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Article
Publication date: 9 May 2023

Baraka Israel

The problems that face health service delivery across different countries are compounded by financial, political, institutional and technical deficiencies. Yet, the role of…

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Abstract

Purpose

The problems that face health service delivery across different countries are compounded by financial, political, institutional and technical deficiencies. Yet, the role of technological aspects in the procurement of health commodities and health service delivery system requires in-depth exploration. This study bridges this gap by examining the mediating effect of an integrated health commodities procurement system on the relationship between responsiveness and health service delivery.

Design/methodology/approach

Data for this study were collected from 274 respondents, comprising procurement staff and pharmacists using a cross-sectional questionnaire survey. A total of 28 government-owned hospitals from 6 regions in the Southern Highland of Tanzania were sampled for observation. Confirmatory factor analysis (CFA) and structural equation modelling (SEM) were used for data analysis.

Findings

The results of the study revealed a positive and significant relationship between responsiveness and integrated health commodities procurement system (β = 0.572, p < 0.001). Responsiveness positively and significantly affects health service delivery (β = 0.175, p = 0.004). The results also show that integrated health commodities procurement system is positive and significantly related to health service delivery (β = 0.264, p < 0.001). Lastly, the bootstrapping confidence intervals revealed that an integrated health commodities procurement system significantly mediates the relationship between responsiveness and health service delivery.

Practical implications

To strengthen the health service delivery system, the study recommends enforcing internal control mechanisms and supporting policies that will monitor and evaluate the effectiveness of the integrated health commodities procurement system and service practitioners' responsiveness. Moreover, health service managers should ensure that the planning, procurement and distribution of health commodities are fully and effectively integrated at each node of the health supply chain.

Originality/value

The study contributes to the body of knowledge which examines the efficacy of health service delivery from procurement perspective. To the best of the author's knowledge, this is the first study that offers empirical evidence for the mediating effect of integrated health commodities procurement system on the link between responsiveness and health service delivery.

Details

International Journal of Health Governance, vol. 28 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Open Access
Article
Publication date: 19 May 2020

Owolabi Lateef Kuye and Olusegun Emmanuel Akinwale

Bureaucracy to a large extent entrenches orderliness and productive means of achieving goals in both public and private organisations across the world. However, bureaucracy is not…

6106

Abstract

Purpose

Bureaucracy to a large extent entrenches orderliness and productive means of achieving goals in both public and private organisations across the world. However, bureaucracy is not suitable in the management of hospitals due to its peculiar nature of operations. This study investigates the conundrum of bureaucratic processes and health-care service delivery in government hospitals in Nigeria.

Design/methodology/approach

The study surveyed 600 outpatients and attendees visiting tertiary and government hospitals in Nigeria using descriptive design to obtained data from the respondents. A research instrument, questionnaire, was used to gather data. Out of the 600 outpatients visiting the 20 hospitals in government and tertiary hospitals, 494 responses were returned from the attendees. The study employed random sampling strategy to collect the information.

Findings

The findings of this study were that service delivery in government hospitals were in adverse position on all the four constructs of bureaucratic dimensions as against quality of service delivery in hospitals in Nigeria. It discovered that bureaucratic impersonality cannot impact on the quality of service delivery in government hospitals in Nigeria. Separation and division of labour among health workers have no significant effect on quality service delivery in government hospitals. Formal rules and regulations (administrative procedure, rules, and policies) prevent quality service delivery in government hospitals in Nigeria. Also, patient’s waiting time was not significant to the quality of service delivery in government hospitals.

Research limitations/implications

The results are constrained with dimensions of bureaucratic processes. Thus, the implication of this study is that bureaucracy in the Nigerian public hospitals is an unnecessary marriage which should be carefully separated and de-emphasised for quality service delivery in the hospitals to thrive.

Practical implications

Largely, this study is practical essential as it unearths the irrelevant operations procedure that hinder progress in Nigerian hospitals.

Originality/value

The study accomplishes recognised importance to survey how bureaucracy impedes quality service delivery in government hospitals. This study has provided a vital clue to elements that will bring rapid attention to patients’outcome in Nigerian hospitals and health-care facilities which hitherto has not been emphasised. The study has contributed to the existing body of knowledge associated to healthcare service quality in developing country.

Details

Journal of Humanities and Applied Social Sciences, vol. 3 no. 1
Type: Research Article
ISSN: 2632-279X

Keywords

Open Access
Article
Publication date: 12 April 2022

Michael Sony, Jiju Antony and Olivia McDermott

The pandemic has reinforced the need for revamping the healthcare service delivery systems around the world to meet the increased challenges of modern-day illnesses. The use of…

3068

Abstract

Purpose

The pandemic has reinforced the need for revamping the healthcare service delivery systems around the world to meet the increased challenges of modern-day illnesses. The use of medical cyber–physical system (MCPS) in the healthcare is one of the means of transforming the landscape of the traditional healthcare service delivery system. The purpose of this study is to critically examine the impact of MCPS on the quality of healthcare service delivery.

Design/methodology/approach

This paper uses an evidence-based approach, the authors have conducted a systematic literature review to study the impact of MCPS on healthcare service delivery. Fifty-four articles were thematically examined to study the impact of MCPS on eight characteristics of the healthcare service delivery proposed by the world health organisation.

Findings

The study proposes support that MCPS will positively impact (1) comprehensiveness, (2) accessibility, (3) coverage, (4) continuity, (5) quality, (6) person-centredness, (7) coordination, (8) accountability and (9) efficiency dimension of the healthcare service delivery. The study further draws nine propositions to support the impact of MCPS on the healthcare service delivery.

Practical implications

This study can be used by stakeholders as a guide point while using MCPS in healthcare service delivery systems. Besides, healthcare managers can use this study to understand the performance of their healthcare system. This study can further be used for designing effective strategies for deploying MCPS to be effective and efficient in each of the dimensions of healthcare service delivery.

Originality/value

The previous studies have focussed on technology aspects of MCPS and none of them critically analysed the impact on healthcare service delivery. This is the first literature review carried out to understand the impact of MCPS on the nine dimensions of healthcare service delivery proposed by WHO. This study provides improved thematic awareness of the resulting body of knowledge, allowing the field of MCPS and healthcare service delivery to progress in a more informed and multidisciplinary manner.

Details

The TQM Journal, vol. 34 no. 7
Type: Research Article
ISSN: 1754-2731

Keywords

Article
Publication date: 28 January 2020

Nirmala Nath, Radiah Othman and Fawzi Laswad

This paper aims to provide insights into how the New Zealand Office of the Auditor-General (NZOAG) legitimised the selection of topics for performance audit in the New Zealand…

Abstract

Purpose

This paper aims to provide insights into how the New Zealand Office of the Auditor-General (NZOAG) legitimised the selection of topics for performance audit in the New Zealand public health sector over a 10-year period, 2003-2013, by fulfilling the key actors’ “taken for granted beliefs” of the dual roles of the NZOAG: its independence and accountability.

Design/methodology/approach

This paper uses evidence gathered from interviews with representatives of the District Health Boards, the Ministry of Health (including Health Advisory Committee members) and NZOAG staff, along with publically available documentary evidence over a 10-year period. The authors draw on Suchman’s (1995) authority on institutional legitimacy to inform the research findings.

Findings

The New Zealand Auditors-General (NZAGs) get inputs from various sources such as their own audit teams, parliamentary deliberations, the Ministry of Health, the District Health Boards, media and public concerns and complaints. These sources initiate ideas for performance audits. Subsequently, the NZAGs use the recurring themes and risk assessment criteria while simultaneously consulting with the auditees (the MOH and the DHBs) and other actors, such as health advisory groups, to select topics for such audits. This signals to the key actors, such as the MOH and the DHBs, that the NZOAG is addressing the topics and concerns relevant to the former while discharging its public accountability role. Furthermore, the consultative approach acts as a catalyst, ensuring that the actors involved with public sector health service delivery, specifically the auditees, accept the selected topic. This leads to a lack of resistance to and criticism of the topic; the selection process, therefore, is legitimatised, and credibility is added to the audits. Because of the consultative approach taken by the NZAGs, the actors, including the performance auditors, continue to believe that the Office acts independently from third party influence in selecting their audit topics, elevating the NZAGs’ moral legitimacy with respect to their public accountability role.

Research limitations/implications

The study’s focus group does not include parliamentary representatives, only representatives from the DHBs, the MOH and the NZOAG; therefore, the conclusions on effective discharge of the NZOAG’s accountability role and Parliamentary acceptance is not conclusive – the NZOAG acts on behalf of the Parliament in discharging its accountability role and the latter is also the formal recipient of the reports.

Practical implications

The implications for practitioners and policymakers are that the use of a consultative approach to select topics for performance audit in the absence of performance auditing standards ensures auditee readiness and acceptance of such audits. This also promotes mutual benefits and “trust” between the AG and auditees. Such audits can be used to bring about efficacy in health service delivery.

Social implications

The selected topics for audits will have an impact on citizens’ lifestyles, with improved health services delivery.

Originality/value

There is a dearth of research on who initiates the ideas for performance auditing and how the Office of the Auditor-General selects topics for such audits. This study adds a new dimension to the existing performance auditing literature. The authors reveal how the NZOAG seeks to legitimise the selection of topics for such audits by consulting with the auditees and other actors associated with public sector health service delivery, while upholding its independent status and making transparent how it discharges its accountability role within the context of performance auditing.

Details

Qualitative Research in Accounting & Management, vol. 17 no. 2
Type: Research Article
ISSN: 1176-6093

Keywords

Article
Publication date: 16 August 2021

Vaidik Bhatt and Samyadip Chakraborty

The purpose of the study was to empirically validate the linkages between IoT adoption and how it overarched influenced the patient care service engagement. This contributes to…

Abstract

Purpose

The purpose of the study was to empirically validate the linkages between IoT adoption and how it overarched influenced the patient care service engagement. This contributes to the body of knowledge and helps hospital managers to understand the relationship and relevance of IoT adoption; otherwise healthcare sector are late movers towards technology adoption. This gives a nuanced framework towards establishing empirically validated framework which will motivate healthcare services providers to be motivated to adopt and implement IoT enabled care delivery. The physician patient interaction and alignment during decision making will foster positive word of mouth, superior care service and reduce extra overheads for healthcare providers without compromise or rather with increment in service delivery proposition.

Design/methodology/approach

The study theoretically and empirically describes that with the adoption of internet of things (IoT) devices in health care, better services can be provided to patients by using partial least square – structure equation modelling-based robust technique and explains the better understanding of the health-care process with the help of information pervasiveness, physician-patient orientation and improved patient and physician involvement in the decision-making process.

Findings

This study shows that wearable IoT device adoption in health-care service delivery opens new opportunities and disrupts the conventional and traditional way of health-care service delivery by empowering the patient to take part in decision-making and enhancing their engagement in health-care service delivery.

Research limitations/implications

The study might influence by generalizability. Perception-based cross-examination knowledge from the patient’s perspective. It is likely that patients who use these devices will grow accustomed to using them and become more capable of using them. Thus, time-series tests have not been used to catch enhanced skills. New patients’ experiences will be altered over time. Regardless, non-response bias and traditional process bias received excessive interest.

Practical implications

The study aims at unravelling how the adoption of IoT enabled practices and usage of IoT devices bolsters the available data points in the context of healthcare especially with respect to patient care delivery. The study conceptualizes and empirically validates how the usage of IoT interface enabled technology enables better patient treatment and caregiver participation. The study puts forth a nuanced understanding regarding how pervasively available ubiquitous care information fosters shared decision making. This study further emphasizes that importance of ensuring a reliable computing environment devoid of privacy and security risks. The study attempts at Emphasizing empirically how the enhanced information pervasiveness catapults the patient-provider interactions, through health data exchange. Highlighting the importance of search feature in cloud storage and recovery mechanisms. The study not only fulfills the overarching linkage between enhanced service engagement with IoT adoption, it provides a mental map and ready to refer framework for hospital and healthcare experts to refer to, which prescribes thar care providers must build new methods aimed at empowerment of patients to participate and take more inclusive role. This unique confluence between patients and physicians will unravel the sync; helping not only avoid costly decision errors, but also improve patient care delivery environment. Patients should be permitted to participate in decision-making,inspire patients to be participatory.

Originality/value

The study efforts to empirically investigate and discover the link between how wearable sensor-based IoT enhances health-care service engagement is underway. Using primary data this linkage validation allows the community and readers at large to gain a nuanced understanding of how superior interaction is enabled by a digital-health-care process with the help of IoT-enabled information pervasiveness, physician-patient orientation and empowered involvement.

Details

Journal of Science and Technology Policy Management, vol. 14 no. 1
Type: Research Article
ISSN: 2053-4620

Keywords

Book part
Publication date: 28 December 2006

Abram Rosenblatt and Laura Compian

Systems of care and evidence-based practice possess distinct histories. Though each developed out of attempts to improve services to youth with emotional and behavioral disorders…

Abstract

Systems of care and evidence-based practice possess distinct histories. Though each developed out of attempts to improve services to youth with emotional and behavioral disorders, they did so from perspectives so different as to appear diametrically opposed. Service systems exist at multiple levels, including the practice, program, and system levels (Rosenblatt, 1988, 2005; Rosenblatt & Woodbridge, 2003). Research on health and mental health service systems similarly varies, often by level of the service system, with the research methods, independent and dependent variables, populations of interest, and ultimately the consumers of the research product interacting differentially in the creation and understanding of what constitutes a knowledge base for service delivery. Systems of care and, with limited exceptions, evidence-based practices exist at different levels of the service delivery structure, require and derive from different research approaches, and speak to overlapping but historically different audiences.

Details

Research on Community-Based Mental Health Services for Children and Adolescents
Type: Book
ISBN: 978-1-84950-416-4

Article
Publication date: 10 April 2017

Joseph Phiri

The purpose of this paper is to explore stakeholder expectations of performance within public healthcare services from a less-developed economic context – Zambia in this case. The…

Abstract

Purpose

The purpose of this paper is to explore stakeholder expectations of performance within public healthcare services from a less-developed economic context – Zambia in this case. The study emerges from extant literature indicating potential variations in stakeholder conceptions and expectations of performance within public services.

Design/methodology/approach

The paper draws on institutional and structuration theories to investigate cross-sectional stakeholder expectations of performance together with power relations embedded within public healthcare performance expectations. Empirical data are drawn from semi-structured interviews with 33 stakeholders including legislators, policymakers, regulators of health services, healthcare professionals and health facility managers.

Findings

The findings not only reiterate the constructed and multi-dimensional nature of performance but also highlight the hierarchical configuration of stakeholder expectations linking macro-level health outcomes with micro facility-level service delivery processes.

Practical implications

The study points towards the need of harmonising the national performance measurement (PM) framework to ensure that macro-level goals are suitably cascaded and translated into micro-level service delivery processes through bottom-up structuration linkages.

Originality/value

In addition to filling the gap of explicating public healthcare PM practices in a less-developed economic context, the paper integrates insights from institutional and structuration theories to depict stakeholder expectations of performance through a multi-level and hierarchical framework.

Article
Publication date: 3 October 2008

Michael Aherne and José L. Pereira

The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge‐management strategies have scaled‐up learning and development…

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Abstract

Purpose

The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge‐management strategies have scaled‐up learning and development in rural, remote and other resource‐constrained Canadian delivery settings.

Design/methodology/approach

Intervention design was realized through a one‐time, collaborative, national capacity‐building project. A project portfolio of 72 sub‐projects, initiatives and strategic activities was used to improve access, enhance quality and create capacity for palliative and end‐of‐life care services. Evaluation was multifaceted, including participatory action research, variance analysis and impact analysis. This has been supplemented by post‐intervention critical reflection and integration of relevant literature.

Findings

The purposeful use of collaboration, innovation and knowledge‐management strategies have been successfully used to support a rapid scaling‐up of learning and development interventions. This has enabled enhanced and new pan‐Canadian health delivery capacity implemented at the local service delivery catchment‐level.

Research limitations/implications

The intervention is bounded by a Canada‐specific socio‐cultural/political context. Design variables and antecedent conditions may not be present and/or readily replicated in other nation‐state contexts. The findings suggest opportunities for future integrative and applied health services and policy research, including collaborative inquiry that weaves together concepts from adult learning, social science and industrial engineering.

Practical implications

Scaling‐up for new capacity is ideally approached as a holistic, multi‐faceted process which considers the total assets within delivery systems, service catchments and communities as potentially being engaged and deployed.

Originality/value

The Pallium Integrated Capacity‐building Initiative offers model elements useful to others seeking theory‐informed practices to rapidly and effectively scale‐up learning and development efforts.

Details

Leadership in Health Services, vol. 21 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 1 June 2007

Steve Haswell and Diane Bailey

This paper reports on the evaluation of a scheme to promote service user involvement in the care delivered by a mental health trust. A case study methodology was employed to…

Abstract

This paper reports on the evaluation of a scheme to promote service user involvement in the care delivered by a mental health trust. A case study methodology was employed to describe the particularity of the scheme in context as experienced by service users and staff involved in its delivery. Mixed methods of semi‐structured interviews and focus groups created the opportunity for all stakeholders to engage in action research through a mutual learning process about the scheme in operation with a view to making changes to improve and develop it in the future. The qualitative data collected was content analysed and grouped according to key themes, which included the benefits of the scheme, the conditions for it to work successfully, suggested changes, limitations of the scheme, and service user involvement generally in a hospital setting. The role of service users as both paid scheme co‐ordinators and volunteer representatives highlights the contribution that people who use mental health services can play in influencing service delivery when employed in relevant and appropriate roles within a mental health organisation.

Details

The Journal of Mental Health Training, Education and Practice, vol. 2 no. 1
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 23 July 2020

Jean-Laurent Domingue, Steve F. Michel, Carole Cléroux, Tom Dobson, Jean-Michel Fréchette, Nina Fusco, Lara Jaroudi, Robert Konecki, Donna Power, Sara Richardson-Brown, Richard Robins, Tony Stufko, Sarah Telford and Whitney Wesley

Forensic mental health programs (FMHPs) in Ontario, Canada provide rehabilitation and supervision services. However, models available to guide their delivery are primarily adapted…

Abstract

Purpose

Forensic mental health programs (FMHPs) in Ontario, Canada provide rehabilitation and supervision services. However, models available to guide their delivery are primarily adapted from fields outside of forensic mental health. To partially fill this gap, this paper aims to provide a general review of the process a multi-professional team took to develop the Integrated Forensic Program [IFP]-Ottawa Model of Risk Management & Recovery.

Design/methodology/approach

Working groups were initiated to identify the needs of patients in their local setting, conduct a literature review on care delivery models in forensic mental health and build a service delivery model specific to forensic mental health.

Findings

The resulting model places patient engagement at its centre and encompasses eight domains of need that contribute towards the patient’s recovery and the management of the safety risk they pose to the public, namely, the basic needs, diversity and spirituality, social, occupational, psychological, substance use, physical health and mental health domains.

Practical implications

The IFP-Ottawa Model of Risk Management & Recovery provides a framework to which therapeutic group services for persons in FMHPs can be aligned.

Originality/value

The leadership teams in FMHPs could use this framework and the method used for its development to ensure group services provided at their FMHPs are evidence-informed and coincide with their patients’ specific needs.

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