Search results

The purpose of this paper is to examine innovation in the resource-constrained context of India’s healthcare industry. It is argued that the process of innovation in addressing healthcare management challenges in such a context occurs through organisational ambidexterity and that human resource management (HRM) plays an important role.

A qualitative research methodology is applied to explore the role of HR practices in facilitating contextual ambidexterity and subsequent innovations in healthcare in India. The unit of analysis is the “case” of healthcare providers in India and in-depth interview and documentary data in two case sites are analysed to reveal the role of HRM in facilitating contextual ambidexterity and innovation. Data analysis was undertaken first at a within-case and then at a cross-case analysis level using interpretive manual coding based on how the data explained the role of HRM in delivering innovative outcomes and supporting organisational ambidexterity.

The authors found evidence of the use of sets of high-involvement HRM practices for exploration of new ideas and efficiency-driven HRM practices for creating contextual ambidexterity in the case organisations. Further, managerial/leadership style was found to play an important role in creating cultures of trust, openness, risk-taking and employee empowerment, supported by an appropriate mix of intrinsic and extrinsic rewards. Finally, training was also reported as being central to creating an ambidextrous context for delivering on various innovations in these healthcare providers.

This study represents an exploration of innovation in the context of India’s healthcare sector through intersecting literatures of ambidexterity, innovation and HRM practices. In light of the emerging economy research context, an important empirical contribution is palpable. Moreover, through a study design which included collecting data from multiple informants on the role of human resources in facilitating innovative outcomes, the authors reveal the role of HR-related initiatives, beyond formal HR practices in creating contextual ambidexterity. This study also reveals the degree to which contextual idiosyncrasies enhance our understanding of the role of HR in facilitating innovation in emerging economies.

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has been recognized as a “gold standard” set of “practical standardized measures” for assessing hospital service quality. Beginning with the HCAHPS, the purpose of this paper is to extend efforts to assess patient-centered communication (PCC) and the quality of healthcare and presents a scale for measuring patient perceptions and expectations of service quality in an emerging economy context.

A self-administered survey of patients in private hospitals (N = 171) was conducted to test the proposed framework. Exploratory and confirmatory factor analyses were used to establish the measurement model. Multiple regression analysis was used to explain the scale's predictive ability. ANOVA was used to analyze service quality gaps and rank patients' priorities.

Five components of PCC are identified. Among these, nurse affective communication has a significant positive effect on patient satisfaction. The gap analysis shows that patients have high expectations for doctors' affective communication, while they perceive a low level of service performance in the realm of nurse affective communication. The study highlights a new means of measuring “reliability” in healthcare. Important findings on patients' priorities are evaluated and discussed.

Healthcare organizations and practitioners can improve patient-centered care by stressing the dimensions of PCC, including clinicians' affective and instrumental communication.

The study expands the understanding of HCAHPS instruments in an emerging economy context and opens avenues for more widespread use of the measures. The research contributes to the literature on patient-centered care and healthcare service quality by proposing a scale for managing specific practices and interactions in healthcare.

The present study used the job-demands and resources (JD-R) framework to understand how the training is transferred to an extreme working context through the analysis of job and personal resources (social support from the leader and colleagues and adaptability). Specifically, the authors tested the mediating role of motivation to transfer in the relationship (1) between the perceived support from the supervisor and colleagues and performance after training and (2) between adaptability and performance in an extreme context of the pandemic crisis – the first peak of COVID-19 in Portugal. Further, an inspection of the factors that predicted knowledge transfer and adaptability under an extreme context was carried out.

To do so, necessary training about the new safety rules regarding the pandemic crisis of COVID-19 was implemented in a healthcare institution as a strategy to help healthcare workers deal with the increasing uncertainty and complexity that was threatening their work. It consisted of three sessions (each with one hour of training) regarding procedures, rules and safety norms. The training occurred in May 2020. Overall, 291 healthcare workers participated in the study and answered one online questionnaire one week after training completion.

The results showed that the motivation to transfer had a significant indirect effect on the relationship between colleagues' and supervisors' support and performance and between adaptability and performance. Additionally, complementary analyses showed that the mediations depended on the levels of self-efficacy in such a way that the indirect relationships were stronger when self-efficacy was higher. Thus, adaptability and support, both from colleagues and the supervisor, are determining factors for knowledge transfer and resultant performance in extreme contexts, such as the COVID-19 pandemic crisis. Lastly, the results showed that the most significant predictors of transference were self-efficacy and the motivation to transfer the learned knowledge. On the other hand, self-efficacy, peer support and the opportunity to use the knowledge were the most significant predictors of adaptability.

These findings provide support for the role of employee motivation to transfer as a mechanism connecting both perceived support and adaptability to performance outcomes under extreme working contexts.

This study, conducted in the middle of the COVID-19 pandemic context – an extreme and uncertain working context – shows the relevance of both job and individual factors to predict employees' adaptability to such contexts.

Using a complexity-informed approach, we aim to understand why introduction of a mobile service delivery model for osteoporosis across diverse organisational and country contexts in the UK National Health Service (NHS) met with variable success.

Six comparative case studies; three prospectively in Scotland using an action research-informed approach; and three retrospectively in England with variable degrees of success. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework explored interactions between multi-level contextual factors and their influence on efforts to introduce and sustain services.

Cross-boundary service development was a continuous process of adaptation and evolution in rapidly shifting healthcare context. Whilst the outer healthcare policy context differed significantly across cases, inner contextual features predominated in shaping the success or otherwise of service innovations. Technical and logistical issues, organisational resources, patient and staff actions combined in unpredictable ways to shape the lifecycle of service change. Patient and staff thoughts about place and access to services actively shaped service development. The use of tacit “soft intelligence” and a sense of “chronic unease” emerged as important in successfully navigating around awkward people and places.

“Chronic unease” and “soft intelligence” can be used to help individuals and organisations “tame” complexity, identify hidden threats and opportunities to achieving change in a particular context, and anticipate how these may change over time. Understanding how patients think and feel about where, when and how care is delivered provides unique insights into previously unseen aspects of context, and can usefully inform development and sustainability of patient-centred healthcare services.

This study has uniquely traced the fortunes of a single service innovation across diverse organisational and country contexts. Novel application of the NASSS framework enabled comparative analysis across real-time service change and historical failures. This study also adds to theories of context and complexity by surfacing the neglected role of patients in shaping healthcare context.

The significance of physician-user interaction has been widely acknowledged in offline and online healthcare consultation. However, limited attempts have been made to explore the influence of physician-user interaction on users' perceived service quality (PSQ) in the mobile context. Based on the literature on physician-user interaction and media synchronicity theory, this study proposes a theoretical model where the interactive factors common across the offline, online and mobile context, i.e. physicians' informational support and emotional support, the interactive factors unique in the mobile context, i.e. physicians' response speed and voice service, and the interaction between the two categories of interactive factors predict users' PSQ in mobile consultation.

This study collects consultation records between 25,225 users and 738 physicians from a leading Chinese mobile consultation application, and employs linear regression to verify the proposed theoretical model.

Physicians' informational, emotional support, response speed and voice service are found to have significant positive impacts on users' PSQ. Besides, physicians' response speed strengthens the positive impacts of physicians' informational and emotional support on users' PSQ, while physicians' voice service weakens the positive link between physicians' informational support on users' PSQ.

This study contributes to the antecedents for users' PSQ in mobile consultation by identifying unique interactive factors in the mobile context, and highlighting the individual and interaction effects of different physician-user interactive factors. Besides, this study employs novel methods, which leverages text classification and text pattern recognition to more accurately depict physicians' online behaviors based on objective communication records.

This paper aims to conceptualize and characterize service ecosystems, addressing calls for research on this important and under-researched topic.

The authors draw on four meta-theoretical foundations of S-D logic – resource integration, resource density, practices and institutions – providing a new integrated conceptual framework of ecosystem well-being. They then apply this conceptualization in the context of a complex healthcare setting, exploring the characteristics of ecosystem well-being at the meso level.

This study provides an integrated conceptual framework to explicate the nature and structure of well-being in a complex service ecosystem; identifies six key characteristics of ecosystem well-being; illustrates service ecosystem well-being in a specific healthcare context, zooming in on the meso level of the ecosystem and noting the importance of embedding a shared worldview; provides practical guidance for managers and policy makers about how to manage complex service ecosystems in their quest for improving service outcomes; and offers an insightful research agenda.

This research focuses on service ecosystems with an illustration in one healthcare context, suggesting additional studies that explore other industry contexts.

Practically, the study indicates the imperative for managing across mutually adapting levels of the ecosystem, identifying specific new practices that can improve service outcomes.

Examining well-being in the context of a complex service ecosystem is critical for policymakers charged with difficult decisions about balancing the demands of different levels and actors in a systemic world.

The study is the first to conceptualize and characterize well-being in a service ecosystem, providing unique insights and identifying six specific characteristics of well-being.

The purpose of this research is to investigate how the consumer’s trusting mechanism influences their behavioral adoption intention in the context of genetic testing.

Based on the technology acceptance theory and trust formation theory, the research posits and develops a comprehensive trust model by integrating trust-related factors that correlate to the consumer’s trusting beliefs and trusting intention. Survey data with 525 respondents allow to test and validate the model.

The tested model shows that technology institutional trust base, end-user’s cognitive trust base and social influence are significant determinants of trusting beliefs. The findings also reveal that mediation effects of performance expectancy and perceived risks exist in the relationship between trusting beliefs and trusting intention.

The foreseeable positive impact and rapid market growth of emerging healthcare technologies necessitate the strong need to study user acceptance. However, there is a lack of research on how consumers trust and their adoption intention of such innovations. Prior empirical evidence from different contexts and perspectives also show contradictory findings. This research extends the existing technology acceptance literature to a healthcare context, provides an improved generalized understanding of the consumer’s trusting mechanism in emerging biotechnology and discusses practical insights for regulatory authorities, healthcare institutes and medical professionals.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

By following the “employee-centric” approach, this study aims at identifying the impact of high-performance work systems (HPWS) on specific employee attitudinal outcomes such as work engagement, job satisfaction and affective commitment in the Indian healthcare industry.

The target population for this study includes the nurses working in large private multi-specialty tertiary care hospitals in India. Partial Least Squares Structural Equation Modelling (PLS-SEM) techniques are used on a sample of 152 nurses working in two large specialty hospitals.

In the Indian healthcare industry context, the nurse's perception of HPWS has shown a significant positive effect on their attitudinal variables such as work engagement, job satisfaction and affective commitment. When checked for mediation of work engagement and job satisfaction variables in HPWS – affective commitment relationship, nurse's job satisfaction partially mediated the relationship, but nurse's work engagement has shown no mediation effect.

This is one of the pioneering studies conducted in the Indian healthcare industry context, especially on the nurse's sample in identifying the impact of high-performance work systems on their attitudinal outcomes. Underscoring the paucity of HPWS research in the Indian healthcare industry, this study's findings will be an addition to the HPWS literature and also to the nursing research in the Indian healthcare settings.

This study examines the role of user psychological empowerment (PE) as a specific type of PE in the context of using health information systems (HIS) and incorporates the contribution of autonomous motivation and knowledge sharing intention (KSI) to the resolution of the key dynamics of interpersonal knowledge sharing behavior (KSB) in healthcare organizations.

For the data analysis, survey data were collected from 350 employees at three large teaching hospitals in Taiwan. In this study, the partial least squares technique was used with SmartPLS 3.3 software to validate the research model.

User PE had significant positive effects on autonomous motivation, KSI and KSB. Additionally, autonomous motivation positively affected KSB directly and indirectly via KSI.

Insights into motivation (e.g. user PE and autonomous motivation) play a key role in driving KSI and lead to effective KSB, which aids managers in tailoring their efforts to foster knowledge dissemination and enhance organizational performance.

While finding ways to encourage employees to share knowledge with one another in an organization is an important task, there exists a lack of understanding as to how this task can be accomplished in the context of healthcare organizations. This study is the first to specifically address this issue from a perspective integrating PE and self-determination theory while also incorporating the HIS context with population-specific measures (healthcare organizations) to expand the application of empowerment theory to the information system domain.