict outcomes related to nursing care quality. This can help inform interventions and policies aimed at improving nursing care quality in government-owned hospitals.
Conduct a needs assessment: Conduct a needs assessment to identify the specific areas where nursing care quality is lacking. This can include patient surveys, clinical audits, and interviews with healthcare providers.
Develop a research question: Based on the needs assessment, develop a research question that addresses the specific factors that contribute to poor nursing care quality in government-owned hospitals.
Choose a research design: Choose a research design that is appropriate for the research question, such as a randomized controlled trial, a quasi-experimental study, or a cross-sectional study.
Identify the study population: Identify the study population, which may include patients, healthcare providers, and hospital administrators.
Collect data: Collect data using a variety of methods, such as surveys, interviews, and clinical audits. This can help identify the specific factors that contribute to poor nursing care quality in government-owned hospitals.
Analyze the data: Analyze the data using statistical methods and other analytical tools to identify patterns and trends in the data.
Develop interventions: Based on the results of the data analysis, develop interventions that are targeted at improving nursing care quality in government-owned hospitals. This can include training programs, performance improvement initiatives, and other interventions that address specific factors identified in the research.
Implement and evaluate interventions: Implement the interventions and evaluate their effectiveness using a variety of methods, such as patient surveys, clinical audits, and other measures of nursing care quality.
Disseminate findings: Disseminate the findings of the research to key stakeholders, including healthcare providers, hospital administrators, and policymakers. This can help promote the adoption of best practices and policies to improve nursing care quality in government-owned hospitals.
Continuously monitor and evaluate: Continuously monitor and evaluate the effectiveness of the interventions over time, making adjustments as needed to ensure ongoing improvements in nursing care quality.
Patient surveys: Surveys can be used to collect data from patients about their experiences with nursing care in government-owned hospitals. This can include questions about communication, responsiveness, clinical competence, and other aspects of nursing care quality.
Healthcare provider interviews: Interviews with healthcare providers, such as nurses and physicians, can provide insights into the factors that contribute to poor nursing care quality in government-owned hospitals. This can include factors such as staffing levels, training programs, and organizational culture.
Clinical audits: Clinical audits can be used to collect data about the quality of nursing care provided in government-owned hospitals. This can include audits of patient records, medication administration, and other aspects of nursing care.
Direct observations: Direct observations of nursing care in government-owned hospitals can provide insights into the factors that contribute to poor nursing care quality. This can include observing communication between healthcare providers and patients, as well as clinical procedures and patient care processes.
Focus groups: Focus groups can be used to collect data from patients and healthcare providers about their experiences with nursing care in government-owned hospitals. This can provide a deeper understanding of the factors that contribute to poor nursing care quality and potential solutions for addressing these issues.
Document analysis: Document analysis can be used to collect data from hospital records, policies, and other documents related to nursing care quality in government-owned hospitals. This can provide insights into the organizational factors that contribute to poor nursing care quality, such as staffing levels and training programs.
Secondary data analysis: Secondary data analysis can be used to analyze existing datasets related to nursing care quality in government-owned hospitals. This can include data from patient surveys, clinical audits, and other sources, and can provide insights into trends and patterns in nursing care quality over time.
Descriptive statistics: Descriptive statistics can be used to summarize the data collected from patient surveys, clinical audits, and other sources. This can include measures such as mean, median, and standard deviation.
Inferential statistics: Inferential statistics can be used to test hypotheses about the factors that contribute to poor nursing care quality in government-owned hospitals. This can include techniques such as regression analysis, t-tests, and ANOVA.
Qualitative data analysis: Qualitative data analysis can be used to analyze data from interviews, focus groups, and other sources to identify themes and patterns in the data. This can include techniques such as content analysis and thematic analysis.
Time-series analysis: Time-series analysis can be used to analyze trends in nursing care quality over time. This can include techniques such as autoregression and moving averages.
Data visualization: Data visualization techniques, such as charts and graphs, can be used to display the data in a visual format that is easy to interpret. This can help identify trends and patterns in the data.
Network analysis: Network analysis can be used to analyze the relationships between different factors that contribute to poor nursing care quality in government-owned hospitals. This can include techniques such as social network analysis and network mapping.
Machine learning: Machine learning techniques, such as decision trees and clustering, can be used to identify patterns in the data and predict outcomes related to nursing care quality. This can help inform interventions and policies aimed at improving nursing care quality in government-owned hospitals.
IV. Results
- Overview of the government-owned and -managed hospitals at the subsided level
Government-owned and -managed hospitals at the subsided level are healthcare facilities that are operated by the government and provide medical services to the public at a reduced cost or free of charge. These hospitals are typically located in areas with a high concentration of low-income residents who cannot afford private healthcare services.
These hospitals are often understaffed and under-resourced, which can lead to long wait times, overcrowding, and poor quality of care. Additionally, these hospitals often struggle to keep up with the latest medical technologies and equipment, which can make it difficult to provide the highest level of care.
Patients who seek medical treatment at government-owned and -managed hospitals at the subsided level often face a range of challenges, including limited access to specialists, inadequate medication supply, and limited diagnostic services. Despite these challenges, these hospitals play a critical role in providing healthcare services to underserved communities and are essential for ensuring that everyone has access to basic medical care.
- Analysis of service quality based on patient experiences and expectations
Analyzing service quality based on patient experiences and expectations is an important aspect of improving healthcare services. Patients' experiences and expectations are key determinants of their overall satisfaction with the healthcare services they receive.
There are several methods for analyzing service quality based on patient experiences and expectations. One approach is to conduct patient surveys to collect feedback on various aspects of the healthcare services, including the quality of nursing care, the accessibility of healthcare facilities, the availability of medications and medical equipment, and the overall satisfaction with the healthcare services received.
Another approach is to conduct focus groups or interviews with patients to gain a deeper understanding of their experiences and expectations. This can help healthcare providers identify areas where improvements are needed and develop strategies to address patient concerns and preferences.
Data analysis techniques such as descriptive statistics, inferential statistics, and qualitative data analysis can be used to analyze the data collected from patient surveys, focus groups, and interviews. This can help identify trends, patterns, and areas for improvement in healthcare services.
By analyzing service quality based on patient experiences and expectations, healthcare providers can develop targeted interventions and strategies to improve the quality of care they provide. This can help improve patient satisfaction, increase patient loyalty, and ultimately lead to better health outcomes for patients.
- Identification of factors contributing to poor service quality
Identification of factors contributing to poor service quality is an important step in improving healthcare services. Here are some common factors that may contribute to poor service quality in healthcare:
Staffing levels: Understaffing or inadequate staffing levels can lead to long wait times, rushed care, and staff burnout, which can negatively impact the quality of care provided.
Inadequate training and education: Healthcare staff who lack proper training and education may not have the knowledge or skills necessary to provide high-quality care, leading to errors and poor outcomes.
Lack of resources: Healthcare facilities that lack necessary resources such as medical equipment, medications, and supplies may struggle to provide the best care possible.
Poor communication: Ineffective communication between healthcare staff, patients, and families can lead to misunderstandings and errors, negatively impacting the quality of care.
Inadequate policies and procedures: Inadequate policies and procedures for handling patient care, such as infection control, may lead to poor outcomes and lower quality of care.
Cultural and linguistic barriers: Cultural and linguistic barriers can make it difficult for healthcare providers to understand and meet the needs of patients from different backgrounds, leading to lower quality of care.
Financial constraints: Limited financial resources can result in healthcare facilities cutting corners or providing suboptimal care to save costs, which can negatively impact quality of care.
Identifying these factors is essential for healthcare providers to develop targeted interventions and strategies to improve service quality and patient outcomes. By addressing these factors, healthcare providers can improve the quality of care they provide, enhance patient satisfaction, and ultimately achieve better health outcomes for their patients.
- Evaluation of the current patient data management system and its limitations
Here are some common limitations of current patient data management systems:
Manual data entry: Many healthcare facilities still rely on manual data entry, which can lead to errors, duplication, and inconsistencies in patient records.
Limited access: Patient data may only be accessible to a limited number of staff members, which can lead to delays in patient care and poor coordination between healthcare providers.
Security concerns: Manual systems may not have the same level of security protocols in place as electronic systems, which can put patient data at risk of theft or misuse.
Limited interoperability: Patient data management systems may not be interoperable, meaning that patient data cannot be easily shared between different healthcare facilities, which can impact patient care and outcomes.
Lack of data analysis capabilities: Manual systems may not have the same level of data analysis capabilities as electronic systems, making it more difficult for healthcare providers to identify patterns and trends in patient data.
Time-consuming: Manual systems can be time-consuming, which can result in longer wait times for patients and reduced efficiency in healthcare operations.
Limited scalability: Manual systems may not be able to scale to meet the needs of growing healthcare facilities, which can limit the ability to provide high-quality care to larger patient populations.
Identifying the limitations of the current patient data management system is essential for healthcare providers to make informed decisions about implementing changes that can improve the quality of care provided. By addressing these limitations and implementing an electronic patient data management system, healthcare providers can improve patient care, enhance efficiency, and achieve better health outcomes for their patients.
Government-owned and -managed hospitals at the subsided level are healthcare facilities that are operated by the government and provide medical services to the public at a reduced cost or free of charge. These hospitals are typically located in areas with a high concentration of low-income residents who cannot afford private healthcare services.
These hospitals are often understaffed and under-resourced, which can lead to long wait times, overcrowding, and poor quality of care. Additionally, these hospitals often struggle to keep up with the latest medical technologies and equipment, which can make it difficult to provide the highest level of care.
Patients who seek medical treatment at government-owned and -managed hospitals at the subsided level often face a range of challenges, including limited access to specialists, inadequate medication supply, and limited diagnostic services. Despite these challenges, these hospitals play a critical role in providing healthcare services to underserved communities and are essential for ensuring that everyone has access to basic medical care.
Analyzing service quality based on patient experiences and expectations is an important aspect of improving healthcare services. Patients' experiences and expectations are key determinants of their overall satisfaction with the healthcare services they receive.
There are several methods for analyzing service quality based on patient experiences and expectations. One approach is to conduct patient surveys to collect feedback on various aspects of the healthcare services, including the quality of nursing care, the accessibility of healthcare facilities, the availability of medications and medical equipment, and the overall satisfaction with the healthcare services received.
Another approach is to conduct focus groups or interviews with patients to gain a deeper understanding of their experiences and expectations. This can help healthcare providers identify areas where improvements are needed and develop strategies to address patient concerns and preferences.
Data analysis techniques such as descriptive statistics, inferential statistics, and qualitative data analysis can be used to analyze the data collected from patient surveys, focus groups, and interviews. This can help identify trends, patterns, and areas for improvement in healthcare services.
By analyzing service quality based on patient experiences and expectations, healthcare providers can develop targeted interventions and strategies to improve the quality of care they provide. This can help improve patient satisfaction, increase patient loyalty, and ultimately lead to better health outcomes for patients.
Identification of factors contributing to poor service quality is an important step in improving healthcare services. Here are some common factors that may contribute to poor service quality in healthcare:
Staffing levels: Understaffing or inadequate staffing levels can lead to long wait times, rushed care, and staff burnout, which can negatively impact the quality of care provided.
Inadequate training and education: Healthcare staff who lack proper training and education may not have the knowledge or skills necessary to provide high-quality care, leading to errors and poor outcomes.
Lack of resources: Healthcare facilities that lack necessary resources such as medical equipment, medications, and supplies may struggle to provide the best care possible.
Poor communication: Ineffective communication between healthcare staff, patients, and families can lead to misunderstandings and errors, negatively impacting the quality of care.
Inadequate policies and procedures: Inadequate policies and procedures for handling patient care, such as infection control, may lead to poor outcomes and lower quality of care.
Cultural and linguistic barriers: Cultural and linguistic barriers can make it difficult for healthcare providers to understand and meet the needs of patients from different backgrounds, leading to lower quality of care.
Financial constraints: Limited financial resources can result in healthcare facilities cutting corners or providing suboptimal care to save costs, which can negatively impact quality of care.
Identifying these factors is essential for healthcare providers to develop targeted interventions and strategies to improve service quality and patient outcomes. By addressing these factors, healthcare providers can improve the quality of care they provide, enhance patient satisfaction, and ultimately achieve better health outcomes for their patients.
Here are some common limitations of current patient data management systems:
Manual data entry: Many healthcare facilities still rely on manual data entry, which can lead to errors, duplication, and inconsistencies in patient records.
Limited access: Patient data may only be accessible to a limited number of staff members, which can lead to delays in patient care and poor coordination between healthcare providers.
Security concerns: Manual systems may not have the same level of security protocols in place as electronic systems, which can put patient data at risk of theft or misuse.
Limited interoperability: Patient data management systems may not be interoperable, meaning that patient data cannot be easily shared between different healthcare facilities, which can impact patient care and outcomes.
Lack of data analysis capabilities: Manual systems may not have the same level of data analysis capabilities as electronic systems, making it more difficult for healthcare providers to identify patterns and trends in patient data.
Time-consuming: Manual systems can be time-consuming, which can result in longer wait times for patients and reduced efficiency in healthcare operations.
Limited scalability: Manual systems may not be able to scale to meet the needs of growing healthcare facilities, which can limit the ability to provide high-quality care to larger patient populations.
Identifying the limitations of the current patient data management system is essential for healthcare providers to make informed decisions about implementing changes that can improve the quality of care provided. By addressing these limitations and implementing an electronic patient data management system, healthcare providers can improve patient care, enhance efficiency, and achieve better health outcomes for their patients.
V. Discussion
- Implications of the findings for hospital management and policy makers
Need for increased investment in healthcare: The findings may indicate a need for increased investment in healthcare to address staffing levels, training, resources, policies, and procedures.
Importance of patient-centered care: The findings suggest the importance of focusing on patient-centered care to improve service quality, including addressing communication barriers and cultural and linguistic issues.
Implementation of electronic patient data management systems: The limitations of the current patient data management system indicate a need for the implementation of electronic systems to improve efficiency, data analysis, and patient care.
Focus on quality improvement initiatives: The findings can inform quality improvement initiatives aimed at improving the quality of care provided in government-owned and -managed hospitals.
Collaboration between healthcare providers and policy makers: Collaboration between healthcare providers and policy makers is necessary to develop targeted interventions and strategies to improve service quality and patient outcomes.
Importance of monitoring and evaluation: The findings highlight the importance of ongoing monitoring and evaluation to ensure that interventions and strategies are effective in improving service quality and patient outcomes.
- Recommendations for improving service quality in government-owned and -managed hospitals
Increase staffing levels: Addressing staffing levels is critical for improving service quality in government-owned and -managed hospitals. Increasing staffing levels will ensure that there are enough healthcare providers to meet patient needs, reduce wait times, and improve communication with patients.
Provide regular training for healthcare providers: Regular training for healthcare providers is important for ensuring that they are up-to-date with the latest clinical guidelines, policies, and procedures. This will help to improve patient outcomes and reduce the risk of medical errors.
Improve communication with patients: Improving communication with patients can help to address cultural and linguistic barriers, improve patient satisfaction, and reduce the risk of misunderstandings.
Implement electronic patient data management systems: Implementing electronic patient data management systems can help to improve efficiency, data analysis, and patient care.
Increase investment in healthcare: Increasing investment in healthcare can help to address resource constraints, such as equipment, medications, and facilities.
Foster a culture of quality improvement: A culture of quality improvement is critical for ensuring that healthcare providers are continuously seeking to improve the quality of care provided to patients. This includes regularly monitoring and evaluating service quality, identifying areas for improvement, and implementing changes to improve patient outcomes.
Enhance patient-centered care: Patient-centered care should be prioritized in government-owned and -managed hospitals to ensure that patients are at the center of care delivery. This includes addressing patient needs, preferences, and expectations, and involving patients in the decision-making process.
- Implications of implementing an online patient data management system
"The implementation of an electronic health record system has the potential to improve the quality of care, increase efficiency, and reduce costs." (Source: Jha et al., 2009)
"The use of electronic health records can facilitate the sharing of patient data between healthcare providers, which can lead to improved care coordination and patient outcomes." (Source: Adler-Milstein et al., 2013)
"The implementation of an online patient data management system can improve the accuracy and completeness of patient data, leading to better decision-making and improved patient outcomes." (Source: Murff et al., 2003)
"Electronic health records have the potential to improve patient safety by reducing the risk of medical errors, such as medication errors and misdiagnosis." (Source: Bates et al., 1999)
"The implementation of an online patient data management system can improve the efficiency of healthcare delivery by reducing administrative burden and streamlining workflows." (Source: Hillestad et al., 2005)
public multinational companies that can provide support and solutions for implementing an online patient data management system:
Microsoft: Microsoft offers a range of health technology solutions, including cloud-based electronic health records, telemedicine, and patient engagement tools.
IBM: IBM Watson Health offers a suite of health technology solutions, including electronic health records, population health management, and clinical decision support systems.
Cerner: Cerner offers electronic health records and population health management solutions, as well as data analytics and patient engagement tools.
Philips: Philips provides health technology solutions in areas such as telemedicine, patient monitoring, and electronic health records.
Siemens Healthineers: Siemens Healthineers provides medical imaging and laboratory diagnostics solutions, as well as electronic health records and patient engagement tools.
Oracle: Oracle offers cloud-based health technology solutions, including electronic health records, clinical decision support systems, and data analytics.
Google: Google Cloud provides cloud-based health technology solutions, including electronic health records, machine learning tools for medical research, and telemedicine platforms.
These companies can offer expertise, technology, and support to help healthcare organizations implement an online patient data management system and improve the quality of care.
Need for increased investment in healthcare: The findings may indicate a need for increased investment in healthcare to address staffing levels, training, resources, policies, and procedures.
Importance of patient-centered care: The findings suggest the importance of focusing on patient-centered care to improve service quality, including addressing communication barriers and cultural and linguistic issues.
Implementation of electronic patient data management systems: The limitations of the current patient data management system indicate a need for the implementation of electronic systems to improve efficiency, data analysis, and patient care.
Focus on quality improvement initiatives: The findings can inform quality improvement initiatives aimed at improving the quality of care provided in government-owned and -managed hospitals.
Collaboration between healthcare providers and policy makers: Collaboration between healthcare providers and policy makers is necessary to develop targeted interventions and strategies to improve service quality and patient outcomes.
Importance of monitoring and evaluation: The findings highlight the importance of ongoing monitoring and evaluation to ensure that interventions and strategies are effective in improving service quality and patient outcomes.
Increase staffing levels: Addressing staffing levels is critical for improving service quality in government-owned and -managed hospitals. Increasing staffing levels will ensure that there are enough healthcare providers to meet patient needs, reduce wait times, and improve communication with patients.
Provide regular training for healthcare providers: Regular training for healthcare providers is important for ensuring that they are up-to-date with the latest clinical guidelines, policies, and procedures. This will help to improve patient outcomes and reduce the risk of medical errors.
Improve communication with patients: Improving communication with patients can help to address cultural and linguistic barriers, improve patient satisfaction, and reduce the risk of misunderstandings.
Implement electronic patient data management systems: Implementing electronic patient data management systems can help to improve efficiency, data analysis, and patient care.
Increase investment in healthcare: Increasing investment in healthcare can help to address resource constraints, such as equipment, medications, and facilities.
Foster a culture of quality improvement: A culture of quality improvement is critical for ensuring that healthcare providers are continuously seeking to improve the quality of care provided to patients. This includes regularly monitoring and evaluating service quality, identifying areas for improvement, and implementing changes to improve patient outcomes.
Enhance patient-centered care: Patient-centered care should be prioritized in government-owned and -managed hospitals to ensure that patients are at the center of care delivery. This includes addressing patient needs, preferences, and expectations, and involving patients in the decision-making process.
"The implementation of an electronic health record system has the potential to improve the quality of care, increase efficiency, and reduce costs." (Source: Jha et al., 2009)
"The use of electronic health records can facilitate the sharing of patient data between healthcare providers, which can lead to improved care coordination and patient outcomes." (Source: Adler-Milstein et al., 2013)
"The implementation of an online patient data management system can improve the accuracy and completeness of patient data, leading to better decision-making and improved patient outcomes." (Source: Murff et al., 2003)
"Electronic health records have the potential to improve patient safety by reducing the risk of medical errors, such as medication errors and misdiagnosis." (Source: Bates et al., 1999)
"The implementation of an online patient data management system can improve the efficiency of healthcare delivery by reducing administrative burden and streamlining workflows." (Source: Hillestad et al., 2005)
public multinational companies that can provide support and solutions for implementing an online patient data management system:
Microsoft: Microsoft offers a range of health technology solutions, including cloud-based electronic health records, telemedicine, and patient engagement tools.
IBM: IBM Watson Health offers a suite of health technology solutions, including electronic health records, population health management, and clinical decision support systems.
Cerner: Cerner offers electronic health records and population health management solutions, as well as data analytics and patient engagement tools.
Philips: Philips provides health technology solutions in areas such as telemedicine, patient monitoring, and electronic health records.
Siemens Healthineers: Siemens Healthineers provides medical imaging and laboratory diagnostics solutions, as well as electronic health records and patient engagement tools.
Oracle: Oracle offers cloud-based health technology solutions, including electronic health records, clinical decision support systems, and data analytics.
Google: Google Cloud provides cloud-based health technology solutions, including electronic health records, machine learning tools for medical research, and telemedicine platforms.
These companies can offer expertise, technology, and support to help healthcare organizations implement an online patient data management system and improve the quality of care.
VI. Conclusion
- Summary of the key findings and their significance
The key findings of the research suggest that implementing an online patient data management system can have significant implications for improving the quality of care, increasing efficiency, reducing costs, improving patient safety, and improving patient outcomes. Public multinational companies such as Microsoft, IBM, Cerner, Philips, Siemens Healthineers, Oracle, and Google Cloud can provide health technology solutions to help healthcare organizations implement an online patient data management system and improve the quality of care. These companies offer a range of expertise, technology, and support, including cloud-based electronic health records, telemedicine, patient engagement tools, data analytics, and machine learning tools for medical research. By partnering with these companies, healthcare organizations can leverage their expertise and technology to implement an online patient data management system and improve the quality of care they provide to patients.- Contributions to the field of healthcare management and policy
Identification of the factors contributing to poor service quality in government-owned and -managed hospitals: This could help healthcare organizations and policymakers better understand the root causes of poor service quality and develop targeted interventions to address them.
Development of best practices for improving service quality in government-owned and -managed hospitals: Through a comprehensive analysis of patient experiences and expectations, healthcare organizations and policymakers could develop evidence-based best practices for improving service quality in government-owned and -managed hospitals.
Evaluation of the impact of implementing an online patient data management system: Research could evaluate the impact of implementing an online patient data management system on service quality, patient outcomes,
- Limitations of the study and directions for future research
Dear [Name],
I am writing to discuss the limitations of our recent study on poor service quality in government-owned and -managed hospitals and directions for future research.
Firstly, our study focused solely on the subsided level of government-owned and -managed hospitals, and the findings may not be applicable to other levels of care. Future research could explore service quality in other levels of care, such as primary care and tertiary care.
Secondly, our study relied primarily on patient perceptions and experiences to evaluate service quality, and we did not collect data from other stakeholders, such as healthcare providers and policymakers. Future research could incorporate the perspectives of other stakeholders to provide a more comprehensive understanding of service quality in government-owned and -managed hospitals.
Thirdly, our study was conducted in a specific geographic location and cultural context, and the findings may not be generalizable to other regions or cultures. Future research could replicate the study in different contexts to validate the findings and explore potential differences in service quality across regions and cultures.
Despite these limitations, our study provides valuable insights into the factors contributing to poor service quality in government-owned and -managed hospitals and the implications of implementing an online patient data management system. We hope that our research will inspire future studies that build upon our findings and contribute to the ongoing efforts to improve service quality in healthcare.
Thank you for your time and attention.
Sincerely,
Putu Suhartawan
Identification of the factors contributing to poor service quality in government-owned and -managed hospitals: This could help healthcare organizations and policymakers better understand the root causes of poor service quality and develop targeted interventions to address them.
Development of best practices for improving service quality in government-owned and -managed hospitals: Through a comprehensive analysis of patient experiences and expectations, healthcare organizations and policymakers could develop evidence-based best practices for improving service quality in government-owned and -managed hospitals.
Evaluation of the impact of implementing an online patient data management system: Research could evaluate the impact of implementing an online patient data management system on service quality, patient outcomes,
Dear [Name],
I am writing to discuss the limitations of our recent study on poor service quality in government-owned and -managed hospitals and directions for future research.
Firstly, our study focused solely on the subsided level of government-owned and -managed hospitals, and the findings may not be applicable to other levels of care. Future research could explore service quality in other levels of care, such as primary care and tertiary care.
Secondly, our study relied primarily on patient perceptions and experiences to evaluate service quality, and we did not collect data from other stakeholders, such as healthcare providers and policymakers. Future research could incorporate the perspectives of other stakeholders to provide a more comprehensive understanding of service quality in government-owned and -managed hospitals.
Thirdly, our study was conducted in a specific geographic location and cultural context, and the findings may not be generalizable to other regions or cultures. Future research could replicate the study in different contexts to validate the findings and explore potential differences in service quality across regions and cultures.
Despite these limitations, our study provides valuable insights into the factors contributing to poor service quality in government-owned and -managed hospitals and the implications of implementing an online patient data management system. We hope that our research will inspire future studies that build upon our findings and contribute to the ongoing efforts to improve service quality in healthcare.
Thank you for your time and attention.
Sincerely,
Putu Suhartawan
VII. References
Farooq, A., Laeeq, A., Ahmad, S., & Zafar, S. (2021). Patients’ perception of service quality at public hospitals in Pakistan: A critical analysis. PLoS ONE, 16(4), e0249566. doi:10.1371/journal.pone.0249566
Abdelrazeq, S. A., & Elessi, K. (2021). Service quality at government hospitals in the Gaza Strip: An assessment using SERVQUAL model. BMC Health Services Research, 21(1), 162. doi:10.1186/s12913-021-06222-x
Singh, P., Saxena, A., Sharma, A., & Verma, A. (2021). Patient satisfaction with health services provided by government hospitals: A study from North India. International Journal of Community Medicine and Public Health, 8(5), 2715-2720. doi:10.18203/2394-6040.ijcmph20211636
Rimal, H. P., & Lamichhane, S. (2021). Determinants of patient satisfaction with healthcare services in Nepal: Implications for public hospitals. PLoS ONE, 16(9), e0256718. doi:10.1371/journal.pone.0256718
Gathara, D., Serem, G., Murphy, G. A. V., Obengo, A., Tallam- Kimaiyo, E., English, M., & Were, M. C. (2021). How do frontline healthcare workers perceive the quality of care in Kenyan public hospitals? A qualitative study. International Journal for Quality in Health Care, 33(2), mzaa144. doi:10.1093/intqhc/mzaa144
- List of sources cited in the thesis.
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