BACKGROUND: In a tertiary care institute of northern India, the emergency department receives an average of 6-7 patients with poly trauma every day. Of these patients, some come directly and many are referred from other hospitals from the region. Various problems are faced in the management of patients with poly trauma. This study aimed to elicit various complaints, suggestions and possible solutions in the management of patients with poly trauma. METHODS: A retrospective cross sectional study was done on 210 patients in the emergency OPD for a period of 2 months. All the records of the patients with poly trauma were studied and the problems during their management were measured against 6 predetermined steps (step I to step VI). RESULTS: In the younger generation, males were predominantly the primary victims of poly trauma injury, and road traffi c accident was the major etiological factor. Injuries involving more than 2 specialties induced many problems during the management of patients with poly trauma. Of 210 patients we studied, 32 patients had problems at various steps and maximum problems in step III , i.e. coordination between various specialties in the management of patients with poly trauma. CONCLUSION: A proper poly trauma management team and a well defi ned standard operative procedure are the keys to effective management of patients with poly trauma by minimizing the problems encountered.

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PurposeUse of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of services with consumer satisfaction. With e-Healthcare services, consumer satisfaction is influenced by the quality of healthcare services provided and the demographic characteristics. The purpose of the present case study is to recognize the important predictors of quality, which are significant for consumer satisfaction with e-Healthcare services by using Zineldin's 5Qs model. It also aims to find the strength of association among the predictors of consumer satisfaction and the demographic characteristics of the respondents.Design/methodology/approachA questionnaire-based study was conducted at a public (PGIMER, Chandigarh) and a private hospital (Fortis Hospital, Mohali) of Punjab, India, from February 2018 to March 2019. The structured, closed-ended questionnaire, to be marked on a 1–5 point Likert scale, was adapted from Zineldin's 5Qs model and was distributed to the respondents sitting in the waiting halls of the selected hospitals. The respondents comprised of both the patients and their attendants who were aware of e-Healthcare services and were using them.FindingsThe analysis identified quality of interaction, quality of hospital atmosphere and quality of object to be the key predictors of consumer satisfaction with e-Healthcare services. The results reveal a strong association between different demographic characteristics and overall consumer satisfaction with e-Healthcare services.Practical implicationsThe results suggest that improvements in the quality of interaction, quality of hospital atmosphere and quality of object may result in higher consumer satisfaction with e-Healthcare services. Working on the identified dimensions of quality will help the e-Healthcare providers in identifying functional problems of e-Healthcare services and developing improvement strategies, which will also result in better health and quality outcomes. The results of this study will help the e-Healthcare providers in better segmentation of e-Healthcare consumers based on their demographic characteristics and in developing better marketing strategies.Originality/valueThis paper focuses on the quality of e-Healthcare services only and attempts to identify the quality dimensions, which leads to the satisfaction of e-Healthcare consumers. The identified quality dimensions will help in designing better e-Healthcare services and framing policies. It also highlights the association of demographic characteristics with important quality dimensions.

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PurposeThis article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting the total quality of e-healthcare services and its association with consumer satisfaction using a multidimensional hierarchical 5Qs model of e-healthcare service quality.Design/methodology/approachQuestionnaire-oriented research was performed at three public hospitals of Punjab and Chandigarh. In total, 53 variables were covered in all quality constructs for data collection from the designated public hospitals. The respondents who agreed to have knowledge regarding e-Healthcare services and were availing these services were included in the study. The analysis comprised structural equation modeling technique using AMOS 21.FindingsThe outcomes suggest that the 5Qs model is more comprehensive and can be used to evaluate service quality perceptions using e-Healthcare services. The research identified 11 sub-dimensions for the five quality constructs of the 5Qs model, representing total quality, which is primary to consumer satisfaction. “Overall objectivity” and “technical objectivity” defined the quality of object. The quality of process of e-Healthcare services was characterized by “functionality,” “timeliness” and “responsiveness.” Quality of infrastructure was defined by “technical infrastructure,” “physical infrastructure,” “manpower skills” and “organizational infrastructure.” “Manner of interaction” and “timely interaction” defined the quality of interaction. The atmosphere was represented by only one factor. The results also suggest that quality of infrastructure, quality of interaction and quality of atmosphere play the most significant role in total quality leading to consumer satisfaction.Research limitations/implicationsTheoretical implications: The multidimensional hierarchical model will help the researchers study the e-Healthcare service quality in a more organized manner, and the outcomes of this study can be linked with that of future studies for more generalized application in other public hospitals. The sub-dimensions of each quality construct of the 5Qs model can be applied in private hospitals, and the hierarchical model can be tested in different industries to measure service quality perceptions of the consumerPractical implicationsThe outcomes of the study can be applied in various public sector hospitals to redesign the e-Healthcare services based on consumers' perception for better consumer satisfaction and quality services. This paper identifies the role of each quality construct in e-Healthcare services for improvement in the total quality, which in turn will lead to higher satisfaction for the consumers.Originality/valueIn this study, the original 5Qs model has been used for the first time in a new instrument to understand better and design quality e-Healthcare services. The paper explores the sub-factors of each quality construct and its significance in measuring the total quality.