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Article

Alan K. Duncan and Margaret A. Breslin

The structure of health care financing, the lack of vertical and horizontal integration, and the slow translation of basic research into meaningful health outcomes for the

Abstract

Purpose

The structure of health care financing, the lack of vertical and horizontal integration, and the slow translation of basic research into meaningful health outcomes for the population conspire to make innovation in health service delivery a difficult task. However, health service organizations that can more effectively and systematically understand patient needs – needs that are now poorly understood and often unarticulated – have an intrinsic advantage in delivering high value care. This ‐paper aims to describe a program for translating those needs into health services innovations.

Design/methodology/approach

The Mayo Clinic, a large integrated multispecialty medical group based in Rochester, Minnesota developed an in‐house design program, the SPARC Innovation Program, to bring design thinking and business analysis together to develop innovations in care delivery. A project example is described to illustrate how designers, business strategists, health care professionals, and patients create new high‐value health care experiences.

Findings

The paper finds that health service organizations need to pay more attention to the patient experience if they are to meet patient needs. The design program described here is one approach that organizations can take if they are serious about deeply understanding patient needs and developing innovations to address them.

Originality/value

While the discipline of design is the core of innovation in many industries, it is not widely known or practiced in health service organizations despite a natural affinity between design and medicine. Understanding and employing the power of design in health services will allow medical institutions to develop more effective health services, enhance patient satisfaction, and meet important human needs.

Details

Journal of Business Strategy, vol. 30 no. 2/3
Type: Research Article
ISSN: 0275-6668

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Article

Seobgyu Song, Courtney Suess, Makarand Amrish Mody and Tarik Dogru

The purpose of this paper is to investigate the relationships between two dimensions of servicescape (i.e. substantive and communicative servicescape), health care

Abstract

Purpose

The purpose of this paper is to investigate the relationships between two dimensions of servicescape (i.e. substantive and communicative servicescape), health care travelers’ emotions, perceived value and word-of-mouth intentions. It also assesses the moderating effects of accommodation type (i.e. hotel and Airbnb) and interior design styles (i.e. traditional and modern) on the relationship between the two servicescape dimensions and travelers’ emotions.

Design/methodology/approach

Using a sample from a survey of 692 health care travelers who stayed at either a peer-to-peer accommodation (i.e. Airbnb) or a hotel, a multi-step structural equation model analysis tested the relationships among variables. It examined the moderating effects of accommodation type and interior design style.

Findings

The relationships between servicescape, emotions, perceived value and word-of-mouth were significant. Also, the two moderators affected how servicescape influenced the emotions of health care travelers. For Airbnb guests, communicative servicescape had a more substantial effect on enhancing their positive emotions than hotel guests. For health care travelers who stayed at an accommodation with a traditional interior design style, in addition to enhancing positive emotions of health care travelers, substantive servicescape significantly reduced their negative emotions.

Practical implications

The findings suggest the need for the lodging industry to examine how health care travelers perceive and experience their accommodations with unique interior design characteristics. Also, stakeholders in the lodging industry should leverage the aspects of substantive servicescape in terms of relevant interior design styles, which, in turn, influence health care travelers’ positive word-of-mouth intentions. Given the increase in medical mobility and demand for accommodations by those traveling to receive health care services, understanding the lodging environment and how it affects travelers in this segment is essential.

Originality/value

This research develops a comprehensive servicescape model with a focus on the communicative dimension. Moreover, this study significantly contributes to the hospitality literature regarding how the core experience and various interior design styles influence a rapidly growing segment of health care travelers. Health care travelers’ emotions are essential to consider given the propensity to experience stress related to travel situational health factors.

Details

International Journal of Contemporary Hospitality Management, vol. 33 no. 1
Type: Research Article
ISSN: 0959-6119

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Book part

Christopher G. Worley

Purpose – This chapter argues that the concept of agility is an effective robust framework for designing sustainable health care systems.Design/methodology/approach – This…

Abstract

Purpose – This chapter argues that the concept of agility is an effective robust framework for designing sustainable health care systems.

Design/methodology/approach – This case study of Alegent Health was based on 7 years of data collection. It includes observations of meetings, large-group interventions, and other activities; site visits to different hospitals in the system to observe changes in practice; interviews with Alegent Health executives, primary care physicians, hospital presidents, specialist physicians and physician groups, and health systems staff and nurses; and a variety of archival data including meeting minutes, video tapes, conference proceedings, and web site material.

Findings – The Alegent Health system has evolved over time according to the principles of agility. It built a series of new capabilities that contribute to improved clinical outcomes, sustained financial results, and more socially and ecologically responsible results. Designing health care systems based on agility is a more effective and sustainable approach than relying on legislative or other criteria.

Originality/value – The discussion of sustainability in health care has focused primarily on specific projects or how to respond to specific technological, regulatory, or clinical changes. Alegent Health's experience provides important lessons, opportunities, and challenges that can help advance our understanding of effective health care and use organizational agility to create more sustainable health care systems. This chapter provides health care system administrators an alternative design option.

Details

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

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Book part

Jessica M. Ray, Rebecca Berg and Stephanie N. Sudikoff

Changes in the physical environments of health care settings have become increasingly common to meet the evolving needs of the health care marketplace, new technologies…

Abstract

Changes in the physical environments of health care settings have become increasingly common to meet the evolving needs of the health care marketplace, new technologies, and infrastructure demands. Physical environment change takes many forms including new build construction, renovation of existing space, and relocation of units with little to no construction customization. The interrelated nature of the complex socio-technical health care system suggests that even small environmental modifications can result in system-level changes. Environmental modifications can lead to unintended consequences and introduce the potential for latent safety threats. Engaging users throughout the change lifecycle allows for iterative design and testing of system modifications. This chapter introduces a flexible process model, PROcess for the Design of User-Centered Environments (PRODUCE), designed to guide system change. The model was developed and refined across a series of real-world renovations and relocations in a large multihospital health care system. Utilizing the principles of user-centered design, human factors, and in-situ simulation, the model engages users in the planning, testing, and implementation of physical environment change. Case studies presented here offer exemplars of how to modify the model to support individual project objectives and outcomes to assess at each stage of the project.

Details

Structural Approaches to Address Issues in Patient Safety
Type: Book
ISBN: 978-1-83867-085-6

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Article

Fouad Jalal Mahmood

This study aims to trace the relationship between the evidence-based design (EBD) process and decision-making during the architectural design process, the barriers to…

Abstract

Purpose

This study aims to trace the relationship between the evidence-based design (EBD) process and decision-making during the architectural design process, the barriers to informing health-care architects and possible methods to overcome these barriers.

Design/methodology/approach

This study aims to explore the barriers to the EBD process during the design process by reviewing the relevant literature and future steps to overcome these barriers and support design decisions.

Findings

The study shows that EBD is a relevant, useful tool for providing evidence that positively affects design decisions. This study divides EBD barriers into simple barriers and complex barriers, depending on the nature of the barrier. Additionally, methods to overcome these barriers are discussed to ensure the best use of EBD findings with a significant impact on health-care design decisions, as they are core elements in informing architects, especially when combined with the traditional design process. This study investigates how likely it is for the EBD to contribute optimally to design decisions depending on architects’ skills and cooperation with researchers.

Originality/value

This study can apprize health-care architects of the need to consider the role of EBD in improving the quality of design decisions, and the importance of combining EBD with the traditional design process to implement optimal design decisions.

Details

Journal of Facilities Management , vol. 19 no. 2
Type: Research Article
ISSN: 1472-5967

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Article

Jonas Boström, Helene Hillborg and Johan Lilja

The purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking…

Abstract

Purpose

The purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking (DT) for improving quality in a health-care setting.

Design/methodology/approach

This paper is based on a case study following a quality improvement (QI) project in a medium-sized Swedish county council in the field of somatic care. The project involved eight health-care professionals, one designer, four patients and two relatives. A multiple data collection method over a period of ten months was used. It included individual interviews, e-mail correspondence and observations of workshops that covered the QI project.

Findings

The result shows tensions between QI work and the daily clinical work of the participants. These tensions primarily concern the conflict between fast and slow processes, the problem of moving between different fields of knowledge, being a resource for the individual clinic and the system and the participants’ expectations and assumptions about roles and responsibilities in a QI project. Furthermore, these findings could be interpreted as signs of a development culture in the health-care context.

Practical implications

There are several practical implications. Among others, the insights can inspire how to approach and contextualize the current concepts, roles and methods of DT and user involvement so that they can be more easily understood and integrated into the existing culture and way of working in the health-care sector.

Originality/value

This study provides a unique insight into a case, trying to uncover what actually is going on and perhaps, why certain things are not happening at all, when user involvement and design practices are applied for improving health-care quality.

Details

International Journal of Quality and Service Sciences, vol. 13 no. 1
Type: Research Article
ISSN: 1756-669X

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Book part

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…

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

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Article

Manish K. Dixit, Shashank Singh, Sarel Lavy and Wei Yan

The purpose of this paper is to identify, analyze and discuss floor finishes used in health-care facilities and their selection criteria in the form of advantages and…

Abstract

Purpose

The purpose of this paper is to identify, analyze and discuss floor finishes used in health-care facilities and their selection criteria in the form of advantages and disadvantages. The authors also identify the top three health-care floor finishes and selection criteria based on the literature review results. Although flooring materials have a considerable impact on the life-cycle cost and indoor environment of health-care facilities, what criteria may be used for such flooring choices is not thoroughly studied.

Design/methodology/approach

The authors performed a systematic review of the literature on certain flooring systems currently used in health-care facilities and the criteria applied for their selection. Peer-reviewed studies and articles published after Year 2000 consistent with the research design were included.

Findings

Sixteen different selection criteria that influence the choice of floor finishes in health-care facilities were determined and discussed. The results show that the top three-floor finish materials preferred in health-care facilities are sheet vinyl, rubber and carpet, and the top three selection criteria for floor finishes are indoor air quality, patient safety and infection control.

Originality/value

The results of this study will assist building owners, architects and interior designers with implementing an informed design decision-making process, particularly in relation to floor finish selection. The findings will also provide guidance to floor finish manufacturers to improve their products based on facility managers’ preferences.

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Book part

Abraham B. (Rami) Shani and Susan Albers Mohrman

Purpose – This chapter provides a reflective synopsis of the chapters in the volume and highlights the learning from the cases about the development of new orientations…

Abstract

Purpose – This chapter provides a reflective synopsis of the chapters in the volume and highlights the learning from the cases about the development of new orientations, design configurations, and learning mechanisms. It charts directions for further research and possible managerial actions.

Design – The chapters in this second volume of the book series “Organizing for Sustainable Effectiveness” capture a rich set of cases in which organizing for sustainable health care was the central focus. Each chapter illuminated the development of a distinct health care system in a unique cultural and national context, and had a special focus on reporting theoretically informed and rigorously explored knowledge to guide purposeful design and learning approaches. Collectively the chapters highlighted the processes, organization and design, system regulation, and continuous learning approaches in complex organizational and multi-organizational health care systems that enable focus on and advancement of economic, social, and ecological outcomes.

Findings – Several critical themes have emerged from the cases, and from the broader literature on health care transformation: the importance of purpose; the need to overcome fragmentation; the need for alternative business models; technology as an investment in sustainable health care; the centrality of knowledge management; the importance of partnership and collaboration; the role of self-organization and leadership; and the criticality of building change capabilities.

Details

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

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Book part

Denise C. Tahara and Richard P. Green

This paper proposes an organizational change process to prepare physicians and other health professionals for their new roles in patient-centered medical homes (PCMHs). It…

Abstract

Purpose

This paper proposes an organizational change process to prepare physicians and other health professionals for their new roles in patient-centered medical homes (PCMHs). It provides physician-centered tools, models, concepts, and the language to implement transformational patient-centered medical care.

Design/methodology/approach

To improve care delivery, quality, and patient engagement, a systems approach to care is required. This paper examines a systems approach to patient care where all inputs that influence patient interactions and participation are considered in the design of health care delivery and follow-up treatment plans. Applying systems thinking, organizational change models, and team-building, we have examined the continuum of this change process from ideation through the diffusion of new methods and behaviors.

Findings

PCMHs make compelling business sense. Studies have shown that the PCMH improves patient satisfaction, clinical outcomes and reduces underuse and overuse of medical services. Patient-centered care necessitates transitioning from an adversarial to a collaborative culture. It is a transformation process predicated on strong leadership able to align an organization toward a vision of patient-centered care, creating a collaborative culture committed to health-goal achievement.

Originality/value

This paper proposes that the PCMH is a rigorous team-building transformational organizational change, a radical departure from the current hierarchical, silo-oriented, medical practice model. It requires that participants within and across health care organizations learn new skills and behaviors to achieve the anticipated quality and efficiency improvements. It is an innovative health care organization model of the future whose success is premised on teams supplanting the individual as the building block and unit of health care performance.

Details

Population Health Management in Health Care Organizations
Type: Book
ISBN: 978-1-78441-197-8

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