Category: Nursing Home

Creating a positive change in people’s lives is what I want to accomplish. Child nursing is a career that fulfils this drive. Coming from a large family and being one of the oldest children, I have grown to love helping others and empathizing with their problems, I feel that nursing is a career that reflects this. Growing up with a deaf brother with learning difficulties, I have seen my mother be his carer, this sparked my interest in working with young people, and it gave me an insight into what it would be like to work with children with additional needs. The dedication and consideration of child nurses go beyond just wanting to treat patients. I gained curiosity in child nursing when I attended an open day, it allowed me to get an awareness of what the course offers, there is a combination of both academic studies and clinical placements, which I believe is perfectly suited to me.

I knew that this would be the ideal course for me. I am a very hands-on type of person but I understand people’s boundaries and find it very easy to connect with new people. I think this is an important quality to possess, as nurses encounter new people each day. I volunteered at a nursing home for elderly people, and since working there I discovered a lot about how every patient is different, being alert is key, and working in a team is tremendously important. Volunteering in an elderly nursing home helped me to choose to specialize in child nursing. I felt more fitted to the role due to my time working with the school nurse, at a primary school as part of my work experience in secondary school. Shadowing the nurse gave me an insight into what it was like dealing with younger children. During this time, I learned that every child has a different way of communicating with the school nurse, and working with younger people I felt myself connecting well with the children. I also carried out a week of work experience in a nursery, I was working with children aged 0-5 years old at this placement I would play with the children as well as help prepare food and supervise them.

Within all three of the placements, I worked with a variety of people both children and adults all from different backgrounds broadening my understanding of how to manage their individual needs. This placement gave me the understanding and knowledge I needed to know about working with very young children.

Currently, I am studying BTEC business, this course has taught me how to deal with people in a working environment, which is a vital quality to have as a nurse. I was employed part-time as a till operator at Tesco, it allowed me to speak to new people and allowed me to develop many new skills that I feel would help me with my future career as a nurse. I also mastered the skill of maturity and responsibility, as I was a prefect in my final year of secondary school. Tesco helped me to improve my teamwork working skills, communication skills and made me able to deal with difficult situations.

As well as volunteering part-time at an elderly home, I thoroughly enjoy performing arts and it has been a hobby of mine since I was a child. I am actively involved in all my school shows which include singing, acting, and dancing. It helped me to build my confidence as I was performing in front of large crowds. Having a hobby, which is very different from nursing I, feel will help me to have a balance between social and work life.

My plans for my career are ultimately to work for the NHS as a pediatric nurse, I understand that there are also many challenges involved in child nursing, it is an extremely demanding career. However, I am determined to not let this get in the way as the benefits would be rewarding. I see myself using the skills I have and the ones I will develop at university to help improve the quality of people’s lives.

The following paper is a critique of an article describing a qualitative study aimed at assessing the satisfaction amongst different stakeholders, including seniors, family members, facility managers, and hospital or community care coordinators, regarding a transitional program whereby seniors are kept in the community while they are awaiting admission into a public long-term care facility. The article is designated “Living in the Community While Waiting for an Admission in Long-term Care: Satisfaction with a Transitional Nursing Home Project” by Diane Morin et al. and was published in the Journal of Nursing Care Quality (January-March 2007). This paper is aimed at critically evaluating all the sections of the aforementioned article, including the title, abstract, introduction, methodology, results, and discussion, highlighting the strengths, weaknesses, and limitations, and provides suggestions for improvement when required.

Title

This article is entitled “Living in the Community While Waiting for an Admission in Long-term Care: Satisfaction with a Transitional Nursing Home Project.” This title adequately describes the study and its purpose, although it does not specify the study population sufficiently. This title could have been improved by the mention of the study subjects, i.e., the various stakeholders involved. The keywords of the title include ”Satisfaction”, ”Nursing home” and ”Transitional”, and they are appropriately chosen as they appropriately address all aspects of the study. The title is also precise and to the point and helps in arousing the interest of the readers.

Abstract

The abstract provided is precise and summarizes the study’s objectives, methodology, and important findings. The abstract does mention the dependent variable of the study viz. satisfaction with the transitional program; it does not, however, mention and discusses the various dimensions of the dependent variable that were measured in order to assess satisfaction. The abstract also doesn’t identify the independent variables of the study, including the characteristics of the study group such as age, gender, comorbid, etc., and their influence on the dependent variable. Moreover, while discussing the results, the abstract only mentions that variation amongst satisfaction between different groups was observed with the greatest satisfaction amongst seniors. It does not point out that the least satisfied group was found to be the hospital and CSSS coordinators. Despite these limitations, the abstract does provide enough information to generate interest amongst readers and to keep them reading the article.

Introduction

The introduction to the study clearly identifies the study question and provides adequate background to it. One limitation, however, was that the magnitude of the problem was not defined clearly. The authors should have included recent statistical and epidemiological figures regarding the number of seniors currently facing the problem of having to wait for bed availability in long-term care facilities i.e., being ”bed blockers”, the demand of the services required, the facilities currently available the gap between these two. This would have helped in not only arousing the readers’ interest but would have also highlighted the enormity of the problem and thus the significance and rationale of conducting the study. Based on the information provided in the introduction, it is difficult to establish whether the problem is significant enough to warrant the study that was conducted. The introduction provides satisfactory theoretical rationale and conceptual framework, which is backed up by previously conducted studies quoted in the literature.

It clearly mentions the operational definition of the study variable of satisfaction and how it was evaluated based on the five most pertinent dimensions including perceived technical competence and interpersonal skills, continuity and accessibility of care, cost and adequacy of the physical environment (Bond, 1992 cited in Morin, 2007). The confounding factors and the limitations of the previously conducted studies are also addressed. The authors point out that most previously conducted studies have focused on the clients’ views regarding satisfaction and this is subject to bias. Using this background, the researchers have clearly defined their study objective viz. evaluating the satisfaction perceived by different stakeholders involved in the transitional program serving the purpose of keeping the seniors in the community while they are awaiting admission into a long term care facility. By including all the stakeholders in the study population, the researchers aimed at overcoming the limitations present in studies previously conducted. Overall, the introduction provides sufficient background about the rationale and purpose of the study and leads logically into the methodology. There are albeit certain limitations: the research hypothesis is not clearly mentioned, and also it is not identified that once the satisfaction is assessed, what purpose will it serve and what will be the implications of this research.

Methodology

The methodology section clearly describes the study design, i.e., qualitative study, the sample size (ninety nine), the study subjects and their characteristics and the inclusion criteria for the different study groups. The exclusion criteria and whether the participants were offered any reimbursement for participation in the study is not mentioned. The data collection procedure is not adequately discussed. The Questionnaires/interview questions employed for the assessment of satisfaction, their contents and the time duration required for each interview should have been clearly discussed. The methodology also lacks relevant information on the psychometric properties, including the sensitivity, specificity reliability and validity of the satisfaction assessment tools and whether these tools have been pre-validated and tested in this particular population under study. The methodology section does describe the scientific procedures in chronological order but requires but in addition to the aforementioned shortcomings, requires a better description of the analysis section, including which statistical tests were applied and what outcome variables were calculated for categorical and descriptive variables. Although the study design and procedure is appropriately chosen keeping in view the study question and objectives, the methodology section does not provide sufficient information on various aspects of the study and thus cannot be replicated or used as a guide for future studies of similar sort.

Results

The result section is well structured in that the important results for each subgroup of the study population are summarized in different sections. However, there were certain shortcomings. The means and standard deviations for descriptive statistics such as the demographic features and the dependent variable, i.e., satisfaction and certain variables, such as the response rate, are not stated. Moreover, the results could have been presented in a more organized way by the use of tables. The results are pertinent to the study question and state that that satisfaction varied among different subgroups, with the seniors being most satisfied and the hospital and CSSS coordinators being least satisfied. However, the strength of these findings could have been improved by stating the magnitude of the difference between the various groups and their statistical significance using p-values.

Discussion and Conclusion

The discussion adequately addresses the pertinent findings, their importance and their congruence and consistency with previously conducted studies. The limitations of the study and its utility for future research, since this study is the first of its kind in addressing all the key players involved, are also pointed out, but the practical implications of the findings in clinical practice are not discussed. The authors should have discussed how the issues that were identified and the factors contributing towards dissatisfaction amongst different subgroups of the study population could be modified and what measures would be undertaken in order to improve the existing program of transitional accommodation of seniors in private nursing homes. The conclusion effectively summarizes the pertinent study findings, their usefulness, and the authors recommendations based on these findings.

Reference List

The references were appropriately cited throughout the text. This article was published in 2007 and the most current reference used by the author was 2004 (Morin, 2007 p. 72). Moreover, further literature search on the previously used assessment tools for satisfaction with emphasis on subgroups other than the seniors, i.e., the family, the private facility owners and managers and the hospital and CSSS coordinators, could have been undertaken. Therefore, the reference list had the limitation of not being extensive and sufficiently current.

General Impression

Overall, this article is fairly well written and organized. The study is unique in that it’s the first one of its kind which assesses satisfaction with the transitional accommodation of seniors in private nursing homes amongst all the key players and stakeholders viz. the seniors, the family, the private facility owners and managers and the hospital and CSSS coordinators. This study is also important because the problem it addresses, i.e., the accommodation of senior citizen in a transitional private facility while they are awaiting admission in a long-term care facility, is significant in today’s society and intervention in order to overcome the burden on long term public facilities is imperative. Certain limitations of this study include a lack of appropriate statistics to highlight the significance of the problem, a weak methodology and lack of appropriately used statistical tests to quote the results. Therefore, this study could have been improved by a more extensive discussion of the methodology especially data collection procedure including the questionnaires/interview questions employed for the assessment of satisfaction, their contents and the time duration required for each, use of appropriate statistical analysis and tests and strengthening the results by the use of means, standard deviations, p-values, etc.

References

Bond S, Thomas LH. (1992) Measuring patients’ satisfaction with nursing care. Journal of Advanced Nursing; 17:52-63.

Morin D., Saint-Laurent L., Dallaire C., Boucher-Dancause G., Lalancette S. & Leblanc N. (2007). Living in the Community While Waiting for an Admission in Long-term Care: Satisfaction with a Transitional Nursing Home Project. Journal of Nursing Care Quality, Vol. 22, No. 1, pp. 66-72.

Introduction

Fernhill nursing home is one of the eighteen nursing homes that are owned and run by Colten Care Limited. It specializes in caring for people with dementia. The elderly form the better part of this group of people although there are some younger persons who suffer the same.

Currently I am working as a full time staff nurse, working night shifts providing general nursing care and doubling up as the team leader for the team of caregivers. This paper will give an overview of the nursing home and my position as a staff nurse working in the home.

An overview of the home’s service delivery

At Colten Care our work is to care for people and therefore we put an emphasis on “Quality of Life”, in all our nursing homes. We understand that we are dealing with different individuals and they have diverse needs. The staffs here are trained to give high quality and personalized care to every resident.

Dignity, independence and privacy of individuals is upheld and maintained within a social setting that provides a warm atmosphere and the needed care. Fernhill specializes in caring for people with dementia and these people are particularly sensitive to how they are treated and their needs keep on changing; here at Fernhill we do our best to give the residents the best.

Our conduct is guided by the NMC professional code of conduct, the Care Standards Act 2000 and the Care Home Regulations 2001 and Colten Care’s policies.

Our commitment is caring for people and we do this by a combination of factors meeting the requirements of the elderly (Elderly Care 1997) which include giving personalized care and services to all, providing a variety of pass time activities which include games, trips and entertainment among others; these are well organized by our activities organizers, first class meals prepared by qualified experienced chefs are provided and a clean hygienic environment in our quality built home.

My position and role at the home

As a team leader, I have to guide my team in our day to day activities by active participation and delegation of duties. Staff management for my team is my responsibility; and of course I am a nurse so my basic role is providing general nursing care to the residents and any other role that might be allocated in compliance with my profession.

I am also expected to carry out my duties professionally as guided by the NMC professional code of conduct, the Care Standards Act 2000 and the Care Home Regulations 2001 and Colten care’s policies. Here is a general overview of my professional and managerial duties associated with my position.

I have to ensure that each resident has his/her needs assessed individually and that the care plan is updated with reference to any special needs or interventions and reviewed in line with the home’s policy.

With these details I have to ensure that the care given to residents is of highest quality and personalized as per individual needs. In the event that the matron manager and/or the deputy matron head of care are absent I have to sit in for them and be in-charge of the home.

My individual development must always be evidence based and this means I have to attend statutory and other training sessions as per my professional requirements ensuring that my personal development is always evidenced. Administration of medication is done according to Colten Care’s Policies and these adhere to the NMC Code of Professional Practice and the NMC Guidelines for Administration of Medication.

It is my responsibility to ensure that this is done right together with keeping accurate records of this and other procedures. It is also my responsibility to organize visits by doctors, social and health workers as may be necessary after careful consultation with them. As a nurse I have to participate fully in the nursing care procedures, attend meetings and offer my contributions towards the company’s well-being.

Being the team leader I have managerial responsibilities over my team. These include; job supervision, effective communication and management of care staff, visiting staff or any other member of staff to ensure highest quality care to the residents. Also acting as an assistant to the Deputy Matron/ Head of Care in identification of care staff’s individual strengths and weaknesses and take necessary actions is part of my duty.

I am responsible for my own safety and that of others and this I do by identifying possible hazards and taking corrective action like reporting it to the person in-charge; and perform any other duties that might be assigned to me. Managerial skills come in handy in such instances.

To be able to take up the leadership role and produce high quality results requires such skills. For instance, effective communication and team building ability are key factors to success of any team. We have to work as a team if we have to provide the quality care needed by our clients; and as a leader you have to be extra vigilant.

Conclusion

Everybody needs a high quality fulfilling life despite their age, gender, race or even health and mental statuses Colten care limited is doing a great job in providing the care that is needed to give people with special needs such as the elderly this kind of life. Here at Fernhill, with the great multidisciplinary experience of our staff we offer the best care possible to the elderly.

Reference

Elderly care: Educating you about senior care options 1997. Web.

Nursing home care for the elderly has been a common practice in the US for many years. Normally, this practice has proved to be a beneficial intervention to many people who are in constant need of special care and treatment, once they have entered their golden years.

The practice also serves as a big relief to many families who may often find themselves tangled in great dilemma on how to best cater for either both or one of their parents who is not able to live independently, as a result of advanced age. Moreover, it is in the best will of the US government to administer special medical concern on the aging generation as it has been constituted in the health regulations.

Bearing the above concerns in mind, home care for the elderly is a necessary intervention in USA and it has always been a welcomed idea in all the states. However, no matter the overall benefits associated with nursing care, there have been great concerns recently, following increased hospitalization of residents of nursing homes (Feder and Komisar, 2005). Oftentimes, this has resulted into numerous hospitalization complications for the patients and unnecessary health care expenditures that have amounted into billions of dollars.

This concern has triggered a number of multifaceted strategies and policy measures that are likely to prevent unnecessary hospitalization of nursing home residents, thus helping to address the current incentives associated with the practice. One such approach which has proved to be promising in addressing this matter is INTERACT.

INTERACT, which is an acronym for ‘Interventions to Reduce Acute Care Transfers’ is a special program of improvement whose main focus and mission is to take care of acute change in the condition of home care residents in the US. As it would be observed, the main objective of this program is to establish desirable care conditions in nursing facilities, thus minimizing the frequency of avoidable hospitalization of home care residents.

These frequent but unnecessary hospitalizations have raised conflicting financial conflicts between Medicaid and Medicare, the two bodies involved in providing for nursing homes and hospital services, respectively. This however, has been observed to be as a result of inadequate or even lacking health care facilities within many nursing care homes. Some of these facilities would include radiology services, on-site pharmacies and well-trained staff in matters of health.

INTERACT comes with educational and clinical tools, among other key strategies that would be necessary in addressing the recurring health issues associated with long-term care institutions (Loeb and Carusone, 2008). Through these interventions, INTERACT has proved to be able to identify and manage health conditions before they can reach stages that necessitate hospital intervention.

This policy measure can be an effective intervention in helping to reduce unnecessary hospitalization of patients from long-term care facilities. According to recent studies on proposed interventions that have been designed with the aim of minimizing avoidable hospitalizations of nursing care residents, INTERACT has proved to be promising in all settings.

However, just like any other realistic strategy, this intervention has its own limitations and disadvantages. One of the biggest limitations associated with the program is that, it is yet to be fully accepted by many nursing home residents, as an effective strategy that could be used to address most of their seemingly complex health problems.

Most people who have entrusted their loved ones in the care of nursing care facilities would prefer hospitals to be the most promising intervention when it comes to the health of their elderly loved ones (Kayser-Jones and Wiener, 1999). Another possible limitation of this intervention is that, it is known only in some states and it is yet to be established in many nursing homes across the country.

Publicity of INTERACT as a program having the necessary infrastructure and leadership commitment in health care matters for the elderly is one promising way that can be used to overcome these issues. The other possible way to deal with the limitations of the program in its services is to advocate for its acceptance by taking it into every corner of the country where it is needed by nursing care residents.

References

Feder, J. and Komisar, H. (2005). Long-term care in the United States: An overview. Health Affairs, 19 (3), 40-56.

Kayser-Jones, J and Wiener, C. (1999). Factors contributing to the hospitalization of nursing home residents. The Gerontologist, 29 (4), 502.

Loeb, M. and Carusone, S. (2008). Effect of a clinical pathway to reduce

hospitalizations in nursing home residents with pneumonia. JAMA: The Journal of the American Medical Association, 295 (21), 2503.

Organizational assessment is required for any change project – it is the foundation on which such initiatives are built. During the evaluation process, the nurse leader identifies the problems in the organization and determines the strong and weak points, resources, gaps, and other factors that determine how the project will develop. Therefore, a needs-based assessment has to include internal and external data gathering and analysis. In the proposed DNP project, the practicum site is a rehabilitation center and nursing home. It serves patients with many conditions and a high rate of diabetes and prediabetes, which is directly related to the DNP project practice change.

To start the assessment process, one must identify the needs of the particular organization. During this step, one collects data about the organization to determine its current performance, culture, processes, and problems (Harrison et al., 2022). For example, a clinic may have outdated practices or not have prevention and education services for a common health issue among its patients. This discrepancy between the current practice and potential improvement becomes an area of opportunity. Next, using the gathered data, one has to identify the leadership styles of the organization to see which approaches are the most effective when implementing change. Furthermore, one may also determine the organizational climate, communication channels, and culture to see how people share and receive information (Miake-Lye et al., 2020). These steps are necessary to plan an effective intervention that suits the facility’s needs.

The following step is finding the stakeholders – people affected by the change project and those who can play a role in its implementation. In the case of nursing change projects, stakeholders are often nurses, including leaders and administrators, as well as patients and other personnel (Wu et al., 2019). Their response to and readiness for change are also part of this assessment. Based on this data, one may choose an appropriate change theory or framework to achieve the best results and adequately prepare for resistance to change.

In the proposed DNP project, the change is concerned with introducing a new educational and support program for patients with diabetes. It is focused on providing people with information and resources to reduce their blood glucose levels through learning about self-management and lifestyle changes. Therefore, one may see several ultimate goals for this project. The first one is to improve the participating nurses’ knowledge about self-malmanagement programs and implement a new way of helping patients deal with type 2 diabetes. Second, this DNP project aims to combat problems related to diabetes in patients, leading to a better quality of life and health outcomes.

The organization under review combines rehabilitation and nursing services. Its mission is to provide care of excellent quality, grow as a professional facility, and create an environment of integrity and kindness. The DNP project’s goals correspond to this mission, as it is also based on such values as quality care and excellence. Improving the programs the organization offers to patients with diabetes may result in better patient outcomes and improve patients’ quality of life. The results of this intervention will demonstrate whether such programs can help individuals with diabetes to self-manage their condition and create another opportunity for the organization to grow as a local leader in the industry.

Overall, organizational assessment is an integral part of change projects. It is impossible to determine knowledge and practice gaps without researching the current state of services and operations at any business. Therefore, the evaluation of a facility should include data gathering and analysis, stakeholder analysis, leadership and communication appraisal, and change model choice. The proposed DNP project aims to introduce a practice change that will improve diabetes self-management and patient outcomes. These aims align with the organization’s values because they are concerned with the quality of care and organizational growth.

References

Harrison, R., Chauhan, A., Le‐Dao, H., Minbashian, A., Walpola, R., Fischer, S., & Schwarz, G. (2022). Achieving change readiness for health service innovations.Nursing Forum, 2022, 1-5. Web.

Miake-Lye, I. M., Delevan, D. M., Ganz, D. A., Mittman, B. S., & Finley, E. P. (2020). Unpacking organizational readiness for change: An updated systematic review and content analysis of assessments.BMC Health Services Research, 20(1), 1-13. Web.

Wu, J., Wang, Y., Tao, L., & Peng, J. (2019). Stakeholders in the healthcare service ecosystem. Procedia CIRP, 83, 375-379. Web.

Identifying Quality Costs for the Construction

The cost of quality of a product stretches from the preventive expenditure used to minimize failure to those costs involved in maintaining quality levels. Firstly, there will be the inclusion of the appraisal costs (AC) which entails the inspection and measurement of activities when the operation is ongoing to determine their conformity to the required standards (Afthanorhan et al., 2019). Some appraisal costs include testing, inspection, and equipment (Syreyshchikova et al., 2021). Secondly, preventive costs (PC) consist of all activities done before the start of the operations to warrant the good quality and inhibit poor quality services. Preventive costs include training, quality improvement teams, and process reviews (Sousa and Nunes, 2019). Thirdly, the construction of the dementia nursing home will involve internal failure costs (IFC), which entail all the expenses incurred to cater to the defects identified before product delivery (Mills et al., 2020). For instance, a product may warrant re-inspection and re-testing before delivery. Lastly, the construction will involve external failure costs (EFC) incurred after a customer gets the products or services. These quality costs have been tabulated in Table 1 of the following section.

Calculating the Estimates

Cost of Quality= PC+AC+IFC+EFC

Table 1. Estimates of Quality Costs Involved in Dementia Nursing Home Construction

The grand total in the above table represents the cost of quality involved in the construction. The reason is that:

• Grand Total= AC+PC+ Failure Cost (IFC and EFC) = Cost of Quality

Therefore, the cost of quality, in this case, would be $244,300 for a fully working dementia nursing home.

Cost of Quality Involved in Insufficient Quality Management Staff

For a business to attain prosperity, a quality management system must sustain its economic relevance in the market. Therefore, the quality management staff is important as it helps the business see that key organizational principles are not overlooked (Prístavka and Krištof, 2018). These include; strong leadership, customer focus, people’s involvement, system approach, process approach, factual decision making, continuous improvement, and improving the value of the company, the suppliers, and its clients (Ghayour and Dehghan, 2021). The lack of quality management staff leads to a lack of these important elements (Balouchi et al., 2019). Poor quality products and services often lead to customer dissatisfaction, leading to decreased customer loyalty and hence loss of revenue by the business.

Cost of Quality Involved when Offering Services without Customer Expectation Survey

Cost of quality is when the management fails to deliver according to customers’ expectations. It refers to the losses the organization may incur if its deliveries do not match the customer’s expectations (Amado et al., 2022). Some of them include; that they are most likely to lose their customers because, in this case, the customer’s expectations will not match the services delivered to them (Al-hamad, K.S., and Abdul-Sattar, 2022). At some point, they might ask for compensation for the losses they might have made in the process (Obaid et al., 2019). Some decide to do business elsewhere where the deliveries match their expectations (Castro et al., 2019). It might also lead to a loss in potential customers since they might come across people complaining about that organization’s ignorance of the customer expectations (Huckfeldt et al., 2018). A customer expectation survey ensures they understand that the survey is about them and that they know how important their feedback is to you (Feng et al., 2019). It is used to measure whether your services satisfy your customers and help them achieve success.

Reference List

Afthanorhan, A., Awang, Z., Rashid, N., Foziah, H. and Ghazali, P. (2019) ‘Assessing the effects of service quality on customer satisfaction’, Management Science Letters, 9(1), pp.13-24.

Al-hamad, K.S. and Abdul-Sattar, R.R. (2022) ‘Relationship Analysis between Mass Customization and Rationalized Quality Costs’, Journal of Madenat Alelem University College, 14(1), pp.228-237.

Amado, G.C., Ferreira, D.C. and Nunes, A.M. (2022) ‘Vertical integration in healthcare: What does literature say about improvements on quality, access, efficiency, and costs containment?’, The International Journal of Health Planning and Management, 37(3), pp.1252-1298.

Balouchi, M., Gholhaki, M. and Niousha, A. (2019) ‘Prioritizing the Main Elements of Quality Costs in Design-Build Mass-Housing Projects’, Civil Engineering Journal, 5(5), pp.1136-1146.

Castro, G.R., Nariño, A.H., Crespo, M.I.G. and Bango, M.A.G. (2019) ‘Procedure for quality costs assessment in health care institutions of Matanzas’, Business Informatics, 15(30), pp.1-12.

Feng, T., Ren, Z.J. and Zhang, F. (2019) ‘Service outsourcing: Capacity, quality and correlated costs’, Production and Operations Management, 28(3), pp.682-699.

Ghayour, F. and Dehghan, K. (2021) ‘The Impact of Quality Costs on Brand Equity Considering the Mediating Role of Green Innovation in Tehran Stock Exchange’, Accounting and Auditing Review, 28(4), pp.691-712.

Huckfeldt, P.J., Weissblum, L., Escarce, J.J., Karaca‐Mandic, P. and Sood, N. (2018) ‘Do skilled nursing facilities selected to participate in preferred provider networks have higher quality and lower costs?’, Health services research, 53(6), pp.4886-4905.

Mills, A., Sorensen, A., Gillen, E., Coomer, N.M., Theis, E., Scope, S., Beadles, C. and Quraishi, J. (2020) ‘Quality, costs, and policy: Factors influencing choice of anesthesia staffing models’, Journal of Healthcare Management, 65(1), pp.45-60.

Obaid, A.M., Al Dulamy, JAAA, AL-Furat, A.L. and Muter, K.J. (2019) ‘The impact of integration of quality costs and targeted cost in achieving a competitive advantage: a perspective from hospitality’, African Journal of Hospitality, Tourism and leisure, 8(5), pp.159-168.

Prístavka, M. and Krištof, K. (2018) ‘Evaluation of quality costs in the production organization’, Manufacturing Technology, 18(3), pp.466-476.

Sousa, S. and Nunes, E. (2019) ‘Integrating quality costs and real time data to define quality control’, Procedia Manufacturing, 38, pp.1600-1607.

Syreyshchikova, N.V., Pimenov, D.Y., Kulygina, I.A. and Moldovan, L. (2021) ‘Hybrid Model for Calculating Quality Costs’, Russian Engineering Research, 41(4), pp.382-386.