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1 – 10 of 187Value-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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Michael Price, Nicholas Wong, Charles Harvey and Mairi Maclean
This study explores how a small minority of social entrepreneurs break free from third sector constraints to conceive, create and grow non-profit organisations that generate…
Abstract
Purpose
This study explores how a small minority of social entrepreneurs break free from third sector constraints to conceive, create and grow non-profit organisations that generate social value at scale in new and innovative ways.
Design/methodology/approach
Six narrative case histories of innovative social enterprises were developed based on documents and semi-structured interviews with founders and long serving executives. Data were coded “chrono-processually”, which involves locating thoughts, events and actions in distinct time periods (temporal bracketing) and identifying the processes at work in establishing new social ventures.
Findings
This study presents two core findings. First, the paper demonstrates how successful social entrepreneurs draw on their lived experiences, private and professional, in driving the development and implementation of social innovations, which are realised through application of their capabilities as analysts, strategists and resources mobilisers. These capabilities are bolstered by personal legitimacy and by their abilities as storytellers and rhetoricians. Second, the study unravels the complex processes of social entrepreneurship by revealing how sensemaking, theorising, strategizing and sensegiving underpin the core processes of problem specification, the formulation of theories of change, development of new business models and the implementation of social innovations.
Originality/value
The study demonstrates how social entrepreneurs use sensemaking and sensegiving strategies to understand and address complex social problems, revealing how successful social entrepreneurs devise and disseminate social innovations that substantially add value to society and bring about beneficial social change. A novel process-outcome model of social innovation is presented illustrating the interconnections between entrepreneurial cognition and strategic action.
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Jacob Mickelsson, Ulla Särkikangas, Tore Strandvik and Kristina Heinonen
People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need. Complex…
Abstract
Purpose
People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need. Complex health conditions frequently transcend the scope of typical health-care service systems. The purpose of this paper is to explore and characterize such unique assemblages of actors and services as “user-defined ecosystems”.
Design/methodology/approach
Building on literature on customer ecosystems, this paper introduces the concept of the user-defined ecosystem (UDE). Using an abductive approach, the authors apply the concept in an interpretive, qualitative study of ten families with special needs children.
Findings
This study uncovers complex UDEs, where families actively combine a broad range of services. These ecosystems are unique for each family and extend beyond the scope of designed service ecosystems. Thus, the families are forced to assume an active, coordinating role.
Research limitations/implications
This paper shows how to identify ecosystems from the user’s point of view, based on the selected user unit (such as a family) and the focal value-creating function of the ecosystem for the user.
Social implications
This paper highlights how service providers can support and adapt to UDEs and, thus, contribute to user value and well-being. This can be used to understand users’ perspectives on service and systems in health and social care.
Originality/value
This study develops the concept of the UDE, which represents a customer-focused perspective on actor ecosystems and contrasts it with a provider-focused and a distributed perspective on ecosystems. This study demonstrates the practical usefulness of the conceptualization and provides a foundation for further research on the user’s perspective on ecosystems.
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Meabh Bonham-Corcoran, Alexandra Armstrong, Amy O’Briain, Amy Cassidy and Niall Turner
This review aims to identify the commonly used nature-based therapies, the cohorts that benefit from these interventions, and the potential environmental impact of nature-based…
Abstract
Purpose
This review aims to identify the commonly used nature-based therapies, the cohorts that benefit from these interventions, and the potential environmental impact of nature-based therapies.
Design/methodology/approach
An integrative review methodology was taken. The literature was analysed and synthesised through thematic analysis.
Findings
Three themes emerged from the analysis: categories of nature-based therapies; benefits of nature-based therapies; and the gains from nature-based therapies are not universal. Evidence of physiological, psychological, social, vocational and quality of life benefits from participation in nature-based therapies was evident in the literature. However, there was insufficient empirical evidence of the benefits for the environment.
Practical implications
Occupational therapists assist populations across the life course. Consequentially, they can be found working in a diverse range of clinical contexts. This review asserts that nature-based therapies could be a positive addition in many of these contexts. Further, while engagement in activities in natural environments is frequently used by occupational therapists practicing within institution environments, there is evidence to support its use in community service models and potentially in public health strategies.
Originality/value
This integrative review brings together evidence on a diverse range of nature-based therapies, cohorts, associated benefits and factors that influence these. The lack of empirical evidence on the benefits of nature-based therapies for the environment is acknowledged as a gap in the literature
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León Poblete, Erik Eriksson, Andreas Hellström and Russ Glennon
This article aims to examine how users' involvement in value co-creation influences the development and orchestration of well-being ecosystems to help tackle complex societal…
Abstract
Purpose
This article aims to examine how users' involvement in value co-creation influences the development and orchestration of well-being ecosystems to help tackle complex societal challenges. This research contributes to the public management literature and answers recent calls to investigate novel public service governances by discussing users' involvement and value co-creation for novel well-being solutions.
Design/methodology/approach
The authors empirically explore this phenomenon through a case study of a complex ecosystem addressing increased well-being, focussing on the formative evaluation stage of a longitudinal evaluation of Sweden's first support centre for people affected by cancer. Following an abductive reasoning and action research approach, the authors critically discuss the potential of user involvement for the development of well-being ecosystems and outline preconditions for the success of such approaches.
Findings
The empirical results indicate that resource reconfiguration of multi-actor collaborations provides a platform for value co-creation, innovative health services and availability of resources. Common themes include the need for multi-actor collaborations to reconfigure heterogeneous resources; actors' adaptive change capabilities; the role of governance mechanisms to align the diverse well-being ecosystem components, and the engagement of essential actors.
Research limitations/implications
Although using a longitudinal case study approach has revealed stimulating insights, additional data collection, multiple cases and quantitative studies are prompted. Also, the authors focus on one country but the characteristics of users' involvement for value co-creation in innovative well-being ecosystems might vary between countries.
Practical implications
The findings of this study demonstrate the value of cancer-affected individuals, with “lived experiences”, acting as sources for social innovation, and drivers of well-being ecosystem development. The findings also suggest that participating actors in the ecosystem should utilise wider knowledge and experience to tackle complex societal challenges associated with well-being.
Social implications
Policymakers should encourage the formation of well-being ecosystems with diverse actors and resources that can help patients navigate health challenges. The findings especially show the potential of starting from the user's needs and life situation when the ambition is to integrate and innovate in fragmented systems.
Originality/value
The proposed model proposes that having a user-led focus on innovating new solutions can play an important role in the development of well-being ecosystems.
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Khwanhathai Changyai, Puangpaka Kongvattananon and Chomchuen Somprasert
The purpose of this paper is to synthesize the experiences and needs of colorectal cancer patients during postoperative recovery.
Abstract
Purpose
The purpose of this paper is to synthesize the experiences and needs of colorectal cancer patients during postoperative recovery.
Design/methodology/approach
This study is an integrative review, conducted by CINAHL, PubMed, ScienceDirect and ThaiJO from 2009 to 2019. Ten research articles published have been selected by PRISMA process.
Findings
Results show the experiences of colon cancer patients during postoperative recovery consisted of four themes, namely suffering, decreased activity, ambivalent feeling and need of caring.
Research limitations/implications
The health care personnel should be aware of these experiences and give holistic care in order to let the patients free from unpleasant experiences and receive the responses which really meet their needs.
Originality/value
Knowledge about the experience and needs of colorectal cancer patients after surgery is of great benefit to healthcare providers who are planning the care, so as to achieve complete holistic care in the future research.
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