Search results

The purpose of this study is to explore strategies during transformation to obtain sustainable development and to identify the human-based factors contributing to the transformation.

This qualitative study explored the strategies that health-care leaders need to adopt during transformation to achieve the Sustainable Development of the United Nations' agenda by 2030. The study was conducted in early 2020 among ten health-care leaders in the USA. The research design was an exploratory qualitative approach that used a semi-structured, open-ended questionnaire asked of ten US health-care leaders who had experience in leading health-care transformation in their organizations. The study findings identified that health-care leaders can facilitate the achievement of Sustainable Development by establishing strategies in knowledge improvement, innovation development, motivation increment, global strategy and local strategy alignment, leadership support and partnership development.

Six major themes emerged from the data linked to the central research question: “What are the strategies during digital transformation to make progress in the achievement of Sustainable Development by 2030?” The compressed collection of themes for the study included the following six major themes: knowledge development; innovation development; motivation; global strategy establishment; leadership; collaboration enhancement; and two minor themes, namely, mindset change and vision creation.

Due to the few numbers of participants selected for this study (N = 10) may not be generalizable to other settings. The implication of this study is to identify the significant factors contributing to making progress in sustainable development in health-care organizations. The health-care leaders can learn what significant strategies can be helpful to establish future-based organizations toward achieving sustainability.

The results of this study provided actionable strategies to empower the employees and increase managerial innovation in health-care organizations.

Promoting partnership of health-care organizations with social and global activities such as sustainable development goals that are contributing in 5Ps: People, Prosperity, Peace, Partnership and Planet.

The main reason for the study was that health-care leaders worldwide could have a novel study that delineates the digital transformation strategies needed for creating impactful outcomes toward achieving sustainable development. Moreover, this unique study provided a useful outlook for health-care leaders to establish future-based health-care organizations while learning the dynamic of digital transformation is the key for health-care organizations to adapt their strategies for a sustainable future.

Integration of health services involves multiple interdependent leaders acting at several levels of their organisation and across organisations. This paper aims to explore the complexities of leadership in an integrated care project and aims to understand what leadership arrangements are needed to enable service transformation.

This case study analysed system and organisational leadership in a project aiming to integrate primary and specialist care. To explore the former, the national policy documents and guidelines were reviewed. To explore the latter, the official documents from the transformation team meetings and interview data from 17 health-care professionals and commissioners were analysed using thematic analysis with the coding framework derived from the comprehensive and multilevel framework for change (Ferlie and Shortell, 2001).

Although integration was supported in the narratives of the system and organisational leaders, there were multiple challenges: insufficient support by the system level leadership for the local leadership, insufficient organisational support for (clinical) leadership within the transformation team and insufficient leadership within the transformation team because of disruptions caused by personnel changes, roles ambiguity, conflicting priorities and insufficient resources.

This study provides insights into the interdependencies of leadership across multiple levels and proposes steps to maximise the success of complex transformational projects.

This study’s practical findings are useful for those involved in the bottom-up integrated projects, especially the transformation teams’ members. The case study highlights the need for a toolkit enabling local leaders to operate effectively within the system and organisational leadership contexts.

Green transformation is more than simply a trend; it is a way of life, a set of habits, a field of knowledge and a dedication to resource conservation. Going green is surely a creative and transformative process for both individuals and organizations. This paper aims to “identify,” “analyse” and “categorise” the readiness factors for green transformation process in health care using total interpretive structural modelling (TISM) and neutrosophic-MICMAC.

To address the study objectives, the study used TISM and neutrosophic-MICMAC analysis. To identify the readiness factors, a literature study was conducted, and the factors were face-validated by the healthcare experts. The factors influence on one another were captured by using a scheduled interview with a closed ended questionnaire. The TISM addressed the identification and analysing of factors and the categorization and ranking the readiness factors is addressed by using neutrosophic-MICMAC analysis.

This study identified 11 green transformation process readiness factors for healthcare organizations. The study states that the key factors or driving factors are awareness of green governance principle, environment leadership and management, green gap analysis, information and communication technology and innovation dynamics.

The factor ranking is sensitive to the respondents’ ratings. The study relied on the past literature and experts’ opinion may result in the subjective biases. The complex nature of healthcare ecosystem challenges to capture all the factors. The study focussed on Indian hospitals.

Study significantly impacts the healthcare practitioners, academicians and policymakers by providing critical insights into the readiness factors required for the healthcare green transformation process. The study offers a better understanding of the crucial or key or driving factors that aid in embracing green and sustainable practices.

Identifying a gap in conceptual and theoretical frameworks for green transformation readiness factors in healthcare organizations and in Indian context. The study addresses this gap by aiming to create a thorough theoretical framework and highlighted by its focus on Indian hospitals.

While digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits realization are translated into practice.

The authors apply a qualitative, comparative case study of two large, public-sector health care organizations in Sweden. Through document and interview data, the authors analyze the process of translation.

The study finds that practice variation is primarily caused by two types of decoupling: policy-practice and means-ends. Contrary to previous studies, coercion in policy compliance is not found to decrease practice variation.

The limitations primarily stem from the empirical selection of two large public health-care organizations in Sweden, affecting the study’s generalizability. Reducing practice variation is more effectively achieved through goal alignment than coercion, leading to implications for the design of governance and control.

Policymakers should, instead of focusing on control-related compliance, work to align organizational objectives and policies to decrease practice variation for successful benefits realization.

The study contributes to better benefits realization of digital transformation initiatives in health care. As such, the authors contribute to a better functioning and more transformative health care in times of increased demand and decreased supply of health-care services.

The study challenges conventional wisdom by identifying that coercion is less effective than goal alignment in reducing practice variation, thereby enhancing the understanding of policy implementation dynamics in health-care settings.

The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. This transformation presents a challenge to many care delivery organizations. The purpose of this paper is to describe attributes shaping successful and unsuccessful practice transformation within four medical practice groups.

As part of a larger study of 25 practices transitioning into a PCMH, the current study focused on diabetes care and identified high- and low-improvement medical practices in terms of quantitative patient measures of glycosylated hemoglobin and qualitative assessments of practice performance. A subset of the top two high-improvement and bottom two low-improvement practices were identified as comparison groups. Semi-structured interviews were conducted with diverse personnel at these practices to investigate their experiences with practice transformation and data were analyzed using analytic induction.

Results show a variety of key attributes facilitating more successful PCMH transformation, such as empanelment, shared goals and regular meetings, and a clear understanding of PCMH transformation purposes, goals, and benefits, providing care/case management services, and facilitating patient reminders. Several barriers also exist to successful transformation, such as low levels of resources to handle financial expense, lack of understanding PCMH transformation purposes, goals, and benefits, inadequate training and management of technology, and low team cohesion.

Few studies qualitatively compare and contrast high and low performing practices to illuminate the experience of practice transformation. These findings highlight the experience of organizational members and their challenges in practice transformation while providing quality diabetes care.

In this chapter, we identify three distinct transformational performance improvement (TPI) approaches commonly used to redesign work processes in health care organizations. We describe the unique components or tools that each approach uses to improve the delivery of health services. We also summarize what is empirically known about the effectiveness of each TPI approach according to systematic reviews and recent studies published in the peer-reviewed literature. Based on examination of this research, we discuss what knowledge is still needed to strengthen the evidence for whole system transformation. This involves the use of conceptual frameworks to assess and guide implementation efforts, and facilitators and barriers to change as revealed in a recent evaluation of one major initiative, the Lean Enterprise Transformation (LET) at the Veterans Health Administration. The analysis suggests ways in which TPI facilitators can be developed and barriers reduced to improve the effectiveness and sustainability of quality initiatives. Finally, we discuss appropriate study designs to evaluate TPI interventions that may strengthen the evidence for their effectiveness in real world practice settings.

Despite many calls to strengthen connections between health systems and communities as a way to improve primary healthcare, little is known about how new collaborations can effectively alter service provision. The purpose of this paper is to explore how a health authority, municipal leaders and physicians worked together in the process of transforming primary healthcare.

A longitudinal qualitative case study was conducted to explore the processes of change at the regional level and within seven communities across Northern British Columbia (BC), Canada. Over three years, 239 interviews were conducted with physicians, municipal leaders, health authority clinicians and leaders and other health and social service providers. Interviews and contextual documents were analyzed and interpreted to articulate how ongoing transformation has occurred.

Four overall strategies with nine approaches were apparent. The strategies were partnering for innovation, keeping the focus on people in communities, taking advantage of opportunities for change and encouraging experimentation while managing risk. The strategies have bumped the existing system out of the status quo and are achieving transformation. Key components have been a commitment to a clear end-in-view, a focus on patients, families, and communities, and acting together over time.

This study illuminates how partnering for primary healthcare transformation is messy and complicated but can create a foundation for whole system change.

Examines the growing use of “work transformation” or process re‐engineering techniques in health‐care organizations. Identifies how pressures on funding and increased expectations are forcing health‐care organizations to adopt radical solutions in their search for lower costs and improved quality of care. Also examines the experience of a number of organizations, and highlights some of the risks involved in taking these approaches.

The author is introducing a toolkit that can assist stakeholders to design, compare and replicate integrated care programmes, by making explicit their view on the transformations of care and cure services, according to a structured template. The purpose of this paper is to address this issue.

The toolkit is made of two elements: a classification and a template. The author adopted a step-wise approach of semantic modelling to work out three layers of a classification in the domain of integration needs related to care and cure services. The third layer consists of 23 non-overlapping classes that fully cover that semantic domain. The classes are used to build a template to elicit the stakeholder's standpoint about the transformations involved in the deployment of a programme. The result is the «Outline» of the programme.

So far, in eight years the author applied the toolkit to 100+ programmes either to design, simulate or evaluate them, either to compare them to similar ones in the same or in different jurisdictions, and we refined the description of the classes according to that experience.

The objective of the toolkit is not to provide solutions, but to stimulate reflections on the transformations involved in a programme and their practical consequences in a precise context. In fact, the Outlines cannot be generalized: they are conceived to reflect the perspective of the stakeholders and thus are intrinsically subjective; in addition, they must be contingent, as they must depend on the local context in the particular timeframe. In case of similar initiatives in other localities, the Outlines must be filled in again by the local stakeholders; however, a subsequent comparison could help to explore similarities and motivated differences.

Ideally the stakeholders should use the Outline of the actual transformations in a programme as a reference to mediate between the principles and the methodologies provided by the «Models» and «Conceptual Frameworks» in the literature (e.g. Chronic Care Model, Rainbow Model, Development Model of Integrated Care Patient-Centered Medical Home and Maturity Models) and the deeper studies using the specific tools developed in their disciplines (e.g. on information modelling, process modelling, cost–benefit analysis and health technology assessment). The toolkit could have its role also in a multi-annual roadmap made of a sequence of programmes to cope with the urgent challenges on ageing, social changes and technological evolution, in synergy with regulations, budget, context maturity, critical success factors and local priorities.

The author argues that the approach of the structured Outline is unique, as the scoring mechanism to assess the relevance of the transformation within each class on the overall change brought by the whole programme into the health systems.