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Article
Publication date: 8 July 2019

The influence of place on health-care customer creativity

Hannah Snyder, Lars Witell, Mattias Elg and Janet R. McColl-Kennedy

When using a service, customers often develop their own solutions by integrating resources to solve problems and co-create value. Drawing on innovation and creativity…

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Abstract

Purpose

When using a service, customers often develop their own solutions by integrating resources to solve problems and co-create value. Drawing on innovation and creativity literature, this paper aims to investigate the influence of place (the service setting and the customer setting) on customer creativity in a health-care context.

Design/methodology/approach

In a field study using customer diaries, 200 ideas from orthopedic surgery patients were collected and evaluated by an expert panel using the consensual assessment technique (CAT).

Findings

Results suggest that place influences customer creativity. In the customer setting, customers generate novel ideas that may improve their clinical health. In the service setting, customers generate ideas that may improve the user value of the service and enhance the customer experience. Customer creativity is influenced by the role the customer adopts in a specific place. In the customer setting customers were more likely to develop ideas involving active customer roles. Interestingly, while health-care customers provided ideas in both settings, contrary to expectation, ideas scored higher on user value in the service setting than in the customer setting.

Research limitations/implications

This study shows that customer creativity differs in terms of originality, user value and clinical value depending on the place (service setting or customer setting), albeit in one country in a standardized care process.

Practical implications

The present research puts customer creativity in relation to health-care practices building on an active patient role, suggesting that patients can contribute to the further development of health-care services.

Originality/value

As the first field study to test the influence of place on customer creativity, this research makes a novel contribution to the growing body of work in customer creativity, showing that different places are more/less favorable for different dimensions of creativity. It also relates customer creativity to health-care practices and highlights that patients are an untapped source of creativity with first-hand knowledge and insights, importantly demonstrating how customers can contribute to the further development of health-care services.

Details

European Journal of Marketing, vol. 53 no. 7
Type: Research Article
DOI: https://doi.org/10.1108/EJM-10-2017-0723
ISSN: 0309-0566

Keywords

  • Creativity
  • Value co-creation
  • Service
  • Health-care

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Article
Publication date: 21 February 2011

Joined‐up Rationing? An Analysis of Priority Setting in Health and Social Care Commissioning

Iestyn Williams, Helen Dickinson and Suzanne Robinson

Joint commissioning is an important part of the current health and social care context and will continue to be crucial in the future. An essential component of any…

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Abstract

Joint commissioning is an important part of the current health and social care context and will continue to be crucial in the future. An essential component of any commissioning process is priority setting, and this paper begins to explore the idea of integrated priority setting as a key element of health and social care commissioning. After setting out the key terminology in this area and the main priority‐setting processes for health and social care, the paper describes a number of barriers that might be encountered in integrated priority setting. We argue that there are significant barriers in financing, accessibility, evidence and politics, and it is important that such barriers are acknowledged if priority setting is to become a component of joint commissioning. While these barriers are not insurmountable, the solution lies in engagement with a range of stakeholders, rather than simply a technical process.

Details

Journal of Integrated Care, vol. 19 no. 1
Type: Research Article
DOI: https://doi.org/10.5042/jic.2011.0030
ISSN: 1476-9018

Keywords

  • Joint commissioning
  • Priority setting
  • Health and social care

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Article
Publication date: 12 March 2020

Information outreach interventions to promote the information access, use and exchange in the rural areas of Pakistan

Salman Bin Naeem, Rubina Bhatti and Khurshid Ahmad

This study is a part of the doctoral dissertation that proposes concrete measures to improve health-care information outreach program for rural health-care professionals…

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Abstract

Purpose

This study is a part of the doctoral dissertation that proposes concrete measures to improve health-care information outreach program for rural health-care professionals in primary and secondary health care in Punjab, Pakistan. This study aims to report on the barriers to accessing and using online health-care information from rural settings of the Punjab province of Pakistan.

Design/methodology/approach

A cross-sectional survey was conducted in primary and secondary health-care settings in the Punjab province of Pakistan. The study’s population consisted of the rural primary care physicians (PCPs), who were geographically dispersed across 2,873 different remote health-care settings across Punjab. These practice settings included 2,455 basic health units, 293 rural health centers, 89 tehsil headquarter hospitals and 36 district headquarter hospitals.

Findings

Limited internet access, non-availability of required equipment and lack of training facilities were identified as the main barriers. PCPs’ gender, previous enrollment in post-graduation programs and type of health-care facility were significant factors in the perceived barriers related to both “non-availability of required equipment” and “inadequate training facilities on the use of information resources”.

Practical implications

The findings of the study hold some important practical implications for different stakeholders. This study identifies and addresses the barriers to accessing and using health-care information for PCPs in rural settings. The success of the health-care information outreach program in Punjab, Pakistan, should rely on the eradication of these barriers.

Originality/value

To the best of the authors’ knowledge, this is the first large-scale study in Pakistan that assesses the barriers and proposes ways to overcome these barriers to effectively access and use health-care information.

Details

Information Discovery and Delivery, vol. 48 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/IDD-09-2019-0066
ISSN: 2398-6247

Keywords

  • Pakistan
  • Barriers
  • Information access
  • Health-care information outreach programme
  • Primary care physicians
  • Rural settings

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Article
Publication date: 21 May 2018

Past, present and future challenges in health care priority setting: Findings from an international expert survey

William Hall, Iestyn Williams, Neale Smith, Marthe Gold, Joanna Coast, Lydia Kapiriri, M. Danis and Craig Mitton

Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a “magic bullet” is replaced by an…

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Abstract

Purpose

Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a “magic bullet” is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues.

Design/methodology/approach

An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015.

Findings

“Decision-making frameworks” and “Engagement” were the two most frequently mentioned notable achievements. “Priority setting in practice” and “Awareness and education” were the two most frequently mentioned policy and practical challenges. “Priority setting in practice” and “Engagement” were the two most frequently mentioned areas in need of future research.

Research limitations/implications

Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly.

Practical implications

Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area.

Originality/value

Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges.

Details

Journal of Health Organization and Management, vol. 32 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/JHOM-01-2018-0005
ISSN: 1477-7266

Keywords

  • Strategic management
  • Hospital management
  • Resource management
  • Health and medicine
  • Health authorities

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Article
Publication date: 2 July 2018

Leveraging supply chain infrastructure to advance patient safety in community health-care settings

Anne W. Snowdon and Deborah Tallarigo

The purpose of this paper is to examine the opportunity for supply chain processes and infrastructure to reduce the risk of medical error and create traceability of…

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Abstract

Purpose

The purpose of this paper is to examine the opportunity for supply chain processes and infrastructure to reduce the risk of medical error and create traceability of adverse events in community care settings. Patient safety has become an important area of focus over the past few decades, with medical error now accounting for the third most common cause of death in Canada and the USA. The majority of patient safety studies to date have focused specifically on safety in hospital settings; however, deaths and harm experienced by patients in the community (home care, long-term care, complex care and rehabilitation settings) are not well understood.

Design/methodology/approach

This paper discusses the evidence that adverse events occur at similar, if not more, frequent rates in community care settings.

Findings

The authors propose that above and beyond current efforts to increase awareness and promote a “safety culture” in health-care settings, system infrastructure should be designed in a way that enables clinicians to provide the safest care possible. There is currently no line of sight across the health-care continuum. The authors suggest that improving system infrastructure would reduce the occurrence of adverse events.

Originality/value

Such visibility across the continuum of care holds the potential to transform health-care in Canada from a fragmented system, where information is inadequately captured and transferred from provider to provider, to a system that provides complete, accurate and up-to-date information regarding patient care, procedures, medications and outcomes so as to provide the best and safest care possible. System visibility achieves quality and safe care, which is transparent and accountable and achieves value for patients.

Details

Leadership in Health Services, vol. 31 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/LHS-03-2018-0017
ISSN: 1751-1879

Keywords

  • Patient safety
  • Community care
  • Adverse events
  • Medical error

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Article
Publication date: 19 September 2016

Formal priority setting in health care: the Swedish experience

Peter Garpenby and Karin Bäckman

From the late 1980s and onwards health care in Sweden has come under increasing financial pressure, forcing policy makers to consider restrictions. The purpose of this…

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Abstract

Purpose

From the late 1980s and onwards health care in Sweden has come under increasing financial pressure, forcing policy makers to consider restrictions. The purpose of this paper is to review experiences and to establish lessons of formal priority setting in four Swedish regional health authorities during the period 2003-2012.

Design/methodology/approach

This paper draws on a variety of sources, and evidence is organised according to three broad aspects: design and implementation of models and processes, application of evidence and decision analysis tools and decision making and implementation of decisions.

Findings

The processes accounted for here have resulted in useful experiences concerning technical arrangements as well as political and public strategies. All four sites used a particular model for priority setting that combined top-down- and bottom-up-driven elements. Although the process was authorised from the top it was clearly bottom-up driven and the template followed a professional rationale. New meeting grounds were introduced between politicians and clinical leaders. Overall a limited group of stakeholders were involved. By defusing political conflicts the likelihood that clinical leaders would regard this undertaking as important increased.

Originality/value

One tendency today is to unburden regional authorities of the hard decisions by introducing arrangements at national level. This study suggests that regional health authorities, in spite of being politically governed organisations, have the potential to execute a formal priority-setting process. Still, to make priority-setting processes more robust to internal as well as external threat remains a challenge.

Details

Journal of Health Organization and Management, vol. 30 no. 6
Type: Research Article
DOI: https://doi.org/10.1108/JHOM-09-2014-0150
ISSN: 1477-7266

Keywords

  • Sweden
  • Disinvestment
  • Implementation
  • Resource allocation
  • Political strategy
  • Priority setting

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Article
Publication date: 1 September 2002

Transitions of care: the next major quality improvement challenge

J. James Cotter, Wally R. Smith and Peter A. Boling

This review and discussion outline domains and a research agenda leading to improvements in the quality of transitions of care between health‐care settings. Over the past…

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Abstract

This review and discussion outline domains and a research agenda leading to improvements in the quality of transitions of care between health‐care settings. Over the past two decades changes in health care financing have restructured the organization and delivery of health care. Health‐care plans and insurers have shifted to provision of health care in less expensive settings and growing concerns about the quality of health care have arisen – continuity may be lost, errors may occur, and patients may end up deeply dissatisfied. To improve the quality across the continuum of care, providers will need to reconceptualize from an intra‐organizational to an inter‐organizational viewpoint and will have to focus on transitions of care across settings. Services, such as case management, must effectively bridge gaps in the continuity of care. Improved measurement of outcomes, such as satisfaction with the transition, will be necessary.

Details

British Journal of Clinical Governance, vol. 7 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/14664100210438307
ISSN: 1466-4100

Keywords

  • Health care
  • Service quality

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Article
Publication date: 1 August 2005

A health‐care model of emotional labour: An evaluation of the literature and development of a model

Sandi Mann

This paper aims to evaluate the literature on emotional labour in the health‐care sector and the benefits and costs of such performance for both the carer and the patient…

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Abstract

Purpose

This paper aims to evaluate the literature on emotional labour in the health‐care sector and the benefits and costs of such performance for both the carer and the patient. The aim is to develop a new health care model of emotional labour that has implications for health‐care management in terms of policy and education as well as for future research in this field.

Design/methodology/approach

A new model to explain the antecedents and consequences of emotional labour within a health‐care setting is developed that builds on existing research.

Findings

The model distinguishes between types of emotional conflict to which emotional labour‐inducing events in health‐care settings might lead. The negative and positive consequences, specific to health‐care settings, of emotional labour performance are also outlined.

Practical implications

Emotional labour should be formally recognised as a key skill in facilitating the patient journey, with emotional skills being taught in innovative ways outside the formal classroom setting. Health‐care professionals should be offered training on coping with the effects of emotional labour performance. Finally, more research should be carried out to further develop the model, particularly in identifying causes of emotional labour within health‐care settings and in differentiating the effects that different kinds of emotional labour performance might have.

Originality/value

The paper draws together previous research on emotional labour within health‐care settings to develop a coherent model that can be used to guide future research and practice.

Details

Journal of Health Organization and Management, vol. 19 no. 4/5
Type: Research Article
DOI: https://doi.org/10.1108/14777260510615369
ISSN: 1477-7266

Keywords

  • Health services
  • Carers
  • Patients

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Article
Publication date: 9 October 2017

An ethnography of humor, ritual and defiance in a cancer care setting

Loyd S. Pettegrew

Health care organizational research should pay greater attention to the specific settings where health is practiced. An ethnographic account of humor, ritual and defiance…

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Abstract

Purpose

Health care organizational research should pay greater attention to the specific settings where health is practiced. An ethnographic account of humor, ritual and defiance is presented from 29 months spent in a private, concierge-type radiation oncology center. A thick description of the setting and interaction among center staff and patients is offered in an attempt to establish why qualitative research of health care settings is so important. Findings are compared to Ellingson’s work on health care setting. Humor, ritual and defiance have therapeutic value and deserve greater attention in cancer treatment centers and health care organizations more broadly. The paper aims to discuss these issues.

Design/methodology/approach

An ethnographic account of humor, ritual and defiance is presented from 29 months spent in a private, concierge-type radiation oncology center through thick description.

Findings

This study reinforces the literature on the value of institutionalizing humor and ritual to improve patients’ experience in cancer care given the dominance of large public institutions, most easily accessed by academic researchers. Suncoast Coast Radiation Center’s “institutionalized humor” is an important finding that should be examine further. Scholarship can also illuminate the use of ritual in settings where health care is practiced.

Research limitations/implications

This study is limited to a particular research setting which is a private, concierge care radiation oncology treatment center in the Southeastern USA.

Practical implications

Cancer care centers should consider carefully institutionalizing humor and ritual into their daily practices. Further, patient defiance should be reinterpreted not as a patient deficiency but as a therapeutic coping mechanism by patients.

Social implications

While nearly half of cancer care in the USA is offered in private, for-profit institutions, the vast majority of the understanding of cancer care comes only from non-profit and government-run institutions. Shining a light of these neglected cancer care settings will add to the understanding and the ability to improve the care offered to patients.

Originality/value

This is the first health ethnography in a concierge care, cancer care treatment setting. It tests the proposition that humor, ritual and defiance play an important role in a private concierge cancer care organization.

Details

Journal of Organizational Ethnography, vol. 6 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/JOE-04-2017-0021
ISSN: 2046-6749

Keywords

  • Ethnography
  • Health care organizations
  • Cancer care
  • Humor
  • Ritual and defiance

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Article
Publication date: 12 August 2019

Improving continuity of forensic mental health care

Vivienne de Vogel, Petra Schaftenaar and Maartje Clercx

Continuity of forensic mental health care is important in building protective structures around a patient and has been shown to decrease risks of relapse. Realising…

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Abstract

Purpose

Continuity of forensic mental health care is important in building protective structures around a patient and has been shown to decrease risks of relapse. Realising continuity can be complicated due to restrictions from finances or legislation and difficulties in collaboration between settings. In the Netherlands, several programs have been developed to improve continuity of forensic care. It is unknown whether professionals and clients are sufficiently aware of these programs. The paper aims to discuss this issue.

Design/methodology/approach

The experienced difficulties and needs of professionals and patients regarding continuity of forensic care were explored by means of an online survey and focus groups. The survey was completed by 318 professionals. Two focus groups with professionals (15 participants), one focus group and one interview with patients (six participants) were conducted.

Findings

The overall majority (85.6 percent) reported to experience problems in continuity on a frequent basis. The three main problems are: first, limited capacity for discharge from inpatient to outpatient or sheltered living; second, collaboration between forensic and regular mental health care; and, third, limited capacity for long-term inpatient care. Only a quarter of the participants knew the existing programs. Actual implementation of these programs was even lower (3.9 percent). The top three of professionals’ needs are: better collaboration; higher capacity; more knowledge about rules and regulation. Participants of the focus groups emphasized the importance of transparent communication, timely discharge planning and education.

Practical implications

Gathering best practices about regional collaboration networks and developing a blueprint based on the best practices could be helpful in improving collaboration between setting in the forensic field. In addition, more use of systematic discharge planning is needed to improve continuity in forensic mental health care. It is important to communicate in an honest, transparent way to clients about their forensic mental health trajectories, even if there are setbacks or delays. More emphasis needs to be placed on communicating and implementing policy programs in daily practice and more education about legislation is needed Structured evaluations of programs aiming to improve continuity of forensic mental health care are highly needed.

Originality/value

Policy programs hardly reach professionals. Professionals see improvements in collaboration as top priority. Patients emphasize the human approach and transparent communication.

Details

Journal of Forensic Practice, vol. 21 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/JFP-04-2019-0012
ISSN: 2050-8794

Keywords

  • Collaboration
  • Discharge planning
  • Continuity of care
  • Forensic treatment
  • Resocialisation
  • Sheltered living

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