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Open Access
Article
Publication date: 16 April 2024

Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the…

Abstract

Purpose

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Design/methodology/approach

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

Findings

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

Originality/value

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

Open Access
Article
Publication date: 18 December 2023

Francesca Ferrè

Value-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.

Details

The TQM Journal, vol. 36 no. 9
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 13 February 2024

Felipa de Mello-Sampayo

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these…

Abstract

Purpose

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

Design/methodology/approach

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Findings

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

Practical implications

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Social implications

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

Originality/value

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

Details

Journal of Economic Studies, vol. 51 no. 9
Type: Research Article
ISSN: 0144-3585

Keywords

Article
Publication date: 27 November 2023

Else Marie Lysfjord and Siv Skarstein

This study aims to examine nurses’ motivation for leadership and explore important challenges nurses face in leadership positions.

Abstract

Purpose

This study aims to examine nurses’ motivation for leadership and explore important challenges nurses face in leadership positions.

Design/methodology/approach

Semi-structured interviews were conducted with 20 nurses in leading positions. Thematic analysis was used to analyse the data.

Findings

Nurse leaders are recruited from clinical settings, and the transition process from clinical nurse to leader is demanding. Their motivation for leadership seems to be in human values and caring for others. Lack of strategic focus might be a challenge. Nurses in leadership positions emphasize the importance of good relationships with the staff and require an increased focus on strategic leadership.

Research limitations/implications

Studies have revealed the frustration associated with the role of a nursing leader. According to an evaluation of a clinical leadership development programme, nurses were found to be inadequately prepared for their roles. They had not experienced positive role models, they felt overwhelmed and they regarded colleagues and nursing management structures as unsupportive. There is a need for further research into effective measures to strengthen nurse managers.

Practical implications

The role of leaders has changed over time. There are now increasing requirements and objectives with regard to laws, action plans, improvement projects and cost-effectiveness. A nurse leader has both many tasks and great responsibility. Good leadership relies on skilled nurse leaders meeting statutory requirements in patient care and delivering good quality and patient-safe services. Engaging in process-oriented guidance, such as mentoring, is one way to become more aware of oneself as a professional leader (Mathena, 2002).

Originality/value

By identifying and understanding the specific challenges that nurse leaders face, this study can contribute to the development of interventions and strategies to improve leadership practices, thereby enhancing organizational effectiveness.

Details

Leadership in Health Services, vol. 37 no. 2
Type: Research Article
ISSN: 1751-1879

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: 22 November 2023

Ngatindriatun Ngatindriatun, Muhammad Alfarizi and Rafialdo Arifian

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Journal of Modelling in Management, vol. 19 no. 3
Type: Research Article
ISSN: 1746-5664

Keywords

Article
Publication date: 14 March 2022

Meryem Zoghlami and Kaouther Saied Ben Rached

This paper aims to examine the health technology use in health information seeking, communication and personal health information management, as well as in the effects they may…

Abstract

Purpose

This paper aims to examine the health technology use in health information seeking, communication and personal health information management, as well as in the effects they may have on his relationship with the physician and on the consumption of medical resources.

Design/methodology/approach

An online survey was conducted. The questionnaires were distributed via online health discussion forums using Google's survey software with a summary presentation of the study’s objective. The final selection of 362 individuals was made using social media, direct email and collaboration with community groups. The empirical validation of the causal model was conducted using the partial least square approach.

Findings

The results show that the use of e-health strengthens the quality of the patient–physician relationship and patient empowerment while increasing the consumption of medical resources.

Originality/value

The results of this research indicate that the internet has transformed the relationship of patients to health, to their doctors and to the health-care system. In this new context, a reconsideration of the status of the patient must be considered by health service providers.

Details

VINE Journal of Information and Knowledge Management Systems, vol. 54 no. 3
Type: Research Article
ISSN: 2059-5891

Keywords

Open Access
Article
Publication date: 15 April 2024

Ingrid Marie Leikvoll Oskarsson and Erlend Vik

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem…

Abstract

Purpose

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.

Design/methodology/approach

In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.

Findings

Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.

Research limitations/implications

This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.

Practical implications

The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.

Originality/value

This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

Open Access
Article
Publication date: 24 April 2024

Zeeshan Hamid and Yasir Mansoor Kundi

This paper aims to explore the mechanisms by which employees’ happiness at work (HAW) can be promoted. Drawing on the social exchange theory (SET), this study examined the…

Abstract

Purpose

This paper aims to explore the mechanisms by which employees’ happiness at work (HAW) can be promoted. Drawing on the social exchange theory (SET), this study examined the relationships among discretionary human resource (HR) practices, perceived organizational support (POS), meaning of work (MOW) and HAW.

Design/methodology/approach

A three-path mediation model was developed to test the proposed relationships. The data were collected from Pakistani business professionals (n = 361), and hypotheses were tested using the PROCESS macro for SPSS .

Findings

The results suggest that POS mediates the relationship between discretionary HR practices and HAW. Also, MOW mediated the relationship between discretionary HR practices and HAW. Hence, both POS and MOW were found to be independent mediators. Further, the data provided support for the serial mediation of POS and MOW in the relationship between discretionary HR practices and HAW.

Practical implications

This research provides insights to organizations and their management on how discretionary HR practices can enhance employees’ POS, MOW and HAW.

Originality/value

The findings show that discretionary HR practices are associated with employees’ HAW. In addition, two mediators (POS and MOW) were found to serially mediate the aforesaid relationships. These findings are novel, as no prior research has used this nascent methodological approach to deepen our understanding by examining the associations between discretionary HR practices, POS, MOW and employees’ HAW.

Details

Evidence-based HRM: a Global Forum for Empirical Scholarship, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2049-3983

Keywords

Open Access
Article
Publication date: 18 July 2023

Michael Kyei-Frimpong, Emmanuel Kodwo Amoako, Bridget Akwetey-Siaw, Kwame Owusu Boakye, Isaac Nyarko Adu, Abdul-Razak Suleman and Amin Abdul Bawa

The current study aimed to examine the moderating role of perceived supervisor support in the nexus between employee empowerment and organizational commitment in the Ghanaian…

3295

Abstract

Purpose

The current study aimed to examine the moderating role of perceived supervisor support in the nexus between employee empowerment and organizational commitment in the Ghanaian hospitality industry.

Design/methodology/approach

A quantitative research design was adopted, and data were collected from 274 frontline workers from 4-star and 5-star hotels at two different waves within a 7-month interval. The data received were analyzed using descriptive and inferential statistics with the aid of Statistical Package for Social Sciences (SPSS V. 23.0) and SmartPLS (V.4.0), respectively.

Findings

As hypothesized in the study, employee empowerment was significantly related to organizational commitment. Furthermore, the results revealed that perceived supervisor support moderated the nexus between employee empowerment and affective and continuance commitment but did not moderate the nexus between employee empowerment and normative commitment.

Originality/value

Arguably, support from supervisors has been theoretically identified as a key construct in enhancing subordinates' commitment to an organization. However, less is known in the literature about the moderating role of perceived supervisory support in the nexus between employee empowerment and organizational commitment, especially in the Ghanaian hospitality industry.

Details

Journal of Work-Applied Management, vol. 16 no. 1
Type: Research Article
ISSN: 2205-2062

Keywords

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