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1 – 10 of over 3000Ritva Rosenbäck and Ann Svensson
This study aims to explore the management learning during a long-term crisis like a pandemic. The paper addresses both what health-care managers have learnt during the COVID-19…
Abstract
Purpose
This study aims to explore the management learning during a long-term crisis like a pandemic. The paper addresses both what health-care managers have learnt during the COVID-19 pandemic and how the management learning is characterized.
Design/methodology/approach
The paper is based on a qualitative case study carried out during the COVID-19 pandemic at two different public hospitals in Sweden. The study, conducted with semi-structured interviews, applies a combination of within-case analysis and cross-case comparison. The data were analyzed using thematic deductive analysis with the themes, i.e. sensemaking, decision-making and meaning-making.
Findings
The COVID-19 pandemic was characterized by uncertainty and a need for continuous learning among the managers at the case hospitals. The learning process that arose was circular in nature, wherein trust played a crucial role in facilitating the flow of information and enabling the managers to get a good sense of the situation. This, in turn, allowed the managers to make decisions meaningful for the organization, which improved the trust for the managers. This circular process was iterated with higher frequency than usual and was a prerequisite for the managers’ learning. The practical implications are that a combined management with hierarchical and distributed management that uses the normal decision routes seems to be the most successful management method in a prolonged crisis as a pandemic.
Practical implications
The gained knowledge can benefit hospital organizations, be used in crisis education and to develop regional contingency plans for pandemics.
Originality/value
This study has explored learning during the COVID-19 pandemic and found a circular process, “the management learning wheel,” which supports management learning in prolonged crises.
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Oti Amankwah, Weng-Wai Choong and Naana Amakie Boakye-Agyeman
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always…
Abstract
Purpose
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always managed and maintained with the attention required. This is due mainly to the complexity of health-care infrastructure and equipment and shortage of maintenance budget. This study aims to determine if patient’s satisfaction of core health-care business is mediated by the quality of health-care infrastructure and equipment.
Design/methodology/approach
This cross-sectional study comprises 622 adult patients at the Physician OPD and Polyclinic of Komfo Anokye Teaching hospital, Tamale Teaching hospital and Cape Coast Teaching hospital in Ghana. Structural equation model Smart PLS was used to analyse the data.
Findings
The study results showed that the quality of health-care infrastructure and equipment has a positive significant influence (mediation) on the relationship between health-care delivery and patient’s satisfaction as well as the relationship between adequacy of health-care resources and patient’s satisfaction. However, it was shown not to have a positive significant influence (mediation) on the relationship between quality of health-care personnel and patients’ satisfaction as well as health-care administrative process and patient’s satisfaction.
Research limitations/implications
First, the study findings are centred on cross-sectional data, which capture the opinion of the patients at a specific time period instead of over a period of time. Consequently, in future, though difficult to achieve, a longitudinal study can be piloted to provide more insight. Second, the data was collected from only one country (Ghana); thus, the ability to generalise the results may be a challenge.
Practical implications
The implication of this study is that there is the need to prudently maintain hospital infrastructure and equipment in good working condition as it has a positive effect on patients’ satisfaction of their overall health-care experience.
Originality/value
Most studies have concentrated on patient’s health-care experience. This study extends the knowledge of patient’s health-care experience by determining the mediating role of quality of health-care infrastructure and equipment on the relationship between patient’s satisfaction and core health-care business. There are limited studies of such nature in Ghana. Therefore, this study will provide invaluable empirical data for the health-care sector of a developing African country.
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Daan Kabel, Jason Martin and Mattias Elg
The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it…
Abstract
Purpose
The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it requires a dynamic and flexible implementation strategy. The implementation of industry 4.0 often involves overcoming several tensions between internal and external stakeholders. This paper aims to explore the paradoxical tensions that arise for health-care organizations when integrating industry 4.0. Moreover, it discusses how a paradox lens can support the conceptualization and proposes techniques for handling tensions during the integration of industry 4.0.
Design/methodology/approach
This qualitative and in-depth study draws upon 32 semi-structured interviews. The empirical case concerns how two health-care organizations handle paradoxical tensions during the integration of industry 4.0.
Findings
The exploration resulted in six recurring technology tensions: technology invention (modularized design vs. flexible design), technology collaboration (automation vs. human augmentation), technology-driven patient experience (control vs. autonomy), technology uncertainty (short-term experimentation vs. long-term planning), technology invention and diffusion through collaborative efforts among stakeholders (selective vs. intensive collaboration) and technological innovation (market maintenance vs. disruption).
Originality/value
A paradox theory-informed conceptual model is proposed for how to handle tensions during the integration of industry 4.0. To the best of the authors’ knowledge, this is the first paper to introduce paradox theory for quality management, including lean and Six Sigma.
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Claudio Rocco, Gianvito Mitrano, Angelo Corallo, Pierpaolo Pontrandolfo and Davide Guerri
The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes…
Abstract
Purpose
The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.
Design/methodology/approach
In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.
Findings
This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.
Originality/value
The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.
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Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the…
Abstract
Purpose
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.
Design/methodology/approach
Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.
Findings
The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.
Originality/value
There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.
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Bernice Skytt, Hans Högberg and Maria Engström
The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.
Abstract
Purpose
The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.
Design/methodology/approach
Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).
Findings
The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.
Originality/value
The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.
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Timothy Bartram, Jillian Cavanagh, Beni Halvorsen, Patricia Pariona-Cabrera, Jessica Borg, Matthew Walker and Narges Kia
Aged-care work has become an extreme form of work. Anti-violence HRM, comprising practices to combat workplace violence, is important in an industry with widespread violence. In…
Abstract
Purpose
Aged-care work has become an extreme form of work. Anti-violence HRM, comprising practices to combat workplace violence, is important in an industry with widespread violence. In this paper, we employ social exchange theory to better understand the effect of anti-violence HRM and trust in the manager on perceived nurse and PCA cynicism working in Australian aged care facilities and their subsequent intention to leave.
Design/methodology/approach
This study used a mixed method with two stages. Stage 1 comprised semi-structured interviews with 10 managers and 50 nurses and PCAs working in Australian aged care facilities. Stage 2 comprised a survey of nurses and PCAs with a total of 254 completed responses in Time 1 (first wave) and 225 completed responses in Time 2 (second wave).
Findings
We tested three hypotheses and reported that interestingly anti-violence HRM was positively associated with organisational cynicism. Organisational cynicism mediated the relationship between anti-violence HRM and intention to leave. Worker trust in the manager moderated the relationship between anti-violence HRM practices and organisational cynicism, such that high levels of trust in the manager increased the effect of anti-violence HRM practices to reduce organisational cynicism and subsequently reduce intention to leave.
Originality/value
We find evidence that in aged care, workers' trust in their managers is critical for effectual anti-violence HRM. We argue that implementation of HRM practices may be more complex in extreme work settings. It is crucial to study HRM in situ and understand the root of social exchange(s) as a foundation for HRM to influence employee attitudes and behaviour.
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Reza Salehzadeh and Mehran Ziaeian
This study aims to advance the understanding of humble leadership (HL) in health care.
Abstract
Purpose
This study aims to advance the understanding of humble leadership (HL) in health care.
Design/methodology/approach
This study presents a scoping review to explore and synthesize the existing knowledge in the literature. The search process encompassed three main online databases, PubMed, Scopus and Web of Science. Due to the novelty of the topic of HL in health care and the lack of research in this area, all articles published until the end of February 2023 were considered in this study.
Findings
A total of 18 studies were included. The results showed that in the period of 2019–2023 more attention was paid to HL in health care than in previous years. The research design used in these articles included quantitative (n = 13) and qualitative (n = 5) methods and the statistical population included nurses, hospital employees and health-care department managers. Based on the results obtained, the definition of HL can be divided into two general approaches, including self-evaluation and the way one treats others. In addition, humble leaders in the health-care sector should exhibit certain behavioral characteristics and finally, the results indicated that HL has several positive consequences; however, little attention has been paid to the factors influencing HL in health care.
Practical implications
This research will help practitioners gain a deeper understanding of the various applications of HL in health care.
Originality/value
To the best of the authors’ knowledge, no comprehensive research review has yet been conducted on the application of HL in health care.
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Bogdan Oprea, Daniela Ionescu-Avram, Iuliana Armas and Eugen Avram
Investigating the role of leadership during the COVID-19 pandemic in maintaining the well-being and performance of the medical personnel, as frontline workers, is of major…
Abstract
Purpose
Investigating the role of leadership during the COVID-19 pandemic in maintaining the well-being and performance of the medical personnel, as frontline workers, is of major importance. The aim of this study was to investigate the relationships between engaging leadership in health care during COVID-19 pandemic and followers’ work engagement and performance and to test the mediating role of followers’ basic psychological need satisfaction in these relationships.
Design/methodology/approach
A cross-sectional study was conducted on a sample consisting of 200 health-care employees. Data were collected starting with May 2020 and ending with November 2020, during the COVID-19 pandemic. Participants reported on the engaging leadership of their direct supervisor and on their own psychological need satisfaction, work meaningfulness, work engagement and quality of care.
Findings
The positive association between engaging leadership and followers’ work engagement was fully mediated by followers’ basic needs satisfaction. The relationship between engaging leadership and followers’ quality of patient care was not supported. Work meaningfulness did not mediate the link between engaging leadership and followers’ engagement.
Practical implications
By meeting followers’ needs for autonomy, competence and relatedness, engaging leaders can stimulate followers’ work engagement during outbreaks and other similar crises. Managers in health care may maintain a high level of followers’ work engagement during crises if they adopt an engaging leadership style.
Originality/value
The study investigated for the first time the role of meeting the psychological needs of health-care workers by leaders during a health-care crisis.
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YunYing (Susan) Zhong, Timothy Bottorff, Jianwen Li, Ladda Thiamwong and Susanny J. Beltran
This study aims to examine the conceptual and empirical operations of hospitality at its intersections with health care, which includes medical and senior care.
Abstract
Purpose
This study aims to examine the conceptual and empirical operations of hospitality at its intersections with health care, which includes medical and senior care.
Design/methodology/approach
This study conducts a systematic review of literature on hospitality in health care published in hospitality, tourism and leisure journals spanning from 1990 to 2023. A total of 50 studies meeting the inclusion criteria are reviewed, providing insights into how hospitality is conceptualized, its practical implementation and the proposed outcomes in health-care settings.
Findings
Hospitality in health care is conceptualized by hospitality scholars in three main ways: as service functions, as a service exchange and as an organizational culture. There is a significant overlap between the notion of hospitality and the concept of person-centered care in gerontology and health-care literature. Also, hospitality contributes positively to patient/resident experiences, organizational performance and societal impacts.
Research limitations/implications
The study is limited by its focus solely on the theoretical and practical aspects of hospitality in health care within hospitality, tourism and leisure journals, excluding relevant literature from gerontological and health-care journals.
Originality/value
Interdisciplinary research requires scholars from different disciplines to develop a common language and understanding of key concepts. This study presents the conceptual and practical domains of hospitality and its relevancy to health-care research and offers future directions to strengthen the interdisciplinary research between hospitality, health care and gerontology.
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