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Abstract
Purpose
One prominent translation of patient‐centred care is public sector consumerism by which patients may influence the services provided by acting like consumers. The focus of this study is the extent to which technological devices in national public healthcare portals in the UK and three Nordic countries transform patients so that they can act as healthcare consumers.
Design/methodology/approach
The paper applies a comparative case study methodology.
Findings
As national healthcare portals, Norway's technological devices, to some extent, and the devices in the UK and Denmark, to a greater extent, equip patients to act as consumers. At present, Sweden's technological devices are much more limited. In Denmark and the UK, these devices that use quality indicators are in the forefront in the development of national healthcare portals.
Originality/value
A theoretical framework is applied that emphasizes the role of technological devices in the construction of calculating consumers as described by Michel Callon. This perspective, which promotes patient‐centred care, enhances the understanding of fundamental design issues related to the role of technology as the individual forms his/her relationship with healthcare systems.
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Empowered patients are allies to the healthcare system, especially in emergency situations. Social media use has emerged to be a major means by which patients interact with the…
Abstract
Empowered patients are allies to the healthcare system, especially in emergency situations. Social media use has emerged to be a major means by which patients interact with the healthcare system, and in times such as the current COVID-19 situation social media has to play an even greater crisis management role by empowering patients. Social media channels serve numerous beneficial purposes, despite them also being blamed for the spread of misinformation during this crisis. In this Gulf Cooperation Council (GCC) focused case study, we will discuss the increasingly greater role being played by the social media in healthcare in the region and how that empowers not just the patients but the system as a whole. In the GCC region, the healthcare sector is found to reflect a steady growth, leading to an increased drive for empowering patients by lowering the barriers to effective communication and consultation through online media. As of today, social media has become an element of the telehealth infrastructure being deployed in the region. During COVID-19, patients are seen to leverage it pointedly for online health consultations thereby lowering the stress on the healthcare system and adding to efficiencies.
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Timothy J. Vogus, Andrew Gallan, Cheryl Rathert, Dahlia El-Manstrly and Alexis Strong
Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by…
Abstract
Purpose
Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.
Design/methodology/approach
This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.
Findings
The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.
Originality/value
The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.
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At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…
Abstract
At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.
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Colin Clarke and Lesley-Jane Eales-Reynolds
– The purpose of this paper is to examine if customer care (CC) can be directly linked to patient safety through a human factors (HF) framework.
Abstract
Purpose
The purpose of this paper is to examine if customer care (CC) can be directly linked to patient safety through a human factors (HF) framework.
Design/methodology/approach
Data from an online questionnaire, completed by a convenience healthcare worker sample (n=373), was interrogated using thematic analysis within Vincent et al.’s (1998) HF theoretical framework. This proposes seven areas affecting patient safety: institutional context, organisation and management, work environment, team factors, individual, task and patient.
Findings
Analysis identified responses addressing all framework areas. Responses (597) principally focused on work environment 40.7 per cent (n=243), organisation and management 28.8 per cent (n=172). Nevertheless, reference to other framework areas were clearly visible within the data: teams 10.2 per cent (n=61), individual 6.7 per cent (n=40), patients 6.0 per cent (n=36), tasks 4.2 per cent (n=24) and institution 3.5 per cent (n=21). Findings demonstrate congruence between CC perceptions and patient safety within a HF framework.
Research limitations/implications
The questionnaire requested participants to identify barriers to rather than CC enablers. Although this was at a single site complex organisation, it was similar to those throughout the NHS and other international health systems.
Practical implications
CC can be viewed as consonant with patient safety rather than the potentially dangerous consumerisation stance, which could ultimately compromise patient safety.
Originality/value
This work provides an original perspective on the link between CC and patient safety and has the potential to re-focus healthcare perceptions.
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Kofi Osei-Frimpong, Alan Wilson and Nana Owusu-Frimpong
The purpose of this paper is to investigate value co-creation processes from the focal dyad of the patient and the physician and how their experiences in the consulting room…
Abstract
Purpose
The purpose of this paper is to investigate value co-creation processes from the focal dyad of the patient and the physician and how their experiences in the consulting room affect the value that is created.
Design/methodology/approach
Semi-structured interviews incorporating the critical incident technique (CIT) were conducted with 8 doctors and 24 outpatients in selected hospitals in Ghana, exploring their experiences during their encounter in the service delivery impacting on the value creating healthcare opportunities. An abductive and thematic analytical approach was used to identify 76 useable critical incidents that had clear consequences on both the outcome of the service and the service experiences of the patient.
Findings
The study reveals three critical areas needed to support the value co-creation process and respective elements or activities to be considered during the service encounter. The critical areas comprise of the social context, beliefs and perceptions, and partnership between the focal dyad. The findings also suggests that patients do not consider “getting well” as the only value that they seek, but also the total experiences they go through in the consulting room. Also some physicians find it difficult to accept the recent changes in the patients’ behaviour and attitudes, resulting in knowledge conflict that adversely affects actors’ experiences in the consulting room.
Research limitations/implications
The study considered only one of the many professionals in the healthcare delivery, which may affect the true value perceptions of the patient.
Practical implications
The study provides service providers understanding of the processes that influence the patients’ experiences and value creation and the changing trends in the patient’s attitudes. The findings suggest a need for providers to take a holistic view of the service delivery and consider the critical areas, which could impact on the overall service outcomes.
Originality/value
This study extends the research on CIT to exploring the value co-creating processes in the healthcare setting. This also provides clarity in understanding the interdependence of the two actors and how this is managed as a resource in the value co-creation process at the micro level.
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Examines some of the quality initiatives occurring in the UK National Health Service. Contrasts quality practices in healthcare with TQM in industry and discusses the implications…
Abstract
Examines some of the quality initiatives occurring in the UK National Health Service. Contrasts quality practices in healthcare with TQM in industry and discusses the implications of adopting total quality in the NHS. Looks at current quality activity and discusses the key components to participative management and quantitative methods. Proposes a model for total quality in healthcare. Concludes that everyone be encouraged to make “breakthroughs” ‐ this means no one can be left out of the process.
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Although marketers in service industries face similar challenges to those in manufacturing, their approach to tackling these challenges can often be very different. A major US…
Abstract
Although marketers in service industries face similar challenges to those in manufacturing, their approach to tackling these challenges can often be very different. A major US health insurance company has successfully applied conventional market segmentation techniques to better understand its customers’ needs, which in turn assisted in improving customer loyalty and increasing member retention. The loyalty research has also helped position the company to respond to the increasing tide of consumerism in the healthcare industry.
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Jon Engström, Olof Norin, Serge de Gosson de Varennes and Aku Valtakoski
The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to…
Abstract
Purpose
The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to facilitate the design of patient-centric services.
Design/methodology/approach
The study was based on a collaborative project with a national healthcare organization following the principles of action design research. The study describes the quantitative segmentation performed during the project, followed by a qualitative interview study of how segments correspond with patient behaviors in an actual healthcare setting, and service design workshops facilitated by segments. A number of design principles are outlined based on the learnings of the project.
Findings
The segmentation approach increased understanding of patient variability within the service provider organization and was considered an effective foundation for modular service design. Patient characteristics and life circumstances were related to specific patterns of health behaviors, such as avoidance or passivity, or a persistent proactivity. These patterns influenced the patients' preferred value co-creation role and what type of support patients sought from the care provider.
Practical implications
The proposed segmentation approach is immediately generalizable to further healthcare contexts and similar services: improved understanding of patients, vulnerable patients in particular, improves the fit and inclusivity of services.
Originality/value
The segmentation approach to service design was demonstrated to be effective in a large-scale context. The approach allows service providers to design service options that improve the fit with individual patients' needs for support and autonomy. The results illuminate how patient characteristics influence health and value co-creation behaviors.
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