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1 – 10 of over 4000Jonas Boström, Helene Hillborg and Johan Lilja
The purpose of this paper is to explore and describe the perspectives and reasoning of senior development leaders in healthcare organizations, when reflecting on design as theory…
Abstract
Purpose
The purpose of this paper is to explore and describe the perspectives and reasoning of senior development leaders in healthcare organizations, when reflecting on design as theory and practice in relation to more traditional methods and tools for improving quality and support innovation.
Design/methodology/approach
The paper is based on a qualitative interview design with five development and innovation leaders from separate healthcare regions in Sweden. They have, to varying degrees, applied design theory and practice for quality improvement and innovation in their organizations. The interview transcript was analysed using a content analysis together with an interpretive approach.
Findings
The major findings are to be found in the balancing act for leadership and organizations in healthcare when it comes to introducing and combining different theories and practices for improving quality and support innovation. The balance is between the change in power dynamics and pushing traditional boundaries in a complex healthcare world.
Practical implications
The narratives from the leaders' experience of applying design theory and practice for improving healthcare quality can help us create readiness and knowledge about how we prevent and/or facilitate planning and implementing design theories, practices, methods and tools in a healthcare context.
Originality/value
The study provides a unique insight when it captures and illustrates five different organizations' experiences when applying design for developing healthcare quality.
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As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing…
Abstract
Purpose
As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work.
Design/methodology/approach
This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level.
Findings
The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions.
Practical implications
The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions.
Originality/value
This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities’ perspective and the organizational perspective to understand the manager’s role in handling the contingency of decisions and managing paradoxes in the decision-making process.
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Ignat Kulkov, Julia Kulkova, Daniele Leone, René Rohrbeck and Loick Menvielle
The purpose of this study is to examine the role of artificial intelligence (AI) in transforming the healthcare sector, with a focus on how AI contributes to entrepreneurship and…
Abstract
Purpose
The purpose of this study is to examine the role of artificial intelligence (AI) in transforming the healthcare sector, with a focus on how AI contributes to entrepreneurship and value creation. This study also aims to explore the potential of combining AI with other technologies, such as cloud computing, blockchain, IoMT, additive manufacturing and 5G, in the healthcare industry.
Design/methodology/approach
Exploratory qualitative methodology was chosen to analyze 22 case studies from the USA, EU, Asia and South America. The data source was public and specialized podcast platforms.
Findings
The findings show that combining technologies can create a competitive advantage for technology entrepreneurs and bring about transitions from simple consumer devices to actionable healthcare applications. The results of this research identified three main entrepreneurship areas: 1. Analytics, including staff reduction, patient prediction and decision support; 2. Security, including protection against cyberattacks and detection of atypical cases; 3. Performance optimization, which, in addition to reducing the time and costs of medical procedures, includes staff training, reducing capital costs and working with new markets.
Originality/value
This study demonstrates how AI can be used with other technologies to cocreate value in the healthcare industry. This study provides a conceptual framework, “AI facilitators – AI achievers,” based on the findings and offer several theoretical contributions to academic literature in technology entrepreneurship and technology management and industry recommendations for practical implication.
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This paper aims to present the Expero4care model. Considering the growing need for a training evaluation model that does not simply fix processes, the Expero4care model represents…
Abstract
Purpose
This paper aims to present the Expero4care model. Considering the growing need for a training evaluation model that does not simply fix processes, the Expero4care model represents the first attempt of a “quality model” dedicated to the learning outcomes of healthcare trainings.
Design/Methodology/Approach
Created as development of the Expero model (Cervai et al., 2013), the Expero4care model has been tailored for workplace learning in the healthcare sector and tested in six organizations across Europe. The model has been validated through the review of an international team of experts and its approval as QualiCert standard.
Findings
Expero4care allows the evaluation of the quality of learning outcomes focusing on competences, impact in the workplace, transferability, participation and credits. The evaluation process involves different categories of stakeholders (learners, trainers, colleagues, managers, internal or external bodies that can benefit the training’s results, i.e. final users of the service, such as patients and citizens), and it is based on a systematic data collection and comparison among expectations and perceptions. The implementation of the Expero4care model gives the opportunity to start a continuous improvement process of the trainings in the healthcare service.
Research limitations/implications
Expero4care has been tested in both university courses and organizational trainings dedicated to professionals in the healthcare sector. The initial sample is not wide enough to cover all the countries and the types of trainings, so a larger implementation is needed to validate its appropriateness.
Social Implication
Expero4care is the first model created specifically for organizations providing training in the healthcare sector. The implementation of the Expero4care model – adaptable to different kind of organizations and trainings – means that it is possible to highlight the value of the training considering its impact on the workplace and on the citizens.
Originality/value
As the most commonly used tools to assess the quality of trainings consist of questionnaires submitted to participants at the end of the training and considering that quality models have not been utilized to analyse learning outcomes in healthcare, Expero4care represents the first quality model dedicated to training in healthcare service.
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Anna Prenestini, Stefano Calciolari and Arianna Rota
During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the…
Abstract
Purpose
During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.
Design/methodology/approach
We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.
Findings
We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.
Originality/value
The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.
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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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Nuala F. Ryan, Michelle Hammond and Sarah MacCurtain
The purpose of the study is an in-depth exploration of the processes through which a leader develops their leader identity in strength, meaning and integration, with resulting…
Abstract
Purpose
The purpose of the study is an in-depth exploration of the processes through which a leader develops their leader identity in strength, meaning and integration, with resulting enrichment outcomes.
Design/methodology/approach
Using multi-domain leader identity theory, this study provides an in-depth exploration of the processes through which a leader develops their leader identity. Set in a healthcare context, 26 participants took part in an 18-month multi-domain leadership development program.
Findings
Findings indicate a typology of leader identities, capturing the dynamic nature of leader identity based on combinations of strength and meaning. Our research also suggests that as the leader develops, their leader identity can change from a differentiated identity as a leader to a more integrated leader identity, with resulting enrichment outcomes.
Research limitations/implications
The results suggested value in inherently multi-domain focus using event-based reflection and, as such, are useful in leader identity development programs. We recommend future research generalize to other settings and a larger population.
Practical implications
By taking a multi-domain approach to leader identity development, the leader has the opportunity to learn and develop in a more holistic way. They are encouraged to reflect on and learn from leadership experiences throughout their entire lives, adding breadth and depth that are often overlooked in development programs.
Social implications
Developing leaders who understand who they are and are capable of critical self-reflection and learning is a fundamental requirement for the positive advancement of society.
Originality/value
The value of the study lies in the first longitudinal, work-based empirical study taking an explicitly multi-domain approach to leader identity development.
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Bonnie Poksinska and Malin Wiger
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…
Abstract
Purpose
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.
Design/methodology/approach
The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).
Findings
The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.
Practical implications
The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.
Originality/value
The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.
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Abstract
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Yee-man Tsui and Ben Y.F. Fong
The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial…
Abstract
Purpose
The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.
Design/methodology/approach
The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.
Findings
The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.
Originality/value
The over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals.
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