https://www.um.edu.mt/library/oar/handle/123456789/63336 Sat, 25 Apr 2026 13:18:16 GMT 2026-04-25T13:18:16Z https://www.um.edu.mt/library/oar/handle/123456789/47835 Title: Addressing quality improvement in community speech-language clinics. Abstract: Purpose of the study The local health Authorities and in general the administration of Health provision in Malta envisage the importance of the development of adequate mechanisms to monitor and audit services provided (Azzopardi-Muscat, 1999). Being part of the Health Department, the Speech Language Department (SLD) needs to adhere to these policies too. The aim of this research is to study the perceptions about aspects of quality from the customers (patients/carers) point of view, Speech Language Pathologists (SLPs) and Management of the SLD and provide recommendations for the development of quality assurance within the community Speech Language Services. Background Donabedian (1980) explained that in Health Services the interaction of service users and providers highlighted the importance of: Accessibility, Inter-personal interaction, technical management and continuity, these are further divided into structure, process and outcome. Research Questions The following questions were investigated +:+ What is the current status of performance and how could this, through quality assurance, lead to a more effective and efficient service? +:+ Which are the important standards for Speech and language serVIces in the community to develop quality improvement? Data was collected by diverse qualitative research techniques (by triangulation). Semi-structured interviews were carried out with personnel in administration of the SLD and 16 service users whilst 3 focus groups carried out with 15 SLPs. Analysis The 3 categories of participants defmed quality in various ways, for clients quality meant: professionals provide services and their condition improved. Staff saw quality as having standards which are followed resulting in satisfied clients. Management considered the availability of resources which are used in an efficient and effective way for client satisfaction. Accessibility: Clients consider physical and geographic accessibility and flexibility of appointments important whilst staff and management consider communication and the environment as facilitating accessibility. Conflicting views emerged on initial appointments and opening hours although satisfaction was expressed together with possible unexpressed dissatisfaction due to missed appointments. In technical Management it was indicated that there were insufficient premises with poor environmental conditions in some places. Staff claimed the need for continuous professional development. Unawareness of the Quality Service Charter by service users was evident, they expressed satisfaction and refrained from placing complaints. For the interpersonal process, Management asked for respect from authorities, staff wanted more manageable caseloads and users requested more involvement. Participants expressed the need for a complaints system and other policies. Continuity was reported to be maintained by a primary service provider system and users recognized service as important and recommendable. Missed appointments were considered by management and staff as a major deterrent to continuity and waste of resources. Conclusions and recommendations Implications for management are that: the QSC needs to be re-evaluated and developed further to satisfy basic requirements. Policies need to be developed to regulate aspects of service deliver and clinical practice. These include policies on admissions and discharge, staff monitoring, and continuous professional development. The setting up of a Structural Changes Steering and Action Committee is recommended to take responsibility of the problems related to structural issues. Setting up of a customer care unit involved in developing and carrying out internal and external customer satisfaction monitoring. MSc. Health Services Management August 2003 Key words: Perceptions of quality Community Speech Language Services Quality improvement/assurance Description: M.SC.HEALTH SERVICES MANGT. Wed, 01 Jan 2003 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/47835 2003-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/45277 Title: Developing a quality service charter for the radiology department. Abstract: This research was designed to gather consumers' opinions together with providers' views regarding the services provided by the Radiology Department. Obtaining such information is the first step towards the development of a Quality Service Charter. A Quality Service Charter is an organisation's written commitment of a quality service to its customers. Quality Service Charters thus ensure that a culture of public accountability is in place in the organisation. As yet, no such charter for the Radiology Department at St. Luke's Hospital, Malta, exists. This study was conducted using a patient satisfaction survey, personal interviews with referring clinicians, a focus group interview with Radiology Department staff, and interviews with the manager and the director of the department. The results demonstrated that patients are generally highly satisfied with the services provided by the department, except for the issues of waiting time and waiting lists. Referring clinicians tend to be less satisfied, the main reason given being the inadequate quality of reporting. Radiology Department staff acknowledge that problems with customers exist but do not feel empowered to introduce any effective changes to improve the service quality. These results are comparable to similar findings presented in the literature review. The main recommendations based on the findings propose organisational changes that need to be introduced in the department before the implementation of a Quality Service Charter. Description: M.SC.HEALTH SERVICES MANGT. Wed, 01 Jan 2003 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/45277 2003-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/45187 Title: The feasibility of introducing user charges at Zammit Clapp Hospital. Abstract: Economic, demographic and technological pressures have led to increased demands upon health services and the need to contain spending on healthcare. Like other developed countries, Malta is facing pressures of sustaining escalating healthcare costs. The purpose of this management project was to explore the perspectives of stakeholders regarding the concept of charging users for public healthcare services and the feasibility of introducing user charges for services provided to inpatients at Zammit Clapp Hospital (ZCH). A combination of qualitative and quantitative methods was utilised. Interviews were carried out with a representative of a non-governmental organisation and six key informants at corporate level in the fields of health policy, social servIces, finance, economics, and hospital management. Structured questionnaires were collected throughout March 2003 from 106 in-patients (n=139) and from 101 of their informal carers who were recruited on informed consent and set inclusion criteria. Patients and carers were asked about charging users for public healthcare services; the willingness to pay part of the cost incurred by ZCH to provide services and knowledge of the daily cost of care. 67% of patients, 58% of their informal carers and all key informants agreed with the concept of paying user charges for public healthcare services. Although 75% of patients and 77% of carers were willing to pay part of the costs of services provided at ZCH, a much lower ability to pay resulted. More than 92% of patients and their carers lacked knowledge of the daily cost of inpatient care. According to interviewees, the current system of funding healthcare was insufficient or created excess demand that would be better rationed if a price were charged. Income-related charges were considered acceptable for most healthcare services. Findings also indicated that the system that would introduce user charges for public healthcare services would have to follow a top-down approach directed by government since it entailed restructuring of the system financing healthcare. As a public hospital, ZCH would therefore have to follow decisions taken centrally related to charging users for services provided. Among options of user charges considered, introducing a charge per bed night for the package of care provided was recommended as the most feasible to implement because of its potential of generating revenue and since it supported equity principles by exempting patients eligible to Free Medical Aid. Preserving social solidarity in terms of equity of access was considered fundamental to the reform process that would introduce user charges for public healthcare services in Malta. Description: M.SC.HEALTH SERVICES MANGT. Wed, 01 Jan 2003 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/45187 2003-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/45069 Title: A study of the requirements for setting up a quality system at a public health microbiology laboratory. Abstract: For a laboratory to be in a position to apply for accreditation, it must develop, implement and maintain a quality system in conformity with the pertinent standard. Most accreditation bodies around the world including the local National Accreditation Body, NAB-MSA, are assessing laboratories seeking accreditation against the requirements stipulated in the international standard ISO/IEe 17025 (1999), also known as ISO 17025. The Public Health Microbiology Laboratory (PHML) was primarily chosen as the subject of this research because of the need for this laboratory to demonstrate competence through accreditation particularly in view of its important role in food control and monitoring of water quality in the Maltese Islands. In addition, it has been proposed by the Government of Malta as the laboratory which should aim for accreditation of its microbiological testing services so as to be recognised as an official food control laboratory once Malta joins the European Union. The PHML laboratory practices were evaluated against the ISO 17025 requirements as at the end of December 2001 and a gap analysis was produced. The evaluation and the gap analysis revealed that the PHML complied with 26% of the standard's requirements, partially complied with 33% and did not comply with 31%. The majority of the partial and non-compliances consisted of the lack of quality system documentation. The remaining 10% of the ISO 17025 requirements were not applicable to the PHML. The actions to be taken by the PHML in order to conform to this standard were subsequently identified and listed. Furthermore, the quality manual, the main document describing the quality system, as well as a number of support quality system documents, i.e. procedures, work instructions and record sheets were developed and documented. It was concluded that according to the findings made until the end of December 2001, a significant number of actions are to be addressed and implemented for the PHML to set up a quality system conforming to ISO 17025 and eventually apply for accreditation. The compiled list of actions and the recommendations forwarded may be used by the management of the PHML as a basis for drawing up an achievable plan of action. In addition, the documentation produced may be integrated with the quality system documents already employed at the PHML and may serve as examples for the other documents to be prepared. Description: M.SC.HEALTH SERVICES MANGT. Wed, 01 Jan 2003 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/45069 2003-01-01T00:00:00Z