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Article
Publication date: 1 August 2018

Sandra C. Buttigieg, Kevin Agius, Adriana Pace and Maria Cassar

The purpose of this paper is to identify the extent to which immigrant nurses have integrated within the Maltese healthcare system.

Abstract

Purpose

The purpose of this paper is to identify the extent to which immigrant nurses have integrated within the Maltese healthcare system.

Design/methodology/approach

This research consisted of a qualitative case study approach which was conducted within Malta’s four public entities in the secondary care sector. In this case study, data were collected through 34 semi-structured interviews with ten nursing managers, 12 Maltese nurses and 12 immigrant nurses. The data were analysed using content analysis. Data were collected between June 2015 and July 2015.

Findings

Four themes emerged from the data. These were: human resources management, language barrier, cultural differences and discrimination. The recruitment of nurses to Malta from other countries translated into several positive and favourable outcomes, such as the sharing of knowledge. However, a number of negative and unfavourable outcomes are also indicated in the data including language barrier and discrimination.

Research limitations/implications

This paper presents a discussion of the issues experienced within a healthcare system in relation to the mobility of nurses. Increasingly, the nursing workforce across the globe comprises of professionals from various nationality, origin, training, culture and professional ethos. The findings are presented in an effort to inform policy makers, management and administrative structures regarding the issues pertaining to the prevalent growing reality of mobility in nurse populations.

Originality/value

This research study provides a unique contribution to the literature regarding the phenomenon of nurse mobility because it embraces the integration of nurses as a two-way process. Since data was collected from immigrant nurses as well as from local nurses and nursing managers, this study hopes to offer a different point of view from previous studies which largely focused on the views of immigrant nurses only.

Details

International Journal of Migration, Health and Social Care, vol. 14 no. 3
Type: Research Article
ISSN: 1747-9894

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Article
Publication date: 15 May 2017

Sandra C. Buttigieg, Adriana Pace and Cheryl Rathert

The purpose of this paper is to give a comprehensive and updated analysis of the available literature on hospital dashboards.

Abstract

Purpose

The purpose of this paper is to give a comprehensive and updated analysis of the available literature on hospital dashboards.

Design/methodology/approach

A search of the current literature was performed by searching electronic databases, including Google Scholar, EBSCO and Medline, as well as books.

Findings

In all, 48 manuscripts consisting of peer reviewed articles, conference proceedings, case reports and text books were included in this review.

Practical implications

Despite the numerous advantages of performance dashboards, several authors have mentioned a number of challenges. It was evident from the literature that any setting requires significant effort, especially to ensure the quality of data being collected. In fact, significant investment, both in terms of financial and human resources, is required to achieve an effective dashboard. Furthermore, most of the studies available in the literature were individual case reports or anecdotal accounts rather than empirical studies. Thus, further research is required to ascertain the effectiveness of performance dashboards. In view of these findings, each organisation should make its own decisions whether or not to adopt performance dashboards.

Originality/value

Most of the literature is fragmented as it reports the use of different types of dashboards, namely strategic, tactical and operational, as separate tools. This literature review contributes to knowledge as it brings together the different types of dashboards and the cascading effect of one dashboard onto another in order to achieve and retain organisational alignment with the overall strategic goals.

Details

Journal of Health Organization and Management, vol. 31 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 20 September 2019

Lorraine Abela, Adriana Pace and Sandra C. Buttigieg

Hospital length of stay (LOS) is not only a function of patient- and disease-related factors, but is also determined by other health system-wide variables. Managers and…

Abstract

Purpose

Hospital length of stay (LOS) is not only a function of patient- and disease-related factors, but is also determined by other health system-wide variables. Managers and clinicians strive to achieve the best possible trade-off between patients’ needs and efficient utilisation of hospital resources, while also embracing ethical decision making. The purpose of this paper is to explore the perceptions of the hospital’s major stakeholders as to what affects the duration of LOS of inpatients.

Design/methodology/approach

Using a data-triangulated case study approach, 50 semi-structured interviews were performed with management, doctors, nurses and patients. Additionally, the hospitals’ standard operating procedures, which are pertinent to the subject, were also included in the thematic analysis.

Findings

This study shows that LOS is a multi-dimensional construct, which results from a complex interplay of various inputs, processes and outcomes.

Research limitations/implications

The findings emerging from a single case study approach cannot be generalised across settings and contexts, albeit being in line with the current literature.

Practical implications

The study concludes that a robust hospital strategy, which addresses deficient organisational processes that may unnecessarily prolong LOS, is needed. Moreover, the hospital’s strategy must be sustained by providing good primary care facilities within the community set-up, as well as by providing more long-term care and rehabilitation beds to support the hospital turnover.

Originality/value

The subject of LOS in hospitals has so far been tackled in a fragmented manner. This paper provides a comprehensive and triangulated account of the complexities surrounding the duration in which patients are kept in hospital by key stakeholders, most of whom were hands-on in the day-to-day running of the hospital under study.

Details

Journal of Health Organization and Management, vol. 33 no. 6
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 11 April 2018

Sandra C. Buttigieg, Lorraine Abela and Adriana Pace

Tertiary hospitals have registered an incremental rise in expenditure mostly because of the increasing demands by ageing populations. Reducing the length of stay (LOS) of…

Abstract

Purpose

Tertiary hospitals have registered an incremental rise in expenditure mostly because of the increasing demands by ageing populations. Reducing the length of stay (LOS) of patients within tertiary hospitals is one of the strategies, which has been used in the last decades to ensure health care systems’ sustainability. Furthermore, LOS is one of the key performance indicators, which is widely used to assess hospital efficiency. Hence, it is crucial that policy makers use evidence-based practices in health care to aim for optimal LOS. The purpose of this paper is to identify and summarize empirical research that brings together studies on the various variables that directly or indirectly impact on LOS within tertiary hospitals so as to develop a LOS causal systems model.

Design/methodology/approach

This scoping review was guided by the following research question: “What is affecting the LOS of patients within tertiary-level health care?” and by the guidelines specified by Arksey and O’Malley (2005), and by Armstrong et al. (2011). Relevant current literature was retrieved by searching various electronic databases. The PRISMA model provided the process guidelines to identify and select eligible studies.

Findings

An extensive literature search yielded a total of 30,350 references of which 46 were included in the final analysis. These articles yielded variables, which directly/indirectly are linked to LOS. These were then organized according to the Donabedian model – structure, processes and outcomes. The resultant LOS causal model reflects its complexity and confirms the consideration by scholars in the field that hospitals are complex adaptive systems, and that hospital managers must respond to LOS challenges holistically.

Originality/value

This paper illustrates a complex LOS causal model that emerged from the scoping review and may be of value for future research. It also highlighted the complexity of the construct under study.

Details

Journal of Health Organization and Management, vol. 32 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 10 April 2017

Adriana Pace and Sandra C. Buttigieg

The purpose of this paper is to analyse hospital dashboards’ visibility of information at different management levels to improve quality and performance in an acute…

Abstract

Purpose

The purpose of this paper is to analyse hospital dashboards’ visibility of information at different management levels to improve quality and performance in an acute general hospital.

Design/methodology/approach

Data were generated via 21 semi-structured interviews across different management levels.

Findings

All management levels had greater visibility of information, could make informed decisions, and registered performance improvement. Specifically, waiting time improved, however since introduction of hospital dashboards was work-in-progress at time of study, managers could not record improvement in terms of cost reductions, clinical effectiveness, patient safety and patient satisfaction. Different managerial levels had different visibility with top management having the greatest.

Research limitations/implications

In single case studies, where only one context is used, the findings cannot be reproduced in different contexts; even though most of the results could be matched with the current literature.

Practical implications

The need to have balanced key performance indicators that take into account other facets of improvements, apart from time, has been emphasised. Furthermore, if middle and departmental managers have greater visibility, this would allow them to work towards a strategic fit between the departments that they manage with the rest of the hospital.

Originality/value

There is scant literature regarding performance dashboards’ enhancement of visibility of information at different management levels. Furthermore, according to the authors’ knowledge, no other paper has tried to identify and discuss the different levels of information, which should be visible from bedside to board namely to management, clinicians and public.

Details

Journal of Health Organization and Management, vol. 31 no. 2
Type: Research Article
ISSN: 1477-7266

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Case study
Publication date: 1 January 2011

Andres Hatum

Strategic and organisational change, adaptation responses under competitive pressure and uncertainty and transformational process.

Abstract

Subject area

Strategic and organisational change, adaptation responses under competitive pressure and uncertainty and transformational process.

Study level/applicability

For Executive MBAs or MBA programs.

Case overview

Founded in 1948 by Adrian Urquía, Aceitera General Deheza (AGD) transformed itself from a small oil-processing factory into the biggest indigenous firm in the industry. Nowadays AGD is a leading edible oil export company and also one of the frontrunners on the retail market for bottled oil with several successful brands. It ranked 40th among the 1,000 top companies in terms of turnover in Argentina in 1999 (Revista Mercado, 1999), and it is considered the fifth most important exporter in the country (Revista Mercado, 1999).After the changes the country went through in the 1990s, the company was able to adapt and thrive in an industry in which most indigenous businesses did not manage to survive. Nevertheless, the roots of AGD's success do not date from the 1990s but long before, in their thinking ahead about ways of improving technology, scale and cost-effective measures – a trio of decisions that would prove to be the right combination for survival and success.

Expected learning outcomes

An understanding of the process of business transformation: type and pace of change. The study of the transformation process of a firm will be complemented conceptually with the understanding of the adaptation process under the Argentinean context characterised by uncertainty. Students will also examine organisational flexibility. Defining organisational flexibility, the determinants of whether a firm is flexible or not and why we can consider AGD as a flexible firm.

Supplementary materials

Teaching note.

Details

Emerald Emerging Markets Case Studies, vol. 1 no. 1
Type: Case Study
ISSN: 2045-0621

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Article
Publication date: 21 August 2017

Adriana Zait

The purpose of this paper was to identify the main necessary competences for smart cities’ development. From their inception until now, smart cities are striving to…

Abstract

Purpose

The purpose of this paper was to identify the main necessary competences for smart cities’ development. From their inception until now, smart cities are striving to clarify their identity and become better, and thus, smarter. The whole process is in many ways similar to the journey of a child in his quest of growing into a smart adult, with the help of parents and support from educators. But it is not easy to tell how we, as citizens, through civic, educational and governance structures, raise smart cities. What competences do we need? This was the main question for the present essay, generated from several theoretical and practical experiences.

Design/methodology/approach

In this study, literature analysis, synthesis and theoretical inferences, for the smart city problematiques, and induction and exploratory qualitative analysis, for soft, civilizational competences, were used.

Findings

The main conclusion is that the literature still associates the smart city especially with its hard dimension, the highly developed and intelligent technologies, including information and communication technologies (ICTs), despite a growing number of studies dedicated to the soft, human and social capital component. The intangible, soft component – the human actor – plays an equally, if not even more important role, through mechanisms affecting all classical dimensions of smart cities (smart economy, people, governance, mobility, environment, living). Civilizational competences, soft skills or human-related characteristics of cities strongly influenced by culture (at national, regional, organizational and individual levels) are crucial for the development of smart and competitive cities. Civilizational competences are grouped into four categories: enterprise culture, discoursive culture, civic culture and daily culture. If we want to make our cities smart, we need to develop these competences – first define them, then identify their antecedents or influence factors and measure them.

Research limitations/implications

The study has several limits. First, the exploratory nature in itself, with many inductive and abductive suppositions that will need further testing. Second, the literature selection has a certain degree of subjectivity owing to the fact that besides the common, classical theory of smart cities, the authors were particularly interested in rather heterodox opinions about the subject, which lead them to the inclusion of singular or isolated points of view on narrower issues.

Practical implications

The findings of this exploratory conceptual essay could be used for further testing of hypotheses on the relationship between civilizational competences and smart cities’ development.

Social implications

Local and regional administrations could use the results to increase civil society’s involvement in the development of smart cities.

Originality/value

The study points out some new connections and relations for the smart city problematiques, and explicitly suggests relating the development of smart cities to the development of civilizational competences, as a complex category of factors going beyond the unique dimension of “people” or “human and social capital” from the smart cities literature. It is an exploratory outcome, generating new research hypotheses for the relationships between smart city development and culture-related factors grouped under the “cities” civilizational competences’ label.

Details

Transforming Government: People, Process and Policy, vol. 11 no. 3
Type: Research Article
ISSN: 1750-6166

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Article
Publication date: 1 November 2006

Adriana Zait

The purpose of this paper is to offer some personal thoughts into the meaning of education in Romania.

Abstract

Purpose

The purpose of this paper is to offer some personal thoughts into the meaning of education in Romania.

Design/methodology/approach

This paper explores a model of four stages of student teacher interactions and the rigidity of teacher behavior in past times. The model is presented: students as dependent, interested, involved and/or self‐directed related to teachers as experts, motivators, facilitators and/or delegators. The paper then expresses the frustrations of modern teaching and the appropriate interactions according to the model.

Findings

Although there are some good professors and good students, who understand what education is, what they can offer and can get, as partners in the educational process, their number is too small, and the pace of adapting to the system of the others (new students or young assistants) is too fast.

Originality/value

The paper stresses the necessary movement away from excessive and oppressive upper level decision‐making behavior in education.

Details

Journal of Organizational Change Management, vol. 19 no. 6
Type: Research Article
ISSN: 0953-4814

Keywords

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Article
Publication date: 15 August 2019

Andreia Gabriela Andrei, Adriana Zait, Claudia Stoian, Oana Tugulea and Adriana Manolica

The purpose of this study is to analyze citizen engagement and to explain the underlying mechanism that makes well-intended people to act as disinformation amplifiers in…

Abstract

Purpose

The purpose of this study is to analyze citizen engagement and to explain the underlying mechanism that makes well-intended people to act as disinformation amplifiers in the online space. The study offers new insights to be used by knowledge management for improving society’s potential to downsize the impact of disinformation that puts both knowledge system and social trust (ST) under high pressure.

Design/methodology/approach

The study proposes an integrative research model to explain how ST and conspiracy mentality (CM) are influencing citizen engagement in public life through different forms of action that is specific to offline or online spaces. The research model and its nine hypotheses are tested based on a survey for data collection and partial least squares method for data analysis.

Findings

The study finds that both online and offline actions are mediating the positive effect of ST on citizen engagement. Yet, CM has a high impact on online actions, and it exerts a significant indirect influence on citizen engagement in this manner.

Originality/value

Revealing the mediator role of online actions in the relationship between CM and civic engagement, the paper brings novel insights on disinformation spreading. The study explains how citizen engagement can sometimes be turned against social well-being because those prone to belief in conspiracies are the perfect targets of deceivers seeking for disinformation amplifiers in the online environment.

Details

Kybernetes, vol. 49 no. 5
Type: Research Article
ISSN: 0368-492X

Keywords

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Article
Publication date: 12 December 2019

Tarun Nanda, Himanshu Gupta, Tejinder P. Singh, Simonov Kusi-Sarpong, Chiappetta Jose Charbel Jabbour and Adriana Cherri

Technology and knowledge have become the buzzwords of the new millennium. Technological changes and demanding customers are creating a more knowledge intensive, turbulent…

Abstract

Purpose

Technology and knowledge have become the buzzwords of the new millennium. Technological changes and demanding customers are creating a more knowledge intensive, turbulent, complex and uncertain environment. Organizations, which are able to continually build faster and cheaper new strategic assets than their competitors, create long-term competitive advantages. Thus, the growth of companies is directly associated with innovativeness and technological development, especially for small organizations that are more vulnerable to dynamic changes in market place. Organizations need a strategic framework that can help them to achieve the goal of technology development and competitiveness. The purpose of this paper is to develop such strategic framework for small organizations for their technology development and, hence, survival in marketplace.

Design/methodology/approach

Options field methodology, options profile methodology, analytic hierarchy process (AHP) and fuzzy set theory are utilized to generate various options and profiles to propose a conceptual framework for technology development.

Findings

The results from the study showed that “mixed approach,” “strategic simulation approach” and the “regulatory environment approach,” in this order, emerged as the top three important options for the strategic technological development of small manufacturing enterprises.

Originality/value

This result can provide an original and more accurate implementation pathway toward technological innovative development in emerging economies. The proposed framework can provide valuable guidelines and recommendations to practicing managers and analysts for policy development to promote innovative and technological developments.

Details

Benchmarking: An International Journal, vol. 27 no. 2
Type: Research Article
ISSN: 1463-5771

Keywords

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