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1 – 10 of over 2000Kumari Youkta and Rajendra Narayan Paramanik
This study aims to measure the level of satisfaction among women with childbirth services provided at public health facilities. Further, to analyse the impact of their…
Abstract
Purpose
This study aims to measure the level of satisfaction among women with childbirth services provided at public health facilities. Further, to analyse the impact of their socio-economic and obstetric characteristics on their level of satisfaction.
Design/methodology/approach
To accomplish these objectives a cross-sectional survey was conducted in two districts of an Indian state, Bihar. Structured questionnaire was developed based on the scale proposed by Okumu and Oyugi (2018) both for vaginal and caesarean birth patients. For empirical analysis multiple linear regression model was employed.
Findings
Results suggest that majority of mothers are satisfied with the care they received during childbirth, regardless of whether they chose a caesarean (55%) or vaginal delivery (53%). Women report the lowest levels of satisfaction with postpartum care and the privacy that was preserved by healthcare personnel at health facility. Further the study also confirms the association between patient’s socio-economic characteristics and their satisfaction level.
Originality/value
This is the first study of its kind to highlight the situation of public healthcare system in Bihar, which is the third most populated state in India with poor social and health indicators.
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Ryan J. Chan, Shiran Isaacksz, Brian Low, Cecile Raymond, Lori Seeton and Christopher T. Chan
Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples…
Abstract
Purpose
Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.
Design/methodology/approach
In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.
Findings
We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.
Practical implications
Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.
Originality/value
There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.
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Samuel Adusei, Dorcas Nuertey and Emmanuel Poku
This study investigated the relationship between last-mile distribution or delivery (LMD) and commodity access through the mediating role of commodity availability and commodity…
Abstract
Purpose
This study investigated the relationship between last-mile distribution or delivery (LMD) and commodity access through the mediating role of commodity availability and commodity security and the moderating effect of supply chain integration (SCI).
Design/methodology/approach
The study adopted the survey research design and employed the questionnaire instrument in collecting primary data from respondents in Eastern Regional Health Institutions in Ghana. The total number of valid responses received was 204. The partial least squares structural equation modeling (PLS-SEM) approach was adopted to analyze the relationship between the study variables.
Findings
The findings showed that there is a positive and significant relationship between LMD and commodity availability as well as LMD and commodity security. Moreover, while the relationship between commodity availability and commodity access is positive and significant, that between commodity security and commodity access is positive but insignificant. Furthermore, there is a positive and statistically significant relationship between LMD and commodity access. The study discovered that the interaction between LMD and commodity access is insignificant and negatively affected by SCI.
Originality/value
To the best of the authors' knowledge, no previous studies have empirically verified the effect of LMD on commodity access in the presence of mediating factors such as commodity availability and commodity security and SCI as the moderating factors.
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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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Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt
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…
Abstract
Purpose
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.
Design/methodology/approach
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).
Findings
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.
Originality/value
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.
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Siu Mee Cheng and Cristina Catallo
The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address…
Abstract
Purpose
The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address the social isolation and health needs of a highly vulnerable older adult population living in the north Toronto communities. These are Russian-speaking Jewish older adult immigrants. The case provides a detailed description of the factors that enabled a diverse group of health and social care organizations to integrate their respective services to address the health and social care needs of their clients using a culturally appropriate and trauma-informed lens.
Design/methodology/approach
A case description comprised of key informant interviews, and a focus group was undertaken of representatives from health and social care organizations serving clients in the north Toronto area.
Findings
This case description identified eleven integration factors that enabled organizations to provide integrated care using a culturally appropriate and trauma-informed lens, and they include developing an aligned vision and goals, communications, an inter-organization culture of inter-dependence, champions, pre-existing relationships, and champions. In addition, operating in the not-for-profit sector, sector differences, enabling public policies and a strong sense of community have influenced integration of services across the organizational partners to serve its high-risk client group.
Originality/value
This case description lends insights into how IHSC can be leveraged to provide culturally appropriate and trauma-informed care for highly vulnerable client/patient populations. A lesson learnt is that social care partners can engage in successful integration leadership in joint health and social care integration efforts.
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Muhammad Junaid, Kiane Goudarzi, Muhammad Faisal Rasheed and Gilles N’Goala
Contrary to want-based services, customer participation has got lesser attention in high-credence services like health care. Customer participation for patients with chronic…
Abstract
Purpose
Contrary to want-based services, customer participation has got lesser attention in high-credence services like health care. Customer participation for patients with chronic illnesses could be life-threatening and goes beyond the service organization’s physical environment. Realizing the importance of transformative service research in health-care services, this study aims to propose and validate the conceptualization of customer participation for patients with chronic illnesses.
Design/methodology/approach
The study uses sequential exploratory research design with mixed method research. The first phase is a qualitative exploration of the nature and meaning of customer participation by synthesizing theory and insights from semi-structured interviews (N = 75) with doctors, patients and paramedical staff. Next, survey data (N = 690) of patients with chronic illnesses is used to validate the proposed conceptualization. Finally, nomological validity was also tested on an additional survey data set (N = 362) using SEM and FsQCA.
Findings
The findings reveal that health-care customer participation is a three-dimensional behavioral construct in which a customer can participate by sharing information, involving in decision-making and ensuring compliance. The study also demonstrates that customer participation is a critical driver of satisfaction with life and perceived control on illness.
Practical implications
The research provides policy guidelines for owners and operators of health-care organizations in developing frameworks for collecting participation data, which can be used in strategies for seeking customer participation.
Originality/value
The research conceptualizes and validates “customer participation” as a multidimensional higher-order construct for patients with chronic illnesses, rarely focused in services marketing and management research on health care.
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Although the use of management control systems (MCS) in crisis management has received extensive attention, limited knowledge exists regarding the benefits of the broad scope…
Abstract
Purpose
Although the use of management control systems (MCS) in crisis management has received extensive attention, limited knowledge exists regarding the benefits of the broad scope, timeliness, integration and aggregation dimensions. This study aims at examining the performance implications of the context-structure combinations of pandemic management strategy (PMS), MCS use and pandemic-induced uncertainty of public health institutions (PHIs) in Ghana.
Design/methodology/approach
Data were collected using online survey questionnaire where 246 public health managers qualified for the study. Data were analyzed using covariance-based structural equations modeling (version 23).
Findings
PMS was found to have a significant and positive impact on three (broad scope, timeliness and aggregation) of the four dimensions. The integrated dimension was statistically insignificant. In addition, the three dimensions had a significant impact on top managers’ satisfaction with MCS use, which in turn impact on cost containment and quality of care. Finally, COVID-19 uncertainty moderated the relationship between MCS use and operational performance.
Practical implications
The three dimensions of broad scope, timeliness and aggregation are critical for PHIs when it comes to crisis management. Moreover, the presence of pandemics strengthens the relationship between top manager use of MCS and performance in health care. More sophisticated MCS information is required when managing pandemic-related crisis by PHIs.
Originality/value
This study presents a theoretical framework that integrates PMS, MCS use and performance of public health care from a contingency perspective. It extends the benefits of contingency theory to include the three dimensions of MCS with respect to crisis management.
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Mahender Singh Kaswan, Rajeev Rathi, Jiju Antony, Jennifer Cross, Jose Arturo Garza-Reyes, Mahipal Singh, Inder Preet Singh and Michael Sony
The coronavirus (COVID-19) pandemic has led to a surge in demand for health-care facilities, medicines, vaccines and other health-care items. The purpose of this study is to…
Abstract
Purpose
The coronavirus (COVID-19) pandemic has led to a surge in demand for health-care facilities, medicines, vaccines and other health-care items. The purpose of this study is to investigate different facets of integrated Green Lean Six Sigma and Industry 4.0 approach in the context of COVID-19 for better healthcare management. Integrating Green Lean Six Sigma (GLSS) and Industry 4.0 (I4.0) has the potential to meet the modern demand of health-care units and also leads to improving the quality of inpatient care with better safety, hygiene and real-time diagnoses. A systematic review has been conducted to determine the tools/techniques, challenges, application areas and potential benefits for the adoption of an integrated GLSS-I4.0 approach within health-care facilities from the perspective of COVID management. Further, a conceptual framework of integrated GLSS-I4.0 has been proposed for better COVID management.
Design/methodology/approach
To conduct the literature review, the authors used the preferred reporting items for systematic reviews and meta-analysis and covers relevant papers from the arrival of COVID-19. Based on the systematic understanding of the different facets of the integrated GLSS-I4.0 approach and through insights of experts (academicians and health-care personnel), a conceptual framework is proposed to combat COVID-19 for better detection, prevention and cure.
Findings
The systematic review presented here provides different avenues to comprehend the different facets of the integrated GLSS-I4.0 approach in different areas of COVID health-care management. In this study, the proposed framework reveals that the Internet of Things, big data and artificial intelligence are the major constituents of I4.0 technologies that lead to better COVID management. Moreover, integration of I4.0 with GLSS aids during different stages of the COVID management, right from diagnosis, manufacture of items and inpatient and outpatient care of the affected person.
Practical implications
This study provides a significant knowledge database to the practitioners by understanding different tools and techniques of an integrated approach for better COVID management. Moreover, the proposed framework aids to grab day-to-day information from the affected people and ensures reduced hospital stay with better space utilization and the creation of a healthy environment around the patient. This inclusive implementation of the proposed framework will enhance knowledge base in medical areas and provides different novel prospects to combat other medical urgencies.
Originality/value
To the best of the authors’ knowledge, this study is the first of its kind to review different facets of the integrated GLSS-I4.0 approach with a view of the COVID health-care perspective and provides a conceptual framework.
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Severine Sirito Augustine Kessy, Gladness Ladislaus Salema and Yusta Simwita
This paper aims to examine lean thinking in medical commodities supply chains by considering its applications and success factors. It determines the drivers and wastes of medical…
Abstract
Purpose
This paper aims to examine lean thinking in medical commodities supply chains by considering its applications and success factors. It determines the drivers and wastes of medical commodity supply chain, and the existing lean tools and practices together with their application in the supply chain processes. The paper also examined the challenges and success factors for effective lean application in the medical commodities supply chains.
Design/methodology/approach
The study used qualitative approaches, in-depth interviews and focus group discussions with key informants to form the basis for data collection. Through thematic analysis, the collected data were analyzed by developing themes reflecting the objectives of the study.
Findings
The main drivers for waste associated with the supply chain were demand management, supplier development, institutional framework and governance. The wastes were observed at the level of inventory, operation costs, transaction costs, delays in terms of service, commodity delivery time and quality. Digitalization, information technology and standardization were the tools for medical supply chain. Poor infrastructure, unreliable internet supply, environmental uncertainty and poor management support were challenges to realizing an effective supply chain.
Research limitations/implications
Although the qualitative approach used in the study provides detailed information, a quantitative study covers a larger sample for generalization.
Practical implications
Capacity building and professionalism should be given a priority because the philosophy of lean focuses on waste removal and continuous improvement, which highly depends on the quality of human resource (Brito et al., 2020). Limited human resource capabilities in supply chain management will, therefore, result into poor operational efficiency, which are wasted. Moreover, systems interoperability is key waste minimization and, therefore, demands interventions.
Social implications
The government under the Ministry of Health and other key sector ministries such as local and regional governments should better understand the role of the waste drivers and adopt system-wide reforms to support improvements to remove waste in the medical supply chain. For example, the current institutional framework creates an administrative block and hence leads to wastes. This bureaucratic procedure should be removed to minimize wastes along the chain.
Originality/value
This study is among the first studies to determine applicability and implementation of lean in a resource-constrained context. The paper identifies contextual factors for lean implementation. This paper focused on a holistic view of the entire supply chains to enhance a well-functioning supply chain in delivering health commodities.
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