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1 – 10 of 107Chiara Oppi, Cristiana Cattaneo and Giovanna Galizzi
Further investigation is needed of network effectiveness in healthcare and how it is influenced by unpredictable events like COVID-19. Based on Provan and Milward’s (2001…
Abstract
Purpose
Further investigation is needed of network effectiveness in healthcare and how it is influenced by unpredictable events like COVID-19. Based on Provan and Milward’s (2001) framework, this study investigates the effectiveness criteria of healthcare networks and their potential contribution to network effectiveness during the pandemic’s challenges.
Design/methodology/approach
This research employs an explanatory case study in a local area of Italy’s Lombardy Region and analyzes network effectiveness at the network level based on network member perceptions.
Findings
Network effectiveness refers to the network’s ability to address patient needs, guaranteeing services through network members' coordinated efforts and a central coordinator that facilitates their interaction. Members’ capacity to strengthen their roles played a crucial part in sustaining network effectiveness when COVID-19 revised other members’ priorities and threatened achievement of network goals.
Practical implications
This study’s findings equip healthcare managers and policymakers with knowledge about network effectiveness criteria at the network level, offering suggestions for managerial practices and network design to address exogenous shocks.
Originality/value
This study identifies factors that influence network effectiveness criteria and provides insight into how network members can contribute to sustaining effectiveness during crises.
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Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide…
Abstract
Purpose
Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.
Design/methodology/approach
Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).
Findings
The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.
Originality/value
Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.
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Armando Calabrese, Antonio D'Uffizi, Nathan Levialdi Ghiron, Luca Berloco, Elaheh Pourabbas and Nathan Proudlove
The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.
Abstract
Purpose
The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.
Design/methodology/approach
The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.
Findings
The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.
Originality/value
The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.
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Anna Hallberg, Ulrika Winblad and Mio Fredriksson
The build-up of large-scale COVID-19 testing required an unprecedented effort of coordination within decentralized healthcare systems around the world. The aim of the study was to…
Abstract
Purpose
The build-up of large-scale COVID-19 testing required an unprecedented effort of coordination within decentralized healthcare systems around the world. The aim of the study was to elucidate the challenges of vertical policy coordination between non-political actors at the national and regional levels regarding this policy issue, using Sweden as our case.
Design/methodology/approach
Interviews with key actors at the national and regional levels were analyzed using an adapted version of a conceptualization by Adam et al. (2019), depicting barriers to vertical policy coordination.
Findings
Our results show that the main issues in the Swedish context were related to parallel sovereignty and a vagueness regarding responsibilities and mandates as well as complex governmental structures and that this was exacerbated by the unfamiliarity and uncertainty of the policy issue. We conclude that understanding the interaction between the comprehensiveness and complexity of the policy issue and the institutional context is crucial to achieving effective vertical policy coordination.
Originality/value
Many studies have focused on countries’ overall pandemic responses, but in order to improve the outcome of future pandemics, it is also important to learn from more specific response measures.
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Daniel Samaan and Aizhan Tursunbayeva
This paper demystifies the fluid workforce phenomenon increasingly discussed in the circles of organizational innovators and explores the characteristic aspects of the fluid…
Abstract
Purpose
This paper demystifies the fluid workforce phenomenon increasingly discussed in the circles of organizational innovators and explores the characteristic aspects of the fluid workforce in the healthcare sector.
Design/methodology/approach
We analyze the concept and provide a generic review of definitions of a fluid workforce in relation to other similar concepts established in the academic and practitioner literature, contextualize the fluid workforce phenomenon in healthcare and distinguish relevant drivers and categories of fluid workers in this sector. We also discuss the implications of a fluid workforce for healthcare organizations, drawing on the health labor market and human resource management (HRM) practices frameworks.
Findings
The fluid workforce in healthcare is not new. Today’s main novelties are related to the wide diversity of types of fluid workforce that have emerged, the expanding scale of diffusion of the fluid workforce and the emergence of digital technologies to support HRM decisions. While a fluid workforce may provide solutions to address mismatches in the supply and demand of health workers, it can also worsen working conditions, increase dual practice and have implications for existing HRM practices.
Originality/value
We disentangle a novel term for the public sector, healthcare and HRM literature. We discern similarities and distinctions, presenting a framework for managing and analyzing this workforce at organizational and labor market levels in the healthcare sector. Acknowledging the challenges in estimating the existing fluid workforce labor market size, we offer practical methodologies to empirically estimate its prevalence within the healthcare industry and build an agenda for future research.
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Veronica Ungaro, Laura Di Pietro, Roberta Guglielmetti Mugion and Maria Francesca Renzi
The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting…
Abstract
Purpose
The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.
Design/methodology/approach
Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.
Findings
The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.
Originality/value
This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.
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Ingrid Marie Leikvoll Oskarsson and Erlend Vik
Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem…
Abstract
Purpose
Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.
Design/methodology/approach
In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.
Findings
Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.
Research limitations/implications
This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.
Practical implications
The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.
Originality/value
This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.
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Nicola Cobelli and Silvia Blasi
This paper explores the Adoption of Technological Innovation (ATI) in the healthcare industry. It investigates how the literature has evolved, and what are the emerging innovation…
Abstract
Purpose
This paper explores the Adoption of Technological Innovation (ATI) in the healthcare industry. It investigates how the literature has evolved, and what are the emerging innovation dimensions in the healthcare industry adoption studies.
Design/methodology/approach
We followed a mixed-method approach combining bibliometric methods and topic modeling, with 57 papers being deeply analyzed.
Findings
Our results identify three latent topics. The first one is related to the digitalization in healthcare with a specific focus on the COVID-19 pandemic. The second one groups up the word combinations dealing with the research models and their constructs. The third one refers to the healthcare systems/professionals and their resistance to ATI.
Research limitations/implications
The study’s sample selection focused on scientific journals included in the Academic Journal Guide and in the FT Research Rank. However, the paper identifies trends that offer managerial insights for stakeholders in the healthcare industry.
Practical implications
ATI has the potential to revolutionize the health service delivery system and to decentralize services traditionally provided in hospitals or medical centers. All this would contribute to a reduction in waiting lists and the provision of proximity services.
Originality/value
The originality of the paper lies in the combination of two methods: bibliometric analysis and topic modeling. This approach allowed us to understand the ATI evolutions in the healthcare industry.
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Tina Bedenik, Claudine Kearney and Éidín Ní Shé
In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and…
Abstract
Purpose
In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.
Design/methodology/approach
Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.
Findings
Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.
Originality/value
Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.
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Dorothy Ai-wan Yen, Benedetta Cappellini, Jane Denise Hendy and Ming-Yao Jen
The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social…
Abstract
Purpose
The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social class, race, cultural proximity to the host country and acculturation levels, more in-depth studies are necessary to fully understand how COVID-19 affects specific migrant groups and their health. Taiwanese migrants were selected because they are an understudied group. Also, there were widespread differences in pandemic management between the UK and Taiwan, making this group an ideal case for understanding how their acculturation journey can be disrupted by a crisis.
Design/methodology/approach
Qualitative data were collected at two different time points, at the start of the UK pandemic (March/April 2020) and six months on (October/November 2020), to explore migrant coping experiences over time. Theoretically, the authors apply acculturation theory through the lens of coping, while discussing health-consumption practices, as empirical evidence.
Findings
Before the outbreak of the pandemic, participants worked hard to achieve high levels of integration in the UK. The pandemic changed this; participants faced unexpected changes in the UK’s sociocultural structures. They were forced to exercise the layered and complex “coping with coping” in a hostile host environment that signalled their new marginalised status. They faced impossible choices, from catching a life-threatening disease to being seen as overly cautious. Such experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society.
Research limitations/implications
It is important to note that the Taiwanese sample recruited through Facebook community groups is biased and has a high level of homogeneity. These participants were well-integrated, middle-class migrants who were highly educated, relatively resourceful and active on social media. More studies are needed to fully understand the impact on well-being and acculturation of migrants from different cultural, contextual and social backgrounds. This being the case, the authors can speculate that migrants with less resource are likely to have found the pandemic experience even more challenging. More studies are needed to fully understand migrant experience from different backgrounds.
Practical implications
Public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. In particular, this paper has shown how separation, especially if embraced temporarily, is not necessarily a negative outcome to be corrected with specific policies. It can be strategically adopted by migrants as a way of defending their health and well-being from an increasingly hostile environment. Migrants' home country experience provides vicarious learning opportunities to acquire good practices. Their voices should be encouraged rather than in favour of a surprising orthodox and rather singular approach in the discussion of public health management.
Social implications
The paper has clear public health policy implications. Firstly, public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. Acknowledging migrants' voice is a critical first step to contribute to the development of a fair and inclusive society. Secondly, to retain skilful migrants and avoid a future brain-drain, policymakers are advised to advance existing infrastructure to provide more incentives to support and retain migrant talents in the post-pandemic recovery phase.
Originality/value
This paper reveals how a group of previously well-integrated migrants had to exercise “coping with coping” during the COVID crisis. This experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society. It contributes to the understanding of acculturation by showing how a such crisis can significantly disrupt migrants' acculturation journey, challenging them to re-acculturate and reconsider their identity stance. It shows how separation was indeed a good option for migrants for protecting their well-being from a newly hostile host environment.