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1 – 10 of 470Sabina De Rosis, Chiara Barchielli, Milena Vainieri and Nicola Bellé
User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on…
Abstract
Purpose
User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.
Design/methodology/approach
65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.
Findings
Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.
Research limitations/implications
Different features referring to different nursing models make the difference in producing an excellent user experience with the service.
Practical implications
These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.
Originality/value
This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.
Highlights
This is one of the first studies on the relationship between provision models of nursing care and patient experience.
Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.
Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.
Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.
This is one of the first studies on the relationship between provision models of nursing care and patient experience.
Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.
Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.
Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.
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Noah Olasehinde, Uche Abamba Osakede and Abdulfatai Adekunle Adedeji
This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of…
Abstract
Purpose
This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of user fees on waiting time at public healthcare facilities were examined. User fees are vital for the fiscal sustainability of healthcare provision for most African economies. Its imposition could debar healthcare access by the poor while its removal can reduce quality of care and induce longer waiting time.
Design/methodology/approach
The wave 3 of the Nigerian General Household Survey (2015/16) data was used for users of public health facilities. Access to healthcare was modelled using utilization data in a logistic regression model while waiting time was through the Negative Binomial Regression Model (NBRM).
Findings
The analyses showed significant effects of user fees on access to both preventive and curative care and on time spent waiting to make use of healthcare services. Individuals were able to access healthcare services regardless of amounts paid. Also, there was a non-negative effect of user fee imposition on waiting time.
Practical implications
Nigeria should improve healthcare facilities to address the enormous demand for healthcare services when designing policy for health sector.
Originality/value
This paper shows that even with the imposition of user fees, healthcare facilities could still not cater for the rising healthcare needs of the populace but cautioned that its abolition may not be a preferred option.
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Floriana Fusco, Marta Marsilio and Chiara Guglielmetti
Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have…
Abstract
Purpose
Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.
Design/methodology/approach
A structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.
Findings
This study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.
Research limitations/implications
This study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.
Practical implications
The framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.
Originality/value
This is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.
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Zhanna Novikov, Sara J. Singer and Arnold Milstein
Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially…
Abstract
Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.
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Emmanuel Eze, Rob Gleasure and Ciara Heavin
The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This…
Abstract
Purpose
The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This study addresses the research question: what existing health-related structures, properties and practices are presented by rural areas of developing countries that might inhibit the implementation of mHealth initiatives?
Design/methodology/approach
This study was conducted using a socio-material approach, based on an exploratory case study in West Africa. Interviews and participant observation were used to gather data. A thematic analysis identified important social and material agencies, practices and imbrications which may limit the effectiveness of mHealth apps in the region.
Findings
Findings show that, while urban healthcare is highly structured, best practice-led, rural healthcare relies on peer-based knowledge sharing, and community support. This has implications for the enacted materiality of mobile technologies. While urban actors see mHealth as a tool for automation and the enforcement of responsible healthcare best practice, rural actors see mHealth as a tool for greater interconnectivity and independent, decentralised care.
Research limitations/implications
This study has two significant limitations. First, the study focussed on a region where technology-enabled guideline-driven treatment is the main mHealth concern. Second, consistent with the exploratory nature of this study, the qualitative methodology and the single-case design, the study makes no claim to statistical generalisability.
Originality/value
To the authors' knowledge, this is the first study to adopt a socio-material view that considers existing structures and practices that may influence the widespread adoption and assimilation of a new mHealth app. This helps identify contextual challenges that are limiting the potential of mHealth to improve outcomes in rural areas of developing countries.
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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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Anu Helkkula, Alexander John Buoye, Hyeyoon Choi, Min Kyung Lee, Stephanie Q. Liu and Timothy Lee Keiningham
The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with…
Abstract
Purpose
The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.
Design/methodology/approach
Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.
Findings
Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.
Practical implications
Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.
Originality/value
This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.
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Muhammad Yusuf Shaharudin, Zulkhairi Mohamad and Asmah Husaini
The wake of the novel coronavirus (COVID-19) pandemic had caused substantial disruptions to the usual delivery of healthcare services. This is because of restrictive orders that…
Abstract
The wake of the novel coronavirus (COVID-19) pandemic had caused substantial disruptions to the usual delivery of healthcare services. This is because of restrictive orders that were put in place to curb the spread of the infection. Palliative care services in Brunei also face challenges to deliver effective services during this period. However, the impact of advanced illnesses on patients' health and end-of-life care are issues that cannot be planned, postponed or cancelled. Hence, the palliative care team needs to continue to deliver effective palliative care services. As Brunei faced its second pandemic wave in August 2021, crucial adaptations were made to ensure palliative care service was not disrupted. This reflective case study aims to discuss the adaptations made in providing palliative care during this era of disruptions.
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Value creation based on artificial intelligence (AI) can significantly change global healthcare. Diagnostics, therapy and drug discovery start-ups are some key forces behind this…
Abstract
Purpose
Value creation based on artificial intelligence (AI) can significantly change global healthcare. Diagnostics, therapy and drug discovery start-ups are some key forces behind this change. This article aims to study the process of start-ups' value creation within healthcare.
Design/methodology/approach
A multiple case study method and a business model design approach were used to study nine European start-ups developing AI healthcare solutions. Obtained information was performed using within and cross-case analysis.
Findings
Three unique design elements were established, with 16 unique frames and three unifying design themes based on business models for AI healthcare start-ups.
Originality/value
Our in-depth framework focuses on the features of AI start-up business models in the healthcare industry. We contribute to the business model and business model innovation by systematically analyzing value creation, how it is delivered to customers, and communication with market participants, as well as design themes that combine start-ups and categorize them by specialization.
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Tyler Aird, Ceara Holditch, Sarah Culgin, Margareta Vanderheyden, Greg Rutledge, Carlo Encinareal, Dan Perri, Fraser Edward and Hugh Boyd
The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute…
Abstract
Purpose
The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report.
Design/methodology/approach
Utilization statistics of the data integration solution were captured at one-month post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group.
Findings
The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts.
Practical implications
A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.
Originality/value
Although there has been a large effort to integrate health data across care levels in the United States and internationally, the groundwork for such integrations between interoperable systems has only just begun in Canada. The implementation of the integration between an enterprise LTC electronic medical record system and an HIS described herein is the first of its kind in Canada. Benefits and lessons learnt from this pilot will be useful for further hospital-to-LTC home interoperability work.
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