Background and context: Resource planning is performed ahead of time within outpatient clinics (OPC). Due to local control of operations (department-centric decision-making) and limited resources, OPCs cannot handle high variability and uncertainty in demand. There is always a difference between planning and reality, and this leads to operational problems such as excessive waiting times. The OPCs often react to the situation when problems are encountered and reaction times play an important role in determining patient waiting times. Objectives: To propose a predictive resource planning that incorporates variability in the short term with the OPC-wide perspective, not department-centric. Methodology: The process and patient data were collected from the OPC under study by observation, interviews and from the records of the hospital management information system. A resource planning model (RPM) was developed that matched resources according to demand in short term. A mathematical model with outputs resource plan for a day was formulated utilizing Takt time (the average time a patient needs to move out of the OPC system) management that is used in Toyota Production System (TPS), to allocate resources to all the departments. Using a Discrete Event Simulation Model,

Purpose -The purpose of this article is to provide an analysis of quality management using the Malcolm Baldrige National Quality Award Criteria (MBNQA) criteria in a 300-bed hospital in South India. Design/methodology/approach -Based on Malcolm Baldrige National Quality Award (MBNQA) criteria in-depth interviews are conducted with the heads of the departments in the case hospital. Data is analysed and compared with the MBNQA points to evaluate the performance of the hospital in all the seven criteria's of MBNQA. Findings -The paper presents the strengths and opportunities for improvement through MBNQA criteria. The total points scored are 753 out of 1,000 points. This reveals that quality performance of case hospital is of higher level. However among all the seven criteria, the hospital has still more opportunity to improve the quality in MBNQA criteria no. 4, i.e. measure, analysis and knowledge management. Research limitations/implications -This study brings out a potential area of research about how the ratings and activities in the case hospital compares with other health care organisations. Practical implications -The outcome of this paper clearly indicates that MBNQA criteria act as a powerful tool to analyse the quality performance of the hospital. The health care organisations can use MBNQA as self-assessment tool to evaluate and to improve the health of the hospitals. MBNQA as self-assessment tool help the hospitals to lay the road map for world-class performance. Originality/value -The paper illustrates the measurement of quality performance through MBNQA to the healthcare administrators that is the first step for managing and improving quality in health care organisations. It provides lessons for those hospitals that have already started quality initiatives.

BackgroundIt is universally accepted that primary healthcare is essential for achieving public health and that assessment of its performance is critical for continuous improvement. The World Health Organization’s (WHO’s) framework for performance assessment is a comprehensive global standard, but difficult to apply in developing countries because of financial and data constraints. This study aims to review the empirical literature on measures for Primary Health Centre (PHC) performance assessment in developing countries, and compare them for comprehensiveness with the aspects described by the WHO Framework.MethodsResearch articles published in English scientific journals between January 1979 and October 2016 were reviewed systematically. The reporting quality of the article and the quality of the measures were assessed with instruments adapted for the purpose of this study. Data was categorized and described.ResultsFifteen articles were included in the study out of 4359 articles reviewed. Nine articles used quantitative methods, one article used qualitative methods exclusively and five used mixed methods. Fourteen articles had a good description of the measurement properties. None of the articles presented validity tests of the measures but eleven articles presented measures that were well established. Mostly studies included components of personnel competencies (skilled/ non-skilled) and centre performance (patient satisfaction/cost /efficiency).ConclusionsIn comparison to the WHO framework, the measures in the articles were limited in scope as they did not represent all service components of PHCs. Hence, PHC performance assessment should include system components along with relevant measures of personnel performance beyond knowledge of protocols. Existing measures for PHC performance assessment in developing countries need to be validated and concise measures for neglected aspects need to be developed.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3423-0) contains supplementary material, which is available to authorized users.

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ObjectiveTo assess the impact of Spirulina Chikki supplementation on the nutritional status of children (6 months−6 years).DesignA cross-sectional study design was adopted to assess the changes in nutritional status among the children (after 12 months of intervention period). The bassline and endline assessment were carried out from September 2020 to August 2021, respectively.SettingTotal 106 villages (108 Anganwadi Centers in nine circles) from Tumkur District were covered.MethodsChildren aged 6 months−6 years were the study subjects. Anthropometric measurements viz., height, weight, and mid-arm circumference were collected from total 971 and 838 children during baseline and endline assessments correspondingly. The information on children's health and nutrition status was gathered from the mothers of sampled children. WHO's Anthro and AnthroPlus software were utilized to estimate the anthropometric measurements (Stunting, wasting, and underweight) of study participants.ResultsThe study found apparent disparities in the prevalence of stunting, wasting and underweight among the male and female children. There was a significant decline viz., 4% (28.6%-baseline to 24.5%-end line) in the prevalence of severe wasting. Also, severe stunting dropped by 6% at end line (30%-end-line to 24%-baseline). Improvement in nutritional status was evident among both female male children in all three indicators stunting, wasting, and underweight. Mid-upper arm circumference (MUAC) measurement shows substantial improvements from baseline to end line: SAM (5.3–0.6%), MAM (23–9%), and normal (72–91%). The study discloses significant improvements in the nutritional status among those children who consumed spirulina chikkis/granules for a longer duration viz., 9–10 months as compared to those who consumed for lesser duration.ConclusionsFindings reveal improvement in nutritional status among the beneficiaries who consumed spirulina chikki/granules as per the recommended quantity (amount) during the intervention period. Post intervention, spirulina chikki supplementation for nutritional intervention is implied to address large scale malnutrition among young children.