Search results
1 – 10 of 219Noor Fadzlina Mohd Fadhil, Say Yen Teoh, Leslie W. Young and Nilmini Wickramasinghe
This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive…
Abstract
Purpose
This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive care performance.
Design/methodology/approach
A case study method was adopted to examine how a hospital integrates its limited resources which leads to the need for resource bundles and an understanding of IS capabilities development to understand how they contribute to the delivery of preventive care in a Malaysian hospital.
Findings
This research proposes a comprehensive framework outlining resource-bundling and IS capabilities development to improve preventive care.
Research limitations/implications
We acknowledge that the problem of transferring and generalizing results has been a common criticism of a single case study. However, our objective was to enhance the reader’s understanding by including compelling, detailed narratives demonstrating how our research results offer practical examples that can be generalized theoretically. The findings also apply to similar-sized public hospitals in Malaysia and other developing countries, facing challenges like resource constraints, HIS adoption levels, healthcare workforce shortages, cultural and linguistic diversity, bureaucratic hurdles, and specific patient demographics and health issues. Further, lessons from this context can be usefully applied to non-healthcare service sector domains.
Practical implications
This study provides a succinct strategy for enhancing preventive care in Malaysian public hospitals, focusing on system integration and alignment with hospital strategy, workforce diversity through recruitment and mentorship, and continuous training for health equity and inclusivity. This approach aims to improve resource efficiency, communication, cultural competence, and healthcare outcomes.
Social implications
Efficiently using limited resources through HIS investment is essential to improve preventive care and reduce chronic diseases, which cause approximately nine million deaths annually in Southeast Asia, according to WHO. This issue has significantly impacted the socioeconomic development of developing countries.
Originality/value
This research refines resource orchestration theory with new mechanisms for resource mobilization, extends IS literature by identifying how strategic bundling forms specialized healthcare IS capabilities, enriches preventive care literature through actionable resource-bundling activities, and adds to HIS literature by advocating for an integrated, preventive care focus from the alignment of HIS design, people and institutional policies to address concerns raised by other research regarding the utilization of HIS in improving the quality of preventive care.
Details
Keywords
Karthik Padamata and Rama Devi Vangapandu
The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between…
Abstract
Purpose
The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between both the groups.
Design/methodology/approach
Authors have referred to the Victorian patient satisfaction monitoring (VPSM) scale and studied the responses of 327 patients and 327 employees collected from six private Indian tertiary care hospitals. SPSS v26 software was used to conduct the data reliability test, descriptive analysis and Mann–Whitney U test.
Findings
Authors have found significant differences in perceptions of quality of care between the patients and employees in the Indian hospitals. Employees have high positive perceptions towards the provided medical care whereas the patients have less favourable perceptions for many quality indicators.
Practical implications
This study findings help the healthcare managers, practitioners and healthcare workers of the Indian hospitals to understand the perceptions of both the employees and the patients towards healthcare quality elements and help to reduce the existing perceptual gap in the process of providing quality healthcare services.
Originality/value
To the best of authors knowledge, this is one of the pioneering studies conducted in Indian healthcare industry to capture and compare the perceptions of both the employees' and the patients' perceptions of various quality of care elements. This study highlighted the existing perceptual gap between the employees and the patients on various healthcare quality elements and indicated the critical areas for improvement to provide high quality healthcare services.
Details
Keywords
Henriikka Anne-Mari Seittu, Anneli Hujala and Minna Kaarakainen
Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred…
Abstract
Purpose
Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred (PC) IC in practice. This context-specific, small-scale study examines what PC-IC means to older patients who went through joint replacement surgery (JRS).
Design/methodology/approach
The data consists of ten in-depth interviews of older patients, focussing on their experiences of care during their patient journey related to joint knee or hip replacement surgery. The data were analysed with thematic analysis.
Findings
Three central dimensions of PC-IC for older patients were identified: information sharing, continuity of care and compassionate encountering. Human validation and compassionate encountering were experienced as important aspects of PC-IC. Compassionate encountering was concretised through professionals’ very small everyday practices, which made the patient feel comfortable and respected. Instead, probably due to the medical and quite straight-forward nature of the joint replacement care process, patients seem to be pleased to trust the expertise of professionals and did not necessarily expect an active role or participation in the decision-making.
Originality/value
This Finnish case study focusses on the patients’ authentic perceptions of what is central to person-centred IC in the specific context of JRS.
Details
Keywords
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.
Details
Keywords
Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the…
Abstract
Purpose
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.
Design/methodology/approach
Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.
Findings
The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.
Originality/value
There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.
Details
Keywords
Camilla Michaëlis, Johanna Falby Falby Lindell, Cæcilie Hansen, Allan Krasnik, Susanne Reventlow, Marie Nørredam, Melissa Lutterodt and Annette Sofie Davidsen
Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the…
Abstract
Purpose
Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the experiences of language minority patients with health-care encounters when an interpreter was needed but not present.
Design/methodology/approach
Semistructured, in-depth interviews were conducted with 13 language minority patients with limited Danish proficiency. All interviews were conducted with interpreters in the participants’ native language. Data were analyzed using an inductive thematic approach.
Findings
Most participants experienced communication difficulties and difficulties participating actively in their own health care. The experience of unresolved language barriers led to a high degree of uncertainty and left the participants with unanswered health concerns. Participants expressed a reluctance to seek health care, which consequently limited the utilization of health care services.
Research limitations/implications
Although the findings only represent a small sample of patients, the results still reveal major challenges that minority-language patients encounter when seeking health care. Future studies should explore, if the intention of the law is met through the user fees.
Practical implications
Despite having the same entitlements as native Danish-speaking patients, minority-language patients experienced difficulties accessing and using health care services due to the user fee and unresolved language barriers. The study elucidates patient perspectives and points to important ways of improving the quality of health care.
Originality/value
To the best of the authors’ knowledge, no investigation into the communicative consequences of the introduction of the user fee for interpreting services exists. Thus, this study seeks to address that gap.
Details
Keywords
Oti Amankwah, Weng-Wai Choong and Naana Amakie Boakye-Agyeman
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always…
Abstract
Purpose
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always managed and maintained with the attention required. This is due mainly to the complexity of health-care infrastructure and equipment and shortage of maintenance budget. This study aims to determine if patient’s satisfaction of core health-care business is mediated by the quality of health-care infrastructure and equipment.
Design/methodology/approach
This cross-sectional study comprises 622 adult patients at the Physician OPD and Polyclinic of Komfo Anokye Teaching hospital, Tamale Teaching hospital and Cape Coast Teaching hospital in Ghana. Structural equation model Smart PLS was used to analyse the data.
Findings
The study results showed that the quality of health-care infrastructure and equipment has a positive significant influence (mediation) on the relationship between health-care delivery and patient’s satisfaction as well as the relationship between adequacy of health-care resources and patient’s satisfaction. However, it was shown not to have a positive significant influence (mediation) on the relationship between quality of health-care personnel and patients’ satisfaction as well as health-care administrative process and patient’s satisfaction.
Research limitations/implications
First, the study findings are centred on cross-sectional data, which capture the opinion of the patients at a specific time period instead of over a period of time. Consequently, in future, though difficult to achieve, a longitudinal study can be piloted to provide more insight. Second, the data was collected from only one country (Ghana); thus, the ability to generalise the results may be a challenge.
Practical implications
The implication of this study is that there is the need to prudently maintain hospital infrastructure and equipment in good working condition as it has a positive effect on patients’ satisfaction of their overall health-care experience.
Originality/value
Most studies have concentrated on patient’s health-care experience. This study extends the knowledge of patient’s health-care experience by determining the mediating role of quality of health-care infrastructure and equipment on the relationship between patient’s satisfaction and core health-care business. There are limited studies of such nature in Ghana. Therefore, this study will provide invaluable empirical data for the health-care sector of a developing African country.
Details
Keywords
Bonnie Poksinska and Malin Wiger
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…
Abstract
Purpose
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.
Design/methodology/approach
The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).
Findings
The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.
Practical implications
The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.
Originality/value
The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.
Details
Keywords
Cinzia Storace, Serafina Esposito, Anna Maria Iannicelli and Carmela Bravaccio
To facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services…
Abstract
Purpose
To facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services post-discharge.
Design/methodology/approach
Hospitalised patients undergo the Blaylock risk assessment screening score (BRASS), a screening tool identifying those at risk of complex discharge.
Findings
Pre-pandemic, patients with a medium-to-high risk of complex discharge were predominantly discharged to their residence or long-term care facilities. During the pandemic, coinciding with an overall reduction in hospitalisation rates, there was a decrease in patients being discharged to their residence.
Originality/value
The analysis of discharges, with the classification of patients into risk groups, revealed a coherence between the BRASS score and the characteristics of the studied sample. This tool aids physicians in decision-making by identifying the need for a planned discharge in a systematic and organised manner, preventing the loss of crucial information.
Details
Keywords
Ellen Pipers, Melissa De Regge, Jochen Bergs, Sara Leroi-Werelds, Katrien Verleye and Sandra Streukens
The aim of this study is twofold: (1) to gain insight into the different perspectives on the relationship between patient and person centeredness and (2) to learn more about the…
Abstract
Purpose
The aim of this study is twofold: (1) to gain insight into the different perspectives on the relationship between patient and person centeredness and (2) to learn more about the differences between non-academic and academic stakeholders in the healthcare system.
Design/methodology/approach
This mixed-methods study includes a scoping review on person and patient centeredness and in-depth interviews with patients, caregivers, staff and management of healthcare organizations. The data were analyzed by following the six phases of Braun and Clarke.
Findings
The analysis of the data showed four different perspectives on patient versus person centeredness: (1) they are synonyms; (2) one term is favorite; (3) they should be in balance; and (4) person centeredness is the surplus on top of patient centeredness.
Research limitations/implications
There are different perspectives on patient versus person centeredness. Perspectives differ between people and can change over time. Some people feel like a patient all the time, other people feel like a person all the time, and some feel like a patient at one point in time and as a person at another point in time.
Practical implications
These different perspectives can have important implications for the so-called moments of truth. In their role as patients, people value functional encounters and in their identity as people they value meaningful encounters with caregivers.
Originality/value
By unraveling these different perspectives, novel insights were found in the different perspectives people can take.
Details