Search results

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.

“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.

The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.

This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

This study aims to advance the understanding of humble leadership (HL) in health care.

This study presents a scoping review to explore and synthesize the existing knowledge in the literature. The search process encompassed three main online databases, PubMed, Scopus and Web of Science. Due to the novelty of the topic of HL in health care and the lack of research in this area, all articles published until the end of February 2023 were considered in this study.

A total of 18 studies were included. The results showed that in the period of 2019–2023 more attention was paid to HL in health care than in previous years. The research design used in these articles included quantitative (n = 13) and qualitative (n = 5) methods and the statistical population included nurses, hospital employees and health-care department managers. Based on the results obtained, the definition of HL can be divided into two general approaches, including self-evaluation and the way one treats others. In addition, humble leaders in the health-care sector should exhibit certain behavioral characteristics and finally, the results indicated that HL has several positive consequences; however, little attention has been paid to the factors influencing HL in health care.

This research will help practitioners gain a deeper understanding of the various applications of HL in health care.

To the best of the authors’ knowledge, no comprehensive research review has yet been conducted on the application of HL in health care.

This study aims to examine the perceptions and evaluations of Muslim COVID-19 survivors and health workers regarding the halal, business and ethical attributes of hospitals during their interactions related to COVID-19 treatment.

Descriptive qualitative research with semi-structured online interviews was used to gather insights from COVID-19 survivors and health workers who treated COVID-19 patients. The findings were then compared with existing literature on hospital services and Sharia attributes.

The study found that patients and health-care workers in hospitals are concerned about whether the hospital follows Sharia law, the quality of health-care and hospital services and the ethical conduct of hospital staff. This is especially true during the COVID-19 pandemic, when patients are more anxious about religious conduct and the afterlife.

Hospitals need to address halal attributes in all aspects of their services for Muslim patients and business attributes such as standard health-care quality, service quality and ethical attributes. Participants indicated that when these needs are met, they are more likely to revisit the hospital and recommend it to others.

This study contributes to understanding the expectations of Muslim patients regarding hospital services that meet Islamic ethical and business requirements. Using the COVID-19 pandemic as a case study broadens the understanding of how to better serve Muslim customers.

Due to its ability to support well-informed decision-making, business intelligence (BI) has grown in popularity among executives across a range of industries. However, given the volume of data collected in health-care organizations, there is a lack of exploration concerning its implementation. Consequently, this research paper aims to investigate the key factors affecting the acceptance and use of BI in healthcare organizations.

Leveraging the theoretical lens of the “unified theory of acceptance and use of technology” (UTAUT), a study framework was proposed and integrated with three context-related factors, including “rational decision-making culture” (RDC), “perceived threat to professional autonomy” (PTA) and “medical–legal risk” (MLR). The variables in the study framework were categorized as follows: information systems (IS) perspective; organizational perspective; and user perspective. In Jordan, 434 healthcare professionals participated in a cross-sectional online survey that was used to collect data.

The findings of the “structural equation modeling” revealed that professionals’ behavioral intentions toward using BI systems were significantly affected by performance expectancy, social influence, facilitating conditions, MLR, RDC and PTA. Also, an insignificant effect of PTA on PE was found based on the results of statistical analysis. These variables explained 68% of the variance (R²) in the individuals’ intentions to use BI-based health-care systems.

To promote the acceptance and use of BI technology in health-care settings, developers, designers, service providers and decision-makers will find this study to have a number of practical implications. Additionally, it will support the development of effective strategies and BI-based health-care systems based on these study results, attracting the interest of many users.

To the best of the author’s knowledge, this is one of the first studies that integrates the UTAUT model with three contextual factors (RDC, PTA and MLR) in addition to examining the suggested framework in a developing nation (Jordan). This study is one of the few in which the users’ acceptance behavior of BI systems was investigated in a health-care setting. More specifically, to the best of the author’s knowledge, this is the first study that reveals the critical antecedents of individuals’ intention to accept BI for health-care purposes in the Jordanian context.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

This study aims to co-develop a Frailty, Health and Care Needs Assessment (FHCNA) questionnaire for people experiencing homelessness and explore the feasibility of its use by non-clinical staff in homeless hostels.

The FHCNA, aimed at identifying frailty and other health and care priorities for people experiencing homelessness, was co-designed in workshops (online and in person) with homelessness and inclusion health staff. Its feasibility was tested by staff and their clients in two hostels, with pre- and post-study focus groups held with hostel staff to gain input and feedback.

The FHCNA was co-developed and then used to collect 74 pairs of resident and key worker inputted data (62% of eligible hostel residents). The mean age of clients was 48 years (range 22–82 years). High levels of unmet need were identified. Over half (53%) were identified as frail. Common concerns included difficulty walking (46%), frequent falls (43%), chronic pain (36%), mental health issues (57%) and dental concerns (50%). In total, 59% of clients reported difficulty in performing at least one basic activity of daily living, while only 14% had undergone a Care Act Assessment. Hostel staff found using the FHCNA to be feasible, acceptable and potentially useful in facilitating explorations of met and unmet health and social care needs of hostel clients. By identifying unmet needs, the FHCNA has the potential to support staff to advocate for access to health and social care support.

To the best of the authors’ knowledge, this is the first study to co-develop and feasibility test a questionnaire for use by non-clinically trained staff to identify frailty and other health and care needs of people experiencing homelessness in a hostel setting.

Drawing on the pay-for-performance (P4P) and job satisfaction literatures through an analysis of qualitative studies published on the topic, the purpose of this study is to investigate the effect of a P4P-based system on job satisfaction and dissatisfaction among health care workers.

A meta-synthesis of the qualitative literature was conducted to investigate health care workers' opinions, perceptions and behaviors and fully understand what processes generate job satisfaction or dissatisfaction under P4P systems.

The findings suggest that P4P systems impact the job (dis-)satisfaction of health care workers based on the institutional, organizational, geographic and cultural context of reference. Specifically, job satisfaction – and thus motivation, occupational well-being and work engagement – can occur when the context is supportive, whereas job dissatisfaction – and thus work stress and pressure, burnout and work-life balance issues and distraction – is generated in the case of unsupportive contexts. Moreover, the findings suggest a virtuous/vicious circle whereby job satisfaction leads to positive performance and further fuels job satisfaction, while conversely job dissatisfaction generates worse performance, and this further worsens worker satisfaction.

There is a lack of studies comparing and analyzing current evidence on the job (dis-)satisfaction of health care workers operating in different contexts based on the reward system. This is the first research to analyze a significant number of studies with reference to the relation between P4P and job (dis-)satisfaction, which are topics in need of further study and investigation in health care settings around the world.

Turnover intention (TOI) has become a severe issue in Saudi Arabia’s health-care system as health professionals leave their organizations. Saudi Arabia’s health-care professionals’ TOI affects the organizations and the patients’ human rights. Therefore, this study aims to assess the factors that affected Saudi Arabia’s health-care professionals’ TOI.

This study based its findings on quantitative cross-sectional data. This study’s respondents were health-care professionals working in Saudi Arabia’s public and private health-care institutions.

By using path analysis, this study’s findings reveal that, on the one hand, job stress (JS), psychological distress (PD) and perceived work exhaustion (PWE) have positive and significant effects on TOI. On the other hand, perceived organizational support (POS) is a positive and significant predictor of TOI.

This study’s findings will help the Saudi Arabian Ministry and policymakers develop policies to encourage health professionals’ perseverance through reducing their JS, PD and PWE and by enhancing POS for health-care staff. Moreover, by controlling the increasing turnover ratio among Saudi Arabia’s health-care professionals, this study’s findings assist in overcoming the violations of human rights.

This study’s findings empirically confirm the development of TOI through JS, PD and PWE among Saudi Arabia’s health-care professionals.

Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in Arizona, United States of America (USA). This study aimed to explore the perspectives of people with a substance use disorder (SUD) on accessing integrated primary care (IPC) services in a rural-serving behavioral healthcare organization in Arizona.

Clients from a behavioral health facility in Arizona (n = 10) diagnosed with SUDs who also accessed IPC participated in a 45-min semi-structured interview.

The authors identified six overarching themes: (1) importance of IPC for clients being treated for SUDs, (2) client low level of awareness of IPC availability at the facility, (3) strategies to increase awareness of IPC availability at the behavioral health facility, (4) cultural practices providers should consider in care integration, (5) attitudes and perceptions about the experience of accessing IPC and (6) challenges to attending IPC appointments. The authors also identified subthemes for most of the main themes.

This is the first study in rural Arizona to identify valuable insights into the experiences of people with SUDs accessing IPC, providing a foundation for future research in the region on care integration.