Asia-Pacific Journal of Health Management (ACHSM)
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Applicability of the “5S Management Method” for Quality Improvement at Health Care Facilities in India
No full textIntroduction: The 5S management method, originally developed in Japanese industries for quality improvement, has since been adopted in healthcare settings worldwide. Several developing countries have reported positive outcomes from its implementation in healthcare, including improved workspace organization, enhanced environments, better compliance with regulations, and increased patient satisfaction. This study aimed to assess the applicability of the 5S management method for quality improvement in tertiary-level healthcare facilities and to evaluate the changes brought about by 5S in the workplace, including both process and outcome measures of healthcare services.
Methods: This mixed-methods study was conducted in twelve departments across the two largest tertiary hospitals in Nadiad, Gujarat, from July 2023 to December 2023. Quantitative data served as the primary component, supplemented by qualitative data. A structured 5S audit checklist and semi-structured interviews were used for baseline assessment, external evaluation, and qualitative data collection, respectively.
Results: Following 5S implementation, the mean scores increased in all twelve departments, with statistically significant improvements in most cases. The mean 5S score in the private hospital increased by 30.99%, while that of the government hospital increased by 43.39%. Post-implementation, turnaround time decreased for case registration, pharmacy, and emergency room services while laboratory efficiency improved, accompanied by reductions in medical errors and hospital-acquired infections. Qualitative analysis identified key themes such as enhanced work environments and improved quality of services.
Conclusion: The study shows that implementing the 5S management method effectively improves work environments, efficiency, quality, and staff satisfaction in both government and private tertiary healthcare facilities in India; sustaining these improvements is essential for long-term success
A Bibliometric Analysis of Hospital Financial Performance: Emerging trends and future directions
No full textBackground: The financial performance of hospitals significantly influences the quality and sustainability of healthcare services, particularly amid rising operational costs and evolving healthcare regulations. While various financial metrics have been studied, there remains a lack of comprehensive bibliometric analyses that map the growth, emerging themes, and future research directions in this field. This study aims to fill that gap by examining the development and patterns of hospital financial performance research.
Methods: A bibliometric analysis was conducted using the SPAR-4-SLR protocol on 2,387 publications retrieved from the Scopus database, spanning from 2014 to October 12, 2024. Bibliometric techniques such as co-authorship, keyword co-occurrence, and citation analysis were performed using VOS viewer to identify research trends, leading contributors, and thematic clusters.
Results: The analysis revealed a steady increase in publications from 2014 to 2021, peaking at 341 papers. A slight decline in subsequent years is likely due to indexing delays, not reduced research activity. Thematic clustering identified four main areas of focus: (1) hospital, (2) COVID-19, and (3) healthcare. In recent years, additional attention has been given to emerging themes such as health equity, access, and the application of artificial intelligence. These findings suggest a dynamic and evolving research landscape that reflects broader shifts in healthcare priorities.
Conclusion: Research on hospital financial performance has expanded notably over the past decade. The COVID-19 pandemic exposed financial system vulnerabilities, shifting research priorities. The United States remains the leading contributor to global output in this field. The identified themes highlight both established and emerging priorities that are likely to shape future inquiry. These insights are essential for informing hospital administrators, policymakers, and healthcare professionals in developing more resilient and equitable financial strategies and health policies. Continued bibliometric monitoring will be valuable for tracking progress and guiding strategic interventions
Prevalence of Emotional and Behavioral Difficulties and Associated Factors Among Adolescents with Divorced or Separated Parents in Vietnam: A cross-sectional study using the SDQ-25
No full textObjectives: This study evaluates the prevalence of emotional and behavioral difficulties using the SDQ-25 self-report version and identifies factors associated with these difficulties among adolescents in urban Vietnam with divorced or separated parents.
Methods: We conducted a cross-sectional study with 309 participants, collecting data through a self-administered questionnaire featuring the SDQ-25 self-report version for assessing emotional and behavioral difficulties.
Results: Findings indicated that 17.5% of students experienced emotional and behavioral difficulties. Among them, 15.2% had both emotional symptoms and peer issues, while 14.9% faced conduct problems, 12.3% showed prosocial behavior, and 9.4% experienced hyperactivity/inattention. Multivariable logistic regression showed that the duration since parental divorce or separation (OR = 4.34; 95% CI: 1.37 - 13.75; p = 0.013) and involvement in physical fights (OR = 2.58; 95% CI: 1.00 - 6.64; p = 0.049) were significant predictors of mental health issues in these adolescents.
Conclusions: The study found a notable prevalence of emotional and behavioral difficulties among adolescents from divorced or separated families, who face a higher risk of these disorders. The length of time since parental divorce or separation and engagement in physical fights were identified as significant predictors of these issues
An Exploration of Leadership Challenges in Government Hospitals in India during Health Crisis: - Confab 360 Degree Annual Conference in Dubai, 2025
No full textIntroduction: Leadership in Indian government hospitals faces serious challenges during health crises like the COVID-19 pandemic, including bureaucratic delays, resource constraints, and ethical dilemmas in resource usage. These issues are further worsened by federal-state tension, inadequate adaptive competency, and systemic inequities, usually resulting in suboptimal crisis response and burnout. This paper includes a systematic literature review (SLR) for exploring these challenges and dynamics to inform practice and policy. By critically reviewing existing literature, the study focuses on bridging the gap in understanding crisis-specific stressors and general healthcare management problems, highlighting the need for a transformative approach in resource-deficient settings.
Method: The SLR method follows PRISMA guidelines, searching databases such as Scopus, PubMed, and Google Scholar. 17 articles were finally selected to be included in the study following the inclusion and exclusion criteria specified. Major themes were identified from the extensive review of the selected articles.
Results: Three interconnected themes emerged: systemic operational challenges covering sub-themes of resource scarcity and governance delays; leadership styles and competencies, including adaptive deficits and mental health gaps; and policy reforms, which covered decentralisation and training as sub-themes. Sub-themes revealed crisis-specific aggravated challenges, such as rural inequities and burnout, with regional successes like Kerala's (Indian State) adaptive strategies contrasting national hierarchical failures.
Conclusion: The review reveals the importance and need for an evolutionary leadership shift to develop resilience in Indian hospitals. Recommendations include adaptive training, decentralisation, mental health support, global partnerships, and post-crisis evaluations
Welcome to This Issue of the College’s Asia Pacific Journal of Health Management
No full textThe Journal stands as one of the integral pillars of our work at the College, providing a platform to share insights, reflections, and research that fuel our collective passion for continuous improvement in health leadership and management. It is a place where knowledge meets practice, where ideas spark conversation, and where those conversations shape the way we lead.
As our leadership journeys unfold, we all come to understand that change is constant. Disruption is inevitable. And from time to time, crises will test both our resolve and our resilience. Check any daily newsfeed about what is happening in health and aged care! What defines us as leaders is not whether these challenges arise, but how we respond to them. The ability to navigate uncertainty, to remain steady while encouraging innovation and courage in others, is a capability that must be continually trained, stretched, and cultivated. Easily said. Much harder to carry out.....
Effect of COVID-19 on Primary Healthcare Nurses' Job Satisfaction and Their Turnover Intention in Singapore
No full textBackground: Globally, COVID-19 has added pressure to the healthcare workforce, particularly nurses, who face an exacerbated shortage. Few studies have investigated job satisfaction and turnover intention among primary healthcare nurses in the long-drawn pandemic situation. Hence, this study aims to examine job satisfaction and retention among primary healthcare nurses.
Aims: To assess the level of job satisfaction and identify factors that affect job satisfaction and turnover intentions among primary healthcare nurses. This will serve to inform organisations on ways to improve processes and support mechanisms that promote job satisfaction and retention for primary healthcare nurses.
Methods: A cross-sectional quantitative study was conducted that involved 132 primary care nurses from seven healthcare centres in Western Singapore. Level of job satisfaction and turnover intentions was assessed using a 39-item questionnaire. Relationships between job satisfaction and turnover intentions were analysed using Pearson correlation and linear regression analysis.
Results: Among the five job satisfaction subscales, personal satisfaction had the highest score (M=3.73, SD=0.47), while satisfaction with workload had the lowest score (M=3.24, SD= 0.69). The overall job satisfaction mean score of 3.47 (SD=0.49), is considered within the moderate range and is similar-to other studies conducted during COVID-19 pandemic. Albeit the challenging period, more than half of the nurses reported their intention to stay in a primary healthcare setting.
Conclusion: This study demonstrated the multifaceted nature of nurses’ job satisfaction and its intricate interplay with various factors, including personal accomplishment, workload, professional support, pay and prospects, training and the challenges posed by the COVID-19 pandemic. The findings of this study provide insight for organisations to look at targeted factors to improve the rate of retention for primary care nurses
A Validation Study on the Pain Beliefs Questionnaire Malay Version (PBQ-M) among Malaysian Adults
No full textThe biopsychosocial approach in chronic pain considers one’s belief, cognition and behaviours related to the pain experience. To date, there is no measure for pain beliefs in Malaysia, highlighting the need for validation of the Pain Beliefs Questionnaire (PBQ). There were 125 participants in this cross-sectional study. The PBQ was first translated from English to Bahasa Malaysia and then back-translated by the team of researchers, reviewed and examined by third party clinical psychologists experienced in chronic pain management. While all participants completed the PBQ, only those who reported having pain exceeding six months (n = 37) were required to complete the Pain Catastrophizing Scale (PCS) and the Pain Self-Efficacy Questionnaire (PSEQ). The organic subscale had a Cronbach’s alpha coefficient of 0.81 while the psychological subscale had a coefficient of 0.71. Overall, the PBQ-M demonstrated good reliability (ICC = 0.81). The Organic subscale of the PBQ had a significant association with PCS, however, there were weak correlations between the organic (p = .058) and psychological (p = .077) subscales of PBQ with the PSEQ. In conclusion, the PBQ-M is a valid and reliable measure of Malaysian adults’ pain beliefs, independent of the presence of the condition, via two scales that can potentially predict pain catastrophizing and pain self-efficacy
To Study and Compare Postural Sway by Romberg Test in Diabetic and Non-Diabetic Subjects
No full textBackground: Diabetes is a silent disorder leading to disabling and fatal complications. The long-term complications of diabetes affect almost every system in the body. Balance impairment and postural instability is also observed in people having chronic diabetes which is a result of diabetic peripheral neuropathy, diabetic retinopathy, and vestibular dysfunctions.
Objective: The objective of this study is to find out the effect of chronic diabetes on postural sway by Romberg’s test and thereby finding effects of diabetes on balance and stability.
Method: 60 participants both male and female between 40 to 60 years of age were included. The participants were divided into diabetic and non-diabetic group (n=30). All the participants performed Romberg’s test. Their postural sway was observed and subsequently Romberg’s sign was noted. The procedure is repeated again two more times to find out average Romberg’s sign.
Results: The data shows a significant difference in postural sway between diabetic and non-diabetic subjects. The chi-square value computed for this comparison was 5.406, yielding a p-value of 0.020. The p-value was below the conventional significance threshold of 0.05, indicating a statistically significant association between diabetes status and the presence of postural sway. Diabetic individuals were significantly more likely to exhibit signs of impaired balance compared to non-diabetic individuals, as evidenced by the highly significant chi-square test result. This finding highlights the impact of diabetes on balance and stability.
Conclusion: The study demonstrated that postural sway and instability was more common in diabetic subjects as compare to non-diabetic subjects between 40 to 60 years of age. Additionally, this study suggested that patients having diabetes should take measures to prevent postural instability, balance impairments and other complications of diabetes
Evaluation of Dermatology Treatment Satisfaction towards Hospital Reputation among Chronic Skin Disease Patients at An Eastern Indonesian Referral Hospital
No full textIntroduction: Chronic skin disease poses a major challenge due to the complexity of these diseases and the variety of symptoms require a highly individualized approach to diagnosis and long-term treatment. This study aimed to evaluate the factor of treatment satisfaction moderated with recurrency towards hospital reputation among patients with chronic skin disorder utilizing the modified Dermasat questionnaire with six variables (treatment effectiveness, convenience of use, impact on daily living, medical care information, treatment side effect tolerable) and an additional variable (physician communication).
Methods :Based on improved patient satisfaction moderated with recurrency towards hospital reputation, a questionnaire survey was conducted among 179 patients at a referral hospital in East Indonesia. The relationship of patient satisfaction, recurrency, and hospital reputation was verified via SmartPLS® version 4.1.0.2.
Results: The majority of the respondents were female from the productive age 18-39 years old (46%), mostly housewives with a senior high school qualification as their educational background level (51.4%). All six factors and moderation with recurrency (towards treatment effectiveness and physician communication) were significant (P-value<0.05) towards overall patient satisfaction. The strongest relationship is demonstrated by physical communication and tolerance of treatment side effects with patient satisfaction. Furthermore, overall patient satisfaction was significantly associated positively with hospital reputation (P-value=0.000).
Conclusions: Six variables were found that were related to skin disease patient satisfaction. Overall patient satisfaction is significantly associated positively with the hospital’s reputation, indicating a higher overall patient satisfaction will increase the hospital’s reputation which can encourage patient trust and compliance in the long term
Organisational Factors in Residential Aged Care Facilities Influencing Specialised Texture Modified Diets
No full textIntroduction: Adherence to specialised diets when prescribed, is critical to support nutritional and general health and well-being for residents of aged care facilities. Understanding the organisational factors that health service and clinical managers action can address the nutritional health of residents of residential aged care facilities.
Objective: Identify the organisational factors that influence the delivery of prescribed textured modified diets in residential aged care facilities.
Design: A scoping review was conducted using searches across four databases. Papers were screened if they were published after 2014 in peer reviewed articles, in English and covered relevant concepts guided by the research questions. Organisational factors that influenced the delivery of prescribed diets in RACFs was then extracted from the studies that met the selection criteria and a quality assessment performed using the Critical Appraisal Skills Program (CASP) tool.
Findings: Thirteen articles were included in the scoping review. The studies were observational and predominately qualitative, with one study incorporating a mixed method design. Six dominant themes were identified as significant factors influencing the influence the delivery of prescribed textured modified diets in residential aged care facilities.
Conclusion: Based on the evidence identified in this scoping review, it highlights a significant gap in research that explores the multifactorial, organisational factors that influence the delivery of prescribed texture modified diets in residential aged care facilities. Recent knowledge from the Royal Commission into Aged Care Quality and Safety and the Aged Care Quality Standards can aid residential aged care facilities, tailored specifically to the organisation, can ensure the highest quality of care and standardised practices are provided for accurate and safe delivery of prescribed texture modified diets