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Open Access
Article
Publication date: 24 January 2024

Bonnie Poksinska and Malin Wiger

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…

Abstract

Purpose

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

Design/methodology/approach

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

Findings

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

Practical implications

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

Originality/value

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 11 March 2024

Anna Hallberg, Ulrika Winblad and Mio Fredriksson

The build-up of large-scale COVID-19 testing required an unprecedented effort of coordination within decentralized healthcare systems around the world. The aim of the study was to…

Abstract

Purpose

The build-up of large-scale COVID-19 testing required an unprecedented effort of coordination within decentralized healthcare systems around the world. The aim of the study was to elucidate the challenges of vertical policy coordination between non-political actors at the national and regional levels regarding this policy issue, using Sweden as our case.

Design/methodology/approach

Interviews with key actors at the national and regional levels were analyzed using an adapted version of a conceptualization by Adam et al. (2019), depicting barriers to vertical policy coordination.

Findings

Our results show that the main issues in the Swedish context were related to parallel sovereignty and a vagueness regarding responsibilities and mandates as well as complex governmental structures and that this was exacerbated by the unfamiliarity and uncertainty of the policy issue. We conclude that understanding the interaction between the comprehensiveness and complexity of the policy issue and the institutional context is crucial to achieving effective vertical policy coordination.

Originality/value

Many studies have focused on countries’ overall pandemic responses, but in order to improve the outcome of future pandemics, it is also important to learn from more specific response measures.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 2 January 2023

Tuomas Hujala and Harri Laihonen

This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform…

2129

Abstract

Purpose

This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform and service integration as a knowledge management (KM) issue and analyse how KM appears and contributes in the context of integrated care, specifically in the process of integrating social and health care.

Design/methodology/approach

The article analyses the case organisation's KM initiatives in light of the integrated care literature and recognises the tasks and requirements for effective KM when building integrated health and social care system. The empirical research material for this qualitative study consisted of the case organisation's strategy documents, the results of an external maturity assessment, KM workshop materials and publicly available documentation of the Finnish health and social care reform.

Findings

This study identifies the mechanisms by which KM can support health and social services integration. At the macro level, national coordination and regional co-operation require common information structures. At the meso level, a shared regional strategy with shared objectives guides both organisational decision-making and collaboration between professionals. At the micro level, technology supported and data-driven planning of service chains complements the experiences of professionals and may help remove obstacles to integration.

Originality/value

This study contributes to the literature on integrated care by providing a more comprehensive view of the role and tasks of knowledge and KM when reforming health and social services than approaches focussing solely on health informatics and internal efficiency.

Details

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 29 February 2024

Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and…

Abstract

Purpose

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

Design/methodology/approach

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Findings

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

Originality/value

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 14 no. 2
Type: Research Article
ISSN: 2042-6747

Keywords

Open Access
Article
Publication date: 27 January 2023

Farooq Ali and Harri Haapasalo

This article aims to address the confusion related to the meanings of interorganisational cooperation, control, coordination and collaboration in collaborative projects by…

3421

Abstract

Purpose

This article aims to address the confusion related to the meanings of interorganisational cooperation, control, coordination and collaboration in collaborative projects by developing a conceptual framework. From this, the authors aim to describe the links among these concepts in terms of development levels of stakeholder relationships. In addition, the authors aim to identify challenges and preconditions in relation to developing relationships at different levels.

Design/methodology/approach

The authors have adopted the directed approach of qualitative content analysis method to validate and extend the conceptual framework of this study. The context of this study is a large hospital construction project located in northern Finland.

Findings

The findings of this study suggest that collaboration is a multilevel process of active engagement of multiple stakeholders. These stakeholders must have a high degree of shared understanding in terms of cooperation, control and coordination to achieve the mutually desired outcomes. This study also identifies the challenges that project stakeholders could face in developing collaborative relationships and propose preconditions for the same.

Practical implications

This study provides a better understanding for project managers to manage interorganisational collaborative construction projects successfully. The outcome of this research would be beneficial to project management team to deliver dispute-free construction projects.

Originality/value

Existing practical research on the development of relationships at different levels in collaborative construction projects is limited. This study offers a framework for the same which is validated in a real-life project.

Details

International Journal of Managing Projects in Business, vol. 16 no. 8
Type: Research Article
ISSN: 1753-8378

Keywords

Open Access
Article
Publication date: 16 March 2023

Imoh Antai and Roland Hellberg

The total defence (TD) concept constitutes a joint endeavour between the military forces and civil defence structures within a TD state. Logistics is essential for such joint…

Abstract

Purpose

The total defence (TD) concept constitutes a joint endeavour between the military forces and civil defence structures within a TD state. Logistics is essential for such joint collaboration to work; however, the mismatch between military and civil defence logistics structures poses challenges for such joint collaboration. The purpose of this paper is to identify logistics concept areas within the TD framework that allow for military and civil defence collaborations from a logistics operations perspective.

Design/methodology/approach

Pattern-matching analysis is used to compare patterns found in the investigated case with those prescribed from the literature and predicted to occur. The study seeks to identify logistics concepts within TD from the literature and from the events describing the Swedish response to the Covid-19 pandemic. Pattern matching thus allows for the reconciliation of logistics concepts from the literature to descriptions of how the response was handled, albeit under a TD framework.

Findings

Findings show quite distinct foci between the theoretical and observational realms in terms of logistics applications. While the theoretical realm identifies four main logistics concepts, the observational realm identifies five logistics conceptual themes. This goes on to show an incongruence between the military and civil parts of the TD.

Research limitations/implications

This study provides basis for further research into the applications and management of logistics activity within TD and emergency response.

Originality/value

Logistics applications within TD have not, until now, received much attention in the literature. Given this knowledge gap, this study is of original value.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 14 no. 2
Type: Research Article
ISSN: 2042-6747

Keywords

Open Access
Article
Publication date: 4 December 2023

Mariona Espaulella-Ferrer, Felix Jorge Morel-Corona, Mireia Zarco-Martinez, Alba Marty-Perez, Raquel Sola-Palacios, Maria Eugenia Campollo-Duquela, Maricelis Cruz-Grullon, Emma Puigoriol-Juvanteny, Marta Otero-Viñas and Joan Espaulella-Panicot

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of…

Abstract

Purpose

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

Design/methodology/approach

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

Findings

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

Originality/value

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

Open Access
Article
Publication date: 9 February 2024

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.

Details

European Journal of Innovation Management, vol. 27 no. 9
Type: Research Article
ISSN: 1460-1060

Keywords

Open Access
Article
Publication date: 16 June 2023

Jan Czarzasty and Adam Mrozowicki

In the context of debates on the role of social partners in shaping anti-crisis policies, the article explores the developments of social dialogue in Poland following the outbreak…

Abstract

Purpose

In the context of debates on the role of social partners in shaping anti-crisis policies, the article explores the developments of social dialogue in Poland following the outbreak of the pandemic. The central research question is whether the crisis has helped to revitalise social dialogue or has it further revealed its weaknesses that were apparent before it.

Design/methodology/approach

The paper is based on the combination of literature review and the analysis of primary data derived from 22 expert interviews with the representatives of trade unions, employers and ministries collected in 2020–2021 in four essential industries (education, health care, social care and logistics).

Findings

The analysis suggests that the pandemic led to reinforcement of “illusory corporatism” in Poland, deepened mistrust among social partners and triggered a shift to informal channels of influencing policymaking. The weakness of the social partners and the strong position of the right-wing populist government meant that fears of recession and a health crisis were insufficient to develop “crisis” corporatism. While business interests were represented better than labour in policymaking, limited labour-friendly outcomes have been achieved as a result of workers’ mobilisation and unilateral decisions of the government rather than tripartite social dialogue.

Originality/value

Based on original empirical research, the article contributes to the discussion on the impact of the crisis on social dialogue under patchwork capitalism. It points to the role of strong governments and informality in circumventing tripartite structures and the importance of essential workers’ mobilisation in response to the lack of social dialogue.

Details

Employee Relations: The International Journal, vol. 45 no. 7
Type: Research Article
ISSN: 0142-5455

Keywords

Open Access
Article
Publication date: 1 January 2024

Caroline Shulman, Rafi Rogans-Watson, Natasha Palipane, Dan Lewer, Michelle Yeung and Briony F. Hudson

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Housing, Care and Support, vol. 27 no. 1
Type: Research Article
ISSN: 1460-8790

Keywords

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