Analysis of the operational risk factors in public hospitals in an Indian state.

Autor:	Vishnu CR; Department of Mechanical Engineering, National Institute of Technology Calicut, Calicut, India., Sridharan R; Department of Mechanical Engineering, National Institute of Technology Calicut, Calicut, India., Ram Kumar PN; Department of Quantitative Methods and Operations Management, Indian Institute of Management Kozhikode, Kozhikode, India., Regi Kumar V; Department of Mechanical Engineering, College of Engineering Trivandrum, Thiruvananthapuram, India.
Jazyk:	angličtina
Zdroj:	International journal of health care quality assurance [Int J Health Care Qual Assur] 2019 Dec 18; Vol. 33 (1), pp. 67-88.
DOI:	10.1108/IJHCQA-06-2018-0156
Abstrakt:	Purpose: Risk management in the healthcare sector is a highly relevant sub-domain and a crucial research area from the humanitarian perspective. The purpose of this paper is to focus on the managerial/supply chain risk factors experienced by the government hospitals in an Indian state. The present paper analyzes the inter-relationships among the significant risk factors and ranks those risk factors based on their criticality. Design/methodology/approach: The current research focuses on 125 public hospitals in an Indian state. Questionnaire-based survey and personal interviews were conducted in the healthcare sector among the inpatients and hospital staff to identify the significant risk factors. An integrated DEMATEL-ISM-PROMETHEE method is adopted to analyze the impact potential and dependence behavior of the risk factors. Findings: The analysis asserts the absence of critical risk factors that have a direct impact on patient safety in the present healthcare system under investigation. However, the results illustrate the remarkable impact potential attributed to the risk factor, namely, staff shortage in inducing other risk factors such as employee attitudinal issues, employee health issues and absenteeism altogether resulting in community mistrust/misbeliefs. Maintenance mismanagement, monsoon time epidemics, physical infrastructure limitations are also found to be significant risk factors that compromise patient satisfaction levels. Practical Implications: Multiple options are illustrated to mitigate significant risk factors and operational constraints experienced by public hospitals in the state. The study warrants urgent attention from government officials to fill staff vacancies and to improve the infrastructural facilities to match with the increasing demand from the society. Furthermore, this research recommends the hospital authorities to start conducting induction and training programs for the hospital employees to instill the fundamental code of conduct while working in hectic, challenging and even in conditions with limited resources. Originality/value: Only limited papers are visible that address the identification and mitigation of risk factors associated with hospitals. The present paper proposes a novel DEMATEL-ISM-PROMETHEE integrated approach to map the inter-relationships among the significant risk factors and to rank those risk factors based on their criticality. Furthermore, the present study discloses the unique setting of the public healthcare system in a developing nation. (© Emerald Publishing Limited.)
Databáze:	MEDLINE
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