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1 – 10 of 67Value-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.
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As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing…
Abstract
Purpose
As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work.
Design/methodology/approach
This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level.
Findings
The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions.
Practical implications
The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions.
Originality/value
This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities’ perspective and the organizational perspective to understand the manager’s role in handling the contingency of decisions and managing paradoxes in the decision-making process.
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Valérie Mérindol and David W. Versailles
Innovation management in the healthcare sector has undergone significant evolutions over the last decades. These evolutions have been investigated from a variety of perspectives…
Abstract
Purpose
Innovation management in the healthcare sector has undergone significant evolutions over the last decades. These evolutions have been investigated from a variety of perspectives: clusters, ecosystems of innovation, digital ecosystems and regional ecosystems, but the dynamics of networks have seldom been analyzed under the lenses of entrepreneurial ecosystems (EEs). As identified by Cao and Shi (2020), the literature is silent about the organization of resource allocation systems for network orchestration in EEs. This article investigates these elements in the healthcare sector. It discusses the strategic role played by entrepreneurial support organizations (ESOs) in resource allocation and elaborates on the distinction between sponsored and nonsponsored ESOs in EEs. ESOs are active in network orchestration. The literature explains that ESOs lift organizational, institutional and cultural barriers, and support entrepreneurs' access to cognitive and technological resources. However, allocation models are not yet discussed. Therefore, our research questions are as follows: What is the resource allocation model in healthcare-related EEs? What is the role played by sponsored and nonsponsored ESOs as regards resource allocation to support the emergence and development of EEs in the healthcare sector?
Design/methodology/approach
The article offers an explanatory, exploratory, and theory-building investigation. The research design offers an abductive research protocol and multi-level analysis of seven (sponsored and nonsponsored) ESOs active in French healthcare ecosystems. Field research elaborates on semi-structured interviews collected between 2016 and 2022.
Findings
This article shows explicit complementarities between top-down and bottom-up resource allocation approaches supported by ESOs in the healthcare sector. Despite explicit originalities in each approach, no network orchestration model prevails. Multi-polar coordination is the rule. Entrepreneurs' access to critical technological and cognitive resources is based on resource allocation modalities that differ for sponsored versus nonsponsored ESOs. Emerging from field research, this research also shows that sponsored and nonsponsored ESOs manage their roles in different ways because they confront original issues about organizational legitimacy.
Originality/value
Beyond the results listed above, the main originalities of the paper relate to the instantiation of multi-level analysis operated during field research and to the confrontation between sponsored versus nonsponsored ESOs in the domain of healthcare-related innovation management. This research shows that ESOs have practical relevance because they build original routes for resource allocation and network orchestration in EEs. Each ESO category (sponsored versus nonsponsored) provides original support for resource allocation. The ESO's legitimacy is inferred either from the sponsor or the services delivered to end-users. This research leads to propositions for future research and recommendations for practitioners: ESO managers, entrepreneurs, and policymakers.
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Martin Beaulieu, Jacques Roy, Denis Chênevert, Claudia Rebolledo and Sylvain Landry
The Covid-19 pandemic generated significant changes in the operating methods of hospital logistics departments. The objective of this research is to understand how these changes…
Abstract
Purpose
The Covid-19 pandemic generated significant changes in the operating methods of hospital logistics departments. The objective of this research is to understand how these changes took place, what collaboration mechanisms were developed with clinical authorities and, to what extent, logistics and clinical care activities should be decoupled to maximize each area's contribution?
Design/methodology/approach
The case study is selected to investigate practices implemented during the COVID-19 pandemic in hospitals in Canada. The pandemic presented an opportunity to contrast practices implemented in response to this crisis with those historically used in this environment.
Findings
The strategy of decoupling logistical tasks of an operational nature from clinical activities is well-founded and helps free clinical staff from tasks for which they are not trained. However, the decoupling of operational tasks should be combined with an integration of the clinical information flow to the logistics hub players. With this clinical information, the logistics hub can generate its full potential enabling better inventory management decisions to be made.
Originality/value
The concept of decoupling is studied to identify configurations that offer the best benefits for clinical staff.
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A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional…
Abstract
Purpose
A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional consequences. The purpose of this article is to discuss new approaches to performance management in health care services when the purpose is to support innovative changes in the delivery of services.
Design/methodology/approach
The article represents cross-boundary work as the theoretical and empirical material used to discuss and reconsider performance management comes from several relevant research disciplines, including systematic reviews of audit and feedback interventions in health care and extant theories of human motivation and organizational control.
Findings
An enabling approach to performance management in health care services can potentially contribute to innovative changes. Key design elements to operationalize such an approach are a formative and learning-oriented use of performance measures, an appeal to self- and social-approval mechanisms when providing feedback and support for local goals and action plans that fit specific conditions and challenges.
Originality/value
The article suggests how to operationalize an enabling approach to performance management in health care services. The framework is consistent with new governance and managerial approaches emerging in public sector organizations more generally, supporting a higher degree of professional autonomy and the use of nonfinancial incentives.
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Edoardo Trincanato and Emidia Vagnoni
Business intelligence (BI) systems and tools are deemed to be a transformative source with the potential to contribute to reshaping the way different healthcare organizations’…
Abstract
Purpose
Business intelligence (BI) systems and tools are deemed to be a transformative source with the potential to contribute to reshaping the way different healthcare organizations’ (HCOs) services are offered and managed. However, this emerging field of research still appears underdeveloped and fragmented. Hence, this paper aims to reconciling, analyzing and synthesizing different strands of managerial-oriented literature on BI in HCOs and to enhance both theoretical and applied future contributions.
Design/methodology/approach
A literature-based framework was developed to establish and guide a three-stage state-of-the-art systematic literature review (SLR). The SLR was undertaken adopting a hybrid methodology that combines a bibliometric and a content analysis.
Findings
In total, 34 peer-review articles were included. Results revealed significant heterogeneity in theoretical basis and methodological strategies. Nonetheless, the knowledge structure of this research’s stream seems to be primarily composed of five clusters of interconnected topics: (1) decision-making, relevant capabilities and value creation; (2) user satisfaction and quality; (3) process management, organizational change and financial effectiveness; (4) decision-support information, dashboard and key performance indicators; and (5) performance management and organizational effectiveness.
Originality/value
To the authors’ knowledge, this is the first SLR providing a business and management-related state-of-the-art on the topic. Besides, the paper offers an original framework disentangling future research directions from each emerged cluster into issues pertaining to BI implementation, utilization and impact in HCOs. The paper also discusses the need of future contributions to explore possible integrations of BI with emerging data-driven technologies (e.g. artificial intelligence) in HCOs, as the role of BI in addressing sustainability challenges.
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Mahmud Akhter Shareef, Yogesh K. Dwivedi, Md. Shazzad Hosain, Mihalis Giannakis and Jashim Uddin Ahmed
This study has conducted exploratory research to understand who should comprise the members of a resilient supply chain for promoting an entrepreneurial ecosystem of a startup…
Abstract
Purpose
This study has conducted exploratory research to understand who should comprise the members of a resilient supply chain for promoting an entrepreneurial ecosystem of a startup project and to determine the mechanisms for the balanced coexistence of all stakeholders. This is necessary to ensure mutual benefits for all stakeholders, each of whom has multidimensional interests. Additionally, this supply chain must be able to withstand any potential disruption risks.
Design/methodology/approach
This research has employed a mixed-design approach. In this context, the study conducted an extensive qualitative and quantitative investigation, including 30 interviews and a survey involving 180 potential stakeholders in this supply network, respectively in the capital city of Bangladesh, Dhaka. The analysis of the interviews utilized principles of matrix thinking, while structural equation modeling (SEM) through LISREL was employed to understand cause-and-effect relationships.
Findings
Network, platform and governance—these three independent constructs have the potential to contribute to the dependent construct, a resilient supply chain, aimed at promoting an entrepreneurial ecosystem for startup projects. It has been revealed that the management of such projects depends on the rules and regulations within the ecosystem. An excellent governance mechanism is essential for this purpose. To facilitate coexistence, the establishment of a platform is crucial, where cooperation among all members is mandatory.
Practical implications
For practitioners, three distinctive but closely interdependent issues are explored and resolved in this philanthropic study. It has unfolded the elements of any startup project with essential settings.
Originality/value
The identification of the structural dynamics of potential stakeholders within the entrepreneurial ecosystem of startups is largely absent in existing literature. Therefore, there is a need to comprehensively investigate the entire network, including their roles, responsibilities and associations. This study makes a significant and novel contribution to the existing literature. Academics and practitioners alike have ample opportunities to learn from this new aspect of relationships across three distinct areas: the entrepreneurial ecosystem, startup projects and the development of a resilient supply chain.
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Bastian Burger, Dominik K. Kanbach and Sascha Kraus
Recent years have seen a meteoric rise in the study of narcissism in entrepreneurship, although little consolidation has occurred in this area. The purpose of this paper is the…
Abstract
Purpose
Recent years have seen a meteoric rise in the study of narcissism in entrepreneurship, although little consolidation has occurred in this area. The purpose of this paper is the development of an integrative framework to harmonise the academic discussion and serve as a structured foundation for future research.
Design/methodology/approach
The authors conducted an artificial intelligence-aided, structured literature review focused on content analysis of concepts and contexts to map out current findings and research gaps in startup narcissism research.
Findings
According to the findings of this study, narcissistic tendencies have the potential to positively influence startup success early on in an entrepreneur's journey, but after a certain point in the process, the influence of narcissism on success becomes predominantly negative.
Research limitations/implications
The research field is currently not very harmonised regarding research measures, research subjects and key research terms. Further research must use a standardised approach to add value to the research body.
Practical implications
Narcissism is a two-sided sword for founders. In the early stages of a company, many of the founder’s tasks can benefit from narcissistic tendencies. In the later stages of a company, that might shift to overwhelmingly negative effects of narcissism.
Originality/value
Methodically, this study is the first one to establish an artificial intelligence component to add value to the results of a review paper to the best of the authors’ knowledge. The results of this study provide a clear framework of entrepreneurial intention, entrepreneurial activity and entrepreneurial performance to give researchers the opportunity of a more differentiated way of organising work.
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Ramy Elzahhar, Jill Aylott, Buddhike Sri Harsha Indrasena, Remig Wrazen and Ahmed Othman
The purpose of this paper is to conceptualise a research study to examine leadership as a relational concept between leaders and followers. The context is within surgical practice…
Abstract
Purpose
The purpose of this paper is to conceptualise a research study to examine leadership as a relational concept between leaders and followers. The context is within surgical practice examining how motivated consultant surgeons are to lead junior doctors and which type of leadership style they use. From a follower perspective, the motivation of junior doctors will be explored, and their leadership preferences will be correlated with those of the actual style of consultant surgeons.
Design/methodology/approach
In this paper, the authors provide a detailed description of the methods for an international quantitative research study, exploring sequentially how motivated consultant surgeons are to lead and how leadership styles impact on the motivation of junior doctors. The objectives, method and data collection of this study are explained, and the justification for each method is described.
Findings
The findings for this outline study illustrate how critical it is to redefine leadership as a relational concept of leader and follower to ensure adequate support is provided to the next generation of consultant surgeons. Without consideration of the relational model of leadership, attrition will continue to be a critical issue in the medical workforce.
Research limitations/implications
The research limitations are that this is a proposed quantitative study due to the need to collect a large sample of data from surgeons across the UK, Egypt and Germany. This research will have immense implications in developing new knowledge of leadership as a relational concept in medicine and healthcare. This study additionally will impact on how leadership is conceptualised in the curriculum for specialist surgical practice.
Practical implications
The practical implications are that relational leadership is supportive of generating a supportive leadership culture in the workplace and generating more effective teamwork.
Originality/value
To the best of the authors’ knowledge, this is the first study of its kind to look at a relational model of leadership in surgical practice between consultant surgeons and surgical trainees. This study will also identify any specific country differences between the UK, Germany and Egypt.
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Siva Shaangari Seathu Raman, Anthony McDonnell and Matthias Beck
Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing…
Abstract
Purpose
Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.
Design/methodology/approach
Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.
Findings
We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.
Research limitations/implications
Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.
Practical implications
Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.
Social implications
Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.
Originality/value
The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.
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