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Open Access
Article
Publication date: 11 April 2016

Denise L. Anthony and Timothy Stablein

The purpose of this paper is to explore different health care professionals’ discourse about privacy – its definition and importance in health care, and its role in their…

13767

Abstract

Purpose

The purpose of this paper is to explore different health care professionals’ discourse about privacy – its definition and importance in health care, and its role in their day-to-day work. Professionals’ discourse about privacy reveals how new technologies and laws challenge existing practices of information control within and between professional groups in health care, with implications not only for patient privacy, but also for the role of information control in professions more generally.

Design/methodology/approach

The authors conducted in-depth, semi-structured interviews with n=83 doctors, nurses, and health information professionals in two academic medical centers and one veteran’s administration hospital/clinic in the Northeastern USA. Interview responses were qualitatively coded for themes and patterns across groups were identified.

Findings

The health care providers and the authors studied actively sought to uphold the protection (and control) of patient information through professional ethics and practices, as well as through the use of technologies and compliance with legal regulations. They used discourses of professionalism, as well as of law and technology, to sometimes accept and sometimes resist changes to practice required in the changing technological and legal context of health care. The authors found differences across professional groups; for some, protection of patient information is part of core professional ethics, while for others it is simply part of their occupational work, aligned with organizational interests.

Research limitations/implications

This qualitative study of physicians, nurses, and health information professionals revealed some differences in views and practices for protecting patient information in the changing technological and legal context of health care that suggest some professional groups (doctors) may be more likely to resist such changes and others (health information professionals) will actively adopt them.

Practical implications

New technologies and regulations are changing how information is used in health care delivery, challenging professional practices for the control of patient information that may change the value or meaning of medical records for different professional groups.

Originality/value

Qualitative findings suggest that professional groups in health care vary in the extent of information control they have, as well in how they view such control. Some groups may be more likely to (be able to) resist changes in the professional control of information that stem from new technologies or regulatory policies. Some professionals recognize that new IT systems and regulations challenge existing social control of information in health care, with the potential to undermine (or possibly bolster) professional self-control for some but not necessarily all occupational groups.

Details

Journal of Health Organization and Management, vol. 30 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 20 July 2021

Elena Bellio and Luca Buccoliero

Delivering patient-centered healthcare is now seen as one of the basic requirements of good quality care. In this research, the impact of the perceived quality of three…

10839

Abstract

Purpose

Delivering patient-centered healthcare is now seen as one of the basic requirements of good quality care. In this research, the impact of the perceived quality of three experiential dimensions (Physical Environment, Empowerment and Dignity and Patient–Doctor Relationship) on patient's Experiential Satisfaction is assessed.

Design/methodology/approach

259 structured interviews were performed with patients in private and public hospitals across Italy. The research methodology is based in testing mediation and moderation effects of the selected variables.

Findings

The study shows that: perceived quality of Physical Environment has a positive impact on patient's Experiential Satisfaction; perceived quality of Empowerment and Dignity and perceived quality of Patient–Doctor Relationship mediate this relationship reinforcing the role of Physical Environment on Experiential Satisfaction; educational level is a moderator in the relationship between perceived quality of Patient–Doctor Relationship and overall Satisfaction: more educated patients pay more attention to relational items. Subjective Health Frailty is a moderator in all the tested relationships with Experiential Satisfaction: patients who perceive their health as frail are more reactive to the quality of the above-mentioned variables.

Originality/value

Physical Environment items are enablers of both Empowerment and Dignity and Patient–Doctor Relationship and these variables must be addressed all together in order to improve the value proposition provided to patients. Designing a hospital, beyond technical requirements that modern medicine demands and functional relationships between different medical departments, means dealing with issues like the anxiety of the patient, the stressful working environment for the hospital staff and the need to build a sustainable and healing building.

Details

The TQM Journal, vol. 33 no. 7
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 9 January 2024

Rania Ahmed Aly El Garem, Amira Fouad and Hassan Mohamed

This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating…

Abstract

Purpose

This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating role of the sociodemographic factors.

Design/methodology/approach

The data were gathered from 462 patients via a structured questionnaire, while structural equation modeling was utilized for the analysis.

Findings

Results indicated that trust, perceived value and patient satisfaction have important roles in shaping the patient loyalty, while patient satisfaction was found to fully mediate the patient’s perceived service quality. Loyalty relationship was also found to partially mediate the trust–loyalty relationship. Nonetheless, the patient’s satisfaction–loyalty relationship was found to be only moderated by the age factor.

Practical implications

Implications are provided to the Egyptian private hospitals in order for them to formulate improvement plans as well as set higher standards of conduct.

Originality/value

This original research is the first one, up to the researcher knowledge, that explores the drivers of patient satisfaction in the private hospitals in Egypt.

Details

Journal of Humanities and Applied Social Sciences, vol. 6 no. 2
Type: Research Article
ISSN: 2632-279X

Keywords

Open Access
Article
Publication date: 14 September 2022

Antonietta Megaro, Luca Carrubbo, Francesco Polese and Carlo Alessandro Sirianni

The aim of this paper is to understand if service innovation (Helkkula et al., 2018), based on artificial intelligence (AI) systems, may guarantee healthcare service ecosystem…

1135

Abstract

Purpose

The aim of this paper is to understand if service innovation (Helkkula et al., 2018), based on artificial intelligence (AI) systems, may guarantee healthcare service ecosystem (H-SES) well-being (Frow et al., 2019; Beirão et al., 2017), taking into account that many doubts relieved in terms of transparency may compromise the patients' perceived quality of health services provided through AI systems.

Design/methodology/approach

A literature review on service innovation, detected in terms of value co-creation, and service ecosystem, investigated in terms of well-being, is drawn. To analyze the implications of service innovation on a H-SES well-being, through the technology acceptance degree and predisposition to use by actors, a case study based on TAM-model 3 determinants as categories is carried out.

Findings

AI-based service innovation archetypes in healthcare may be considered as antecedents of the service ecosystem well-being conditions as long as they enable actors to co-create value. To make it possible, a patient-driven service innovation is necessary in order to mitigate the risks of its inactivity due to fears in terms of transparency.

Originality/value

Service innovation and service ecosystem well-being may be studied in an integrated way, with a multidisciplinary approach, and are linked by value co-creation, because only thanks a patient-driven service innovation is possible to foster service ecosystem well-being in healthcare.

Open Access
Article
Publication date: 24 February 2020

Nicola Cobelli and Andrea Chiarini

The main purpose of this exploratory study is to investigate the attitude of pharmacists, as small- and medium-sized enterprise (SME) owners, toward new technologies, and more…

6010

Abstract

Purpose

The main purpose of this exploratory study is to investigate the attitude of pharmacists, as small- and medium-sized enterprise (SME) owners, toward new technologies, and more precisely, toward the adoption of mobile apps for mobile health (mHealth). Such apps are generally used to improve customer satisfaction and loyalty. This study measures pharmacists’ subjective experiences of mobile apps for mHealth and aims to understand how these pharmacists make sense of these apps.

Design/methodology/approach

The study adopted the narrative inquiry technique combined with critical event analysis. Participants' experiences were categorized based on how they viewed new technology tools. Interpretative inductive analysis identified precise aspects of the sense making illustrative of non-adoption or confused adoption of new technologies by pharmacists.

Findings

This study investigates to what extent new technology tools such as mobile apps affect retailers and more precisely the reasons why mobile apps are and are not adopted by retailers, as potential users, in the pharmaceutical industry. We identified four aspects of sense making that illustrated non-adoption or confused adoption of new technologies by pharmacists. These aspects are deeply discussed in the paper and are referred to the dimensions of confusion to confidence; suspicion to trust; frustration to education; mistrust to cooperation.

Research limitations/implications

The main limitation of the present study is the limited number of territories investigated. This limitation arose because of the exploratory nature of the available research, which is generally based on case studies, and the lack of clear operationalization of the research available at the time of data collection. Another limitation is that the sample included only SMEs operating in the Italian pharmacy industry.

Originality/value

Many studies have highlighted the opportunities related to new mobile apps in the business-to-business market. Several have investigated customer interest in such new technology. If some contributions have indirectly investigated the acceptance of information technology tools, to the best of our knowledge, no study has been conducted to investigate directly and precisely the level of pharmacists' acceptance, use, and willingness to adopt information technology (e.g., mobile apps) for customer service in mHealth and mainly the reasons of non-adoption.

Details

The TQM Journal, vol. 32 no. 6
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 19 December 2022

Nancy S. Bolous, Dylan E. Graetz, Hutan Ashrafian, James Barlow, Nickhill Bhakta, Viknesh Sounderajah and Barrie Dowdeswell

Healthcare tribalism refers to the phenomenon through which different groups in a healthcare setting strictly adhere to their profession-based silo, within which they exhibit…

1912

Abstract

Purpose

Healthcare tribalism refers to the phenomenon through which different groups in a healthcare setting strictly adhere to their profession-based silo, within which they exhibit stereotypical behaviours. In turn, this can lead to deleterious downstream effects upon productivity and care delivered to patients. This study highlights a clinician-led governance model, implemented at a National Health Service (NHS) trust, to investigate whether it successfully overcame tribalism and helped drive innovation.

Design/methodology/approach

This was a convergent mixed-methods study including qualitative and quantitative data collected in parallel. Qualitative data included 27 semi-structured interviews with representatives from four professional groups. Quantitative data were collected through a verbally administered survey and scored on a 10-point scale.

Findings

The trust arranged its services under five autonomous business units, with a clinician and a manager sharing the leadership role at each unit. According to interviewees replies, this equivalent authority was cascaded down and enabled breaking down professional siloes, which in turn aided in the adoption of an innovative clinical model restructure.

Practical implications

This study contributes to the literature by characterizing a real-world example in which healthcare tribalism was mitigated while reflecting on the advantages yielded as a result.

Originality/value

Previous studies from all over the world identified major differences in the perspectives of different healthcare professional groups. In the United Kingdom, clinicians largely felt cut off from decision-making and dissatisfied with their managerial role. The study findings explain a governance model that allowed harmony and inclusion of different professions. Given the long-standing strains on healthcare systems worldwide, stakeholders can leverage the study findings for guidance in developing and implementing innovative managerial approaches.

Details

Journal of Health Organization and Management, vol. 37 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 23 September 2022

Katharina Jahn, Frederike Marie Oschinsky, Bastian Kordyaka, Alla Machulska, Tanja Joan Eiler, Armin Gruenewald, Tim Klucken, Rainer Brueck, Carl Friedrich Gethmann and Bjoern Niehaves

Immersive virtual reality (IVR) has been frequently proposed as a promising tool for learning. However, researchers have commonly implemented a plethora of design elements in…

1017

Abstract

Purpose

Immersive virtual reality (IVR) has been frequently proposed as a promising tool for learning. However, researchers have commonly implemented a plethora of design elements in these IVR systems, which makes the specific aspects of the system that are necessary to achieve beneficial outcomes unclear. Against this background, this study aims to combine the literature on presence with learning theories to propose that the ability of IVR to present 3D objects to users improves the presence of these objects in the virtual environment compared with 2D objects, leading to increased learning performance.

Design/methodology/approach

To test this study’s hypotheses, the authors conducted a 2 (training condition: approach vs avoid) x 2 (object presence: high vs low) between-subjects laboratory experiment that used IVR with 83 female participants.

Findings

The results support this study’s hypotheses and show that training with high object presence leads to greater reactions to cues (chocolate cravings) and improved health behaviour (chocolate consumption).

Originality/value

This study shows that increased object presence leads to unique experiences for users, which help reinforce training effects. Moreover, this work sheds further light on how immersive computer technologies can affect user attitudes and behaviour. Specifically, this work contributes to IVR research by showing that learning effects can be enhanced through an increased degree of object presence.

Details

Internet Research, vol. 32 no. 7
Type: Research Article
ISSN: 1066-2243

Keywords

Open Access
Article
Publication date: 27 February 2024

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.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 29 December 2023

Ajimon George and Jobin Sahadevan

This study aims to deal with the paucity of studies in the stages of the development of loyalty behaviour of customers in the healthcare context by incorporating three crucial…

Abstract

Purpose

This study aims to deal with the paucity of studies in the stages of the development of loyalty behaviour of customers in the healthcare context by incorporating three crucial service quality dimensions (physical environment, personnel quality and technical quality) and also investigating trust and commitment as mediating factors.

Design/methodology/approach

Survey data were obtained from 420 respondents admitted to government hospitals in Kerala employing a convenience sampling method. The formulated hypotheses were tested using partial least square structural equation modelling.

Findings

Results indicate that patient satisfaction, trust and commitment can create favourable behavioural intentions amongst patients. When patients reveal higher trust, they are more inclined to value healthcare services and willing to commit to a long-term relationship, resulting in increased patient loyalty.

Practical implications

Organisational efforts should improve trust and commitment and build a good relationship between service providers and patients. Efforts should be taken to raise the standard of technical and personnel aspects, and a focus on physical infrastructure should also be considered to build a favourable behavioural intention to revisit and positive referrals.

Originality/value

This is the first empirical study to analyse technical quality, personnel quality and physical environment along with the mediating effect of trust, and commitment in a four-stage loyalty development model in the healthcare context of Kerala, India.

Details

Rajagiri Management Journal, vol. 18 no. 2
Type: Research Article
ISSN: 0972-9968

Keywords

Open Access
Article
Publication date: 19 February 2021

Isto Huvila, Åsa Cajander, Jonas Moll, Heidi Enwald, Kristina Eriksson-Backa and Hanife Rexhepi

Data from a national patient survey (N = 1,155) of the Swedish PAEHR “Journalen” users were analysed, and an extended version of the theory of technological frames was developed…

3306

Abstract

Purpose

Data from a national patient survey (N = 1,155) of the Swedish PAEHR “Journalen” users were analysed, and an extended version of the theory of technological frames was developed to explain the variation in the technological and informational framing of information technologies found in the data.

Design/methodology/approach

Patient Accessible Electronic Health Records (PAEHRs) are implemented globally to address challenges with an ageing population. However, firstly, little is known about age-related variation in PAEHR use, and secondly, user perceptions of the PAEHR technology and the health record information and how the technology and information–related perceptions are linked to each other. The purpose of this study is to investigate these two under-studied aspects of PAEHRs and propose a framework based on the theory of technological frames to support studying the second aspect, i.e. the interplay of information and technology–related perceptions.

Findings

The results suggest that younger respondents were more likely to be interested in PAEHR contents for general interest. However, they did not value online access to the information as high as older ones. Older respondents were instead inclined to use medical records information to understand their health condition, prepare for visits, become involved in their own healthcare and think that technology has a much potential. Moreover, the oldest respondents were more likely to consider the information in PAEHRs useful and aimed for them but to experience the technology as inherently difficult to use.

Research limitations/implications

The sample excludes non-users and is not a representative sample of the population of Sweden. However, although the data contain an unknown bias, there are no specific reasons to believe that it would differently affect the survey's age groups.

Practical implications

Age should be taken into account as a key factor that influences perceptions of the usefulness of PAEHRs. It is also crucial to consider separately patients' views of PAEHRs as a technology and of the information contained in the EHR when developing and evaluating existing and future systems and information provision for patients.

Social implications

This study contributes to bridging the gap between information behaviour and systems design research by showing how the theory of technological frames complemented with parallel informational frames to provide a potentially powerful framework for elucidating distinct conceptualisations of (information) technologies and the information they mediate. The empirical findings show how information and information technology needs relating to PAEHRs vary according to age. In contrast to the assumptions in much of the earlier work, they need to be addressed separately.

Originality/value

Few earlier studies focus on (1) age-related variation in PAEHR use and (2) user perceptions of the PAEHR technology and the health record information and how the technology and information–related perceptions are linked to each other.

Details

Information Technology & People, vol. 35 no. 8
Type: Research Article
ISSN: 0959-3845

Keywords

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