Governmental hospitals in Palestine operate beyond their intended capacity, negatively impacting quality of care. A study of Alia Hospital in Hebron found gaps in all quality dimensions according to patients' perceptions versus expectations. The responsiveness dimension had the largest gap of 0.982. The pediatrics department scored highest for quality gaps among inpatient departments. Analyses of processes in the emergency and pediatrics departments revealed weaknesses in communication, documentation, resource allocation, and layout. Recommendations include restructuring emergency department processes to reduce non-value-added activities, increasing medical staffing, adding a daycare unit, and improving triage. The pediatrics department needs more nurses, staff reallocation, and equipment. Hospital-

1. K
QUALITY IMPROVEMENT THROUGH
CAPACITY MANAGEMENT IN HOSPITALS
The Case of the Governmental Hospital in Hebron "Alia Hospital", Palestine.
By: Wasim Idris Sultan
Abstract
Governmental Hospitals in Palestine operate at the limits of their design
capacity. On average, the Governmental Hospital in Hebron “Alia Hospital” is over
occupied. This state of work to cope with high demand leaves behind adaptive
responses and practices that negatively affect the quality of care.
This study scores the operational quality of care services delivered in Alia
Hospital as being the deviation of patients’ perceptions from their expectations.
Adapted SERVQUAL questionnaire tool is used to measure the relative gaps in five
dimensions of quality, tangibility, reliability, responsiveness, assurance, and empathy.
The researcher had conducted a pilot study to improve and test the questionnaire
first, then cross-sectional data of 118 respondents sample revealed gaps in all the
dimensions of quality in Alia Hospital; maximum relative gap of 0.982 was measured
for the responsiveness dimension. The Pediatrics Department scored the maximum
average gap (0.93) between all the inpatient departments of Alia Hospital.
Actual activities, processes and procedures to deliver care services were
analyzed, observations and interviews were conducted in the Emergency and Pediatrics
Departments. Nurses were a sample of human resources in the hospital. Results show
weaknesses in communication, documentation process, resource allocation, and layout.
Process analysis in the Emergency Department shows the needs for process
restructure to eliminate non-value added activities, and to increase the medical team.
The department also needs a daycare unit to balance load with inpatient departments,
and to objectively manage the triage unit.
Process analysis in the Pediatrics Department shows the need for; more nurses,
nursing staff reallocation, and additional primary equipments. The admission room in
the department will operate efficiently.
To effectively manage the interdependency relations between departments, a
whole communication process improvement is recommended. The researcher strongly
recommends the implementation of Medical Record and Information Systems. These
two systems are effective quality improvement tool and decision making tool.