Quality for services has always been a concern for all professional services. It determines how customers respond to the services provided, and finally, the success of the whole thing. Healthcare providers in the public scene have tried to provide quality services, which are essential, not only for the well-being of the society, but that they contribute to a healthy community, because patients are taken care of well, as far as the diseases and illnesses are concerned. Quality services cut across many areas including the level of training of the staff; the level of services provided; the level of facilities provided. In many cases, the customers judge the quality of a service, and providers can utilize this information to improve on the services. Thus, for every service, feedback information from customers is very important.
Quality in health sector is achievement of suitable physical and psychological health through accessible and cost-effective care that is indiscriminative of social class, beliefs or other backgrounds. It is the availability of a treatment, nursing or any other form of medical attention at the right time. Delays in health care can be costly especially if surrounded by bureaucracy in their availability. Quality health care enables one to stay healthy since the arising medical needs will be taken care of in good time and affordably.
The issue of quality of service may be linked to the management and leadership in healthcare centers. Nordgren Discusses the application of “service management” in healthcare, where they think that delegation of tasks to patients “seems not to be a matter of course” (2008) (see also Storey, and Holti, 2009; Lagrosen, Backstrom, 2006; Carr, Lhussier, and Reynolds, 2009; Camgroz-Akdag, and Zineldin, 2010; Raja, and Deshmukh, 2007; and Somu, 2008). When there is desired quality in health sector, it means that there is efficiency, effectiveness, customer satisfaction and continuous professional enrichment of various dimensions of health sector. An efficient health sector will have reduced cost of operations and increased productivity. Effectiveness in health sector goes hand in hand with customer satisfaction whereby the customer gains central role. Cooperation at all levels of health sector; team work and good working environment are also other important parameters of a quality in health sector.
For quality in health care to be enhanced, various health care stakeholders like governments and many other practioners – including individuals – have to be committed in playing their roles and ensuring that mechanisms are put in place to sustain the sector in an optimal level. Mohammadi (2010) finds the need to have a shared collaboration between the education and health sector as relates to the “practical elements and potential benefits” so as to address the challenges regarding promotion of health in schools.
Partnerships can influence healthcare performance. Mooney, Boddy, Statham and Warwick (2008) find that “health promoting work in the early years sector” can be facilitated through adequate resourcing in the local and national levels, development of “partnerships between health and early years professionals” and other practices (see also Sciulli, 2008; Pate, Fischbacher, and Mackinnon, 2010).
Barriers to quality health services
Health sector is faced by a number of barriers that hinders quality enhancement and continuous upper trend in the sector performance. Barriers in the sector are classified in many categories. Changing society needs, technology advances, rising costs living, managerial and organizational set –ups of health institutions among many others are just examples of barriers that affect health sector. There are various challenges facing healthcare sectors (e.g. Ramani and Mavalankar, 2006; Storey, Buchanan, 2008). Nielson and Knudsen (2008) find that the challenges encountered for the public health can be overcome in two concepts; increasing size of the organization and including “as many aspects of the environment as possible”. (See also Ritson, 2006).
Change in people’s lifestyles has continuously created a need for change in health sector. People have developed a need for more customized products and services to suit them. For instance many will wish to have a personal doctor that attends to their health needs whenever the need arises. Responding to such health care issue is difficult since the health institution may not have adequate resources to support the same or market such services.
The ratio between the number of trained personnel and clients to be served is unproportional. There are less trained personnel to serve people seeking health attention. Significance for the statement regarding the choice to make in healthcare is lost because patients usually have limited information (Nordgren, 2010). Vagnoni and Maran (2008) professionalism has a great say in healthcare while no clarity existed for partnership vision.
Demographic factors such as increase in population are also a challenge in health sector. High population puts pressure on health sector to protect, care for and promote health care among the people. Technological changes are another barrier to quality health services. Many health institutions lack adequate technology in their operations. Such institutions have not taken advantage of technology to replace their traditional paper based operations with flexible electronic means that could see significant cost reduction and improving effectives in terms of timely delivery of services. Health sector should embrace information communication and technology in bringing life – enhancing knowledge to people in ways they can use it at their appropriate time and place. Without modern technology, health care institutions cannot use this technology flexibility in reaching a wide range of communities and other clients.
In the “processing and interpretation of health information” there are factors that need to be considered such as “health literacy, format presentation of information, and human cognitive biases and effective/personal influences” (Vahabi, 2006). Exton (2008) has found that power structures may affect the occurrence of change within organizations. Badri and Attia (2007) use Confirmatory Factor Analysis (CFA) to test models and recommend one with “quality of care, process and administration, and information” as constructs. For more effectiveness of healthcare services, some things such as “sustainability and quality”, “management and governance” as well as “technological assessment” are important (Bowman, Matzopoulos, and Lerer, 2008).
In particular, technology barrier will have numerous limitations in achieving a quality health sector. When technology is lacking there is high disparities between the services offered in urban and rural areas, due to lack information transfer medium and other technology supported infrastructure. Education campaigns on health matters will be compromised since the transfer of information may be restricted. Inadequate technology jeopardizes exchange of information among researchers, doctors, students and other players in the health sector.
Challenges in managerial and organizational set –ups are another barrier pinning down the health sector. Lack of effective and efficient managerial strategies pulls down health sectors. Managerial teams in many health institutions lack mission and vision to steer their objectives and policies.
An increasing number of health care institutions are being established as a way of generating income even without caring on quality of products or services being offered. Health sector institutions and other stakeholders continually default in adhering to set sector regulations and standards and fail to sign in commitment to quality assurance. Organizational barrier to quality in health care is also another major challenge. Health care institutions are not organized in a way that promotes efficiency and effectiveness. There is need for researchers and practitioners to consider the organizational barriers that face the sector so as to come up with quality organizational flow.
Lack of accountability and corruption in health sector is major obstacle. Practice of social injustice like corruption and misuse of resources is increasingly making it difficult for health sector to operates in it optimal capacity. For example, Government health officers or Private pharmaceutical companies, hospitals or insurers may acts dishonestly to enrich themselves which “kills” the health sector.
Disparities in social classes and economic inequality of people; and their beliefs is yet another obstacle in health sector. Health institutions may be established to serve a certain class of people which may discriminates others. The challenge is that no one size to fit all.
A formula exists to guide population health class satisfaction determined by resources at hand. Communities find their own solutions, by figuring out what their most pressing problems in health are and then matching it with what they can afford. This might not be the best option since people in a higher class have a better option of getting best health care services.
Rising costs of living have continuously affected health sector negatively. Increasing costs of medicines, hospital equipments and insurance costs hampers growth in health sector. Rising levels of inflation affects health sector making resources availed by governments and other private sectors inadequate. In many countries, shrinking government’s resources may not be enough to cater for this rising inflation.
Lack of professionalism and adequate knowledge in the health sector is yet another challenge. Nefarious activities of quacks and other unqualified personnel’s in health sector have continuously lowered the sector performance. Many health care personnel –health technicians, radiographers, doctors, nurses and laboratory scientists – are not fully qualified. This results to lack of confidence in the health sector and poor product and services in the sector.
Health care sector is a victim of gender discrimination. There is no gender equity in many health institutions. In many countries, the primary health-care personnel are males. The lack of female health-care providers is a deterrent in obtaining quality in health care.
In other occasions, Cultural practices may dictate that women should not be treated male health care providers or vice versa.
These restrictions may make a health care personnel’s from certain a gender to be preferred than the other though they might be less qualified. Consideration of the future of the healthcare costs and the risk adjustment in healthcare in the future is of importance (see Cucciare and O’Donohue, 2006). It may be helpful to utilize “volume flexible strategies, volume flexible capability, patient satisfaction, and organizational performance” in enhancing outcomes in healthcare (Powers and Jack, 2008; Jack and Powers, 2006; see also Harris, Cortvriend and Hyde, 2007). However, proposed healthcare costs containment strategies may no longer admirable since they are unethical always and increase healthcare inequities (Hosseini, 2010). The importance of “high awareness activities” such as improving employee training among others is have also been looked into (Moore and Parahoo, 2010).
Health and illnesses among men and women will be determined by “quality-related work environment factors” (Aronsson and Blom, 2010). Moullin and Price (2007) (see also Cryant, and Buttigieg, 2009) find that public healthcare can be improved through the use of Public Sector Score Card (see also Cole and Radnor, 2009 regarding annual checks and Gross, Ashkenazi, and Porath, 2008). Addicott and Ferlie have found that in the understanding of “power relations within London MCNs”, a “model of bounded pluralism” can be employed (2007). It is not possible to justify health behaviors that connect trust and communications (Braithwaite, Ledema, 2007). There is need for the change of general trend regarding health campaigns to keep the consumer interested (Basu and Wang, 2009).
Regarding the solutions for the various problems and challenges, Goddard, and Mannion, (2006) find professional experience central to making decisions in healthcare centers. Greenfield, Braithwaite, Pawsey (2008) identify surveyor styles necessary for the enactment of the role of “healthcare accreditation surveyors”. Haines and Horrocks (2006) find possibility of the “design/methodology/approach” in “promoting health information literacy”. (See also Sheffeild, 2008; Simonen, Viitanen, Lehto, and Koivisto, 2009 and Lemmergaard, 2008). Jaffe, Nash, and Schwartz (2007) find that “an approach to the causes of ill health appears more promising than re-configuration of current disease reactive, symptom treatment care”. Jarret (2006) in order to “encourage greater price competition among priorities”, there is need to restructure the “health service market”. “Hospital support functions” have been found important in influencing the perceptions of the patients (Baalbaki, 2006). The quality of care in the institutions is very important (see Rashid, and Jusoff, 2008). The quality of care is different in some states as compared to others (Guo, 2008).
“Organizational commitment, job satisfaction and Personal and professional variables” are linked with job performance (Al-Ahmadi, 2009; see also Bridges, and Fitzgerald, 2006 about outsourcing workforce, Moscguris, and Kondylis, 2007; and Young). Badri, Attia, and Ustadi (2009) find out that it is possible to test “patient satisfaction casualty” through the application of “structural equation modeling”. Ben-David (2009) find “an equilibrium path” “for the demand for consumption and for medical care goods, per capita level of health, capital, savings, trade balance, and net foreign assets”. Change may at times be needed to result in good performance. Brunton, and Mathen (2009) find that subcultures affect change.
Quality in healthcare cuts across many fields, including the level of services (such as the technology employed in the service) and the level of training provided to staff. Quality of healthcare is important because it results in healthy communities. Participants in the healthcare sector should foster an environment for change in the sector by creating an infrastructure to support evidence-based practice facilitating the use of necessary changes; like embracing technology in their modern operations. Players in the sector –government and the private should identify priority conditions that need to be addressed first and provide resources to stimulate innovation and initiate the change process required in health sector. For instance governments should increase resources allocated in this sector and ensure streamlined use of such funds. In addition, Healthcare organizations and individuals should support fully the changes needed to improve the health care sector.
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