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Article
Publication date: 25 September 2019

Eleonora Gheduzzi, Cristina Masella and Federica Segato

The purpose of this paper is to study four cases of the adoption of co-production and compare them according to the type of user involvement, contextual factors and the…

Abstract

Purpose

The purpose of this paper is to study four cases of the adoption of co-production and compare them according to the type of user involvement, contextual factors and the organizational structure.

Design/methodology/approach

In total, 30 interviews were conducted in four mental health organizations which are implementing co-production in the North of Italy. Interviews were conducted with clinicians, nurses, patients and family members. The data collected was triangulated with further sources and official documents of organizations. The results have been compared by means of a validated international framework (IAP2) regarding the contextual factors and the level of co-production adopted.

Findings

The adoption of co-production in the four cases differs by the activities implemented and how organizations involve informal actors. It seems to be influenced by the contextual factors specific to each organization: power, professionals’ opinions and leadership. Organizations whose practitioners and leaders are willing to distribute their power and value informal actors’ opinions seem to facilitate the systematic involvement of users. Overall, the results highlight the importance of considering contextual factors when evaluating and describing co-production activities.

Originality/value

This paper contributes to describing how mental health organizations are implementing co-production. It examines the influence of contextual factors on the type of co-production adopted.

Details

The Journal of Mental Health Training, Education and Practice, vol. 14 no. 6
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 25 September 2020

Raffaella Gualandi, Cristina Masella, Daniela Viglione and Daniela Tartaglini

This study aims to describe and understand the contributions of frontline, middle and top management healthcare professionals in detecting areas of potential improvement in…

Abstract

Purpose

This study aims to describe and understand the contributions of frontline, middle and top management healthcare professionals in detecting areas of potential improvement in hospital patient flow and proposing solutions.

Design/methodology/approach

This is a qualitative interview study. Semistructured interviews were conducted with 22 professionals in the orthopedic department of a 250-bed academic teaching hospital. Data were analyzed through a thematic framework analytical approach by using an a priori framework. The Consolidated Criteria for Reporting Qualitative (COREQ) checklist for qualitative studies was followed.

Findings

When dealing with a hospital-wide process, the involvement of all professionals, including nonhealth professionals, can reveal priority areas for improvement and for services integration. The improvements identified by the professionals largely focus on covering major gaps detected in the technical and administrative quality.

Research limitations/implications

This study focused on the professional viewpoint and the connections between services and further studies should explore the role of patient involvement. The study design could limit the generalizability of findings.

Practical implications

Improving high-quality, efficient hospital patient flow cannot be accomplished without learning the perspective of the healthcare professionals on the process of service delivery.

Originality/value

Few qualitative studies explore professionals' perspectives on patient needs in hospital flow management. This study provides insights into what produces value for the patient within a complex process by analyzing the contribution of professionals from their particular role in the organization.

Details

Journal of Health Organization and Management, vol. 34 no. 8
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 19 December 2019

Raffaella Gualandi, Cristina Masella and Daniela Tartaglini

Improving hospital patient flow has become a policy priority, to effectively balance the increasing demands of an unknown and variable volume of patients with limited available…

1546

Abstract

Purpose

Improving hospital patient flow has become a policy priority, to effectively balance the increasing demands of an unknown and variable volume of patients with limited available hospital resources. A systematic literature review was conducted in order to identify actions, actors involved and enablers in improving hospital patient flow. The paper aims to discuss this issue.

Design/methodology/approach

Searches were conducted in Scopus, Web of Science, MEDLINE and The Cochrane Library for quantitative and qualitative empirical primary studies with patients (adults) receiving inpatient acute hospital care. The study protocol was based on PRISMA-P guidance. A critical appraisal of included studies was performed by using the Quality Improvement Minimum Quality Criteria Set.

Findings

In total, 38 key papers were identified. A wide range of actions are reported, but most studies focus on one or a few departments instead of a whole hospital. Process efficiency is most often used as a performance indicator, clinical outcomes are poorly analyzed, and patients’ expectations and experience are rarely considered. Top-management commitment and front-line staff involvement are considered key factors for the success of implementations. Patient involvement in the process improvement is rarely mentioned.

Originality/value

Achieving improvements in hospital patient flow requires the design and implementation of complex, multifaceted and coordinated interventions. This study may be of value to healthcare managers, helping them to act effectively in their context, and to researchers of future studies including the different variables and the patient’s perspective.

Details

Business Process Management Journal, vol. 26 no. 6
Type: Research Article
ISSN: 1463-7154

Keywords

Article
Publication date: 1 May 1993

Giovanni Azzone, Umberto Bertele and Cristina Masella

Evaluating investments in new product development has been a muchdebated question over the last few years. Traditional methods arerecognized as inadequate but there is no dominant…

Abstract

Evaluating investments in new product development has been a much debated question over the last few years. Traditional methods are recognized as inadequate but there is no dominant methodology. Presents a case study, developed at Olivetti, in which new and old methodologies have been used together to analyse and evaluate an investment project in new product development. The suggested approach supports decision making better than scoring methods, and data obtained are more reliable than those provided by traditional financial methods.

Details

Management Decision, vol. 31 no. 5
Type: Research Article
ISSN: 0025-1747

Keywords

Article
Publication date: 1 March 1991

Giovanni Azzone, Cristina Masella and Umberto Bertelè

An increasing number of firms are planning to become“time‐based companies”, that is to consider time as the mainissue of their manufacturing strategy. However, such change in…

Abstract

An increasing number of firms are planning to become “time‐based companies”, that is to consider time as the main issue of their manufacturing strategy. However, such change in attitude, in order to be effective, must be supported by a performance measurement system focused on time. This article suggests a framework useful for designing a performance measurement system which is consistent with time‐based principles and can support managers both in strategic and in operating decisions. The framework takes into account the different ways through which a company can use time to create a competitive advantage and considers the main activities that are critical for achieving such results. Hence, a “minimum set of measures”, consistent with the information requirements of each company, is determined.

Details

International Journal of Operations & Production Management, vol. 11 no. 3
Type: Research Article
ISSN: 0144-3577

Keywords

Book part
Publication date: 25 July 2012

Emanuele Lettieri, Abraham B. (Rami) Shani, Annachiara Longoni, Raffaella Cagliano, Cristina Masella and Franco Molteni

Purpose – This chapter examines the impact of technology on sustainable effectiveness by focusing on the dynamic synchronization between the technical and the social subsystems at…

Abstract

Purpose – This chapter examines the impact of technology on sustainable effectiveness by focusing on the dynamic synchronization between the technical and the social subsystems at the Villa Beretta Rehabilitation Hospital (VBRH) and illustrates that technology can trigger and enable sustainable health care organizations.

Design/methodology/approach – The case study of VBRH relies on several data sources. They include interviews with key informants (VBRH executives, health care professionals, and technology suppliers), follow-up e-mails and phone conversations, direct observations of actors’ behavior, and notes of processes in action and archival data, such as patient pathway protocols, technical information systems documentation, performance and managerial reports, and administrative guidelines.

Findings – VBRH was capable to dynamically synchronize the social subsystem with the continuous innovation of the technical subsystem. This capability enabled sustainable effectiveness in three main areas. First, the correct alignment between technology and professionals’ practices and behaviors improved triple-bottom-line performance by promoting a more conscious use of the environmental, social, and financial resources. Second, technology-based initiatives promoted research-oriented plans of action that nurtured a culture of change and continuous improvement. Third, technology facilitated the extension of the research and operation networks that generated new ideas and initiatives for achieving sustainable effectiveness. Additionally, evidence from VBRH demonstrated that organization design, change management, and learning mechanisms are essential when institutionalizing new technology that requires the disruption of current professional practices and individuals’ behavior.

Originality/value – Previous contributions about sustainable effectiveness in health care failed to unveil and frame the complexity of dynamic synchronization between the technical and the social subsystems that is at the core of the sustainability of health care delivery. This chapter provides new insights that pave the way for a deeper-level understanding of the role that technology plays in sustainable effectiveness dynamics and outcomes in health care delivery. The chapter illustrates how different groups of technology contribute to sustainable effectiveness and the mechanisms that make them work.

Details

Organizing for Sustainable Health Care
Type: Book
ISBN: 978-1-78190-033-8

Keywords

Article
Publication date: 9 November 2012

Luca Gastaldi, Emanuele Lettieri, Mariano Corso and Cristina Masella

This study seeks to further the current debate about how to systematically improve hospital performance by enhancing and balancing knowledge exploration and knowledge exploitation

1955

Abstract

Purpose

This study seeks to further the current debate about how to systematically improve hospital performance by enhancing and balancing knowledge exploration and knowledge exploitation capabilities through the development of an electronic medical record (EMR).

Design/methodology/approach

The study has an interpretative, inductive perspective, based on multiple and embedded case studies. Three large size Italian hospitals that have introduced an EMR were considered. Evidence was gathered by triangulating multiple sources of evidence.

Findings

Three emergent strategies of EMR development are identified. Pros and cons of each strategy are stated and a set of propositions to be tested in further research are formulated. These results provide hospital managers and professionals with clearer guidelines about how to improve performance by implementing a tailored strategy to balance knowledge exploration and knowledge exploitation through the development of an EMR.

Originality/value

Most of the literature on EMRs is focused on the benefits, the barriers and the enablers of their adoption. Little is understood about how hospital managers and professionals might leverage on the EMR to ambidextrously combine knowledge exploration and knowledge exploitation, and thus increase hospital performance. The study addresses this gap and offers original insights to advance both theory and practice.

Article
Publication date: 1 April 2002

Mariolina Longo and Cristina Masella

The paper presents the main results of a benchmarking project involving eight Italian hospitals. The project sought to examine and compare the organisational processes adopted in…

1162

Abstract

The paper presents the main results of a benchmarking project involving eight Italian hospitals. The project sought to examine and compare the organisational processes adopted in different operating blocks, i.e. complex organisational units comprising many different actors whose performance often has a significant influence on the level of work of the overall structure. The organisational survey was carried out by means of interviews with head nurses, surgeons and anaesthetists. In order to identify the managerial significance of activities and processes, a theoretical model of the operating block was developed, together with an appropriate performance measurement system. On the basis of this model and using analytic hierarchy process, we together with experts from the sector were able both “to measure” the strategic importance of the activities and to identify the best practices.

Details

International Journal of Operations & Production Management, vol. 22 no. 4
Type: Research Article
ISSN: 0144-3577

Keywords

Book part
Publication date: 12 August 2014

Giovanni Radaelli, Emanuele Lettieri, Abraham B. (Rami) Shani, Cristina Masella and Michele Tringali

Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful implementation of…

Abstract

Purpose

Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful implementation of these practices depends on policy-makers’ capacity to involve professionals dispersed in the ecosystem, and who are unaccustomed to cooperating. Our case study investigates the institutional work pursued by the Lombardy Region to stimulate a Health Technology Assessment (HTA) program.

Design/methodology/approach

This chapter is based on a longitudinal case study of institutional change linked with a HTA program in the Lombardy Region. The HTA program initiatives were implemented during the 2009–2012 period. The case study is based on triangulating data from archival data, contents of the assessment forms and interviews with regional staff and experts.

Findings

The Lombardy Region implemented two distinct strategies, with mixed results. A strategy that was based on the formalization of the HTA program in a legislative direct through educational efforts did not obtain the commitment of the key actors in the relevant ecosystem. Subsequently, the Region implemented an ‘institutional work’ design strategy that included a combination of political, cultural, technical and structural work. This strategy stimulated local HTA experiments that might be used in the future to legitimize the full diffusion of the new practice in the ecosystem.

Originality/value

This study highlights a viable strategy of change that policy-makers can use to manage processes of institutional change in a professional ecosystem. The ‘institutional work’ strategy can support the establishment of new practices that incorporate the logic of cost-opportunity, which might rationalize the use of resources and improve investment decisions.

Article
Publication date: 1 January 2000

Cristina Masella and Andrea Rangone

Literature on supply chain management has been recently stressing the need for co‐operation and integration between suppliers and customers, highlighting the critical role played…

4100

Abstract

Literature on supply chain management has been recently stressing the need for co‐operation and integration between suppliers and customers, highlighting the critical role played by the supplier in contributing to the overall performance of the purchaser. Consequently supplier selection is one of the purchasing manager’s most critical tasks, as demonstrated by the number of articles that have dealt with vendor selection criteria and techniques in the light of the requirements of the new environment. The paper proposes four different vendor selection systems (VSSs) depending on the time frame (short‐term versus long‐term) and on the content (logistic versus strategic) of the co‐operative customer/supplier relationships. More precisely, the suggested VSSs consider, in an analytic hierarchy process framework, different sets of measures, deriving from a non‐conventional model of the supplier based on the dynamic system and on the resource‐based approach.

Details

International Journal of Operations & Production Management, vol. 20 no. 1
Type: Research Article
ISSN: 0144-3577

Keywords

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