Search results

1 – 10 of over 11000
To view the access options for this content please click here
Article

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…

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.

Details

Journal of Health Organization and Management, vol. 19 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Article

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.

Details

Journal of Facilities Management , vol. 17 no. 3
Type: Research Article
ISSN: 1472-5967

Keywords

To view the access options for this content please click here
Article

J. Parnaby and D.R. Towill

The purpose of this paper is to provide a comprehensive description, justification and modus operandi for implementation of cellular operations within healthcare delivery

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.

Details

The International Journal of Logistics Management, vol. 20 no. 1
Type: Research Article
ISSN: 0957-4093

Keywords

To view the access options for this content please click here
Article

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…

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 healthcaredelivery 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 healthcaredelivery systems.

Details

Business Process Management Journal, vol. 15 no. 1
Type: Research Article
ISSN: 1463-7154

Keywords

To view the access options for this content please click here
Article

Pradeep Kumar

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…

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.

Details

Journal of Asia Business Studies, vol. 14 no. 2
Type: Research Article
ISSN: 1558-7894

Keywords

To view the access options for this content please click here
Article

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…

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.

To view the access options for this content please click here
Article

Morad Benyoucef, Craig Kuziemsky, Amir Afrasiabi Rad and Ali Elsabbahi

Service‐oriented architecture is becoming increasingly important for healthcare delivery as it assures seamless integration internally between various teams and…

Abstract

Purpose

Service‐oriented architecture is becoming increasingly important for healthcare delivery as it assures seamless integration internally between various teams and departments, and externally between healthcare organizations and their partners. In order to make healthcare more efficient and effective, we need to understand and evaluate its processes, and one way of achieving that is through process modeling. Modeling healthcare processes within a service‐oriented environment opens up new perspectives and raises challenging questions. The purpose of this paper is to investigate one of these questions, namely the suitability of web service orchestration and choreography, two closely related but fundamentally different methodologies for modeling web service‐based healthcare processes.

Design/methodology/approach

The authors use a case‐based approach that first developed a set of 12 features for modeling healthcare processes and then used the features to compare orchestration and choreography for modeling part of the scheduled workflow.

Findings

The findings show that neither methodology can, by itself, meet all healthcare modeling requirements in the context of the case study. The appropriate methodology must be selected after consideration of the specific modeling needs. The authors identified usability, capabilities, and evolution as three key considerations to assist with selection of a methodology for healthcare process modeling. Further, sometimes one method will not meet all modeling needs and hence the authors recommend combining the two methodologies in order to harness the benefits of modeling healthcare processes in a service‐oriented environment.

Originality/value

Although literature exists on process modeling of web services for healthcare, there are no criteria describing necessary features for micro‐level modeling, nor is there a comparison of the two leading service composition methodologies within the healthcare context. This paper provides some necessary formalization for process modeling in healthcare.

Details

Business Process Management Journal, vol. 17 no. 4
Type: Research Article
ISSN: 1463-7154

Keywords

To view the access options for this content please click here
Article

Phil Joyce, Rosamund Green and Graham Winch

Purpose – The core theme of this paper is that, to provide the best kind of process systems to support a “quality” healthcare provider, it is essential to “engineer‐in”…

Abstract

Purpose – The core theme of this paper is that, to provide the best kind of process systems to support a “quality” healthcare provider, it is essential to “engineer‐in” quality as early as possible – effectively at the specification and design phase. It extends to the healthcare context a novel approach, which provides a transparent model of how an envisioned structure delivers services and fulfils stakeholders' needs. Design/methodology/approach – In the paper a new construct, developed by the authors, is described and then extended to the healthcare sector. The underpinning theories of the new construct are discussed and examples for a health care service are presented. Findings – The paper finds that there is a full literature on quality and TQM, but relatively little offers practical tools for supporting design and implementation processes that enhance the likelihood of achieving quality operations. The presentation and discussion of the construct presented argue that the approach presented here can achieve this aim. Practical implications – In the paper, as with many ventures, organisations charged with healthcare delivery are presently facing the dual challenges of seeking to satisfy widely extended stakeholder groups and implement complex ICT systems to support e‐fulfilment. To ensure that quality is “engineered‐in”, a holistic, integrated and quality approach is required, and Total Quality Management (TQM) principles are the obvious foundations for this. Originality/value – The paper shows that electronically delivered information and funds transaction systems do offer healthcare organisations great potential, but many large integrated ICT systems have notoriously disappointed the stakeholder health care service. An integrative view of the delivery system design, based on the literature from strategic management, business process design, e‐business design, and TQM, has yielded a unique construct, which integrates these views in a transparent model readily accessible to the various domain experts. The specific role of this in healthcare fulfilment system design applications is demonstrated.

Details

The TQM Magazine, vol. 18 no. 6
Type: Research Article
ISSN: 0954-478X

Keywords

To view the access options for this content please click here
Article

Devendra Dhagarra, Mohit Goswami, P.R.S. Sarma and Abhijit Choudhury

Significant advances have been made in the field of healthcare service delivery across the world; however, health coverage particular for the poor and disadvantaged still…

Abstract

Purpose

Significant advances have been made in the field of healthcare service delivery across the world; however, health coverage particular for the poor and disadvantaged still remains a distant dream in developing world. In large developing countries like India, disparities in access to healthcare are pervasive. Despite recent progress in ensuring improved access to health care in past decade or so, disparities across gender, geography and socioeconomic status continue to persist. Fragmented and scattered health records and lack of integration are some of the primary causes leading to uneven healthcare service delivery. The devised framework is intended to address these challenges. The paper aims to discuss these issues.

Design/methodology/approach

In view of such challenges, in this research a Big Data and blockchain anchored integrative healthcare framework is proposed focusing upon providing timely and appropriate healthcare services to every citizen of the country. The framework uses unique identification number (UID) system as formalized and implemented by the Government of India for identification of the patients, their specific case histories and so forth.

Findings

The key characteristic of our proposed framework is that it provides easy access to secure, immutable and comprehensive medical records of patients across all treatment centers within the country. The model also ensures security and privacy of the medical records based upon the incorporation of biometric authentication by the patients for access of their records to healthcare providers.

Originality/value

A key component of our evolved framework is the Big Data analytics-based framework that seeks to provide structured health data to concerned stakeholders in healthcare services. The model entails all pertinent stakeholders starting from patients to healthcare service providers.

Details

Business Process Management Journal, vol. 25 no. 7
Type: Research Article
ISSN: 1463-7154

Keywords

To view the access options for this content please click here
Article

Gyan Prakash

– The purpose of this paper is to explore regulation in India’s healthcare sector and makes recommendations needed for enhancing the healthcare service.

Abstract

Purpose

The purpose of this paper is to explore regulation in India’s healthcare sector and makes recommendations needed for enhancing the healthcare service.

Design/methodology/approach

The literature was reviewed to understand healthcare’s regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS).

Findings

Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges.

Research limitations/implications

This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach).

Practical implications

Healthcare pitfalls across the world seem to follow similar follies. India’s complexity and experience is useful for emerging and developed economies.

Originality/value

The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient’s perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

1 – 10 of over 11000