Healthcare performance management using integrated FUCOM-MARCOS approach: The case of India.

AIMS: The goal of this research is to propose a simpler and more efficient model for evaluating healthcare establishments (HCEs). With this motivation, this study aims to discover key performance indicators (KPIs) that affect HCE performance, present a ranking model for KPIs in Indian HCEs, and evaluate Indian HCEs using the identified and prioritised KPIs. MATERIAL AND METHODS: Through extensive literature review and expert opinions, this research identifies the various KPIs in HCEs, classifies them into six main categories, and prioritises them using the full consistency method (FUCOM). Further, well-known HCEs across northern India were evaluated and ranked using Measurement Alternatives and Ranking according to Compromise Solution. RESULTS: The 'technology adoption related indicators' is found as the most important main KPIs, whereas 'adequate number of hospital beds and bathrooms (IE5)' as the most dominating sub-category KPIs. Also, amongst the 20 evaluated Indian HCEs 'healthcare establishment-1 (HCE1)' was found to be the best performing HCE while 'healthcare establishment-12 (HCE12)' was found to be the worst-performing HCE. The stability and consistency of the results are ascertained by performing sensitivity analysis and comparing the results with other existing methodologies. CONCLUSION: The findings of this study are quite important for HCEs management to fully comprehend the key areas to improve upon so that managers can improve medical standards in a targeted manner. The developed prioritisation model and methodology shown in this paper will help and motivate managers and intellectuals of HCEs to evaluate and improve the HCE's performance.

An integrated DEMATEL-MMDE-ISM approach for analyzing environmental sustainability indicators in MSMEs.

The Micro, Small and Medium Enterprises (MSMEs) face numerous environmental challenges encompassing resource and energy conservation; waste generation and disposal; water and air pollution; and so on. As a result, it becomes critical to implement policies, strategies, and technologies that can help in reducing the adverse impacts of manufacturing activities on the environment. In this context, the current study identified 15 critical environmental sustainability indicators to assess the impact of manufacturing activities on the environment by taking a case study of lock manufacturing MSMEs. To understand the interdependence among the selected indicators, the study further utilizes an integrated DEMATEL-MMDE-ISM approach to analyze the inputs of industry professionals. The results of the study highlighted that green product design, which facilitates the product to be disassembled, reused, or recycled and are free from hazardous materials, plays a significant role in enhancing the environmental sustainability of the concerned industry. Green product design significantly affects 12 other indicators out of 15 under consideration; thus, incorporating green practices in the design and development of a product leads to significant improvement in environmental sustainability. The study is expected to aid decision-makers (industry practitioners and academic researchers) to identify strategic areas in order to achieve higher environmental sustainability in manufacturing organizations.

Antrochoanal Polyp in Anterior Nasal Cavity: A Case Report.

We report a case of antrochoanal polyp, which has unusual presentation according to the location of the polyp in a 15-year-female patient. The patient came complaining of nasal obstruction, headache, and postnasal drip for a two-week period. The antrochoanal polyp measured 2.5 x 2 cm in the left maxillary sinus and extended to the anterior part of the nasal cavity. CT imaging demonstrated a total opacified left maxillary sinus, maxillary ostium with widening of the left maxillary ostium by polypoid mucosal thickening suggesting an antrochoanal polyp obstructing the left anterior nasal cavity. This case is reported as there are not many articles in world literature describing an antrochoanal polyp presented in the anterior nasal cavity.

A critical study of quality parameters in health care establishment: developing an integrated quality model.

PURPOSE: The purpose of this article is to identify and critically analyze healthcare establishment (HCE) quality parameters described in the literature. It aims to propose an integrated quality model that includes technical quality and associated supportive quality parameters to achieve optimum patient satisfaction. DESIGN/METHODOLOGY/APPROACH: The authors use an extensive in-depth healthcare quality literature review, discerning gaps via a critical analysis in relation to their overall impact on patient management, while identifying an integrated quality model acceptable to hospital staff. FINDINGS: The article provides insights into contemporary HCE quality parameters by critically analyzing relevant literature. It also evolves and proposes an integrated HCE-quality model. RESEARCH LIMITATIONS/IMPLICATIONS: Owing to HCE confidentiality, especially regarding patient data, information cannot be accessed. PRACTICAL IMPLICATIONS: The integrated quality model parameters have practical utility for healthcare service managers. However, further studies may be required to refine and integrate newer parameters to ensure continuous quality improvement. ORIGINALITY/VALUE: This article adds a new perspective to understanding quality parameters and suggests an integrated quality model that has practical value for maintaining HCE service quality to benefit many stakeholders.

Best practices of total quality management implementation in health care settings.

Due to the growing prominence of total quality management (TQM) in health care, the present study was conducted to identify the set of TQM practices for its successful implementation in healthcare institutions through a systematic review of literature. A research strategy was performed on the selected papers published between 1995 and 2009. An appropriate database was chosen and 15 peer-reviewed research papers were identified through a screening process and were finally reviewed for this study. Eight supporting TQM practices, such as top-management commitment, teamwork and participation, process management, customer focus and satisfaction, resource management, organization behavior and culture, continuous improvement, and training and education were identified as best practices for TQM implementation in any health care setting. The article concludes with a set of recommendations for the future researchers to discuss, develop, and work upon in order to achieve better precision and generalizations.