The decreasing Australian health dollar requires closer scrutiny on what outcome is purchased for it. Quality outcomes are produced by quality services, it is important to identify the constructs of quality care from individual stakeholders' perspectives. Empirical research on quality constructs is limited to medical and nursing literature. Within Physiotherapy and Chiropractics, little research has been undertaken to examine the constructs of quality care from individual stakeholder perspectives, or to develop monitoring systems that reflect the nature and philosophy of Physiotherapy and Chiropractic care / This research explored and expanded upon current knowledge on the constructs of quality and current quality monitoring standards within Physiotherapy and Chiropractic private sector services in Australia. This research explored individual primary stakeholder perspectives of quality (patients, providers and funders). The study identified factors that acted as barriers and incentives in the provision of quality care. This research generated a model of innovative quality monitoring strategies, which reflected stakeholders' perspectives, and could be utilised across private and public funding sectors / This research utilised a mixed method approach of qualitative and quantitative research paradigms. The main methods comprised of interviews with key stakeholders, surveys of patient's perspectives of quality care and an educational outreach program for providers / The findings highlight the multi-dimensional and multifactorial nature of health care quality and its constructs from the perspectives of different stakeholders. Patients and providers' expectations of quality were congruent and contained quality constructs ranging across structure, process and outcome dimensions. This research identified that patient expectations of quality are underpinned by patient-centred care and effective communication between patient and provider. In contrast, funders' perspectives of quality were unidimensional with predominant emphasis on cost of services. This study found funders' monitoring standards were inadequate in identifying poor practices or providing incentives to improve practice. This research provided ways in which funding agencies could continue to use traditional methods of monitoring (such as costs) as well as employing innovative strategies such as patient perspectives on the quality of care they would receive / This research provides the first known evaluation approach for patients to provide feedback on their expectations of quality of Physiotherapy and Chiropractic services. The unique evaluation instrument is profession-specific and it considers patients' expectations using an episode-of-care model rather than the traditional occasion-of-service model. The findings from the survey of Physiotherapy and Chiropractic patients identified the importance of meeting patient expectations prior to, during, and after, the first occasion-of-service with the provider in the episode, and then at three subsequent service points in the episode / This research identified providers' perspectives of an educational outreach program, which aimed to inform and educate them regarding the quality of care they provided. The findings indicated that providers were genuinely interested in uptake of patient feedback into clinical practice. Numerous dissemination strategies were possible within their practices and within their profession / This explanatory research is the first of its kind in providing foundational research evidence on the constructs of quality within private practice Physiotherapy and Chiropractics from different stakeholders' perspectives. It has also established that patients can be effectively engaged in monitoring quality of care. The findings highlight that patient expectations of quality vary throughout an episode-of-care and this needs to be recognised by other stakeholders in quality monitoring and quality improvement initiatives. The findings from this research can form the basis for future research in examining relationships of constructs of quality across other patient populations with other Allied Health disciplines, and in testing innovative quality improvement initiatives / Thesis (PhD)--University of South Australia, 2005

University of Technology, Sydney. / This overall objective of this research was to identify factors that were important in forming middle managers' attitudes toward quality and quality programs in their organisations. An underlying assumption of the research, supported by the literature, was that a middle manager's attitude toward his/her quality program could be an important indicator of behaviour toward the program e.g. resistance, willingness to be involved. Reviews of the literature on middle management, quality, attitude measurement and research more specifically related to the research topic was undertaken. The work of Ajzen (1988) was particularly useful in devising an overall theoretical framework for the research . A number of hypotheses related to the overall research question were formulated. Twenty-one organisations agreed to participate in the research. These all had a quality program. Some of the organisations were quite advanced in quality, a number had won Australian Quality Awards, others were much less advanced. Organisations were drawn from manufacturing and services in both private and public sectors. Data was collected in two main ways. Firstly, a questionnaire was designed, piloted and distributed to approximately 1100 middle managers in participating organisations. The response rate was approximately 50%. Secondly, in depth interviews were carried out with middle managers, senior managers and quality managers in a number of the participating organisations. The results generally confirm the importance of the middle management group as key to the success of a quality program. Middle managers across all of the participating organisations generally believed that the TQM approach to management was an effective one. Their views on the effectiveness of IS09000 were less positive. Middle managers generally believed that the quality programs were more likely to benefit their organisations rather than to directly benefit themselves, although quality programs did provide some opportunities for some middle managers. Middle managers generally believed that their quality programs provided both operational and strategic benefit for their organisations. Paradoxically, a widely held belief among middle managers was that quality programs did not reduce short term thinking and over-reacting to short term goals. Positive attitudes to quality in the organisation were associated particularly with the values and beliefs that middle managers held regarding: a) program support from top management, from their direct boss and from their colleagues; b) a range of program outcomes for the organisation and c) a range of program outcomes related to the individual middle manager. For middle managers actively involved in their organisations quality program the clarity of their program role was positively related to program attitudes. Training/education in quality was also significantly related to some beliefs and attitudes towards quality and quality programs. Middle managers generally believed that quality programs involved a significant increase in paper work and bureaucracy. However this was not a significant influence on their attitudes toward quality in their organisations. An important finding was that for a wide range of beliefs and attitudes related to quality no significant differences were found between the types of jobs held by middle managers. An exception was the quality specialist group who generally had significantly more positive attitudes and beliefs about quality and their quality programs than did other job categories. Middle managers seemed relatively at ease with most of the changes that were taking place as part of their programs. In particular they had relatively positive views on devolution of responsibility to lower level employees. Middle managers also seemed relatively at ease with their own performance being more tightly monitored with program implementation. The research supported the more optimistic view of middle Management that has been reported recently (e.g. Fenton-O'Creevy 1998). The notion of the middle management still had currency in all of the organisations participating in the research despite the many structural changes that had taken place.

The decreasing Australian health dollar requires closer scrutiny on what outcome is purchased for it. Quality outcomes are produced by quality services, it is important to identify the constructs of quality care from individual stakeholders' perspectives. Empirical research on quality constructs is limited to medical and nursing literature. Within Physiotherapy and Chiropractics, little research has been undertaken to examine the constructs of quality care from individual stakeholder perspectives, or to develop monitoring systems that reflect the nature and philosophy of Physiotherapy and Chiropractic care / This research explored and expanded upon current knowledge on the constructs of quality and current quality monitoring standards within Physiotherapy and Chiropractic private sector services in Australia. This research explored individual primary stakeholder perspectives of quality (patients, providers and funders). The study identified factors that acted as barriers and incentives in the provision of quality care. This research generated a model of innovative quality monitoring strategies, which reflected stakeholders' perspectives, and could be utilised across private and public funding sectors / This research utilised a mixed method approach of qualitative and quantitative research paradigms. The main methods comprised of interviews with key stakeholders, surveys of patient's perspectives of quality care and an educational outreach program for providers / The findings highlight the multi-dimensional and multifactorial nature of health care quality and its constructs from the perspectives of different stakeholders. Patients and providers' expectations of quality were congruent and contained quality constructs ranging across structure, process and outcome dimensions. This research identified that patient expectations of quality are underpinned by patient-centred care and effective communication between patient and provider. In contrast, funders' perspectives of quality were unidimensional with predominant emphasis on cost of services. This study found funders' monitoring standards were inadequate in identifying poor practices or providing incentives to improve practice. This research provided ways in which funding agencies could continue to use traditional methods of monitoring (such as costs) as well as employing innovative strategies such as patient perspectives on the quality of care they would receive / This research provides the first known evaluation approach for patients to provide feedback on their expectations of quality of Physiotherapy and Chiropractic services. The unique evaluation instrument is profession-specific and it considers patients' expectations using an episode-of-care model rather than the traditional occasion-of-service model. The findings from the survey of Physiotherapy and Chiropractic patients identified the importance of meeting patient expectations prior to, during, and after, the first occasion-of-service with the provider in the episode, and then at three subsequent service points in the episode / This research identified providers' perspectives of an educational outreach program, which aimed to inform and educate them regarding the quality of care they provided. The findings indicated that providers were genuinely interested in uptake of patient feedback into clinical practice. Numerous dissemination strategies were possible within their practices and within their profession / This explanatory research is the first of its kind in providing foundational research evidence on the constructs of quality within private practice Physiotherapy and Chiropractics from different stakeholders' perspectives. It has also established that patients can be effectively engaged in monitoring quality of care. The findings highlight that patient expectations of quality vary throughout an episode-of-care and this needs to be recognised by other stakeholders in quality monitoring and quality improvement initiatives. The findings from this research can form the basis for future research in examining relationships of constructs of quality across other patient populations with other Allied Health disciplines, and in testing innovative quality improvement initiatives / Thesis (PhD)--University of South Australia, 2005

Thesis (M.S.)--Rochester Institute of Technology, 1993. / Typescript. Includes bibliographical references (leaves 133-134).

Thesis PlanB (M.S.)--University of Wisconsin--Stout, 2008. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, Ann Arbor, 1985. / Typescript (photocopy). Includes bibliographical references (leaves 66-71). Also issued in print.

Thesis (M.S.)--University of Michigan, Ann Arbor, 1985. / Typescript (photocopy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 66-71).

The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on October 13, 2009). Thesis advisor: Dr. Glenn Washer. Includes bibliographical references.

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1994. / Source: Masters Abstracts International, Volume: 45-06, page: 2960. Typescript. Includes bibliographical references (leaves 85-86).

Thesis (Ph. D.)--Illinois State University, 1998. / Title from title page screen, viewed July 14, 2006. Dissertation Committee: Paul J. Baker (chair), Dianne E. Ashby, William C. Rau, Nancy E. Gibson. Includes bibliographical references (leaves 139-144) and abstract. Also available in print.