Previously known as Department of Health Services Management https://www.um.edu.mt/library/oar/handle/123456789/688 2026-11-03T03:08:51Z 2026-11-03T03:08:51Z https://www.um.edu.mt/library/oar/handle/123456789/149795 2026-10-07T09:57:50Z 2026-01-01T00:00:00Z

Title: Assessing the quality of healthcare practice : a risk-based approach Abstract: Background: This research article explores a novel framework for assessing the Quality of Healthcare based on principles of Clinical Risk Management, including the development of a theoretical construct for the quality of healthcare services based on stakeholder needs, and a conceptual model for managing risks at an institutional level. Methodology: The study consisted of a cross-sectional secondary assessment of healthcare service and system-level indicators, guided by a structured decision tree based on face, construct, content, and criterion validity. Established performance measures identified from international benchmarking and institutional quality improvement frameworks were classified and validated for assessment of clinical risks according to indicator type. Results: A total of 233 performance indicators were evaluated, of which 200 (86%) consisted of measures for assessing failures in clinical practice. According to the proposed framework, (30%) and (14%) of indicators met the criteria for assessing risks associated with clinical processes and organizational systems design respectively. Conclusion: More targeted use of indicators is required in order to achieve a greater degree of accuracy and actionability of performance assessment measures in healthcare practice. The proposed framework offers an applied method to enhance the specificity of quality indicators and direct efforts to improve systems design and decision-making capability.

2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/149588 2026-10-01T11:45:38Z 2026-01-01T00:00:00Z

Title: Introducing national quality and patient safety indicators for acute care hospitals : a stakeholder-based approach Abstract: Background: Healthcare organisations must deliver safe, effective, and person-centred care consistently. Measuring quality and safety is essential for monitoring performance, preventing harm, identifying errors, and supporting continuous improvement. Quality and patient safety indicators are needed to generate data that support governance processes and drive quality assurance and improvement initiatives by hospitals. Aim: To develop indicators to support the licensing and monitoring of the quality of care in acute care hospitals in Malta. It also aimed to evaluate the feasibility of implementing such indicators. Methodology: A mixed-method, exploratory sequential design was employed. A structured, purposive sampling approach was employed to recruit participants. A focus group was conducted with policymakers. The RAND/UCLA Appropriateness Method was used to set the indicators. This comprised an online questionnaire with key stakeholders for the first rating of indicators and a consensus meeting for the second-round rating of indicators. Each indicator was evaluated against three criteria: ‘Relevance/Appropriateness,’ ‘Validity and Reliability,’ and ‘Feasibility.’ Information about factors affecting the implementation of indicators from the different methods was triangulated. Results: The preliminary set of indicators was identified from the literature. The final 92 indicators were mapped into a conceptual framework comprising five quality dimensions and three domains. Most indicators were mapped to the structure and process domains, while the outcome domain included the Patient-Reported Experience Measures (PREMs). Indicators related to domains of safety and effectiveness were rated highly prioritised, reflecting participants’ familiarity with clinically oriented, evidence-based practices and the presence of supporting mechanisms. In contrast, indicators addressing the domains related to human factors and system-level patient safety, particularly responsive governance and person-centred care, were less prioritised and often rated uncertain or low potential. Feasibility received the lowest scores overall, highlighting gaps in safety governance and significant systemic weaknesses that hinder the implementation of these indicators. Conclusions and recommendations: This research identified quality and patient safety indicators for acute care hospitals. Recommendations were made for the implementation of these indicators. Description: M.Sc.(Melit.)

2026-01-01T00:00:00Z Abed, Nida Pérez-Esteve, Clara Knežević-Krajina, Hana Buttigieg, Sandra C. Tella, Susanna Srulovici, Einav Sousa, Paulo Jorge Dos Santos Knezevic, Bojana Mira, Jose J. https://www.um.edu.mt/library/oar/handle/123456789/148439 2026-08-07T08:56:14Z 2026-01-01T00:00:00Z

Title: Strengthening safety for informal caregivers in home care Authors: Abed, Nida; Pérez-Esteve, Clara; Knežević-Krajina, Hana; Buttigieg, Sandra C.; Tella, Susanna; Srulovici, Einav; Sousa, Paulo Jorge Dos Santos; Knezevic, Bojana; Mira, Jose J. Abstract: This scientific letter aims to raise awareness of the critical role informal caregivers play in home care settings and the need to find new approaches to ensure patient safety in this specific environment. With Europe’s aging population, the shift of hospital care to the home, and deinstitutionalization policies, the demand for informal caregiving in developing countries is rapidly rising. Informal care, provided by family members, neighbours, friends, and hired personnel by the families, in maintaining patient safety and well-being, Informal care has been estimated to have an economic value equivalent to 50-90% of the overall cost of long-term care across the European countries. In spite of the alteration towards home-based care, the existing patient safety literature remains focused on formal institutions, creating a major gap in patient safety within the unregulated home care environments.

2026-01-01T00:00:00Z Buttigieg, Sandra C. Soares, Ana Luísa Bak, Bartosz McFadden, Sonya Hughes, Ciara McClure, Patricia Couto, Jose Guilherme Bravo, Isabel https://www.um.edu.mt/library/oar/handle/123456789/148438 2026-08-07T08:52:26Z 2026-01-01T00:00:00Z

Title: Beyond the hospital walls : integrating clinical wisdom and global equity into the circular economy healthcare paradigm - a response to recent commentaries Authors: Buttigieg, Sandra C.; Soares, Ana Luísa; Bak, Bartosz; McFadden, Sonya; Hughes, Ciara; McClure, Patricia; Couto, Jose Guilherme; Bravo, Isabel Abstract: The publication of our foundational analysis, “A Review of the Applicability of Current Green Practices in Healthcare Facilities,” has catalyzed a sophisticated dialogue that transcends operational efficiency. This commentary is a collective insight that fundamentally shifts our strategic focus from mere green practices, often paying lip service to the term, to a systemic regenerative ethos, thereby aligning with the Lancet Commission’s assertion that the climate crisis represents the greatest global health opportunity of the 21st century. It is a response to the six commentaries that are offered by Gan & Kim, Wu & Liang, Weimann, Zanobini et al, von Eiff & von Eiff, and Esmaeili, which constitute a rigorous international scholarly peer review. Our purpose here is to synthesize these diverse perspectives into a cohesive roadmap for future health policy, bridging the gap between theoretical frameworks and actionable realities of healthcare leadership, so as to achieve a revolutionary shift to an environmentally friendly health sector.

2026-01-01T00:00:00Z