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1 – 10 of over 17000Michael 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…
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.
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Olusegun Emmanuel Akinwale and Olusoji James George
The mass exodus of the professional healthcare workforce has become a cankerworm for a developing nation like Nigeria, and this worsens the already depleted healthcare systems in…
Abstract
Purpose
The mass exodus of the professional healthcare workforce has become a cankerworm for a developing nation like Nigeria, and this worsens the already depleted healthcare systems in underdeveloped nation. This study investigated the rationale behind medical workers' brain-drain syndrome and the quality healthcare delivery in the Nigerian public healthcare sector.
Design/methodology/approach
To stimulate an understanding of the effect of the phenomenon called brain drain, the study adopted a diagnostic research design to survey the public healthcare personnel in government hospitals. The study administered a battery of adapted research scales of different measures to confirm the variables of interest of this study on a probability sampling strategy. The study surveyed 450 public healthcare sector employees from four government hospitals to gather pertinent data. The study used a structural equation model (SEM) and artificial neural networks (ANNs) to analyse the collected data from the medical personnel of government hospitals.
Findings
The findings of this study are significant as postulated. The study discovered that poor quality worklife experienced by Nigerian medical personnel was attributed to the brain-drain effect and poor healthcare delivery. The study further demonstrated that job dissatisfaction suffered among the public healthcare workforce forced the workforce to migrate to the international labour market, and this same factor is a reason for poor healthcare delivery. Lastly, the study discovered that inadequate remuneration and pay discouraged Nigerian professionals and allied healthcare workers from being productive and ultimately pushed them to the global market.
Originality/value
Practically, this study has shown three major elements that caused the mass movement of Nigerian healthcare personnel to other countries of the world and that seems novel given the peculiarity of the Nigerian labour market. The study is original and novel as much study has not been put forward in the public healthcare sector in Nigeria concerning this phenomenon.
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This paper explores the enablers of modular healthcare services.
Abstract
Purpose
This paper explores the enablers of modular healthcare services.
Design/methodology/approach
A survey-based approach was adopted with specialised hospitals as the unit of analysis. A structural model was developed based on a literature review and assessed using a cross-sectional research design. A 23-indicator questionnaire was circulated among service providers in the healthcare system across India, and 286 valid responses were received. The data were analysed using partial least squares-structural equation modeling (PLS-SEM).
Findings
The results reveal that professional competence, technological versatility, clear division of tasks, channelised flow of information and professional autonomy act as enablers that may drive modular service delivery.
Research limitations/implications
By examining service providers' perspectives, this paper highlights the influence of the identified enablers on modular service delivery in healthcare organisations.
Practical implications
For practitioners, the study provides suggestions for designing patient-centric healthcare services via modular healthcare delivery. The identified structural relationships can facilitate immediate corrective actions and the formulation of future policies. The findings will help practitioners foresee opportunities for patient participation in value co-creation, meet patients' varying needs, decompose service offerings, mix and match components develop sets of rules as interfaces between service modules and design service packages on an ongoing basis.
Social implications
This study underscores the emergence of patient-centric care and may aid the design of processes that deliver health to the patient as a person.
Originality/value
This paper identifies and empirically validates relationships between healthcare service delivery processes and modular service delivery.
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D.R. Towill and M. Christopher
Aims to show that material flow concepts developed and successfully applied to commercial products and services can form equally well the architectural infrastructure of effective…
Abstract
Purpose
Aims to show that material flow concepts developed and successfully applied to commercial products and services can form equally well the architectural infrastructure of effective healthcare delivery systems.
Design/methodology/approach
The methodology is based on the “power of analogy” which demonstrates that healthcare pipelines may be classified via the Time‐Space Matrix.
Findings
A small number (circa 4) of substantially different healthcare delivery pipelines will cover the vast majority of patient needs and simultaneously create adequate added value from their perspective.
Research limitations/implications
The emphasis is firmly placed on total process mapping and analysis via established identification techniques. Healthcare delivery pipelines must be properly engineered and matched to life cycle phase if the service is to be effective.
Practical implications
This small family of healthcare delivery pipelines needs to be designed via adherence to very specific‐to‐purpose principles. These vary from “lean production” through to “agile delivery”.
Originality/value
The proposition for a strategic approach to healthcare delivery pipeline design is novel and positions much currently isolated research into a comprehensive organisational framework. It therefore provides a synthesis of the needs of global healthcare.
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Oti Amankwah, Weng-Wai Choong and Abdul Hakim Mohammed
Facilities management (FM) professionals state that adopting FM will positively support core service delivery and ensure customer satisfaction. Evidences of such claim are…
Abstract
Purpose
Facilities management (FM) professionals state that adopting FM will positively support core service delivery and ensure customer satisfaction. Evidences of such claim are important as it will enhance the rationale for institutionalising prudent FM service quality in hospitals in Ghana. This paper aims to assess the mediating effect of healthcare FM service quality on patients’ satisfaction and overall healthcare delivery.
Design/methodology/approach
This is a cross-sectional study involving adult patients at the Physician outpatient departments and Polyclinics of Komfo Anokye, Tamale and Cape Coast Teaching hospitals in Ghana. A questionnaire survey using a well-structured five-point likert scale based on the SERVQUAL dimensions and Healthcare core service dimensions rooted in the FM framework was used to collect data from 660 patients. Smart PLS was used to analyse the data of 622 valid questionnaires.
Findings
The study results revealed that FM service quality mediates the relationship between patients’ satisfaction and three of the constructs under core healthcare delivery. That is, (the quality of healthcare delivery, the quality of healthcare personnel and the adequacy of healthcare resources) – surprisingly, the fourth construct (the quality of administration process) was not supported.
Originality/value
There is no or at best very limited studies on the contribution of healthcare FM on patients satisfaction of core healthcare delivery in Ghana. Therefore, this study will enrich and contribute to knowledge in healthcare FM in general and that of a developing African country in particular.
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The purpose of this paper is to provide a comprehensive description, justification and modus operandi for implementation of cellular operations within healthcare delivery supply…
Abstract
Purpose
The purpose of this paper is to provide a comprehensive description, justification and modus operandi for implementation of cellular operations within healthcare delivery supply chains. The methodology outlined has a sound theoretical basis, has been proven in a wide range of market sectors (including hospitals) and hence qualifies for consideration as a contribution to “new management theory”.
Design/methodology/approach
Approach is based on the well established management‐by‐projects (MBP) methodology for analysis, design and effective implementation of change. There is detailed coverage of the five‐step MBP programme with specific applications in healthcare. The importance of “people involvement” as a core requirement is demonstrated via the set‐up of task forces to design and operate such cells. These groups integrate cognate activities so as to provide seamless patient flow within the healthcare delivery process. MBP is derived from a systems perspective. This in turn is concerned with maintaining quality, reducing uncertainty, smooth transference, synchronisation, schedule adherence, and minimisation of throughput times.
Findings
The outputs from case studies executed in a large UK teaching hospital confirm the substantial benefits accruing from cellular operation. In both materials supplies and urology admission processes significant improvements result form adoption of the MBP change methodology. This includes substantive 50 per cent reduction in patient throughput times, plus 25 per cent increase in bed utilisation. Measurable cost benefits are achieved in materials supply, especially via simplification of ordering systems.
Research limitations/implications
The healthcare applications demonstrate the applicability of MBP within this specialised scenario. However, the solutions depend on the innovatory capability of the relevant task forces who execute the projects. Since these necessarily include participation by coal‐face “players”, i.e. doctors, nurses, support staff, etc. advised by internal “change experts” the solutions adopted are shaped to be the best and most appropriate “local” schema.
Practical implications
It is essential that task forces be properly constituted, well trained, well advised, and actively practice the plan‐do‐check‐act cyclic route of well‐tested improvement. “Train‐Do” is the key. However, in healthcare especially, the “Elephant Must Be Eaten in Bite Sized Chunks”. In other words the organisation needs visible progressive change, unit‐by‐unit, thus avoiding saturation of scarce resources.
Originality/value
Brings together the MBP methodology and cellular organisational concepts into an integrated, sustainable, systems based approach to the analysis, design and implementation of effective change.
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Archie Lockamy and Douglas L. Smith
The purpose of this paper is to provide a conceptual framework along with underlying propositions for the design and deployment of telemedicine projects which provide healthcare…
Abstract
Purpose
The purpose of this paper is to provide a conceptual framework along with underlying propositions for the design and deployment of telemedicine projects which provide healthcare organizations with strategic benefits.
Design/methodology/approach
Field research conducted at four healthcare organizations along with academic literature in the areas of telemedicine and process management form the basis for the conceptual framework and propositions provided in this paper.
Findings
Telemedicine can be used as a process enabler for enhanced healthcare‐delivery systems. However, there are several challenges which must be considered prior to its implementation. The framework and propositions provided in the paper can be used to facilitate successful telemedicine project deployments.
Research limitations/implications
The framework and propositions are derived from a small sample and must be validated through more rigorous empirical research studies.
Practical implications
The concepts presented in the paper can be used by healthcare planners to increase the likelihood of telemedicine deployment success within their organizations.
Originality/value
This paper begins to fill a void in the literature concerning how telemedicine can be used as a process enabler for improving healthcare‐delivery systems.
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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.
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Anna Corinna Cagliano, Giulio Mangano, Carlo Rafele and Sabrina Grimaldi
The objective of this paper is to propose an approach to comparatively analyze the performance of drugs and consumable products warehouses belonging to different healthcare…
Abstract
Purpose
The objective of this paper is to propose an approach to comparatively analyze the performance of drugs and consumable products warehouses belonging to different healthcare institutions.
Design/methodology/approach
A Cluster Analysis is completed in order to classify warehouses and identify common patterns based on similar organizational characteristics. The variables taken into account are associated with inventory levels, the number of SKUs, and incoming and outgoing flows.
Findings
The outcomes of the empirical analysis are confirmed by additional indicators reflecting the demand level and the associated logistics flows faced by the warehouses at issue. Also, the warehouses belonging to the same cluster show similar behaviors for all the indicators considered, meaning that the performed Cluster Analysis can be considered as coherent.
Research limitations/implications
The study proposes an approach aimed at grouping healthcare warehouses based on relevant logistics aspects. Thus, it can foster the application of statistical analysis in the healthcare Supply Chain Management. The present work is associated with only one regional healthcare system.
Practical implications
The approach might support healthcare agencies in comparing the performance of their warehouses more accurately. Consequently, it could facilitate comprehensive investigations of the managerial similarities and differences that could be a first step toward warehouse aggregation in homogeneous logistics units.
Originality/value
This analysis puts forward an approach based on a consolidated statistical tool, to assess the logistics performances in a set of warehouses and, in turn to deepen the related understanding as well as the factors determining them.
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This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the…
Abstract
Purpose
This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the strategies and contextual influences to attain patient recovery flexibility.
Design/methodology/approach
This paper uses a case study method based on a semi-structured interview with healthcare professionals, observations and informal discussions.
Findings
In the present study, several dimensions of patient recovery flexibility are reported. Different internal and external strategies to exhibit patient recovery flexibility, as well as two contextual influences, are identified. An integrative framework is developed to establish the relationship of patient recovery flexibility with service experience in public healthcare.
Research limitations/implications
The study was conducted in a public healthcare setting in India. The sample size for the semi-structured interview was limited to healthcare professionals, and the patient’s perspective is missing.
Originality/value
This paper contributes to the growing need for patient recovery flexibility as a strategy in the public healthcare delivery system. It offers new insights to address the gap in the literature regarding the linkage of patient recovery flexibility and service experience. The study provides an integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and the impact on the service experience. The framework and propositions presented in the study will guide future research that is needed in this area. This study provides an overview to shape and redesign the after-service support from a flexibility perspective in public healthcare for the improved service experience.
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