Search results

Procedures can be categorized as certain surgeries based on their necessity and outcomes while others are classified as uncertain surgeries based on these areas. To account for this variance, policies such as the Affordable Care Act (ACA) call for health care providers to engage in shared decision making (SDM) with patients to ensure they are informed of treatment options and asked their preferences. Yet, gender may influence the decision-making process. Thus, this project examines the decision process and how gender impacts patients’ participation in decisions to undergo certain surgeries compared to uncertain surgeries.

This research project analyzed data from the National Survey of Medical Decisions 2006–2007 which surveyed the medical decisions of US residents 40 and older.

First, the data reveals that women felt more informed having uncertain surgeries compared to men. Second, patients were less likely asked their preference for surgery when undergoing certain surgeries compared to uncertain surgeries. Third, compared to men, women having uncertain surgeries were less likely to make the final decision to have surgery, compared to sharing the final decision with health care providers.

Due to the sample size, this project could not perform three-way interactions between gender, race, and surgery type.

Gender influences the level patients feel informed having uncertain surgeries. Though policy calls for SDM, health care providers are less likely to ask patients their preference for surgery regarding certain surgeries, relative to uncertain surgeries. Gender impacts the final decision-making process regarding whether patients should have uncertain surgeries.

Previous research on routine dynamics has most commonly incorporated consideration of power, politics, and conflict by using the notion of “truce.” In this paper, the authors propose a novel approach to integrating theories of power and politics with those of routine dynamics, and illustrate it by drawing on an in-depth study of operating room routines in a general hospital. The authors show how the dynamic interaction among groups’ sources of power, interests, and strategies is linked to the performance and patterning of routines. The approach opens up the originally rather static notion of “truce” to an inherently more dynamic and processual view of the micropolitics underpinning routines. The authors contribute to the routine dynamics literature by showing how and why the micropolitical context may influence, undermine, or reproduce the patterning and performing of organizational routines following a change initiative, and more broadly by illustrating an approach to integrating political considerations into the theory of routine dynamics.

Industry 5.0 focuses on human–machine collaboration and sustainability with collaborative robots (CoBots) and artificial intelligence (AI) penetration via different technology-enabled devices. Such devices have gained increasing interest to facilitate more efficient, effective, and budget-friendly outcomes in major sectors, including healthcare. The healthcare sector has been evolving at an increasing speed across the globe. In this context, challenges and opportunities have arisen in terms of improving patient outcomes and improving the efficiency of healthcare practitioners’ work. Hence, the adoption of CoBots and AI-enabled devices in this sector is now crucial, and they have been implemented in several domains in healthcare, including diagnosis, medication development, and treatment. However, the successful implementation depends on the users’ attitudes toward the adoption. While extant studies have shown that such devices have significant practical advantages from the patients’ perspective, little is known about healthcare practitioners’ willingness to adopt tech-enabled devices. Thus, this study focuses on the adoption of CoBots and AI-enabled devices in the healthcare sector by examining Turkish medical doctors’ attitudes toward adopting them in their daily operations. The study supplements current literature on Industry 5.0 in healthcare, sheds light on real-life practices, and proposes future directions.

This paper examines the relationship between human resource practices in 173 hospitals in the United Kingdom and four organizational outcome categories – clinical, financial, employee attitudes and perceptions, and patient attitudes and perceptions. The overarching proposition set forth and examined in this paper is that human resource management (HRM) practices and delivery of care practices have varied effects on each of these outcomes. More specifically, the authors set forth the proposition that specific practices will have positive effects on one outcome category while simultaneously having a negative effect on other performance outcomes, broadly defined.

The paper introduces a broader stakeholder framework for assessing the HR–performance relationship in the healthcare setting. This multi-dimensional framework incorporates the effects of human resource practices on customers (patients), management, and frontline staff and can also be applied to other sectors such as manufacturing. This approach acknowledges the potential for incompatibilities between stakeholder performance objectives. In the healthcare industry specifically, our framework broadens the notion of performance.

Overall, our results provide support for the proposition that different stakeholders will be affected differently by the use of managerial practices. We believe that the findings reported in this paper highlight the importance of examining multiple stakeholder outcomes associated with managerial practices and the need to identify the inherent trade-offs associated with their adoption.

The research analyzes good practices in health care “management experimentation models,” which fall within the broader range of the integrative public–private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the “management experimentation models” are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations.

In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC – Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies.

The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable.

The recognition of ISMETT’s good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

It is estimated that approximately 3,000 women develop obstetric fistula, leading to unhealthy pregnancy, early and prolonged labor, and in some cases stillbirth in Tanzania every year. Fistula often compounds the vulnerability of the women who are victims of a poor health facility, early marriage, and other gender gaps.

In this chapter, the author explores the extra-medical causes of fistula in remote locations (Pwani Region) of Tanzania from a practitioner’s perspective. The author considers the stories of four women who experienced fistula. The author interviewed the women over a period of five years between 2013 and 2018. Using narrative analysis, the author examined the interviews.

The narrative analysis indicates that fistula is a product of a gender biased social system that favors men, ultimately limits women’s freedom, stifling their development. Importantly, the main value of this analysis is to promote awareness that aside from medical treatment, social interventions are required to reconstruct the social belief system and eliminate the stigma associated with obstetric fistula. A list of social interventions that proactively manage the incidence of fistula and help integrate affected women back into the society sustainably is recommended.

Education is both a human right and an indispensable means of achieving other rights. Provision of education for irregular status migrant children tests the commitment of nation states to this basic right even as states curb irregular immigration. In the US, the right to go to school was guaranteed to irregular migrant children, by the case of Plyler v. Doe in 1982. This article argues that the right enshrined in that decision faces considerable risk of being eroded in the current political context. The article presents a detailed critical analysis of the rationale in the case, with a full consideration of the shaky constitutional framework on which the decision was based. It also examines the direct legal challenges to the right to education since Plyler, and the potential impact of new political and legal changes in contemporary times.

Effective competence-based management (CBM) requires in the first instance an ability to identify an organization’s competences and the sources of those competences. Identifying competences can be especially challenging in the context of not-for-profit organizations, which have often been characterized as being “different” from for-profit organizations. In this paper we argue that not-for-profit organizations have fundamentally the same systemic requirements for survival and success as for-profit organizations – and therefore that not-for-profits ought to be amenable to competence identification and analysis through use of CBM concepts and theory in essentially the same way as for-profit organizations. We support this basic proposition through a case study of competence identification and analysis in a humanitarian relief organization (HRO), an increasingly important kind of not-for-profit organization.