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Electronic Health Records (EHRs) and other Health Information Technologies (HITs) pose significant challenges for clinicians, administrators and managers in the field of primary care. While there is an abundance of literature on the challenges of HIT systems in primary care, there are also practices where HITs are well-integrated and useful for care delivery. This study aims to (1) understand how exemplary primary care practices conceptualized data and HIT system use in their care delivery and (2) describe components that support and promote data and HIT system use in care delivery.

This paper is a sub-analysis of a larger qualitative data set on exemplary primary care in which data was collected using in-depth interviews, observations, field notes and primary source documents from week-long site visits at each organization. Using a combination of qualitative analysis methods including elements of thematic analysis, discourse analysis, and qualitative comparison analysis, we examined HIT-related data across six exemplary primary care organizations.

Three key components were identified that underlie engagement with data and HIT systems: data audience identification, defined data purpose and structures for participation in both data design and maintenance.

Within the context of primary care, these findings have implications for effective integration of HIT systems into primary care delivery.

The purpose of this study is to develop a methodology in which alternate Six Sigma projects are prioritized and selected using appropriate multi-criteria decision-making (MCDM) methods in healthcare organizations. This study addresses a particular gap in implementing a systematic methodology for Six Sigma project prioritization and selection in the healthcare industry.

This study develops a methodology in which alternate Six Sigma projects are prioritized and selected using a modified Kemeny median indicator rank accordance (KEMIRA-M), an MCDM method based on a case study in healthcare organizations. The case study was hypothetically developed in the healthcare industry and presented to demonstrate the proposed framework’s applicability and validity for future decision-makers who will take place in Six Sigma project selection processes.

The study reveals that the Six Sigma project prioritized by KEMIRA-M assign the highest ranks to patient satisfaction, revenue enhancement and sigma level benefit criteria, while resource utilization and process cycle time receive the lowest rank.

The methodology developed in this paper proposes an MCDM-based approach for practitioners to prioritize and select Six Sigma projects in the healthcare industry. The findings regarding patient satisfaction and revenue enhancement mesh with the current trends that dominate and regulate the industry. KEMIRA-M provides flexibility for Six Sigma project selection and uses multiple criteria in two-criteria groups, simultaneously. In this study, a more objective KEMIRA-M method was suggested by implementing two different ranking-based weighting approaches.

This is the first study that implements KEMIRA-M in Six Sigma project prioritization and selection process in the healthcare industry. To overcome previous KEMIRA-M shortcomings, two ranking based weighting approaches were proposed to form a weighting procedure of KEMIRA-M. As the first implementation of the KEMIRA-M weighting procedure, the criteria weighting procedure of the KEMIRA-M method was developed using two different weighting methods based on ranking. The study provides decision-makers with a methodology that considers both benefit and cost type criteria for alternates and gives importance to experts’ rankings related to criteria and the performance values of alternates for criteria.

The purpose of this paper is to provide a systematic review of empirical evidence on the labour market effects of health insurance from the supply side.

The study covers the largest peer-reviewed and working paper databases for labour economics and health studies. These include Web of Science, Google Scholar, Pubmed and the most popular economics working paper sources such as NBER, ECONSTOR, IDEAS, IZA, SSRN, World Bank Working Paper Series. The authors follow the PRISMA 2009 protocol for systematic reviews.

The collection includes 63 studies. The outcomes of interest are the number of hours worked, the probability of employment, self-employment and the level of economic formalisation. The authors find that the current literature is vastly concentrated on the USA. Spousal coverage in the USA is associated with reduced labour supply of secondary earners. The effect of Medicaid in the USA on the labour supply of its recipients is ambiguous. The employment-coverage link is an important determinant of the labour supply of people with health problems and self-employment decisions. Universal coverage may create either an incentive or a disincentive to work depending on the design of the system. Finally, evidence on the relationship between health insurance and the level of economic formalisation in developing countries is fragmented and limited.

This study reviews the existing literature on the labour market effects of health insurance from the supply side. The authors find a large knowledge gap in emerging economies where health coverage is expanding. The authors also highlight important literature gaps that need to be filled in different themes of the topic.

This is the first systematic review on the topic which is becoming increasingly relevant for policy makers in developing countries where health coverage is expanding.

Lean Six Sigma (LSS) is a widely accepted business improvement methodology in healthcare, which aims to improve operations and quality and reduce cost, medical errors and waiting time by combing the principles of lean thinking with Six Sigma methodologies. To implement LSS successfully in healthcare organizations it is necessary to know the readiness level before starting the change process. Thus, the purpose of this paper is to assess the readiness level for the implementation of LSS in healthcare using a fuzzy logic approach.

The current study uses a fuzzy logic approach to develop an assessment model for readiness to implement LSS. The conceptual model for readiness is developed with 5 enablers, 16 criteria and 48 attributes identified from the literature review. The current study does the study in a medium-size hospital from India.

The fuzzy readiness for implementation of LSS index (FRLSSI) and fuzzy performance importance index (FPII) are calculated to identify the readiness level for the implementation of LSS in the case hospital. The FRLSSI is computed as average ready with (3.30, 5.06 and 6.83) and the FPII computed helps to identify 15 weaker attributes from 48 attributes.

The current study uses only one hospital for study. In the future, the model can be tested in many hospitals.

The current study would be used by the managers of a healthcare organization to identify the readiness level of their organization to implement LSS. The proposed model is based on the identification of enablers, criteria and attributes to assess the readiness level of a healthcare organization and it helps to improve the readiness level to implement LSS effectively.

The present study contributes to the knowledge of readiness for the implementation of LSS in a healthcare organization. The conceptual model is developed for assessing the readiness level of a healthcare organization and it helps to improve the readiness level for successful implementation of LSS. Weaker attributes are identified and necessary corrective actions should be taken by the management to improve the readiness. The continuation of the assessment readiness model over a period of time would help to improve the readiness level of healthcare for the implementation of LSS.

Launched in 2005, the Food Systems Leadership Institute (FSLI) is a 2-year leadership development program primarily focused on academic leaders. As of spring 2020, FSLI has enrolled 15 Cohorts, training a total of 347 Fellows. In 2020, a review of the graduated cohorts was undertaken to understand both the range of institutions served by FSLI and the career trajectory of the 319 graduated Fellows who participated in Cohorts 1-14. A total of 78 different organizations have enrolled FSLI participants, including 79% of the 1862 Land Grant Universities, 68% of the 1890 Land Grant Universities, and 12% of the 1994 Institutions, in addition to fewer participants from non-Land Grant public universities, government institutions, industry, and institutions located outside of the U.S. FSLI has served participants from 84% of the US and Territories. The review showed that 46% of Fellows in Cohorts 1-14 advanced into higher positions of academic administration and they filled 169 new hierarchical positions, including college-level, university-level and system-level administration positions in higher education. Similar trajectories were found in industry-organizations, although in smaller numbers. In all, 470 administrative and leadership positions have been filled in these organizations by the 319 members of the cohorts reviewed. While career progression is a limited measure of leadership success, this brief review supports the hypothesis that participation in the FSLI program contributes to the careers of the enrolled participants.

This paper aims to examine the views of physicians in senior management positions regarding the distinctive characteristics and roles of leaders in the Israeli health-care system and what might be the interactions between management and leadership.

In total, 13 semi-structured in-depth interviews were conducted with physicians in senior management positions. Interviews were recorded, transcribed and analyzed using the qualitative-phenomenological method.

Interviewees discerned leaders as exhibiting traits of transformational leadership and managers, as expressing characteristics of transactional leadership. Most interviewees asserted that physicians should act as social leaders promoting public health and equality in health care, beyond their clinical practice. They agreed that physicians should fill most senior positions in the health-care system, provided they undergo appropriate training in management, leadership and interdisciplinary collaboration.

Interviewees revealed gaps between the aspiration to lead, perceptions of physicians as leaders and what occurs in reality: physicians wish to assume leadership roles in the health-care system and emphasize the qualities of transformative leadership, but medical education does not include leadership training. Therefore, there is a need to develop training programs for physicians in management and leadership. There is also a need to integrate physicians from various communities to promote local leadership in the health-care field and to reduce disparities. The consideration of health-care leadership is especially applicable in the context of the Covid-19 pandemic, which has placed the question of leadership within and outside of the medical community in a broader social context.

The purpose of this paper is to examine the predictors of perceived quality of work life (QWL) by accentuating on human resource interventions in healthcare units.

Primary data were accumulated from 158 health care employees through a structured questionnaire from healthcare organisations in India. Statistical analysis was done using tools like factor analysis and multiple regression analysis by using SPSS (version 20).

A total of 18 independent variables was used in the study, only four factors were extracted specifically work life balance, communication, teamwork and empowerment were found to be significant predictors of perceived QWL. The proposed hypotheses for this study are significant.

This work provides a pragmatic view about the compendium of human resource interventions pivotal for better QWL in healthcare organisations. The survey also offers insights to healthcare managers, administrators and practitioners for implementing these interventions.

This work clearly reflects on the relationship of HR intervention and QWL in the new context of health care.

Governments everywhere are implementing reform to improve primary care. However, the existence of a high degree of professional autonomy makes large-scale change difficult to achieve. The purpose of this paper is to elucidate the change dynamics and the involvement of professionals in a primary healthcare reform initiative carried out in the Canadian province of Quebec.

An empirical approach was used to investigate change processes from the inception of a public policy to the execution of changes in professional practices. The data were analysed from a multi-level, combined contextualist-processual perspective. Results are based on a longitudinal multiple-case study of five family medicine groups, which was informed by over 100 interviews, questionnaires, and documentary analysis.

The results illustrate the multiple processes observed with the introduction of planned large-scale change in primary care services. The analysis of change content revealed that similar post-change states concealed variations between groups in the scale of their respective changes. The analysis also demonstrated more precisely how change evolved through the introduction of “intermediate change” and how cycles of prescribed and emergent mechanisms distinctively drove change process and change content, from the emergence of the public policy to the change in primary care service delivery.

This research was conducted among a limited number of early policy adopters. However, given the international interest in turning to the medical profession to improve primary care, the results offer avenues for both policy development and implementation.

The findings offer practical insights for those studying and managing large-scale transformations. They provide a better understanding of how deliberate reforms coexist with professional autonomy through an intertwining of change content and processes.

This research is one of few studies to examine a primary care reform from emergence to implementation using a longitudinal multi-level design.

The Food Systems Leadership Institute (FSLI) is a 2-year leadership development program consisting of 3 intensive in-person immersion retreats, and a robust and customizable distance-based program. Participants come primarily from land-grant and public universities and learn about personal, organizational and system leadership with a focus on food systems as an organizing theme. For this study, program graduates from FSLI Cohorts 4-6 (n=60) were asked to complete an online retrospective pre- and post-test of skill competency and skill use for 20 competencies addressed in the program, with 47 (78%) completing the survey. Data indicate participants’ ratings of skill competency increased significantly across all 20 targeted areas.Participants further noted that they used these skills more after completing the program as compared to prior to the Fellowship training. Data suggest the FSLI model of leadership development can have a significant impact on participants’ perceived skill level in and use of important skills in both personal and organizational leadership in academic and food system settings.

The purpose of this paper is to identify the primary executive leadership skills required to promote the effectiveness of Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) and to create a new substantive theory describing these skills. The author identifies that MSSP ACO is a relatively new value-based care delivery (VBCD) structure in the USA that links clinicians’ compensation to their clinical outcomes. The research question concerns what primary executive leadership skills are essential in the VBCD era.

This single, embedded, exploratory case study is based on interviews, a focus group discussion and archival record data of MSSP ACO executives in the Northeast, Midwest, South and West of the USA.

The findings represented seven major categories or the primary executive leadership skills required to succeed in the VBCD environment. Each category or skill included five subcategories or concepts supporting the leadership skills essential for reaching VBCD goals. The categories and subcategories gave rise to a new substantive theory – the Accountable Healthcare Leadership Theory of Five Ps: promoting partnership between providers, patients and payers.

The empirical generalizability of the results was limited by its essence as a single, embedded, exploratory case study of 18 MSSP ACO executives in 4 regions of the USA. The strength of this study, however, lies in its potential for making analytic generalizations for identifying theoretically meaningful leadership skills essential for success in the VBCD era.

The author has developed and validated a new theory describing the primary executive leadership skills required to succeed in the VBCD environment.