Search results
1 – 10 of 106A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional…
Abstract
Purpose
A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional consequences. The purpose of this article is to discuss new approaches to performance management in health care services when the purpose is to support innovative changes in the delivery of services.
Design/methodology/approach
The article represents cross-boundary work as the theoretical and empirical material used to discuss and reconsider performance management comes from several relevant research disciplines, including systematic reviews of audit and feedback interventions in health care and extant theories of human motivation and organizational control.
Findings
An enabling approach to performance management in health care services can potentially contribute to innovative changes. Key design elements to operationalize such an approach are a formative and learning-oriented use of performance measures, an appeal to self- and social-approval mechanisms when providing feedback and support for local goals and action plans that fit specific conditions and challenges.
Originality/value
The article suggests how to operationalize an enabling approach to performance management in health care services. The framework is consistent with new governance and managerial approaches emerging in public sector organizations more generally, supporting a higher degree of professional autonomy and the use of nonfinancial incentives.
Details
Keywords
Dorothy Ai-wan Yen, Benedetta Cappellini, Jane Denise Hendy and Ming-Yao Jen
The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social…
Abstract
Purpose
The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social class, race, cultural proximity to the host country and acculturation levels, more in-depth studies are necessary to fully understand how COVID-19 affects specific migrant groups and their health. Taiwanese migrants were selected because they are an understudied group. Also, there were widespread differences in pandemic management between the UK and Taiwan, making this group an ideal case for understanding how their acculturation journey can be disrupted by a crisis.
Design/methodology/approach
Qualitative data were collected at two different time points, at the start of the UK pandemic (March/April 2020) and six months on (October/November 2020), to explore migrant coping experiences over time. Theoretically, the authors apply acculturation theory through the lens of coping, while discussing health-consumption practices, as empirical evidence.
Findings
Before the outbreak of the pandemic, participants worked hard to achieve high levels of integration in the UK. The pandemic changed this; participants faced unexpected changes in the UK’s sociocultural structures. They were forced to exercise the layered and complex “coping with coping” in a hostile host environment that signalled their new marginalised status. They faced impossible choices, from catching a life-threatening disease to being seen as overly cautious. Such experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society.
Research limitations/implications
It is important to note that the Taiwanese sample recruited through Facebook community groups is biased and has a high level of homogeneity. These participants were well-integrated, middle-class migrants who were highly educated, relatively resourceful and active on social media. More studies are needed to fully understand the impact on well-being and acculturation of migrants from different cultural, contextual and social backgrounds. This being the case, the authors can speculate that migrants with less resource are likely to have found the pandemic experience even more challenging. More studies are needed to fully understand migrant experience from different backgrounds.
Practical implications
Public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. In particular, this paper has shown how separation, especially if embraced temporarily, is not necessarily a negative outcome to be corrected with specific policies. It can be strategically adopted by migrants as a way of defending their health and well-being from an increasingly hostile environment. Migrants' home country experience provides vicarious learning opportunities to acquire good practices. Their voices should be encouraged rather than in favour of a surprising orthodox and rather singular approach in the discussion of public health management.
Social implications
The paper has clear public health policy implications. Firstly, public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. Acknowledging migrants' voice is a critical first step to contribute to the development of a fair and inclusive society. Secondly, to retain skilful migrants and avoid a future brain-drain, policymakers are advised to advance existing infrastructure to provide more incentives to support and retain migrant talents in the post-pandemic recovery phase.
Originality/value
This paper reveals how a group of previously well-integrated migrants had to exercise “coping with coping” during the COVID crisis. This experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society. It contributes to the understanding of acculturation by showing how a such crisis can significantly disrupt migrants' acculturation journey, challenging them to re-acculturate and reconsider their identity stance. It shows how separation was indeed a good option for migrants for protecting their well-being from a newly hostile host environment.
Yunwei Gai, Alia Crocker, Candida Brush and Wiljeana Jackson Glover
Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes…
Abstract
Purpose
Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.
Design/methodology/approach
Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.
Findings
Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.
Originality/value
This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.
Details
Keywords
Marta Postula, Krzysztof Kluza, Magdalena Zioło and Katarzyna Radecka-Moroz
Environmental degradation resulting from human activities may adversely affect human health in multiple ways. Until now, policies aimed at mitigating environmental problems such…
Abstract
Purpose
Environmental degradation resulting from human activities may adversely affect human health in multiple ways. Until now, policies aimed at mitigating environmental problems such as climate change, environmental pollution and damage to biodiversity have failed to clearly identify and drive the potential benefits of these policies on health. The conducted study assesses and demonstrates how specific environmental policies and instruments influence perceived human health in order to ensure input for a data-driven decision process.
Design/methodology/approach
The study was conducted for the 2004–2020 period in European Union (EU) countries with the use of dynamic panel data modeling. Verification of specific policies' impact on dependent variables allows to indicate this their effectiveness and importance. As a result of the computed dynamic panel data models, it has been confirmed that a number of significant and meaningful relationships between the self-perceived health index and environmental variables can be identified.
Findings
There is a strong positive impact of environmental taxation on the health index, and the strength of this relationship causes effects to be observed in the very short term, even the following year. In addition, the development of renewable energy sources (RES) and the elimination of fossil fuels from the energy mix exert positive, although milder, effects on health. The reduction of ammonia emissions from agriculture and reducing noise pollution are other health-supporting factors that have been shown to be statistically valid. Results allow to identify the most efficient policies in the analyzed area in order to introduce those with the best results or a mix of such measures.
Originality/value
The results of the authors' research clearly indicate the health benefits of measures primarily aimed at improving environmental factors, such as environmental taxes in general. The authors have also discovered an unexpected negative impact of an increase in the share of energy taxes in total taxes on the health index. The presented study opens several possibilities for further investigation, especially in the context of the rapidly changing geopolitical environment and global efforts to respond to environmental and health challenges. The authors believe that the outcome of the authors' study may provide new arguments to policymakers pursuing solutions that are not always easily acceptable by the public.
Details
Keywords
Anja Wittmers, Kai N. Klasmeier, Birgit Thomson and Günter W. Maier
Drawing on COR theory and based on a person-centered approach, this study aims to explore profiles of both leadership behavior (transformational leadership, abusive supervision…
Abstract
Purpose
Drawing on COR theory and based on a person-centered approach, this study aims to explore profiles of both leadership behavior (transformational leadership, abusive supervision) and well-being indicators (cognitive irritation, emotional exhaustion). Additionally, we consider whether certain resource-draining (work intensification) and resource-creating factors (leader autonomy, psychological contract fulfillment) from the leaders' work context are related to profile membership.
Design/methodology/approach
The profiles are built using LPA on data from 153 leaders and their 1,077 followers. The relationship between profile membership and correlates from the leaders' work context is examined using multinomial logistic regression analyses.
Findings
LPA results in an interpretable four-profile solution with the profiles named (1) Good health – constructive leading, (2) Average health – inconsistent leading, (3) Impaired health – constructive leading and (4) Impaired health – destructive leading. The two groups with the highest sample share – Profiles 1 and 3 – both show highly constructive leadership behavior but differ significantly in their well-being indicators. The regression analyses show that work intensification and psychological contract fulfillment are significantly related to profile membership.
Originality/value
The person-centered approach provides a more nuanced view of the leadership behavior – leader well-being relationship, which can address inconsistencies in previous research. In terms of practical relevance, the person-centered approach allows for the identification of risk groups among leaders for whom organizations can provide additional resources and health-promoting interventions.
Details
Keywords
Anna Prenestini, Stefano Calciolari and Arianna Rota
During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the…
Abstract
Purpose
During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.
Design/methodology/approach
We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.
Findings
We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.
Originality/value
The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.
Details
Keywords
Bonnie Poksinska and Malin Wiger
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…
Abstract
Purpose
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.
Design/methodology/approach
The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).
Findings
The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.
Practical implications
The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.
Originality/value
The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.
Details
Keywords
Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt
This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and…
Abstract
Purpose
This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.
Design/methodology/approach
This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).
Findings
Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.
Originality/value
This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.
Details
Keywords
Mehroosh Tak, Kirsty Blair and João Gabriel Oliveira Marques
High levels of child obesity alongside rising stunting and the absence of a coherent food policy have deemed UK’s food system to be broken. The National Food Strategy (NFS) was…
Abstract
Purpose
High levels of child obesity alongside rising stunting and the absence of a coherent food policy have deemed UK’s food system to be broken. The National Food Strategy (NFS) was debated intensely in media, with discussions on how and who should fix the food system.
Design/methodology/approach
Using a mixed methods approach, the authors conduct framing analysis on traditional media and sentiment analysis of twitter reactions to the NFS to identify frames used to shape food system policy interventions.
Findings
The study finds evidence that the media coverage of the NFS often utilised the tropes of “culture wars” shaping the debate of who is responsible to fix the food system – the government, the public or the industry. NFS recommendations were portrayed as issues of free choice to shift the debate away from government action correcting for market failure. In contrast, the industry was showcased as equipped to intervene on its own accord. Dietary recommendations made by the NFS were depicted as hurting the poor, painting a picture of helplessness and loss of control, while their voices were omitted and not represented in traditional media.
Social implications
British media’s alignment with free market economic thinking has implications for food systems reform, as it deters the government from acting and relies on the invisible hand of the market to fix the system. Media firms should move beyond tropes of culture wars to discuss interventions that reform the structural causes of the UK’s broken food systems.
Originality/value
As traditional media coverage struggles to capture the diversity of public perception; the authors supplement framing analysis with sentiment analysis of Twitter data. To the best of our knowledge, no such media (and social media) analysis of the NFS has been conducted. The paper is also original as it extends our understanding of how media alignment with free market economic thinking has implications for food systems reform, as it deters the government from acting and relies on the invisible hand of the market to fix the system.
Details
Keywords
Iryna Alves, Bruno Gregório and Sofia M. Lourenço
This study investigates theoretical relationships among personality characteristics, preferences for different types of rewards and the propensity to choose a job in auditing by…
Abstract
Purpose
This study investigates theoretical relationships among personality characteristics, preferences for different types of rewards and the propensity to choose a job in auditing by management-related higher education students. Specifically, the authors consider motivation, locus of control (internal and external) and self-efficacy (SE) as personality characteristics and financial, extrinsic, support and intrinsic as types of rewards.
Design/methodology/approach
Data were collected through a questionnaire targeted at management-related higher education students in Portugal. Partial least squares structural equation modelling was used to analyse the data.
Findings
The full sample results show that different types of motivation, locus of control and SE are related to different reward preferences. The authors also find a positive association between a preference for extrinsic rewards and the propensity to choose a job in auditing. Moreover, when the authors consider the role of working experience in the model, the authors find that the reward preferences that drive the choice of an auditing job differ according to that experience.
Originality/value
This study enriches the literature by assessing preferences for different types of rewards, considering multiple personality characteristics and a comprehensive set of rewards. Furthermore, the authors identify the reward preferences that drive the choice of an auditing career. This knowledge empowers auditing firms to devise recruitment strategies that resonate with candidates’ preferences, which boosts the capacity of these companies to attract new auditors.
Details