Practicing Quality Care in the Kingdom Book Report

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[. . .] , 2013). Nearly all hospitals in the KSA lack a "look-alike, sound-alike" list of pharmaceuticals, which is helpful in preventing the wrong drugs from being administered to patients. Likewise, more than 20% of medical errors committed in KSA hospitals occurred during operations, while more than 18% occurred in the ER. As a result of these deficiencies, medical errors and the ensuing cases of litigation that naturally follow such cases have disrupted the lives of patients and providers, particularly in hospitals operated by the Ministry of Health (Aljarallah, Alrowaiss, 2013).

With respect to the rest of the world, Saudi Arabia's quality of care in terms of safety issues is neither better nor worse. As Aiken, Van den Heede, McKee et al. (2012) show, "the percentage of nurses reporting poor or fair quality of patient care varies substantially by country" and the same goes for nurses who grade their hospitals on safety. Burnout is considered a contributing factor to safety issues and work environments are also considered factors in how well safety precautions are followed and/or implemented throughout Europe as well as the United States (Aiken et al., 2012). What this shows is that "deficits in hospital care quality" are a common feature among all countries of the world (Aiken et al., 2012). Improvements, such as those recommended by the IOM, are needed across the board.


Patient satisfaction can be used as a gauge of health care providers' effectiveness in providing quality care and patient sentiment is typically obtained during discharge. Of patients assessed in eastern Saudi Arabia, those leaving private hospitals were found to have higher levels of satisfaction than those treated in public hospitals (Mahrous, 2013). However, communication between pharmacists and patients has been shown to be poor, with more than 60% of patients reporting that they failed to understand their pharmacists' instructions and about a quarter of all patients reported receiving no information about their prescriptions whatsoever (Alturki, Khan, 2013).

In Riyadh, patients reported slightly higher satisfaction with pharmacists, stating that doctors not only gave instructions about the prescription drug but also discussed possible side effects (Al-Arifi, 2012). However, still nearly half of all patient respondents in Riyadh failed to express or communicate satisfaction. Still more troubling is the percentage of patients who do not report errors committed by health care professionals as a result of "administrative barriers" -- i.e., poor access to reporting for patients (Almutairi, Moussa, 2014).


Patient-centered care is often a problem in Saudi Arabia. One of the main aspects of patient-centered care involves informing the patient of his or her rights -- "especially the rights to be kept fully informed of his/her diagnosis and treatment plan" (Almutairi, Moussa, 2014, p. 804). By acknowledging patients' rights, providers show concern and respect for patients. As Al Momani and Al Korashy (2012) show, "failure of nurses and other health care providers to take into account factors observed and reported by patients as important to their nursing care is inconsistent with the notion of patient-centered care and patient empowerment" (p. 42). Treating each patient in the manner that he or she wishes to be treated is what providing quality care is all about. This means that understanding patient needs and interacting with patients in a way that demonstrates respect for the patient's culture, beliefs, and attitudes is a significant part of health care. Administering to symptoms, ailments and illnesses is only one portion of providing care. Because patients are people with feelings, concerns, fears, and questions, they have to be approached with empathy. The study by Alturki and Khan (2013) showed a significant lack of empathy on the part of health care providers towards patients in Saudi Arabia -- and this is a considerable problem that must be addressed.

Providing patient-centered care while recognizing cultural diversity and the patient or designee as a full partner in the decision-making process is a vital standard to primary care nursing, as stated by the National Organization of Nurse Practitioner Faculty (NONPF, 2013): the reason for this is that patient-centered care places the patient and his or her needs at the fore of the care giving process and orients the nurse practitioner to the idea of being fully attendant to the patient's rights, needs, cultural beliefs and desires. By being sensitive to the uniqueness of every patient and respecting every patient accordingly, the nurse practitioner is better able to provide the highest level of quality care possible to the patient.


Timeliness is a problem on both ends of the patient-provider relationship. First, many patients do not seek out medical advice in a timely manner, which results in conditions worsening or in a lack of preventive care being possible to administer. The main cause for this delay in the seeking of care is found in cultural beliefs that are firmly embedded in the Saudi culture. However, the second point to be made is that a third of specialists sampled in a study by Eleishi and Allison (2009) showed a significant failure to refer patients to the respective help they needed, again resulting in an obstacle to preventive and quality care being achieved. Thus, on both ends of the spectrum, timeliness is an issue in Saudi Arabia that both patients and providers must address.

As a study by Mourra, Fish and Pfeffer (2015) shows, timeliness is also an issue that needs to be addressed in European hospitals: "deficits in communication between inpatient and outpatient physicians in the post-hospital discharge period are common and potentially detrimental to person-centered doctor-patient relationships and to patient health." Mourra et al. (2015) suggest that education, better use of communication tools, and a shift to a more person-centered health care approach can help nurses and physicians to overcome obstacles related to timeliness.

A Frontline documentary hosted by T. R. Reid in 2008 focused on health care systems around the world. Timeliness was a huge factor in several systems. In the UK, timeliness was not always evident, especially when elective care was the case. Wait times for patients could be considerably long -- many months in fact. In Taiwan, on the other hand, timeliness was very important to the people and the health care system that was devised was based on the idea that for quality care to be obtained, patients should have direct, easy and timely access to providers -- and not have to wait in long lines or put off operations for months on end. The problem that the Taiwanese are running into, however, is that there is simply not enough money to cover this type of care. As a result, the Taiwanese government is borrowing heavily from banks to fund timely care for its citizens. This is not a situation that can be supported in perpetuity. A better solution will need to found.


Efficiency can be measured by evaluating a number of factors in health care -- from the quality of work life for primary care givers to workplace environment, staffing, burnout, professional development opportunities, and so on. One study conducted in the Jazan region of Saudi Arabia showed that the quality of work life for primary care givers in this region is below average and needs to be improved (Almalki, Fitzgerald, Clark, 2012).

Compared to the rest of the world, Saudi Arabia has room to grow, too, in terms of providing quality care by implementing new technology. A study by Chaudhry et al. (2006) notes that "experts consider health information technology key to improving efficiency and quality of health care" (p. 742). This finding is supported by other research in Europe and the US that indicates that the use of new technology and especially eHealth and e-Medicine can be of a great facility in the improvement of efficiency and quality care (Abernathy et al., 2008).


Similar to efficiency, equitability can be measured by a number of factors. The study by Al Onaz et al. (2012) examined differences between morning and night shift nurses in Saudi Arabia, focusing in particularly on levels of empathy displayed by nurses on each shift. The findings showed that morning and night shift nurses were perceived by patients to have different levels of empathy.

Equitability is not an issue that is unique to Saudi Arabia. Countries around the world suffer from the same type of unequal application of care to patients, as Ganz, Casillas and Hahn (2008) have shown. The main problem is that every nurse and physician must be aware at an individual level just how he or she is interacting with patients at all moments during the job.

As Reid (2008) shows in his Frontline documentary on health care systems around the world, equitability is a major issue for many countries -- yet not all countries approach it the same way. In countries where socialized medicine is the source of universal coverage, there is competition among providers for government funds. In the UK,… [end of preview; READ MORE]

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Practicing Quality Care in the Kingdom.  (2017, June 30).  Retrieved January 22, 2020, from

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"Practicing Quality Care in the Kingdom."  30 June 2017.  Web.  22 January 2020. <>.

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"Practicing Quality Care in the Kingdom."  June 30, 2017.  Accessed January 22, 2020.