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Book part
Publication date: 7 February 2024

Clair Reynolds Kueny, Alex Price and Casey Canfield

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…

Abstract

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

Details

Research and Theory to Foster Change in the Face of Grand Health Care Challenges
Type: Book
ISBN: 978-1-83797-655-3

Keywords

Article
Publication date: 23 August 2022

Jean C. Essila

This study aims to identify empirically proven strategies for reducing healthcare supply chain inventory costs.

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Abstract

Purpose

This study aims to identify empirically proven strategies for reducing healthcare supply chain inventory costs.

Design/methodology/approach

The author conducted in-depth interviews in 80 hospitals covering different supply chains. The author treated the healthcare firm as the unit of analysis and examined Vrat's taxonomy of inventory models based on the static and dynamic complexity theories of inventory models to identify an appropriate approach. The author addressed 33 highly priced and moderately priced stock-keeping units from 1,432 items and test several inventory policies. Next, the author applied combinations of inventory models, testing probabilistic hybrid inventory models.

Findings

The study finds that medical supplies, equipment, and medications are indispensable for a quality healthcare system. Hence, healthcare supply chain management (SCM) professionals must adopt basic inventory cost-reduction strategies, implementing inventory software functionalities effectively and efficiently. This study shows that probabilistic hybrid inventory techniques in healthcare SCM effectively determine an optimal stocking level, significantly reducing costs.

Research limitations/implications

This study analyzes data from primary care and (to some extent) secondary care institutions. Although tertiary and quaternary care systems do not represent a large portion of the healthcare system, future research should also address these highly specialized organizations' needs.

Practical implications

This study proposes practical strategies to help continuously improve supply chain operations in healthcare organizations worldwide.

Originality/value

This study suggests probabilistic hybrid inventory models as empirically proven solutions for evaluating stock-keeping units in the healthcare sector. In doing so, the study provides a new healthcare supply chain approach, proposing a modified taxonomy of inventory models.

Details

Benchmarking: An International Journal, vol. 30 no. 8
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 26 February 2024

Mohit Datt, Ajay Gupta, Sushendra Kumar Misra and Mahesh Gupta

The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a…

Abstract

Purpose

The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a comprehensive conceptual model for practitioners and researchers.

Design/methodology/approach

This research employs a comprehensive review of available literature by using multiple keywords on different electronic repositories using the recommendations of the PRISMA approach for the selection of articles. A critical analysis of available studies helped in compiling a list of core service quality dimensions in healthcare services.

Findings

This paper presents a comprehensive account of different dimensions and their measurement items used by various researchers to assess service quality in healthcare systems. Most of the researchers have used SERVQUAL model either in its original or modified form while the others have proposed and used totally different dimensions to assess the service quality in healthcare. Many dimensions are just an existing dimension of SERVQUAL that has undergone a name change while others are completely new. The dimensions used by many researchers have items drawn from more than one dimension of SERVQUAL model. The availability of so many dimensions and models adds to the confusion that researchers and practicing managers experience when determining the appropriate model to be used in their work. To mitigate this confusion, there is a need to develop a comprehensive model; the current work is an attempt to meet this need. Through our analysis, we identify four major service quality dimensions: clinical quality, infrastructural quality, relationship and managerial quality and propose a model named CIRMQUAL.

Originality/value

After exploring all available models in the domain of healthcare, this research presents the best possible areas to enhance the quality of healthcare services. It also enhances the research insights for academicians and working professionals by developing and proposing a comprehensive model for measuring healthcare service quality. The proposed model covers almost all of the service quality dimensions used by other researchers and will make the choice of dimensions/model easy for the future researchers/practitioners interested in measuring and improving the quality of services offered by their healthcare units. Such a comprehensive model has not been developed by any researcher thus far.

Details

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

Keywords

Article
Publication date: 9 May 2024

Claudio Rocco, Gianvito Mitrano, Angelo Corallo, Pierpaolo Pontrandolfo and Davide Guerri

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes…

Abstract

Purpose

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

Design/methodology/approach

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

Findings

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

Originality/value

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

Details

Business Process Management Journal, vol. 30 no. 3
Type: Research Article
ISSN: 1463-7154

Keywords

Book part
Publication date: 7 February 2024

Anne M. Hewitt

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…

Abstract

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

Article
Publication date: 27 June 2024

Anke Aarninkhof-Kamphuis, Hans Voordijk and Geert Dewulf

The main objective of this study was to design a dynamic adaptive decision support model for healthcare organizations facing deep uncertainties by considering promising dynamic…

Abstract

Purpose

The main objective of this study was to design a dynamic adaptive decision support model for healthcare organizations facing deep uncertainties by considering promising dynamic adaptive approaches. The main argument for this is that healthcare organizations have to make strategic decisions under deep uncertainty, but lack an approach to deal with this.

Design/methodology/approach

A Dynamic Adaptive Decision Support model (DADS) is designed using the Design Science Research methodology. The evaluation of an initial model leads, through two case studies on ongoing and strategic decision-making, to the final design of this needed model for healthcare organizations.

Findings

The research reveals the relevance of the designed dynamic and adaptive tool to support strategic decision-making for healthcare organizations. The final design of DADS innovates Decision Making under Deep Uncertainty (DMDU) approaches in an organizational context for ongoing and strategic decision-making.

Originality/value

The designed model applies the Dynamic Adaptive Policy Pathways approach in an organizational context and more specifically in health care organizations. It further integrates Corporate Real Estate Management knowledge and experience to develop a most needed tool for decision-makers in healthcare. This is the first DADS designed for an organization facing deep uncertainties in a rapidly changing healthcare environment and dealing with ongoing and strategic decision-making.

Details

Journal of Health Organization and Management, vol. 38 no. 5
Type: Research Article
ISSN: 1477-7266

Keywords

Abstract

Details

World Healthcare Cooperatives: Challenges and Opportunities
Type: Book
ISBN: 978-1-80455-775-4

Article
Publication date: 27 March 2024

Sunil Kumar Yadav, Shiwangi Singh and Santosh Kumar Prusty

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within…

Abstract

Purpose

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within the healthcare sector and investigates their evolution in emerging economies (EEs) and developed economies (DEs). This study aims to uncover these two contexts' shared characteristics and unique variances through a comparative analysis.

Design/methodology/approach

The paper systematically investigates and consolidates the literature on healthcare by employing the antecedents, decisions and outcomes (ADO) framework and finally examines 71 shortlisted articles published between 2003 and 2022.

Findings

The recognition of the BM within healthcare is increasing, both in EEs and DEs. EEs prioritize value creation and capture through cost efficiency, while DEs focus on innovation. Key theories employed include a resource-based view, the network theory and the theory of innovation. Case studies are commonly used as a methodology. Further research is needed to explore the decisions and outcomes of BMs.

Research limitations/implications

The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Practical implications

Beyond comparing and highlighting gaps in BMs between EEs and DEs, benchmarking DE's healthcare business models (HBMs) helps healthcare organizations in EEs align their practices, mitigate risks and establish efficient healthcare systems tailored to their specific contexts. The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Originality/value

The study analyzes HBMs using an SLR framework perspective and provides practical implications for academicians and practitioners to enhance their decision-making.

Details

Benchmarking: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 25 September 2023

Anchal Patil, Vipulesh Shardeo, Jitender Madaan, Ashish Dwivedi and Sanjoy Kumar Paul

This study aims to evaluate the dynamics between healthcare resource capacity expansion and disease spread. Further, the study estimates the resources required to respond to a…

Abstract

Purpose

This study aims to evaluate the dynamics between healthcare resource capacity expansion and disease spread. Further, the study estimates the resources required to respond to a pandemic appropriately.

Design/methodology/approach

This study adopts a system dynamics simulation and scenario analysis to experiment with the modification of the susceptible exposed infected and recovered (SEIR) model. The experiments evaluate diagnostic capacity expansion to identify suitable expansion plans and timelines. Afterwards, two popularly used forecasting tools, artificial neural network (ANN) and auto-regressive integrated moving average (ARIMA), are used to estimate the requirement of beds for a period when infection data became available.

Findings

The results from the study reflect that aggressive testing with isolation and integration of quarantine can be effective strategies to prevent disease outbreaks. The findings demonstrate that decision-makers must rapidly expand the diagnostic capacity during the first two weeks of the outbreak to support aggressive testing and isolation. Further, results confirm a healthcare resource deficit of at least two months for Delhi in the absence of these strategies. Also, the study findings highlight the importance of capacity expansion timelines by simulating a range of contact rates and disease infectivity in the early phase of the outbreak when various parameters are unknown. Further, it has been reflected that forecasting tools can effectively estimate healthcare resource requirements when pandemic data is available.

Practical implications

The models developed in the present study can be utilised by policymakers to suitably design the response plan. The decisions regarding how much diagnostics capacity is needed and when to expand capacity to minimise infection spread have been demonstrated for Delhi city. Also, the study proposed a decision support system (DSS) to assist the decision-maker in short- and long-term planning during the disease outbreak.

Originality/value

The study estimated the resources required for adopting an aggressive testing strategy. Several experiments were performed to successfully validate the robustness of the simulation model. The modification of SEIR model with diagnostic capacity increment, quarantine and testing block has been attempted to provide a distinct perspective on the testing strategy. The prevention of outbreaks has been addressed systematically.

Details

International Journal of Physical Distribution & Logistics Management, vol. 53 no. 10
Type: Research Article
ISSN: 0960-0035

Keywords

Article
Publication date: 17 June 2024

Sonica Rautela, Nehajoan Panackal and Adya Sharma

India has been on the pathway of improvement concerning healthcare and health outcomes of its population. However, India must overcome its unique challenges and cover a long…

Abstract

Purpose

India has been on the pathway of improvement concerning healthcare and health outcomes of its population. However, India must overcome its unique challenges and cover a long journey ahead. This mandates a need for a high-quality, contemporary and community-based health system that promises consistent and quality healthcare, is trusted and valued by all its citizens, considers the changing population needs and should be affordable and accessible.

Design/methodology/approach

The study examines various dimensions and elements associated with the integrated healthcare system in India and uses input, process and output structural measures.

Findings

The present paper proposes an integrated, comprehensive healthcare system in India that endorses participation from diverse stakeholders such as the government, organizations, the community and individuals who can contribute uniquely. It also focuses on defined and measurable output that can make health a topic of social movement or “Jan Andolan” and create a sustainable and integrated care system.

Originality/value

The study is unique as it focuses on the role of stakeholders in health care. The research emphasized the involvement of the government, community, people and organizations in developing an integrated healthcare ecosystem that includes modern technology, skilled employees, enough finance, governance, efficient delivery platforms and top-tier infrastructure. The model’s output is focused on healthcare that is inexpensive, accessible, available, accountable and user-centered. This would gradually improve everyone’s health and well-being.

Details

Journal of Integrated Care, vol. 32 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

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