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Background This study evaluated the factors influencing patient satisfaction with hospital services and respect for patient rights in outpatient consultation in Rwanda, aiming to provide insights into improving the overall quality of care. Methods This was cross-sectional study design. We recruited participants from all (30) districts in Rwanda using stratified sampling. A structured questionnaire assessed satisfaction across seven hospital areas, including cashier, waiting, triage, doctor consultation, laboratory, pharmacy, and respect for patient rights. We used descriptive statistics, Chi-square, and Multivariate Regression analyses. Results The study showed that most participants expressed satisfaction with hospital services and respect for their rights: doctor consultations (93.8%), triage (92.0%), dispensing pharmacy (88.2%), laboratory services (87.2%), waiting area (85.3%), patient rights (74.3%), cashier services (73.3%). At bivariate analysis, we observed that satisfaction in waiting areas was associated with location ( p  = 0.036), provinces ( p  < 0.001), and hospital rank ( p  < 0.001), while satisfaction in triage was associated with age categories ( p  < 0.001) and visits ( p  = 0.02). The association of satisfaction in cashier services with age categories ( p  < 0.001), visits ( p  = 0.032), and hospital rank ( p  = 0.005) was also significant, as well as satisfaction in dispensing pharmacy and provinces ( p  < 0.001), location ( p  = 0.002), and visits ( p  = 0.008). Multiple logistic regression indicated higher satisfaction in waiting areas among patients from Northern (OR = 3.81, 95%CI = 1.85–5.64), Western (OR = 1.95, 95%CI = 1.48–3.60), and Southern provinces (OR = 1.93, 95%CI = 1.17–2.85), while urban patients (OR = 0.65, 95%CI = 0.47–0.91) and those from high-rank hospitals had lower satisfaction (OR = 0.59, 95%CI = 0.43–0.82). High-rank hospital patients were more satisfied with triage (OR = 1.86, 95% CI = 1.14–3.13) while returning patients were less satisfied (OR = 0.51, 95%CI = 0.33–0.90). Lower satisfaction in dispensing pharmacy was observed among the City of Kigali (OR = 0.11, 95%CI = 0.05–0.24), Northern province (OR = 0.43, 95%CI = 0.23–0.80), and returning patients (OR = 0.51, 95%CI = 0.33–0.76). Urban (OR = 2.5, 95%CI = 1.32–5.16) and high-rank hospital patients (OR = 1.96, 95%CI = 1.08–3.77) reported higher laboratory satisfaction. However, cashier services had lower satisfaction among Kigali (OR = 0.37, 95%CI = 0.21–0.64), Northern (OR = 0.44, 95%CI = 0.29–0.65), and Western province patients(OR = 0.63, 95%CI = 0.43–0.91), returning patients (OR = 0.73, 95%CI = 0.55–0.96), and those from high-rank hospitals(OR = 0.70, 95%CI = 0.54–0.92). Conclusion Our study has revealed disparities in satisfaction with ambulatory care services delivery by provinces, hospital rank and visit status. We recommend hospital to take initiatives aiming at streamlining payments, optimizing waiting area services, and enhancing coordination, staff training, regional equity, and patient-centered policies for continuous service improvement.

Debriefing has been pivotal in medical simulation training, but its application to the real-world operating room environment has been challenging. We reviewed the literature on routine surgical debriefing with special reference to its implementation, barriers, and effectiveness. Descriptive systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were papers pertaining to debriefing in routine surgical practice. Excluded were papers reporting simulation training. We searched Google Scholar, CINAHL, Web of Science Core Collection, PsychINFO, Medline, Embase, and ProQuest Theses & Dissertations Global. The last search was performed on March 14, 2022. Quality was assessed on a 21-point checklist adapted from a standard reporting guideline. Synthesis was descriptive. The search process resulted in 19 papers. Publication dates ranged from 2007-2022. Study methods included surveys, interviews, and analysis of administrative data. Five papers involved a specific intervention. Quality scores ranged from 12-19 out of 21. On synthesis, we identified five topics: explanations of how debriefing had been implemented; the value of coaching and audit; the learning dimensions of debriefing, both team learning and quality improvement at the organizational level; the effect of debriefing on patient safety or the organization's culture; and barriers to debriefing. Successful implementation programs were characterized by strong commitment from management and support by frontline workers. Integration with administrative quality and safety processes, and information feedback to frontline workers are fundamental to successful debriefing programs. Debriefing can improve teamwork, learning, and psychological safety but is difficult to practice in the operating room environment. It is relevant to review the benefits and barriers to debriefing, and to learn from the experience of others, in order to run better debriefing models in our own hospitals.

Purpouse: This research aims to investigate, using the Servqual model, the level of gaps in services offered by four-star hotels in a winter season city, characteristic of Switzerland, called Campos do Jordão/SP, Brazil.   Teorical Framework: Quality of service is crucial to the success of any service organization. As customers participate in the delivery and consumption of services, they closely interact with various aspects of organizations, critically evaluating the services they provide. Customers assess the quality of a service they receive by comparing it with the service they desire. Thus, quality of service plays a critical role in adding value to the overall service experience.   Metodology: This research uses qualitative and quantitative data. The data collection instrument was a Servqual questionnaire published by Parasuraman et al. (1988), which was applied to eight hotels (owners, managers, and customers). In this way, we verify significant dysfunctions and service results about the competitive factors that customers value.   Findings: This research sought to investigate the level of gaps in the services offered by hotels in the city of Campos do Jordão, the size of gaps related to competitive, strategic, and operational dysfunctions in the businesses surveyed, and to test a set of hypotheses. All of the hypotheses were confirmed. The research did not observe significant dysfunctions pointing to strong adherence among the agents, so much so that the medians of all the gaps were null. From the results, it can be concluded that the competitive gap is influenced equally by the operational and strategic gaps.   Research, Paratical and Social Implicantions: This research sought to investigate the level of gaps in the services offered by hotels in the city of Campos do Jordão, the size of gaps related to competitive, strategic, and operational dysfunctions in the businesses surveyed, and to test a set of hypotheses. All of the hypotheses were confirmed. The research did not observe significant dysfunctions pointing to strong adherence among the agents, so much so that the medians of all the gaps were null. From the results, it can be concluded that the competitive gap is influenced equally by the operational and strategic gaps.   Originality/Value: The results help stimulate new research on the quality of services and facilitate an analysis of the procedures used to meet the expectations of hospitality in hotels. Finally, this study has presented some initial considerations and guidelines for the elaboration of specific projects that allow quantifying the quality of services and developing actions that reduce or even eliminate competitive dysfunctions, as well as contributing to future studies regarding the proposition of new models for the evaluation of the quality of services.

Provides a business model based on the UCLA Health System and explains how other businesses can use the same system to provide excellent customer experiences and dominate their industry.

Fifth generation new radio (5G NR) is bringing revolutions in almost every field such as healthcare, industrial automation, smart farming, and defense. These fields utilize three major use case scenarios of 5G NR viz. eMBB, URLLC, and mMTC. 5G NR deployment relies on two major frequency bands such as sub-6 GHz and high-frequency bands (millimeter waves). Among all sub-6 GHz bands, the n78 band (3300–3800 MHz) is gaining popularity due to its unique characteristics viz. higher capacity and coverage, wide bandwidth, and higher data rate. Despite these unique characteristics, in the 5G standalone architecture, users expect high-speed video/voice transmission without delay and good quality of services (QoS) requirements. QoS is one of the important paradigms that indicates the quality of services experienced by end users instead of services claimed by service providers. In this work, we have designed a QoS scenario that utilizes the n78 band with an “urban macro mixed office scenario with low loss” path loss model. As per types of services are concerned, the scenario utilizes six different traffic templates (i.e., FTP, Voice, Video, COAP, CBR, and Email). The path loss model operates on non-line-of-sight scenarios with Rayleigh fading and eigen beamforming using 64 × 32 antenna elements. The performance of the proposed scenario is examined through different metrics i.e., throughput, packet drop ratio, and delay. Here, priorities to different traffic templates are assigned based on GBR and non-GBR resource types. In addition, the proportional fair scheduling algorithm is employed to schedule the resources. It was observed that video services achieved a higher throughput of 25.93 Mbps due to their prioritization in the QoS model. Conversely, FTP services experienced higher delay, measured at 64 ms, and a packet delivery ratio of 5.94%.

Prior studies in Wireless Sensor Network (WSN) optimization mostly concentrate on maximizing network coverage and minimizing network energy consumption. However, there are other factors that could affect the WSN Quality of Service (QoS). In this paper, four objective functions that affect WSN QoS, namely end-to-end delay, end-to-end latency, network throughput and energy efficiency are studied. Optimal value of packet payload size that is able to minimize the end-to-end delay and end-to-end latency, while also maximizing the network throughput and energy efficiency is sought. To do this, a smart grid application case study together with a WSN QoS model is used to find the optimal value of the packet payload size. Our proposed method, named Multi-Objective Optimization Algorithm Based on Sperm Fertilization Procedure (MOSFP), along with other three state-of-the-art multi-objective optimization algorithms known as OMOPSO, NSGA-II and SPEA2, are utilized in this study. Different packet payload sizes are supplied to the algorithms and their optimal value is derived. From the experiments, the knee point and the intersection point of all the obtained Pareto fronts for all the algorithms show that the optimal packet payload size that manages the trade-offs between the four objective functions is equal to 45 bytes. The results also show that the performance of our proposed MOSFP method is highly competitive and found to have the best average value compared to the other three algorithms. Furthermore, the overall performance of MOSFP on four objective functions outperformed OMOPSO, NSGA-II and SPEA2 by 3%, 6% and 51%, respectively.