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Open Access
Article
Publication date: 5 October 2023

Maria Vincenza Ciasullo, Alexander Douglas, Emilia Romeo and Nicola Capolupo

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are…

1144

Abstract

Purpose

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

Design/methodology/approach

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

Findings

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

Research limitations/implications

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

Practical implications

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

Originality/value

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

Details

International Journal of Quality & Reliability Management, vol. 41 no. 3
Type: Research Article
ISSN: 0265-671X

Keywords

Open Access
Article
Publication date: 13 February 2024

Veronica Ungaro, Laura Di Pietro, Roberta Guglielmetti Mugion and Maria Francesca Renzi

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting…

Abstract

Purpose

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Design/methodology/approach

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

Findings

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

Originality/value

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

Details

Journal of Service Theory and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2055-6225

Keywords

Open Access
Article
Publication date: 11 October 2022

Relinde De Koeijer, Mathilde Strating, Jaap Paauwe and Robbert Huijsman

This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and…

1584

Abstract

Purpose

This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and performance) in hospitals. As part of this research, the authors examine the interplay between “hard” and “soft” practices for LM&SS and “soft” HR practices.

Design/methodology/approach

A cross-sectional, multisite survey study covering all internal service units at all eight Dutch university hospitals was conducted (42 units, N = 218 supervisors, N = 1,668 employees), and multivariate multilevel regression analyses were performed.

Findings

A systems approach involving “soft” LM&SS practices that are specifically HR-related has a positive effect (β is 0.46) on a climate for LM&SS. A climate for LM&SS is not related to perceived performance or employee health. It is, however, positively related to employee happiness and trusting relationships (both βs are 0.33). We did not find that a climate for LM&SS had a mediating effect.

Research limitations/implications

This study shows that a balanced approach involving both “hard” and “soft” factors is crucial to achieving the desired breadth and depth of LM&SS adoption at the macro, meso, and micro levels. The authors found that a climate for LM&SS positively affects employee well-being in hospitals.

Practical implications

In their attempt to create mutual gains for both their organization and their employees, hospitals that adopt LM&SS should foster a climate for LM&SS by embracing a balanced approach consisting of both “hard” and “soft” practices, thereby internalizing LM&SS at the macro, meso, and micro levels.

Originality/value

This is one of the first studies to examine in-depth the impact of “hard” and “soft” LM&SS on both employee well-being (subdivided into different components) and performance in healthcare, as well as the role of “soft” HRM in this relationship. Linking LM&SS, HRM and outcomes to a climate for LM&SS is relatively a new approach and has led to a deeper understanding of the mechanisms underpinning the internalization of LM&SS in healthcare.

Details

The TQM Journal, vol. 36 no. 3
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 25 May 2023

Suchismita Swain, Kamalakanta Muduli, Anil Kumar and Sunil Luthra

The goal of this research is to analyse the obstacles to the implementation of mobile health (mHealth) in India and to gain an understanding of the contextual inter-relationships…

Abstract

Purpose

The goal of this research is to analyse the obstacles to the implementation of mobile health (mHealth) in India and to gain an understanding of the contextual inter-relationships that exist amongst those obstacles.

Design/methodology/approach

Potential barriers and their interrelationships in their respective contexts have been uncovered. Using MICMAC analysis, the categorization of these barriers was done based on their degree of reliance and driving power (DP). Furthermore, an interpretive structural modeling (ISM) framework for the barriers to mHealth activities in India has been proposed.

Findings

The study explores a total of 15 factors that reduce the efficiency of mHealth adoption in India. The findings of the Matrix Cross-Reference Multiplication Applied to a Classification (MICMAC) investigation show that the economic situation of the government, concerns regarding the safety of intellectual technologies and privacy issues are the primary obstacles because of the significant driving power they have in mHealth applications.

Practical implications

Promoters of mHealth practices may be able to make better plans if they understand the social barriers and how they affect each other; this leads to easier adoption of these practices. The findings of this study might be helpful for governments of developing nations to produce standards relating to the deployment of mHealth; this will increase the efficiency with which it is adopted.

Originality/value

At this time, there is no comprehensive analysis of the factors that influence the adoption of mobile health care with social cognitive theory in developing nations like India. In addition, there is a lack of research in investigating how each of these elements affects the success of mHealth activities and how the others interact with them. Because developed nations learnt the value of mHealth practices during the recent pandemic, this study, by investigating the obstacles to the adoption of mHealth and their inter-relationships, makes an important addition to both theory and practice.

Details

International Journal of Industrial Engineering and Operations Management, vol. 6 no. 2
Type: Research Article
ISSN: 2690-6090

Keywords

Open Access
Article
Publication date: 17 April 2024

Daan Kabel, Jason Martin and Mattias Elg

The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it…

Abstract

Purpose

The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it requires a dynamic and flexible implementation strategy. The implementation of industry 4.0 often involves overcoming several tensions between internal and external stakeholders. This paper aims to explore the paradoxical tensions that arise for health-care organizations when integrating industry 4.0. Moreover, it discusses how a paradox lens can support the conceptualization and proposes techniques for handling tensions during the integration of industry 4.0.

Design/methodology/approach

This qualitative and in-depth study draws upon 32 semi-structured interviews. The empirical case concerns how two health-care organizations handle paradoxical tensions during the integration of industry 4.0.

Findings

The exploration resulted in six recurring technology tensions: technology invention (modularized design vs. flexible design), technology collaboration (automation vs. human augmentation), technology-driven patient experience (control vs. autonomy), technology uncertainty (short-term experimentation vs. long-term planning), technology invention and diffusion through collaborative efforts among stakeholders (selective vs. intensive collaboration) and technological innovation (market maintenance vs. disruption).

Originality/value

A paradox theory-informed conceptual model is proposed for how to handle tensions during the integration of industry 4.0. To the best of the authors’ knowledge, this is the first paper to introduce paradox theory for quality management, including lean and Six Sigma.

Details

International Journal of Lean Six Sigma, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2040-4166

Keywords

Open Access
Article
Publication date: 24 January 2024

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.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 21 August 2023

Joseph Odhiambo Onyango

This study aims to document students’ supply chain solutions developed through the internship hackathon program. The study profiled innovative solutions developed by university…

1200

Abstract

Purpose

This study aims to document students’ supply chain solutions developed through the internship hackathon program. The study profiled innovative solutions developed by university students in Kenya to solve health supply chain logistics challenges during and beyond COVID-19. This is done by exploring students’ experience in developing sustainable logistics and supply chain management capacity-building programs in a low-middle-income country (LMIC).

Design/methodology/approach

This study used a qualitative approach to explore the experiences and perceptions of students and mentors who participated in a hackathon program. The study followed a cross-sectional descriptive survey design, collecting data from the participants through online questionnaires. The data were analyzed and presented using thematic analysis and narrative techniques.

Findings

Findings provide preliminary evidence for narrowing the gap between theory and practice through a hackathon internship blended with a mentorship program. Assessment of this program provides evidence for developing solutions toward ensuring the availability of essential medicine in LMICs during a pandemic such as COVID-19 by students. The profiled solutions demonstrate a broader perspective of innovative solutions of university students, mentors and potential opportunities for a triple helix approach to innovation for health supply chain system strengthening.

Research limitations/implications

This original study provides evidence for advancing contribution to developing innovative solutions through partnerships between investors, universities and industry practitioners interested in mentoring students in the health-care supply chain during COVID-19 in LMICs. Specifically, contingency factors that affect the implementation of innovative programs during and beyond global pandemics such as COVID-19 by students’ innovators are identified, and implications for policy action are discussed based on the praxis of sensemaking.

Practical implications

This study examines a novel approach that combines internship, mentorship and hackathon projects for logistics and supply chain students in LMICs. The approach aims to bridge the gap between theory and practice and to create innovative solutions for essential medicines during and after COVID-19. The study urges more resources for supporting such programs, as they benefit both academia and industry. The study also argues that hackathon internship programs can help the logistics and supply chain industry adapt to the post-pandemic era. The study offers insights for investors, universities and practitioners in the health-care industry.

Originality/value

This study shows how to develop innovative solutions for the health-care supply chain during COVID-19 in an LMIC through partnerships between investors, universities and industry practitioners who mentor students. The study identifies the contingency factors that influence the success of such programs during and beyond global pandemics such as COVID-19 and discusses the policy implications based on the sensemaking praxis of the student innovators.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 14 no. 1
Type: Research Article
ISSN: 2042-6747

Keywords

Open Access
Article
Publication date: 14 September 2022

Petra Pekkanen and Timo Pirttilä

The aim of this study is to empirically explore and analyze the concrete tasks of output measurement and the inherent challenges related to these tasks in a traditional and…

Abstract

Purpose

The aim of this study is to empirically explore and analyze the concrete tasks of output measurement and the inherent challenges related to these tasks in a traditional and autonomous professional public work setting – the judicial system.

Design/methodology/approach

The analysis of the tasks is based on a categorization of general performance measurement motives (control-motivate-learn) and main stakeholder levels (society-organization-professionals). The analysis is exploratory and conducted as an empirical content analysis on materials and reports produced in two performance improvement projects conducted in European justice organizations.

Findings

The identified main tasks in the different categories are related to managing resources, controlling performance deviations, and encouraging improvement and development of performance. Based on the results, key improvement areas connected to output measurement in professional public organizations are connected to the improvement of objectivity and fairness in budgeting and work allocation practices, improvement of output measures' versatility and informativeness to highlight motivational and learning purposes, improvement of professional self-management in setting output targets and producing outputs, as well as improvement of organizational learning from the output measurement.

Practical implications

The paper presents empirically founded practical examples of challenges and improvement opportunities related to the tasks of output measurement in professional public organization.

Originality/value

This paper fulfils an identified need to study how general performance management motives realize as concrete tasks of output measurement in justice organizations.

Details

International Journal of Productivity and Performance Management, vol. 73 no. 11
Type: Research Article
ISSN: 1741-0401

Keywords

Open Access
Article
Publication date: 5 April 2024

Aku Valtakoski and Besma Glaa

The study aims to promote the use of qualitative methods in service research by investigating how these methods are reported in service journals, how the level of reporting has…

Abstract

Purpose

The study aims to promote the use of qualitative methods in service research by investigating how these methods are reported in service journals, how the level of reporting has evolved and whether methodological reporting influences the downloads or citations received by qualitative articles.

Design/methodology/approach

Methodological reporting practices were identified through content analysis of 318 qualitative articles published in three major service research journals and comparison with prior methodological literature. Regression analysis was used to test how the level of methodological reporting influences article downloads and citations.

Findings

The study identifies 29 reporting practices related to 9 key methodological reporting areas. The overall level of methodological reporting in published qualitative articles has increased over time. While differences in the level of reporting between service journals persist, they are narrowing. The level of methodological reporting did not influence downloads or citations of qualitative articles.

Research limitations/implications

Service scholars using qualitative methods should pay attention to methodological reporting as it can improve the chances of being published. Factors such as theoretical contributions are likely to have a greater influence on article impact than methodological reporting.

Originality/value

No prior study has explored methodological reporting practices across different qualitative methodologies or how reporting influences article impact. For authors, reviewers and editors, the study provides an inventory of reporting practices relevant for evaluating qualitative articles, which should lower barriers for qualitative methods in service research by providing practical guidelines on what to focus on when reporting and assessing qualitative research.

Details

Journal of Service Management, vol. 35 no. 6
Type: Research Article
ISSN: 1757-5818

Keywords

Open Access
Article
Publication date: 30 April 2024

Sujeet Jaydeokar, Mahesh Odiyoor, Faye Bohen, Trixie Motterhead and Daniel James Acton

People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This…

Abstract

Purpose

People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This paper aims to detail the process of developing a risk stratification tool to identify those individuals who are higher risk of premature mortality.

Design/methodology/approach

This study used population health management principles to conceptualise a risk stratification tool for avoidable deaths in people with intellectual disability. A review of the literature examined the existing evidence of causes of death in people with intellectual disability. A qualitative methodology using focused groups of specialist clinicians was used to understand the factors that contributed towards avoidable deaths in people with intellectual disability. Delphi groups were used for consensus on the variables for inclusion in the risk stratification tool (Decision Support Tool for Physical Health).

Findings

A pilot of the Decision Support Tool for Physical Health within specialist intellectual disability service demonstrated effective utility and acceptability in clinical practice. The tool has also demonstrated good face and construct validity. A further study is currently being completed to examine concurrent and predictive validity of the tool.

Originality/value

To the best of the authors’ knowledge, this is the only study that has used a systematic approach to designing a risk stratification tool for identifying premature mortality in people with intellectual disability. The Decision Support Tool for Physical Health in clinical practice aims to guide clinical responses and prioritise those identified as at higher risk of avoidable deaths.

Details

Advances in Mental Health and Intellectual Disabilities, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2044-1282

Keywords

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