Search results

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.

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).

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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

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

Policy coherence is a complex and tough task for many developing nations because their capacity to examine and deliver evidence-based inputs to policymaking is limited, and policy dialogue platforms need to be effectively used. Resolving these difficulties is a critical requirement for policy consistency. As a result, the study focuses on the level of policy coherence for climate change adaptation (CCA), disaster risk reduction (DRR) and sustainable development goals (SDG) in Sri Lanka and suggests routes for policy coherence for Resilience. This study aims to investigate the coherent approach of CCA, DRR and SDG; to identify concerns in policy documents addressing the coherence of CCA, DRR and SDG in local context; and to propose policy coherence suggestions for resilience in Sri Lanka.

Methodology comprises a review and content analysis of 17 policy and legal documents in Sri Lanka and a qualitative study. The qualitative approach consists of semistructured interviews that obtained deep and broad expertise knowledge with ten government representatives and stakeholders. Both content analysis and interview data were analyzed by using NVivo.

It was discovered that there are several issues with the coherence of policies in Sri Lanka, including the fragmented approach, lack of integration, inadequate coordination, limited resources and lack of monitoring and evaluation. The policies are inspired by international frameworks, and local implementations are not focused, leading to inadequate implementation of policies. The lack of development cooperation for the use of innovative approaches, such as climate-resilient infrastructure and environmentally friendly solutions for CCA and DRR, further aggravates the situation. Another concern is the lack of land use management and responsibility for the development of physical infrastructure for DRR integration with CCA. It is found that there is a limited community involvement which is vital for the implementation of policies. Local implementations are encouraged to fill the gaps in existing policies/acts. The analytical framework of the study is based on a preliminary examination of policy documents, a review of the literature and discussions with practitioners. The framework reflects the current situation of policy integration which addresses strategic, conceptual, institutional, operational and financial coherence. The research suggests pathways for achieving policy coherence in CCA, DRR and SDG in Sri Lanka, such as enhancing the strategic coherence by improving goals to increase the coherence within CCA, DRR and SDG; improving the credibility of the unified approach for developing DRR and CCA risk assessments; intensifying institutional cooperation and stakeholder management; improving the common monitoring and evaluation; establishing implementation strategies; and increasing the community involvement.

The study on policy coherence in Sri Lanka recommends increasing community and professional involvement, conducting more research, developing a national strategy, increasing capacity building, strengthening international collaboration and fostering multisectoral collaboration. These recommendations can help improve policy coherence between CCA, DRR and SDGs, align policies with national goals and priorities and improve implementation effectiveness. By implementing these recommendations, Sri Lanka can address the challenges of climate change and natural disasters and achieve SDGs.

The study on policy coherence for resilience in Sri Lanka has practical implications, including improved coordination and resource allocation, increased capacity building, improved reputation and sustainability. By integrating CCA, DRR and SDGs, this study can help Sri Lanka become more resilient to climate change and natural disasters, achieve SDGs and become a responsible actor in the international community. These implications can contribute to a more sustainable future and ensure that development goals are achieved in a way that is resilient to climate change and natural disasters.

Increased community participation: the study emphasizes the importance of community involvement in the policy development process. This can help build trust between communities and government agencies, improve transparency and ensure that policies are developed in a way that is responsive to local needs and priorities.

Based on the identified existing loopholes in the policies and pathways to policy coherence, the issues in policymaking could be overcome. It could be used to establish strong linkages between policies based on CCA, DRR and SDGs to achieve long-term resilience.

Sailing toward sustainability is becoming the strategic focus of shipping firms. Drawing on organizational information processing theory (OIPT) and the theory of planned behavior (TPB), we investigated the impact of digital transformation (DT) on shipping firms’ sustainable management performance and the boundary conditions guiding this relationship.

The authors examined the hypotheses by employing hierarchical linear modeling on two-wave time-lagged data from 189 shipping firm employees in China.

The results suggest that a shipping firm’s DT is positively associated with its sustainable management performance and that the relationship is strengthened by having better cross-functional and customer coordination mechanisms. Furthermore, our three-way interaction analyses show that while injunctive norms in a shipping firm’s networks can strengthen the contingency roles of both cross-functional and customer coordination mechanisms, descriptive norms alone significantly influence customer coordination.

Drawing on organizational information processing and planned behavior theories, the present research provides new insights into leveraging DT for sailing toward sustainable success. Moreover, this study extends the current understandings of the boundary conditions of the relationship between DT and sustainable management performance by showing the two-way and three-way interaction effects of coordination mechanisms and subjective norms. The findings of the present research can be utilized as effective strategies for promoting sustainable management performance.

Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred (PC) IC in practice. This context-specific, small-scale study examines what PC-IC means to older patients who went through joint replacement surgery (JRS).

The data consists of ten in-depth interviews of older patients, focussing on their experiences of care during their patient journey related to joint knee or hip replacement surgery. The data were analysed with thematic analysis.

Three central dimensions of PC-IC for older patients were identified: information sharing, continuity of care and compassionate encountering. Human validation and compassionate encountering were experienced as important aspects of PC-IC. Compassionate encountering was concretised through professionals’ very small everyday practices, which made the patient feel comfortable and respected. Instead, probably due to the medical and quite straight-forward nature of the joint replacement care process, patients seem to be pleased to trust the expertise of professionals and did not necessarily expect an active role or participation in the decision-making.

This Finnish case study focusses on the patients’ authentic perceptions of what is central to person-centred IC in the specific context of JRS.

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.

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).

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.

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.

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.

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).

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.

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.

The purpose of this paper is to give an account for preparative collaboration between the police and municipal eldercare in Sweden concerning missing persons with dementia.

Design/methodology/approach used was a qualitative case study design, consisting of one focus group with representatives for the participating organisations, followed by directed content analysis.

The findings showed a lack of current collaboration and reluctance to new collaborative initiatives. However, when focussing on preparative collaboration of coordinated responses to missing incidents, possibilities for improvement could be identified. The improvements concerned updated personnel response checklists, along with suggestions for an elaborate life story document in eldercare, with police access. Finally, better coordination of the return of the found person and a follow up were proposed.

It is suggested that collaboration must be given different meanings and use different approaches adapted to the different phases in a rescue operation. In the preparation and the response phase, the focus should be on coordination of the resources available. In the pre-planning and prevention phases, as well as in evaluation and learning, horizontal collaboration is more suitable. The amount of data in this study is a research limitation which calls for further research.

It is suggested that collaboration must be given different meanings and use different approaches adapted to the different phases in a rescue operation. In the preparation and the response phase, the focus should be on coordination of the resources available. In the pre-planning and prevention phases, as well as in evaluation and learning, horizontal co-operation is more suitable.

The originality/value of this paper can be found in the novelty of missing person research in Sweden, and in practical suggestions for preparative collaboration concerning persons with dementia who go missing. Finally, it can be found in the suggested need for a more dynamic and process-sensitive view of collaboration in SAR or rescue operations.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.