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1 – 10 of over 35000Bhavana Mathur, Sumit Gupta, Makhan Lal Meena and G.S. Dangayach
The purpose of this paper is to examine the causal linkages among supply chain practices, effectiveness of supply chain performance (SCP) and organizational performance (OP) in…
Abstract
Purpose
The purpose of this paper is to examine the causal linkages among supply chain practices, effectiveness of supply chain performance (SCP) and organizational performance (OP) in Indian healthcare industries.
Design/methodology/approach
This paper is helpful in developing a framework for linking a healthcare supply chain practice to its OP, and thus identifies how such a linkage can be connected to the effectiveness of SCP. Such effort also enables the authors to derive a set of recommended supply chain practices for SC performance.
Findings
From the literature review, this paper finds that, in the context of Indian healthcare industries, efficient SC performance may play a critical role for overall OP improvement, as there is a close interrelationship between supply chain management (SCM) practices and SCP that may have a more significant effect on OP improvement.
Research limitations/implications
The principle limitation of the paper is that it is performed only in a particular industry and with a questionnaire survey which could be extended in future for other industries also. Another limitation of the paper is that it is focused only on the SCP of medical device and equipment supply chain which is a small portion of the whole healthcare supply chain, and therefore requires further research covering various other domains of healthcare supply chain. Another limitation of the study is that the sample survey has been taken from only one respondent per company at one point of time which may create biasness in the results. Thus, future research should collect data through multiple members from the organization.
Practical implications
This study contributes to know the effect of SCM practices on healthcare SCP and provides a practical and useful tool to evaluate the extent of effectiveness of SCP and finally their impact on the healthcare OP. Finally, this study provides conceptual and descriptive literature regarding SCM practices that leads to improvement in healthcare performance.
Social implications
This study adds to the knowledge on healthcare SCM performance by exploring the relationship between supply chain practices, healthcare SCP and healthcare OP and by developing and testing a research framework thus help in improving patient satisfaction.
Originality/value
This study attempts to show how the potential benefits of supply chain practices can no longer be ignored in healthcare supply chain.
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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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Pauline Hwang, David Hwang and Paul Hong
Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other…
Abstract
Purpose
Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations.
Design/methodology/approach
The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital.
Findings
Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals.
Practical implications
An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices.
Social implications
Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific organisations and inter-organisational networks.
Originality/value
Healthcare managers are adopting business practices that improve efficiency and productivity while ensuring their healthcare mission and guaranteeing that customer values are achieved. Shared understanding about complex goals (e.g. reducing waste and enhancing customer value) at the front-end is crucial for implementing successful lean practices. In particular, this study shows that nursing practices, which are both labour intensive and technology enabled, are good candidates for lean practice.
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Ashish Malik, Brendan Boyle and Rebecca Mitchell
The purpose of this paper is to examine innovation in the resource-constrained context of India’s healthcare industry. It is argued that the process of innovation in addressing…
Abstract
Purpose
The purpose of this paper is to examine innovation in the resource-constrained context of India’s healthcare industry. It is argued that the process of innovation in addressing healthcare management challenges in such a context occurs through organisational ambidexterity and that human resource management (HRM) plays an important role.
Design/methodology/approach
A qualitative research methodology is applied to explore the role of HR practices in facilitating contextual ambidexterity and subsequent innovations in healthcare in India. The unit of analysis is the “case” of healthcare providers in India and in-depth interview and documentary data in two case sites are analysed to reveal the role of HRM in facilitating contextual ambidexterity and innovation. Data analysis was undertaken first at a within-case and then at a cross-case analysis level using interpretive manual coding based on how the data explained the role of HRM in delivering innovative outcomes and supporting organisational ambidexterity.
Findings
The authors found evidence of the use of sets of high-involvement HRM practices for exploration of new ideas and efficiency-driven HRM practices for creating contextual ambidexterity in the case organisations. Further, managerial/leadership style was found to play an important role in creating cultures of trust, openness, risk-taking and employee empowerment, supported by an appropriate mix of intrinsic and extrinsic rewards. Finally, training was also reported as being central to creating an ambidextrous context for delivering on various innovations in these healthcare providers.
Originality/value
This study represents an exploration of innovation in the context of India’s healthcare sector through intersecting literatures of ambidexterity, innovation and HRM practices. In light of the emerging economy research context, an important empirical contribution is palpable. Moreover, through a study design which included collecting data from multiple informants on the role of human resources in facilitating innovative outcomes, the authors reveal the role of HR-related initiatives, beyond formal HR practices in creating contextual ambidexterity. This study also reveals the degree to which contextual idiosyncrasies enhance our understanding of the role of HR in facilitating innovation in emerging economies.
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Iris Wallenburg, Anne Essén and Roland Bal
Performance metrics have become widely used and much lamented – about tools for measuring healthcare quality. In this paper, the authors reflect on the development and use of…
Abstract
Performance metrics have become widely used and much lamented – about tools for measuring healthcare quality. In this paper, the authors reflect on the development and use of performance metrics in healthcare regulation and clinical practice. Studying multi-actor settings of performance measurement systems in healthcare in Sweden and the Netherlands, the authors show how regulatory agencies (i.e., the inspectorate and national registries), patients, hospitals, and practitioners engage in the constitution of healthcare practices through developing performance indicators that form the input for ranking, ensuing intensive dialogues on what should be measured and accounted for, and to what effects. The authors analyze this process as caring for numbers. The authors discern two practices of caring for numbers: validating and contexting. Validating refers to the practices of making numbers reflect those practices they intend to depict; contexting is about how with the use of numbers specific contexts of healthcare are built. These processes together emphasize the performative character of numbers as well as the reflexive uses of performativity. The paper shows how collaborative and rather pragmatic practices of caring for numbers co-construct specific practices of healthcare. Though this reflexive entanglement of production and use of numbers actors not only constitute specific performance metrics and ranking practices but also perform healthcare.
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Ann Svensson, Linn Gustavsson, Irene Svenningsson, Christina Karlsson and Tina Karlsson
This paper presents findings from a qualitative study of healthcare professionals’ practice, where learning is taking place when a digital artefact is implemented for…
Abstract
Purpose
This paper presents findings from a qualitative study of healthcare professionals’ practice, where learning is taking place when a digital artefact is implemented for identification of patients’ cognitive impairment. The use of digital artefacts is increasing in various workplaces, to include professionals in healthcare. This paper aims to explore the following research question: How is the professional learning unfolding in patient-based work when a digital artefact transforms the practice?
Design/methodology/approach
Various data collection methods are used for this study, consisting of dialogue meetings, interviews and a reference-group meeting. Thematic analysis is used to inductively bring forth the themes of the collected data.
Findings
Professionals’ knowledge and experience are of vital importance in learning and changing work practices. Together with their ability to reflect on changes, their knowledge and experience constitute the prefiguration when the introduction of a digital application brings about indeterminacy in the work practice.
Originality/value
This paper makes a contribution to practice-based research as it consolidates previous research and identifies professionals knowledge and learning in a healthcare context. This can be used to further explore and advance the field, as well as to establish the evidence-based importance of transforming practices based on implementation of digital artefacts.
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Tharushi Sandunika Ilangakoon, Samanthi Kumari Weerabahu, Premaratne Samaranayake and Ruwan Wickramarachchi
This paper proposes the adoption of Industry 4.0 (I4) technologies and lean techniques for improving operational performance in the healthcare sector.
Abstract
Purpose
This paper proposes the adoption of Industry 4.0 (I4) technologies and lean techniques for improving operational performance in the healthcare sector.
Design/methodology/approach
The research adopted a systematic literature review and feedback of healthcare professionals to identify the inefficiencies in the current healthcare system. A questionnaire was used to get feedback from the patients and the hospital staff about the current practices and issues, and the expected impact of technology on existing practices. Data were analysed using descriptive statistics, correlation analysis and multiple regression analysis.
Findings
The results indicate that I4 technologies lead to the improvement of the operational performance, and the perceptions about I4 technologies are made through the pre-medical diagnosis. However, a weak correlation between lean practices and healthcare operational performance compared to that of I4 technologies and operational performance indicate that lean practices are not fully implemented in the Sri Lankan healthcare sector to their full potential.
Research limitations/implications
This study is limited to two government hospitals, with insights from only the doctors and nurses in Sri Lanka. Furthermore, the study is limited to only selected aspects of I4 technologies (big data, cloud computing and IoT) and lean concepts (value stream mapping and 5S). Therefore, recommendations on the adoption of I4 technologies in the healthcare sector need to be made within the scope of the study investigation.
Practical implications
The implementation of I4 technologies needs careful consideration of process improvement as part of the overall plan for achieving the maximum benefits of technology adoption.
Originality/value
The findings of the research can be used as a benchmark/guide for other hospitals to explore the adoption of I4 technologies, and how process improvement from lean concepts could influence the overall operational performance.
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Mattias Elg, Klara Palmberg Broryd and Beata Kollberg
– The purpose of this study is to contribute to the knowledge base on how performance measurement drives improvements in healthcare practice.
Abstract
Purpose
The purpose of this study is to contribute to the knowledge base on how performance measurement drives improvements in healthcare practice.
Design/methodology/approach
The study is based on a single in-depth case study. The critical incident technique (CIT) has been applied in order to identify significant occurrences of performance measurement in terms of events, incidents, processes, and issues identified by respondents from the case organization. These critical incidents have been analysed and interpreted using a theoretical framework suggesting that performance measurement may be applied for exploratory or regulatory purposes as well as ad hoc or continuously in healthcare practice.
Findings
The study suggests that performance measurement may be a versatile method for driving improvement in healthcare organizations. Six types of activities directly or indirectly drive improvement in the clinical department: continuous follow-up in formal arenas and meetings; improvement work; professional efforts; goal deployment; reporting based on external demands; and creating awareness in everyday clinical work. Healthcare organizations that strive to practice performance measurement as a driver for improvement need to find infrastructures in which it is being integrated into the daily life of organizational healthcare practice.
Originality/value
The study provides an original account of the prerequisites and actions for driving improvement through performance measurement in a healthcare setting. Since the operations management perspective in healthcare is significantly lacking, the study offers a unique perspective which may be the basis for both practice development and further scholarly inquiry and theory development.
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Charles R. Gowen, Kathleen L. McFadden and William J. Tallon
Healthcare organizations have addressed current error issues by adopting quality programs, which usually include strategic human resource management (HRM). However, little…
Abstract
Purpose
Healthcare organizations have addressed current error issues by adopting quality programs, which usually include strategic human resource management (HRM). However, little research has focused on the determinants of successful quality programs at healthcare organizations. The purpose of this paper is to examine the centrality of strategic HRM for addressing healthcare errors, error reduction barriers, quality management processes and practices, quality program results, and competitive advantage.
Design/methodology/approach
The methodology of this study involves the analysis of questionnaire data from the quality and/or risk directors of 587 US hospitals by factor analysis and regression analysis.
Findings
The findings focus on highly statistically significant relationships of strategic HRM with antecedent healthcare error sources, error reduction barriers, and quality management processes and practices, as well as the strategic HRM consequences of perceived quality program results and sustainable competitive advantage.
Research limitations/implications
The limitations of perceptual data and common method variance are checked. Future research could investigate international effects.
Practical implications
The practical implications are that hospital errors can be successfully addressed with effective strategic HRM, quality management processes, and quality management practices.
Originality/value
The original contribution of this paper is the centrality of strategic HRM as a determinant of successful quality programs at healthcare organizations.
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