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1 – 10 of 324Value-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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Joan Carlini, Rachel Muir, Annette McLaren-Kennedy and Laurie Grealish
The increasing financial burden and complexity of health-care services, exacerbated by factors such as an ageing population and the rise of chronic conditions, necessitate…
Abstract
Purpose
The increasing financial burden and complexity of health-care services, exacerbated by factors such as an ageing population and the rise of chronic conditions, necessitate comprehensive and integrated care approaches. While co-created service design has proven valuable in transforming some service industries, its application to the health-care industry is not well understood. This study aims to examine how health consumers are involved in health-care service co-creation.
Design/methodology/approach
The study searched 11 electronic databases for peer-reviewed articles published between 2010 and 2019. Additionally, hand searches of reference lists from included studies, Google© citation searches and searches for grey literature were conducted. The Whittemore and Knafl integrative framework guided the systematic review, and Callahan’s 6 Ws framework was used to extract data from the included articles, facilitating comparisons.
Findings
The authors identified 21 articles, mainly from the UK, North America and Australia. Despite the need for more research, findings reveal limited and geographically narrow empirical studies with restricted theory and method applications. From these findings, the authors constructed a conceptual model to enhance nuanced understanding.
Originality/value
This study offers four contributions. First, it introduces the Health Service Design Transformation Model for Comprehensive Consumer Co-Creation, illustrating health consumers’ multifaceted roles in shaping services. Second, consumer vulnerabilities in co-creating services are identified, linked to diverse consumer groups, power dynamics and decision complexity. Third, this study suggests broadening participant inclusion may enhance consumer-centricity, inclusivity and innovation in service design. Finally, the research agenda explores consumer experiences, organizational dynamics, value outcomes and co-creation theory for health-care service advancement.
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Victor Pimentel and Carlo A. Mora-Monge
This study aims to benchmark the operational efficiency of fifty-eight public hospitals across Mexico between 2015 and 2018 and identifies the most critical inputs affecting their…
Abstract
Purpose
This study aims to benchmark the operational efficiency of fifty-eight public hospitals across Mexico between 2015 and 2018 and identifies the most critical inputs affecting their efficiency. In doing so, the study analyzes the impact of policy changes in the Mexican healthcare system introduced in recent years.
Design/methodology/approach
To measure the operational efficiency of Mexican public hospitals, data envelopment analysis (DEA) window analysis variable returns to scale (VRS) methodology using longitudinal data collected from the National Institute for Transparency and Access to Information (IFAI). Hospital groups are developed and compared using a categorization approach according to their average and most recent efficiency.
Findings
Results show that most of the hospitals in the study fall in the moving ahead category. The hospitals in the losing momentum or falling behind categories are mostly large units. Hospitals with initially low efficiency scores have either increased their efficiency or at least maintained a steady improvement. Finally, the findings indicate that most hospitals classified as moving ahead focused on a single care area (cancer, orthopedic care, child care and trauma).
Research limitations/implications
This study examined the technical efficiency of the Mexican healthcare system over a four-year period. Contrary to conventional belief, results indicate that most public Mexican hospitals are managed efficiently. However, recent changes in public and economic policies that came into effect in the current administration (2018) will likely have long-lasting effects on the hospitals' operational efficiency, which could impact the results of this study.
Originality/value
To the best of authors’ knowledge, this is the first study that examines the efficiency of the complex Mexican healthcare system using longitudinal data.
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Madalyn Anne Scerri and Rajka Presbury
Spoken service language is critical for service experiences and human welfare in many service settings. However, little is known about how spoken service language can enhance…
Abstract
Purpose
Spoken service language is critical for service experiences and human welfare in many service settings. However, little is known about how spoken service language can enhance customer well-being in transformative service contexts. This paper explores spoken service language and well-being for customers experiencing vulnerability in a transformative service context, informed by an empirical account of the human welfare service of residential aged care.
Design/methodology/approach
Situated within transformative service research (TSR), this study was guided by a theoretical framework of service language and adopts a strengths-based approach to customer experiences of vulnerability. A qualitative multiple case study methodology was applied to explore carers’ perspectives on spoken service language and well-being from three residential aged care homes in Australia.
Findings
The findings demonstrate five spoken service language practices and four principles of spoken service language for well-being that co-create customer well-being and support the alleviation of customer experiences of vulnerability. Conceptualised as transformative spoken service language, the spoken service language practices and principles collectively recognise, support and leverage residents’ capabilities and uplift customer well-being, by enacting a process of mattering highly salient to transformative service contexts.
Originality/value
This study is the first to conceptualise how employee spoken service language can be used to support customer well-being and enhance transformative value for customers experiencing vulnerability to align with the goals of TSR. Practically, the study advocates for a greater awareness and more considered use of transformative spoken service language in human welfare and other transformative service contexts.
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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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Adela Elena Popa, Marta Kahancová and Mehtap Akgüç
This paper makes a conceptual contribution by intersecting two strands of literature (return to work following health issues and industrial relations) to facilitate our…
Abstract
Purpose
This paper makes a conceptual contribution by intersecting two strands of literature (return to work following health issues and industrial relations) to facilitate our understanding of the potential role of social dialogue in supporting return to work (RTW) following the diagnosis of a chronic illness. It conceptualises the levels and channels through which various actors and their interactions may play a role in RTW facilitation within the actor-centred institutional framework.
Design/methodology/approach
The paper uses an exploratory design based mainly on desk research but is also informed by roundtable discussions done in six countries as part of a larger project.
Findings
The conceptual and analytical framework (CAF) is developed to explain how various actors interact together in ways shaped by the RTW policy framework and the industrial relations systems, resulting in a continuum of RTW facilitation situations.
Originality/value
There is limited research on return-to-work policies following diagnosis of chronic illness from a comprehensive actor-oriented perspective. The existing literature usually focusses on just one stakeholder, overlooking the role of social dialogue actors. By bridging the two streams of literature and incorporating all potential actors and their interactions in a unitary model, the proposed framework provides a valuable tool to further discuss how successful RTW after a diagnosis of chronic illness can be facilitated.
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Ilkay Cankurtaran and M. Halis Gunel
Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem…
Abstract
Purpose
Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem. Additionally, a considerable number of studies have introduced the ‘healing environment concept’ as a substantial input for healthcare buildings. The purpose of this paper is to present a design guide for cancer treatment services that is compatible with the healing environment concept.
Design/methodology/approach
In this context, studies on the healing environment have been analyzed, and the legislation of some selected countries has been assessed. Then, all the filtered data are used to form the design guideline for chemotherapy department, radiation oncology department and inpatient care services under a new series of analysis criteria.
Findings
The resulting principles are revealed according to the criteria of general settlement principles, internal function relations, medical necessities, user experience, interior design, social interaction/privacy, safety, landscape design and outdoor relations by the help of proposed plans, diagrams and schematic drawings.
Originality/value
This research constitutes the first and yet only study in its field that aims to increase efficiency and user satisfaction and provide better patient-centered care while providing a design guide on health-care architecture.
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Junaid Ansari and Syed Irfan Hyder
This paper aims to understand the religio-spiritual insights of the consumers and investigate their relationship with the consumers’ attitude towards advertising and its…
Abstract
Purpose
This paper aims to understand the religio-spiritual insights of the consumers and investigate their relationship with the consumers’ attitude towards advertising and its antecedents. Religious festivals, such as Ramadan, are celebrated with high religio-spiritual contemplations, which are often targeted by intensive marketing campaigns. During these religious festivals, consumers’ attitude toward advertising is influenced when television commercials contain “unnecessary” entertainment, “inappropriate casting” of celebrities with less credibility, “cluttered” information, “phony claims” related to good for economy and “annoying content” increasing consumers’ irritation.
Design/methodology/approach
This study developed a higher-order construct of religio-spiritual insights and used “Theory of Reasoned Action” for measuring the effect of religio-spiritual insights on consumers’ attitude toward advertising. Exploratory sequential mixed methods research design was used to develop and validate the instrument. A total of 30 semi-structured interviews were conducted during i-depth analysis phase to generate themes and questionnaire. During instrument validation phase, 839 Muslim consumers were surveyed by using the questionnaire, and instrument was validated by using the co-variance-based structural equation modeling approach.
Findings
This study develops and validates the instrument of religio-spiritual insights and identifies its significant direct and mediating effects between the consumer’s attitude toward advertising and its determinants.
Originality/value
The newly developed instrument of religio-spiritual insights is based on six dimensions, namely, “beliefs and practices,” “association with higher power,” “interconnectedness,” “self-actualization,” “heart and mind involvement,” “knowledge and meanings.” This instrument of religio-spiritual insights was validated and then tested by using a conceptual framework based on the several variables, such as attitude toward advertising, irritation, good for economy, entertainment, credibility and information.
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Clair Reynolds Kueny, Alex Price and Casey Canfield
Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…
Abstract
Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.
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Constantin Bratianu, Alexeis Garcia-Perez, Francesca Dal Mas and Denise Bedford