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Article
Publication date: 1 October 2002

Sandra J. Hartman and Stephen M. Crow

In this research we report an analysis of comments from managers and executives in healthcare organizations to provide insights into the strategic management needs of…

Abstract

In this research we report an analysis of comments from managers and executives in healthcare organizations to provide insights into the strategic management needs of healthcare organizations. The comments were obtained as part of a survey that asked upper‐level managers and executives to identify strategic management skill and knowledge needs in healthcare organizations. After completing the survey, the respondents were given the opportunity to comment on any topics of concern to them. A total of 67 comments, many of them extensive and insightful, were obtained. In this paper, we review the literature dealing with educational and developmental needs of healthcare managers. Much of this literature is academic in nature and permits an interesting comparison to the perspective of management and executive practitioners. Emerging from the literature was a concern for environmental turbulence and a recognition that healthcare managers are at risk of falling behind in terms of skill development under such conditions. Respondent comments suggested a recognition of the potential problems. The comments are classified into four major categories: needs and skills in turbulent conditions; program and educational needs; issue clarification; and additional comments. Moreover, the first two categories appeared to break out into a set of six additional themes, which we suggest will be important to those designing programs for executive development in healthcare during turbulent times. While the source of this research is healthcare settings in Canada and the USA, the findings should be applicable to international healthcare organizations that use strategic management concepts and practices.

Details

Journal of Management in Medicine, vol. 16 no. 5
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 7 March 2016

Anna-Aurora Kork and Jarmo Vakkuri

Poor access to healthcare and increasing demand for services represent a management dilemma how to balance between needs and costs. Scrutinising the concept of demand…

Abstract

Purpose

Poor access to healthcare and increasing demand for services represent a management dilemma how to balance between needs and costs. Scrutinising the concept of demand management and using a case study from Finnish primary care, the purpose of this paper is to examine the complexities of managing demand for health services.

Design/methodology/approach

Convenience has explained the popularity of walk-in clinics (WIC), making it an attractive demand management tool. By analysing the quantitative service utilisation data of frequent attenders at WIC, the paper exemplifies what enhanced access to care means for demand management of public welfare services.

Findings

High user rates and satisfaction indicate demand for this type of service; however, the establishment of WIC provided supplementary care for the high users of health services, most suffering chronic diseases.

Research limitations/implications

Better understanding of the structure of service demand is needed in order to develop a more coordinated service system and to manage demand for public welfare services.

Practical implications

The study demonstrates the importance of identifying service utilisation patterns in managing demand. Instead of single solutions, a wider system-level perspective is essential.

Originality/value

Managing demand and facilitating access are core primary care attributes but there is little evidence about the impact of demand management strategies. The paper ties together important healthcare management issues: how to control demand and improve the access? Moreover, few studies have examined the frequent attendance at WIC. This paper presents a practical illustration of demand management tool and indicates some demand management problems to be considered in healthcare management.

Details

International Journal of Public Sector Management, vol. 29 no. 2
Type: Research Article
ISSN: 0951-3558

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Article
Publication date: 11 May 2021

Hisahiro Ishijima, Noriyuki Miyamoto, Fares Masaule and Raynold John

The purpose of this study is to see how the 5S-KAIZEN-TQM approach can contribute to improve the management of healthcare waste (HCW) in the regional level public…

Abstract

Purpose

The purpose of this study is to see how the 5S-KAIZEN-TQM approach can contribute to improve the management of healthcare waste (HCW) in the regional level public hospitals in Tanzania.

Design/methodology/approach

This study employed an explanatory case study framework and focused on improvement of HCW management by assessing the information obtained through the direct observation and systematic interviewing during the consultation visits and external hospital performance assessment (EHPA) and the self-administrated questionnaires as sources of evidence.

Findings

Based on the observations, 100% adoption of the 5S approach was observed in 25 of 28 regional referral hospitals (RRHs). At these RRHs, segregation of HCW management has been improved by applying color codes and symbols for establishing self-explanatory system on proper segregation. In addition, seven out of 28 RRHs applied the KAIZEN process and reduced occurrences of improper waste segregation.

Research limitations/implications

This study has the following limitations in terms of the information. The data were collected through the direct observation. Moreover, areas for the implementation of the KAIZEN vary from hospital to hospital, and only 25% of RRHs completed the KAIZEN processes for improvement of HCW management. Caveats are, therefore, needed in extrapolating the study results to other settings. Despite these caveats, the findings will provide important insights for implementing the 5S-KAIZEN approach in Tanzania and other African countries for improvement of HCW management.

Originality/value

This is an original study to provide evidence about the usefulness of the 5S-KAIZEN-TQM approach for improving HCW management in a low-income country in Africa.

Details

The TQM Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1754-2731

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Article
Publication date: 30 December 2019

C.R. Vishnu, R. Sridharan, P.N. Ram Kumar and V. Regi Kumar

Risk management in the healthcare sector is a highly relevant sub-domain and a crucial research area from the humanitarian perspective. The purpose of this paper is to…

Abstract

Purpose

Risk management in the healthcare sector is a highly relevant sub-domain and a crucial research area from the humanitarian perspective. The purpose of this paper is to focus on the managerial/supply chain risk factors experienced by the government hospitals in an Indian state. The present paper analyzes the inter-relationships among the significant risk factors and ranks those risk factors based on their criticality.

Design/methodology/approach

The current research focuses on 125 public hospitals in an Indian state. Questionnaire-based survey and personal interviews were conducted in the healthcare sector among the inpatients and hospital staff to identify the significant risk factors. An integrated DEMATEL–ISM–PROMETHEE method is adopted to analyze the impact potential and dependence behavior of the risk factors.

Findings

The analysis asserts the absence of critical risk factors that have a direct impact on patient safety in the present healthcare system under investigation. However, the results illustrate the remarkable impact potential attributed to the risk factor, namely, staff shortage in inducing other risk factors such as employee attitudinal issues, employee health issues and absenteeism altogether resulting in community mistrust/misbeliefs. Maintenance mismanagement, monsoon time epidemics, physical infrastructure limitations are also found to be significant risk factors that compromise patient satisfaction levels.

Practical implications

Multiple options are illustrated to mitigate significant risk factors and operational constraints experienced by public hospitals in the state. The study warrants urgent attention from government officials to fill staff vacancies and to improve the infrastructural facilities to match with the increasing demand from the society. Furthermore, this research recommends the hospital authorities to start conducting induction and training programs for the hospital employees to instill the fundamental code of conduct while working in hectic, challenging and even in conditions with limited resources.

Originality/value

Only limited papers are visible that address the identification and mitigation of risk factors associated with hospitals. The present paper proposes a novel DEMATEL–ISM–PROMETHEE integrated approach to map the inter-relationships among the significant risk factors and to rank those risk factors based on their criticality. Furthermore, the present study discloses the unique setting of the public healthcare system in a developing nation.

Details

International Journal of Health Care Quality Assurance, vol. 33 no. 1
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 3 May 2013

Patience Aseweh Abor

– The paper aims to examine the healthcare waste management practices of selected hospitals in Ghana.

Abstract

Purpose

The paper aims to examine the healthcare waste management practices of selected hospitals in Ghana.

Design/methodology/approach

The study adopted a multiple case approach, using two public and two private hospitals.

Findings

Findings indicate that both public hospitals and one private hospital have a waste management policy. Public and private hospitals have waste management plans and waste management teams. Public hospitals were found to generate more waste than the private hospitals. One private hospital and the public hospitals segregate their waste into different categories. This is done by first identifying the waste type and then separating non-infectious or general waste from infectious waste. Both public and private hospitals have internal storage facilities for temporarily storing the waste before they are finally disposed off-site. On-site transportation in the public hospitals is done by using wheelbarrows, while covered bins with wheels are used to transport waste on-site in the private hospitals. In public and private hospitals, off-site transportation of the hospital waste is undertaken by Municipal Assemblies with the use of trucks. Both public and private hospitals employ standard methods for disposing of healthcare waste.

Originality/value

The article provides insights into healthcare waste management from a Ghanaian perspective.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 16 May 2016

Mia von Knorring, Kristina Alexanderson and Miriam A Eliasson

– The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations.

Abstract

Purpose

The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations.

Design/methodology/approach

In total, 18 of Sweden’s 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians’ sickness certification practice. A discourse analysis approach was used for data analysis.

Findings

Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes “physician” or “non-physician” to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of “yes, but […]” approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers.

Research limitations/implications

Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians.

Practical implications

The results suggest that there is a need to address the organisational conditions for managers’ role taking in healthcare organisations.

Originality/value

Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.

Details

Journal of Health Organization and Management, vol. 30 no. 3
Type: Research Article
ISSN: 1477-7266

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Book part
Publication date: 25 November 2019

Panita Surachaikulwattana and Nelson Phillips

Drawing on a case study of the adoption of an American organizational form – the “Academic Health Science Centre” (or “AHSC”) – in English healthcare, the authors develop…

Abstract

Drawing on a case study of the adoption of an American organizational form – the “Academic Health Science Centre” (or “AHSC”) – in English healthcare, the authors develop a model of the “translation work” required to translate an organizational form from one organizational field to another. The findings contribute to the literature on translation and shed light on the microfoundations of institutions by examining the complex relationship among agency, meaning, institutions, and temporality that underpin the translation of a contested organizational form. The authors also show the important, but limited, role of agency when translation occurs at the broad field level and argue that the translation of organization forms can, in at least some situations, best be understood as a “garbage can” rather than the linear and agentic view usually described in the translation literature.

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Article
Publication date: 2 August 2013

Eivor Oborn, Michael Barrett and Girts Racko

The authors draw selectively on theories of learning and knowledge, which currently have received little attention from knowledge translation (KT) researchers, and suggest…

Abstract

Purpose

The authors draw selectively on theories of learning and knowledge, which currently have received little attention from knowledge translation (KT) researchers, and suggest how they might usefully inform future development of the KT literature. The purpose of this paper is to provide conceptual tools and strategies for the growing number of managers, clinicians and decision makers navigating this arena.

Design/methodology/approach

The authors conducted a narrative review to synthesise two streams of literature and examine evolving conceptual landscape concerning knowledge translation over the previous three decades. Conceptual mapping was used iteratively to develop and synthesise the literature. Iterative feedback from relevant research and practice stakeholder groups was used to focus and strengthen the review.

Findings

KT has been conceptualised along three competing frames; one focusing on linear (largely unidirectional) transfer of knowledge; one focusing on KT as a social process; and another that seeks to more fully incorporate contextual issues in understanding research implementation. Three overlapping themes are found in the management literature that inform these debates in the health literature, namely knowledge boundaries, organisational learning and absorptive capacity. Literature on knowledge boundaries problematizes the nature of boundaries and the stickiness of knowledge. Organisational learning conceptualises the need for organisational wide systems to facilitate learning processes; it also draws on a more expansive view of knowledge. Absorptive capacity focuses at the firm level on the role of developing organisational capabilities that enable the identification, assimilation and use of new knowledge to enable innovation.

Research limitations/implications

The paper highlights the need to consider KT processes at multiple levels, including individual, organisational and strategic levels. These are important not only for research but also have practical implications for individuals and organisations involved in KT processes.

Originality/value

This review summarises and integrates two largely separate literature streams on knowledge translation – namely health services research and management scholarship. In addition to outlining and organising the conceptual landscape around knowledge transfer, the paper contributes by highlighting how management literature on knowledge and learning theories might inform health services research on knowledge translation.

Details

Journal of Health Organization and Management, vol. 27 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 4 April 2016

Muhammad Kashif, Siti Zakiah Melatu Samsi, Zainudin Awang and Mahadzirah Mohamad

The customer experience quality (EXQ) cannot be measured by using traditional tools to investigate service quality. There is a need to use new tools to directly measure…

Abstract

Purpose

The customer experience quality (EXQ) cannot be measured by using traditional tools to investigate service quality. There is a need to use new tools to directly measure EXQ from a customer perspective. The current study aims to contribute in this domain of knowledge and validate EXQ scale by linking it to marketing outcomes of satisfaction, loyalty and word of mouth in Malaysian private healthcare settings.

Design/methodology/approach

The authors collected data from 330 randomly selected Malaysians, visiting private hospitals in the city of Kuala Lumpur. The data analysis is performed by confirmatory factor analysis using structural equation modelling – SEM – procedures.

Findings

The results reveal that two dimensions of EXQ scale moments of truth and peace of mind are highly valued by customers. Furthermore, the EXQ perceptions significantly contribute to satisfaction and loyalty. In a mediating relationship, the customer satisfaction is found to be a positive and significant variable.

Practical implications

Healthcare marketing policymakers should emphasize on recruitment of frontline staff – individuals with strong interpersonal skills and expertise who are able to create a memorable customer service experience.

Originality/value

The study is an original contribution to the existing body of knowledge – generally in services marketing literature and specifically in the field of healthcare marketing with a focus on customer experience in a developing country context of Malaysia.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 10 no. 1
Type: Research Article
ISSN: 1750-6123

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Article
Publication date: 9 May 2016

Kevin J. Johnson

Change excessiveness is argued as a critical contextual aspect of change management. The purpose of this paper is to identify three major dimensions to change…

Abstract

Purpose

Change excessiveness is argued as a critical contextual aspect of change management. The purpose of this paper is to identify three major dimensions to change excessiveness: change frequency, extent, and impact. A three-factor structure is proposed to broaden the emerging study on the contextual aspects of change. Its pertinence is proposed in addressing healthcare employees’ exhaustion, change-related uncertainty, and support for change.

Design/methodology/approach

Using questionnaires, a first pilot sample (n=131) was recruited to test the psychometric properties and validity of the three-factor structure, while controlling for affectivity. Structural equation modeling techniques following a two-step approach were used on a second sample (n=363). First a confirmatory assessment of the three-factor structure of excessive change is tested. Second, a full mediation effect of excessive change, as a second-order latent factor, regrouping change frequency, impact and extent as first-order factors, was modeled to predict a tripartite conception of change-related reactions: exhaustion, uncertainty, and support for change.

Findings

The excessive change three-factor structure is validated, while showing its superiority over alternative models. The fully mediated model is confirmed. Therefore, the significant added effects of change frequency, impact, and extent are positively related to emotional exhaustion and cognitive uncertainty, while negatively related with behavioral support for change.

Originality/value

This study contributes by proposing a three-factor structure to excessive change assessment based on previous and independent findings in the literature. It also contributes in modeling the added effect of change frequency, extent, and impact in the full mediation relationship of change excessiveness on a tripartite reactions to change in healthcare management settings.

Details

Journal of Organizational Change Management, vol. 29 no. 3
Type: Research Article
ISSN: 0953-4814

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