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Open Access
Article
Publication date: 25 July 2024

Märt Vesinurm, Inka Sylgren, Annika Bengts, Paulus Torkki and Paul Lillrank

This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and…

Abstract

Purpose

This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.

Design/methodology/approach

The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.

Findings

PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.

Research limitations/implications

This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.

Practical implications

We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.

Originality/value

Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.

Article
Publication date: 27 August 2024

Augustino Mwogosi and Cesilia Mambile

The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and…

Abstract

Purpose

The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and the adaptive strategies employed by healthcare practitioners. It utilises an Activity Theory (AT) approach to understand the dynamic interactions between healthcare providers, CDS tools and the broader healthcare system.

Design/methodology/approach

The research adopts a qualitative approach in two prominent regions of Tanzania, Dar es Salaam and Dodoma. It involves semi-structured interviews with 26 healthcare professionals and key stakeholders across ten healthcare facilities, supplemented by document reviews. The study employs AT to analyse the interactions between healthcare professionals, CDS tools and the broader healthcare system, identifying best practices and providing recommendations for optimising the use of CDS tools.

Findings

The study reveals that Tanzanian healthcare practitioners predominantly rely on non-computerised CDS tools, such as clinical guidelines prepared by the Ministry of Health. Despite the availability of Health Information Systems (HIS), these systems often lack comprehensive decision-support functionalities, leading practitioners to depend on traditional methods and their professional judgement. Significant challenges include limited accessibility to updated clinical guidelines, unreliable infrastructure and inadequate training. Adaptive strategies identified include using non-standardised tools like Medscape, professional judgement and reliance on past experiences and colleagues’ opinions.

Research limitations/implications

The investigation was constrained by access limitations because it was challenging to get some respondents to share information. However, a sufficient number of individuals participated in the interviews, and their knowledge was very beneficial in understanding the procedures and tools for clinical decision support.

Originality/value

This study contributes to AT by extending its application to a low-resource healthcare setting, uncovering new dimensions of the theory related to socio-cultural and technological constraints in healthcare facilities in Tanzania. It provides valuable insights into the practical barriers and facilitators of HIS and CDS tool implementation in developing countries, emphasising the need for context-specific adaptations, robust training programs and user-centred designs. The findings highlight the resilience and imagination of healthcare practitioners in adapting to systemic limitations, offering recommendations to enhance clinical decision-making and improve patient care outcomes in Tanzania.

Details

Information Technology & People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0959-3845

Keywords

Article
Publication date: 26 April 2024

Moyosore Adegboye

This paper aims to explore the intricate relationship between artificial intelligence (AI) and health information literacy (HIL), examining the rise of AI in health care, the…

286

Abstract

Purpose

This paper aims to explore the intricate relationship between artificial intelligence (AI) and health information literacy (HIL), examining the rise of AI in health care, the intersection of AI and HIL and the imperative for promoting AI literacy and integrating it with HIL. By fostering collaboration, education and innovation, stakeholders can navigate the evolving health-care ecosystem with confidence and agency, ultimately improving health-care delivery and outcomes for all.

Design/methodology/approach

This paper adopts a conceptual approach to explore the intricate relationship between AI and HIL, aiming to provide guidance for health-care professionals navigating the evolving landscape of AI-driven health-care delivery. The methodology used in this paper involves a synthesis of existing literature, theoretical analysis and conceptual modeling to develop insights and recommendations regarding the integration of AI literacy with HIL.

Findings

Impact of AI on health-care delivery: The integration of AI technologies in health-care is reshaping the industry, offering unparalleled opportunities for improving patient care, optimizing clinical workflows and advancing medical research. Significance of HIL: HIL, encompassing the ability to access, understand and critically evaluate health information, is crucial in the context of AI-driven health-care delivery. It empowers health-care professionals, patients and the broader community to make informed decisions about their health and well-being. Intersection of AI and HIL: The convergence of AI and HIL represents a critical juncture, where technological innovation intersects with human cognition. AI technologies have the potential to revolutionize how health information is generated, disseminated and interpreted, necessitating a deeper understanding of their implications for HIL. Challenges and opportunities: While AI holds tremendous promise for enhancing health-care outcomes, it also introduces new challenges and complexities for individuals navigating the vast landscape of health information. Issues such as algorithmic bias, transparency and accountability pose ethical dilemmas that impact individuals’ ability to critically evaluate and interpret AI-generated health information. Recommendations for health-care professionals: Health-care professionals are encouraged to adopt strategies such as staying informed about developments in AI, continuous education and training in AI literacy, fostering interdisciplinary collaboration and advocating for policies that promote ethical AI practices.

Practical implications

To enhance AI literacy and integrate it with HIL, health-care professionals are encouraged to adopt several key strategies. First, staying abreast of developments in AI technologies and their applications in health care is essential. This entails actively engaging with conferences, workshops and publications focused on AI in health care and participating in professional networks dedicated to AI and health-care innovation. Second, continuous education and training are paramount for developing critical thinking skills and ethical awareness in evaluating AI-driven health information (Alowais et al., 2023). Health-care organizations should provide opportunities for ongoing professional development in AI literacy, including workshops, online courses and simulation exercises focused on AI applications in clinical practice and research.

Originality/value

This paper lies in its exploration of the intersection between AI and HIL, offering insights into the evolving health-care landscape. It innovatively synthesizes existing literature, proposes strategies for integrating AI literacy with HIL and provides guidance for health-care professionals to navigate the complexities of AI-driven health-care delivery. By addressing the transformative potential of AI while emphasizing the importance of promoting critical thinking skills and ethical awareness, this paper contributes to advancing understanding in the field and promoting informed decision-making in an increasingly digital health-care environment.

Details

Library Hi Tech News, vol. 41 no. 7
Type: Research Article
ISSN: 0741-9058

Keywords

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

Article
Publication date: 19 July 2024

S.S. Dulari, M. Dhanya and Indu Nair

This research paper aims to study the achievement of the objectives set by the Government of Kerala through the Arogyakeralam Pain and Palliative Care project.

Abstract

Purpose

This research paper aims to study the achievement of the objectives set by the Government of Kerala through the Arogyakeralam Pain and Palliative Care project.

Design/methodology/approach

The research paper delves into diverse facets of an individual’s well-being including medical, emotional, spiritual and social aspects, when confronted with an incurable and incapacitating disease through the intervention of the PPC project. This insightful study was conducted in the state of Kerala, India.

Findings

The analysis reveals that quality of life (QoL) is most influenced by spiritual, social and psychological factors. This paper raises pertinent questions about the effectiveness of PPC initiatives within the realm of medical care.

Social implications

The thought, conception and preparation of the subject is on improving social health care by assessing the existing practices followed by the local governance. This, by far, would benefit millions by formulating appropriate policies for improving the QoL.

Originality/value

The Kerala model of health care has garnered global acclaim, standing shoulder to shoulder with the health systems of developed nations. Adopting “active total care” to address pain and allied indications, the Arogyakeralam palliative care program significantly enhances patients' QoL. The focus was to uplift the QoL of patients suffering from terminal illnesses post-pandemic.

Details

International Journal of Health Governance, vol. 29 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Open Access
Article
Publication date: 3 June 2024

Zhening Liu, Alistair Brandon-Jones and Christos Vasilakis

The purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the…

Abstract

Purpose

The purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the significant expansion in this and other forms of telehealth worldwide over the last decade. We use our analysis of the literature to develop a comprehensive framework that incorporates the patient journey, multidimensionality, antecedents and consequences, interventions and improvement options, as well as the cyclic nature of patient engagement. We also propose measures suitable for empirical assessment of different aspects of our framework.

Design/methodology/approach

We undertook a comprehensive review of the extant literature using a systematic review approach. We identified and analysed 63 articles published in peer-reviewed scientific journals between 2003 and 2022.

Findings

We conceptualise patient engagement with remote consultation across three key aspects: dimensions, process, and the antecedents and consequences of engagement. We identify nine contextual categories that influence such engagement. We propose several possible metrics for measuring patient engagement during three stages (before service, at/during service and after service) of remote consultation, as well as interventions and possible options for improving patient engagement therein.

Originality/value

The primary contribution of our research is the development of a comprehensive framework for patient engagement in remote consultation that draws on insights from literature in several disciplines. In addition, we have linked the three dimensions of engagement with the clinical process to create a structure for future engagement assessment. Furthermore, we have identified impact factors and outcomes of engagement in remote consultation by understanding which can help to improve levels of adoption, application and satisfaction, and reduce healthcare inequality. Finally, we have adopted a “cyclic” perspective and identified potential interventions that can be combined to further improve patient engagement in remote consultation.

Details

International Journal of Operations & Production Management, vol. 44 no. 13
Type: Research Article
ISSN: 0144-3577

Keywords

Article
Publication date: 17 September 2024

Anna Roberta Gagliardi, Luca Carrubbo, Shai Rozenes, Adi Fux and Daniela Siano

This study aims to examine the effects of Internet of Things (IoT) technology on efficiency and patient care in Italian and Israeli intensive care units (ICUs). The goal is to…

Abstract

Purpose

This study aims to examine the effects of Internet of Things (IoT) technology on efficiency and patient care in Italian and Israeli intensive care units (ICUs). The goal is to study how IoT might improve care settings by controlling health dynamics and responding to life-threatening circumstances.

Design/methodology/approach

This survey-based research explores IoT use, challenges and adaptability in ICUs in both countries. Interviews and surveys of ICU health-care workers are used to get both quantitative and qualitative data on integrating experiences and perspectives.

Findings

The research found significant variations between Italy and Israel due to technology infrastructures and health-care practices. Israel shows a more concentrated deployment in a major medical centre with advanced but limited uptake, whereas Italy shows application throughout ICUs highlighting regional health-care system disparities. Interoperability, data security and IoT training are common difficulties.

Research limitations/implications

This research has limitations. One drawback is the geographical dispersion of study sites, with a bigger sample size in Italy than in Israel. This discrepancy may affect findings applicability. However, these preliminary findings provide a foundation for further research into the complexities of deploying IoT in various health-care settings.

Originality/value

This study compares IoT integration in two national health-care systems, adding to health-care technology literature. Regional variations affect technology adoption, but IoT may enhance ICU operations and patient care, according to one research. This study helps health-care practitioners, academics and policymakers understand the pros and cons of IoT in health care.

Details

Digital Policy, Regulation and Governance, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2398-5038

Keywords

Article
Publication date: 13 August 2024

Subhajit Chakraborty, Jorge A. Gonzalez, Miguel Sahagun and Cara-Lynn Scheuer

To better understand the nature and effective delivery of quality health-care globally, this paper aims to study the role of quality leadership on patient care quality (PCQ…

Abstract

Purpose

To better understand the nature and effective delivery of quality health-care globally, this paper aims to study the role of quality leadership on patient care quality (PCQ) delivered in hospitals, including the intervening role of technology integration and two country-level factors – national culture and infrastructure development – in North America (Canada, Mexico and the USA).

Design/methodology/approach

PCQ comprises four facets: interpersonal, technical, environmental and administrative quality. Using survey data and interdisciplinary theoretical support (e.g. quality management and the Global Leadership and Organizational Behavior Effectiveness Project [GLOBE] model of national culture), this paper tested for moderated mediation between hospital quality leadership and the four-facet PCQ model with technology integration as the mediator and national culture and infrastructure development as moderators.

Findings

Results show that technology integration partially mediates the relationship between hospital quality leadership and PCQ and that national culture and infrastructure development shape the role of hospital quality leadership on PCQ. Hence, these national factors must be considered holistically to understand the impact of hospital quality leadership on patient care.

Practical implications

To improve PCQ, hospital leaders should broaden their understanding of quality health-care to include technology integration and an awareness of cultural and institutional differences across nations.

Originality/value

This paper used primary data from hospital quality leaders and the four-facet PCQ conceptualization across three large North American nations, offering a more global understanding of service quality in health-care.

Details

International Journal of Quality and Service Sciences, vol. 16 no. 3
Type: Research Article
ISSN: 1756-669X

Keywords

Article
Publication date: 20 September 2024

Sheikh Basharul Islam, Suhail Ahmad Bhat, Mushtaq Ahmad Darzi and Syed Owais Khursheed

Community health centres (CHCs) play a vital role in healthcare service delivery in rural India and act as a crucial link between the primary and tertiary healthcare systems. The…

Abstract

Purpose

Community health centres (CHCs) play a vital role in healthcare service delivery in rural India and act as a crucial link between the primary and tertiary healthcare systems. The rural population in the union territory of Jammu and Kashmir primarily depends on CHCs for healthcare services due to the scarcity of private healthcare infrastructure and the lack of access to tertiary hospitals. The purpose of this study is to analyse the impact of management capability, staff competence, waiting time and patient satisfaction on revisit intention among patients visiting CHCs for care needs. It further examines the mediational role of patient satisfaction between antecedents of patient satisfaction and revisit intention.

Design/methodology/approach

A survey by questionnaire was used to collect data from 318 inpatients and outpatients visiting CHCs. Partial least square-structural equation modelling was performed with the help of SmartPLS 3 software to evaluate the causal relationships between variables.

Findings

The findings of the study ascertain that staff competence and waiting time are strong predictors of patient satisfaction while management capability was reported as an insignificant factor. Patient satisfaction significantly affects revisit intention and successfully mediates the impact of management capability, staff competence and waiting time on revisit intention.

Originality/value

CHCs play a significant role in bridging the gap between primary healthcare and tertiary healthcare and in delivering healthcare services to the vast rural population in India. This study necessitates the active participation of management to ensure the smooth functioning of CHCs. There is a need to provide adequate staff and necessary infrastructural facilities to reduce the treatment waiting time.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1750-6123

Keywords

Book part
Publication date: 13 September 2024

Elena Maggioni and Francesco Mazziotta

Common challenges for healthcare systems worldwide are population ageing, rising therapy spending and reduced economic resources. In response, AI can play a crucial role in…

Abstract

Common challenges for healthcare systems worldwide are population ageing, rising therapy spending and reduced economic resources. In response, AI can play a crucial role in facilitating managerial and economic objectives within a holistic vision of care and improve the experience of patients and professionals. AI may change the delivery of services and the demand for them as well. This raises questions of how to balance the supply and demand sides of healthcare services, how to leverage competitive positioning and how to differentiate strategies specific to the public and to the private sector.

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