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Article
Publication date: 9 May 2024

Claudio Rocco, Gianvito Mitrano, Angelo Corallo, Pierpaolo Pontrandolfo and Davide Guerri

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes…

Abstract

Purpose

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

Design/methodology/approach

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

Findings

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

Originality/value

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

Details

Business Process Management Journal, vol. 30 no. 3
Type: Research Article
ISSN: 1463-7154

Keywords

Open Access
Article
Publication date: 29 February 2024

Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and…

Abstract

Purpose

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

Design/methodology/approach

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Findings

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

Originality/value

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 14 no. 2
Type: Research Article
ISSN: 2042-6747

Keywords

Open Access
Article
Publication date: 8 September 2023

Arianna Maever Loreche, Veincent Christian F. Pepito and Manuel M. Dayrit

This review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.

7146

Abstract

Purpose

This review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.

Design/methodology/approach

The authors conducted a scoping review in PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Central, Journal Storage (JSTOR) and the Philippine Council for Health Research and Development – Health Research and Development Information Network (HERDIN). The authors included all studies on self-care practices to manage common acute conditions, namely low back pain, allergic rhinitis, general acute pain, cough, cold, diarrhea, constipation and stress, published up to 2021 in the Philippines. Information on the article type, aim of the study, study design and setting, population characteristics and size, and self-practices employed for the conditions were extracted and synthesized.

Findings

The authors identified various self-care practices for acute conditions among the general population and indigenous peoples in the Philippines from 26 studies included in the review: the use of medicines with and without a prescription, appropriate and inappropriate antibiotic use, use of medicinal plants and other traditional and alternative therapies and products, recreational activities and healthy habits and behaviors, and self-management or seeking care from traditional healers (albularyo or manggagamot) or health professionals. A number of considerations influenced their decision on how to manage symptoms, including perceived severity of the condition, availability and perceived effectiveness of treatment, cost, and advice from trusted sources of health information.

Research limitations/implications

The authors searched five major databases and a local research database, but some studies may still have been missed in the review. The review also excluded intervention studies on the outcomes of self-care, which limits the authors' ability to make conclusions on the effectiveness of the different modalities of self-care.

Social implications

Filipinos engage in a variety of “safe” (or evidence-informed) and “unsafe” (or harmful) self-care practices. While the term “self-care” is not routinely used by the general population and health providers, it is widely enculturated and practiced in the Philippines. Self-care benefits individuals and the health system, but there are also practices that increase risk of adverse outcomes and death including inappropriate antibiotic use, prescription sharing and reuse, and delays in seeking adequate treatment from a health professional. To leverage on self-care in advancing Universal Health Coverage (UHC) goals, the authors recommend a national strategy that provides guidance on how to practice responsible self-care, further research on the effectiveness and safety of alternative medicine and other priority areas, and better integration of self-care in the formal education and health systems. The authors also propose that the research agenda on self-care include acute health conditions, given their impact and burden on health and the economy.

Originality/value

This is the first published review of self-care practices for managing common acute health conditions, which captured practices of various groups and populations including indigenous peoples.

Details

International Journal of Health Governance, vol. 28 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

Open Access
Article
Publication date: 28 November 2023

Georgia Watson, Cassie Moore, Fiona Aspinal, Andrew Hutchings, Rosalind Raine and Jessica Sheringham

Many countries have a renewed focus on health inequalities since COVID-19. In England, integrated care systems (ICSs), formed in 2022 to promote integration, are required to…

Abstract

Purpose

Many countries have a renewed focus on health inequalities since COVID-19. In England, integrated care systems (ICSs), formed in 2022 to promote integration, are required to reduce health inequalities. Integration is supported by population health management (PHM) which links data across health and care organisations to inform service delivery. It is not well-understood how PHM can help ICSs reduce health inequalities. This paper describes development of a programme theory to advance this understanding.

Design/methodology/approach

This study was conducted as a mixed-methods process evaluation in a local ICS using PHM. The study used Framework to analyse interviews with health and care professionals about a PHM tool, the COVID-19 vaccination uptake Dashboard. Quantitative data on staff Dashboard usage were analysed descriptively. To develop a wider programme theory, local findings were discussed with national PHM stakeholders.

Findings

ICS staff used PHM in heterogeneous ways to influence programme delivery and reduce inequalities in vaccine uptake. PHM data was most influential where it highlighted action was needed for “targetable” populations. PHM is more likely to influence decisions on reducing inequalities where data are trusted and valued, data platforms are underpinned by positive inter-organisational relationships and where the health inequality is a shared priority.

Originality/value

The COVID-19 pandemic accelerated a shift toward use of digital health platforms and integrated working across ICSs. This paper used an evaluation of integrated data to reduce inequalities in COVID-19 vaccine delivery to propose a novel programme theory for how integrated data can support ICS staff to tackle health inequalities.

Details

Journal of Integrated Care, vol. 31 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 7 May 2024

Leda Sivak, Luke Cantley, Rachel Reilly, Janet Kelly, Karen Hawke, Harold Stewart, , Andrea McKivett, Shereen Rankine, Waylon Miller, Kurt Towers and Alex Brown

Aboriginal and Torres Strait Islander (Aboriginal) people are overrepresented in Australian prisons, where they experience complex health needs. A model of care was designed to…

Abstract

Purpose

Aboriginal and Torres Strait Islander (Aboriginal) people are overrepresented in Australian prisons, where they experience complex health needs. A model of care was designed to respond to the broad needs of the Aboriginal prisoner population within the nine adult prisons across South Australia. The purpose of this paper is to describe the methods and findings of the Model of Care for Aboriginal and Torres Strait Islander Prisoner Health and Wellbeing for South Australia.

Design/methodology/approach

The project used a qualitative mixed-method approach, including a rapid review of relevant literature, stakeholder consultations and key stakeholder workshop. The project was overseen by a Stakeholder Reference Group, which met monthly to ensure that the specific needs of project partners, stakeholders and Aboriginal communities were appropriately incorporated into the planning and management of the project and to facilitate access to relevant information and key informants.

Findings

The model of care for Aboriginal prisoner health and wellbeing is designed to be holistic, person-centred and underpinned by the provision of culturally appropriate care. It recognises that Aboriginal prisoners are members of communities both inside and outside of prison. It notes the unique needs of remanded and sentenced prisoners and differing needs by gender.

Social implications

Supporting the health and wellbeing of Indigenous prison populations can improve health outcomes, community health and reduce recidivism.

Originality/value

Only one other model of care for Aboriginal prisoner health exists in Australia, an Aboriginal Community Controlled Health Organisation-initiated in-reach model of care in one prison in one jurisdiction. The South Australian model of care presents principles that are applicable across all jurisdictions and provides a framework that could be adapted to support Indigenous peoples in diverse prison settings.

Details

International Journal of Prison Health, vol. 20 no. 2
Type: Research Article
ISSN: 2977-0254

Keywords

Article
Publication date: 31 July 2023

Fazeelath Tabassum and Nitu Ghosh

This paper aims to explore the role of retention strategies and psychological contract (PC) factors in private hospitals.

Abstract

Purpose

This paper aims to explore the role of retention strategies and psychological contract (PC) factors in private hospitals.

Design/methodology/approach

The current study is an empirical research. The study was conducted by receiving responses from a sample size of 190 respondents who participated in the Doctors and Nurses’ survey.

Findings

The study results show the relationship between PC and the retention strategies of employees in hospitals. The research found that employees try to be committed to the hospital due to the image of the hospital and career development opportunities. Creating a sense of commitment among the employees towards their job and organisation, making to feel pride in the job, creating an attitude among the employees, a willingness to advocate the benefits and advantages and satisfaction among the employee towards the job and organisation.

Research limitations/implications

With a population of more than one million employees (Doctors and Nurses) in the Indian health-care sector, the sample needs to be more adequate. However, these limitations present scope for future studies on this topic bearing on the aspiration for generalisation of the findings on the entire population.

Practical implications

The study has strong practical implications in strengthening the relationships by identifying the factors of PC and influencing the retention strategies of health-care professionals in the hospital.

Originality/value

This research explores the changing dynamics of the Indian health-care sector. Health-care professionals may perceive and react differently to the retention strategies and policies of the HR system in the health-care sector and have more expectations of PC fulfilment that enhance their capability to use professional skills and resources in the realisation of their organisational goals.

Details

Industrial and Commercial Training, vol. 55 no. 4
Type: Research Article
ISSN: 0019-7858

Keywords

Article
Publication date: 20 December 2023

Abhishek Raj, Vinaytosh Mishra, Ajinkya Tanksale and Cherian Samuel

The purpose of this study is to solve the problem of healthcare waste management in developing countries. The buildup of medical waste has attracted the attention of all spheres…

Abstract

Purpose

The purpose of this study is to solve the problem of healthcare waste management in developing countries. The buildup of medical waste has attracted the attention of all spheres of society due to the expanding population and developing economy. Timely collection and processing of medical waste are extremely important due to its potential hazards. Although the problem of planning medical waste management has been addressed in developed countries, it persists in several developing countries. This research is motivated by an example of a city in India characterized by a dense population, abundant health-care facilities and a lack of planning for managing large medical waste generated daily.

Design/methodology/approach

The authors address the problem of designing the network of collection and processing facilities for medical waste and optimizing the vehicle route that collects and transfers the waste between facilities. Due to distinct topographic restrictions in the considered city, the collection and transfer process needs to be conducted in two echelons – from hospitals to collection centers using smaller vehicles and then to the processing facilities using trucks. This work addresses these two problems as a two-echelon location-routing problem.

Findings

A mixed-integer programming model is developed to minimize the cost of opening the facilities and transporting medical waste. Several managerial insights are drawn up to assist planners and decision-makers.

Originality/value

This study follows a case study approach to provide a descriptive and prescriptive approach to hospital waste management in the ancient city of Varanasi. The city has witnessed unplanned growth over the years and is densely populated. The health-care facilities in the city have a large catchment area and attract patients from neighboring districts. The situation analysis based on secondary data and unstructured interviews of the stakeholders suggests that the ad hoc approach prevails in present hospital waste management in the city.

Details

Facilities , vol. 42 no. 5/6
Type: Research Article
ISSN: 0263-2772

Keywords

Article
Publication date: 23 August 2023

Daniel Mark Alton

Population Health Management (PHM) is a methodology which has the potential to help support the aspirations of the NHS's Integrated Care Systems to address health inequalities…

Abstract

Purpose

Population Health Management (PHM) is a methodology which has the potential to help support the aspirations of the NHS's Integrated Care Systems to address health inequalities, shift from reactive to proactive care and prevention, work in a more integrated manner, and deliver person-centered care tailored to the individual's needs. Although PHM is featured in a number of key national policy documents, moving from the conceptual to widespread adoption requires some key conditions to be in place and barriers to be overcome. It may also require a wider cultural change amongst teams as part of a more truly integrated, holistic ethos.

Design/methodology/approach

This Viewpoint Paper sets out the advantages and challenges associated with the adoption of PHM.

Findings

Key features of PHM are outlined, as well as the conditions needed for successful adoption. Key barriers which need to be overcome are discussed, not least occasional scepticism from clinical colleagues and how this can be addressed and translated into a source of energy and enthusiasm for a new approach.

Originality/value

This is a viewpoint based on the author's personal experience of supporting the implementation and spread of PHM in England's NHS, summarising shared learning and suggesting practical strategies.

Details

Journal of Integrated Care, vol. 31 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 19 December 2023

Mihai Picior

The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health…

Abstract

Purpose

The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities.

Design/methodology/approach

This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it.

Findings

Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies.

Research limitations/implications

The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient’s health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care.

Practical implications

It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities.

Social implications

Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour.

Originality/value

The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities.

Details

Journal of Integrated Care, vol. 32 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 19 October 2023

Rajat Kumar Behera, Pradip Kumar Bala, Prabin Kumar Panigrahi and Shilpee A. Dasgupta

Despite technological advancements to enhance patient health, the risks of not discovering the correct interactions and trends in digital health are high. Hence, a careful policy…

Abstract

Purpose

Despite technological advancements to enhance patient health, the risks of not discovering the correct interactions and trends in digital health are high. Hence, a careful policy is required for health coverage tailored to needs and capacity. Therefore, this study aims to explore the adoption of a cognitive computing decision support system (CCDSS) in the assessment of health-care policymaking and validates it by extending the unified theory of acceptance and use of technology model.

Design/methodology/approach

A survey was conducted to collect data from different stakeholders, referred to as the 4Ps, namely, patients, providers, payors and policymakers. Structural equation modelling and one-way ANOVA were used to analyse the data.

Findings

The result reveals that the behavioural insight of policymakers towards the assessment of health-care policymaking is based on automatic and reflective systems. Investments in CCDSS for policymaking assessment have the potential to produce rational outcomes. CCDSS, built with quality procedures, can validate whether breastfeeding-supporting policies are mother-friendly.

Research limitations/implications

Health-care policies are used by lawmakers to safeguard and improve public health, but it has always been a challenge. With the adoption of CCDSS, the overall goal of health-care policymaking can achieve better quality standards and improve the design of policymaking.

Originality/value

This study drew attention to how CCDSS as a technology enabler can drive health-care policymaking assessment for each stage and how the technology enabler can help the 4Ps of health-care gain insight into the benefits and potential value of CCDSS by demonstrating the breastfeeding supporting policy.

Details

Journal of Systems and Information Technology, vol. 25 no. 4
Type: Research Article
ISSN: 1328-7265

Keywords

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