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21 – 30 of over 35000Nanna Ahlmark, Susan Reynolds Whyte, Tine Curtis and Tine Tjørnhøj-Thomsen
The purpose of this study is to explore how healthcare professionals in Denmark perceived and enacted their role as diabetes trainers for Arabic-speaking immigrants in three new…
Abstract
Purpose
The purpose of this study is to explore how healthcare professionals in Denmark perceived and enacted their role as diabetes trainers for Arabic-speaking immigrants in three new local authority settings. The paper used positioning theory, which is a dynamic alternative to the more static concept of role in that it seeks to capture the variable, situationally specific, multiple and shifting character of social interaction, as the analytical tool to examine how people situationally produce and explain behaviour of themselves and others.
Design/methodology/approach
The paper generated data through observation of diabetes training and of introductory interviews with training participants in three local authority healthcare centres over a total of five months. The authors conducted 12 individual interviews and two group interviews with healthcare professionals.
Findings
Healthcare professionals shifted between three positionings – caregiver, educator and expert. The caregiver was dominant in professionals’ ideals but less in their practice. Healthcare professionals other-positioned participants correspondingly as: vulnerable, difficult students and chronically ill. The two first other-positionings drew on dominant images of an ethnic other as different and problematic.
Practical implications
Becoming more reflexive and explicit about one's positionings offer the potential for a more conscious, confident, flexible and open-ended teaching practice. Such reflexivity may also reduce the perception that teaching challenges are rooted in participants’ ethnic background.
Originality/value
The paper provides a new understanding of healthcare practice by showing professionals’ multiple and reciprocal positionings and the potential and risks in this regard. The paper demonstrates the need for healthcare workers to reflect on their positionings not only in relation to immigrants, but to all patients.
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Shelley Maeva Farrington and Riyaadh Lillah
The purpose of this study is to investigate the influence of servant leadership on job satisfaction within private healthcare practices.
Abstract
Purpose
The purpose of this study is to investigate the influence of servant leadership on job satisfaction within private healthcare practices.
Design/methodology/approach
Criterion sampling has been used to draw a sample of private healthcare practitioners and their employees. The data collected from 241 useable questionnaires have been statistically analysed. Factor analysis and Cronbach’s alpha coefficients have been used to assess the validity and reliability of the measuring instrument, and multiple regression analyses have been performed to test the influence of the dimensions of servant leadership on job satisfaction.
Findings
The findings show that private healthcare practitioners display the dimensions of servant leadership investigated in this study. Furthermore, a significant positive relationship between developing others and job satisfaction for both sample groups, but only between caring for others and job satisfaction for the employee sample group, was reported. Acts of humility and servanthood by practitioners were not found to influence job satisfaction.
Practical implications
Educators can use the findings of this study to identify gaps in the leadership training of healthcare practitioners, and healthcare regulators can use the recommendations provided to implement appropriate interventions to ensure that healthcare practitioners fulfil their mandate of practising in an appropriate manner.
Originality/value
This study contributes to the limited understanding of servant leadership among private healthcare practitioners and it provides recommendations on how private healthcare practitioners can improve their servant leadership behaviour.
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Mohamad Alnajem, Jose Arturo Garza-Reyes and Jiju Antony
The purpose of this paper is to develop a framework to assess the lean readiness within emergency departments (EDs) and identify the key quality practices deemed essential for…
Abstract
Purpose
The purpose of this paper is to develop a framework to assess the lean readiness within emergency departments (EDs) and identify the key quality practices deemed essential for lean system (LS) implementation.
Design/methodology/approach
An extensive review of the lean healthcare literature was conducted, including LS implementation within the healthcare sector (both generally and in EDs), best ED quality practices, essential factors for LS implementation within healthcare and lean readiness assessment frameworks. The authors identified six main categories from a literature review (top management and leadership, human resources, patient relations, supplier relations, processes and continuous improvement (CI)), and validated these based on experts’ opinion.
Findings
Several factors were identified as crucial for EDs, including top management and leadership, human resources, patient relations, supplier relations, processes and CI.
Research limitations/implications
The framework has not yet been tested, which prevents the author from declaring it fit for EDs.
Practical implications
This framework will help ED managers determine the factors that will enable/hinder the implementation of LSs within their premises.
Originality/value
To the author’s knowledge, this is the first lean readiness assessment framework for EDs and one of the few lean readiness assessment frameworks in the literature.
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Peter F. Martelli, Peter E. Rivard and Karlene H. Roberts
Given the pace of industry change and the rapid diffusion of high reliability organization (HRO) approaches, lags and divergences have arisen between research and practice in…
Abstract
Purpose
Given the pace of industry change and the rapid diffusion of high reliability organization (HRO) approaches, lags and divergences have arisen between research and practice in healthcare. The purpose of this paper is to explore several of these theory-practice gaps and propose implications for research and practice.
Design/methodology/approach
Classic and cutting-edge HRO literature is applied to analyze two industry trends: delivery system integration, and the confluence of patient-as-consumer and patient-centered care.
Findings
Highly reliable integrated delivery systems will likely function very differently from classic HRO organizations. Both practitioners and researchers should address conditions such as how a system is bounded, how reliable the system should be and how interdependencies are handled. Additionally, systems should evaluate the added uncertainty and variability introduced by enhanced agency on the part of patients/families in decision making and in processes of care.
Research limitations/implications
Dramatic changes in the sociotechnical environment are influencing the coupling and interactivity of system elements in healthcare. Researchers must address the maintenance of reliability across organizations and the migration of decision-making power toward patients and families.
Practical implications
As healthcare systems integrate, managers attempting to apply HRO principles must recognize how these systems present new and different reliability-related challenges and opportunities.
Originality/value
This paper provides a starting point for the advancement of research and practice in high-reliability healthcare by providing an in-depth exploration of the implications of two major industry trends.
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Jennifer D. Chandler and Steven Chen
The purpose of this paper is to examine how practices influence service systems.
Abstract
Purpose
The purpose of this paper is to examine how practices influence service systems.
Design/methodology/approach
Data across three service contexts (crafts, healthcare and fitness) were collected through depth interviews and netnographic analysis, and analyzed with a two-study multi-method approach focusing first on the micro- (individual) level and then on the macro- (network) level of service systems. Study 1 focused on a micro-level analysis using qualitative techniques (Spiggle, 1994). Study 2 focused on a macro-level analysis using partial least squares regression.
Findings
The results illustrate how practices can change service systems. This occurs when a nuanced practice (i.e. a practice style) orders and roots a service system in a specific form of value creation. The findings reveal four practice styles: individual-extant, social-extant, individual-modified and social-modified practice styles. These practice styles shift in response to event triggers and change service systems. These event triggers are: service beneficiary enhancement, service beneficiary failure, service provider failure and social change. Thus, the findings show that practices – when shifting in response to event triggers – change service systems. This transpires in the understudied meta-layer of a service system.
Practical implications
The study identifies four practice styles that can serve as the basis for segmentation and service design.
Originality/value
Service systems are dynamic and ever changing. This study explores how service systems change by proposing a practice approach to service systems.
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Ann Dadich, Penny Abbott and Hassan Hosseinzadeh
Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare…
Abstract
Purpose
Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare systems, it is important to identify strategies that bolster clinician-capacity to promote evidence-based care. The purpose of this paper is to identify strategies to increase Practice Nurse capacity to promote evidence-based sexual healthcare within general practice.
Design/methodology/approach
A survey of 217 Practice Nurses in an Australian state and ten respondent-interviews regarding two resources to promote evidence-based sexual healthcare – namely, a clinical aide and online training.
Findings
The perceived impact of both resources was determined by views on relevance and design – particularly for the clinical aide. Resource-use was influenced by role and responsibilities within the workplace, accessibility, and support from patients and colleagues.
Research limitations/implications
This is the first Australian study to reveal strategies to promote evidence-based sexual healthcare among Practice Nurses. The findings provide a platform for future research on knowledge translation processes, particularly among clinicians who might be disengaged from sexual healthcare.
Practical implications
Given the benefits of evidence-based practices, it is important that managers recognize their role, and the role of their services, in promoting these. Without explicit support for evidence-based care and recognition of the Practice Nurse role in such care, knowledge translation is likely to be limited.
Originality/value
Knowledge translation among Practice Nurses can be facilitated by: resources-deemed informative, relevant, and user-friendly, as well as support from patients, colleagues, and their workplace.
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Rebecca K. Givan, Ariel Avgar and Mingwei Liu
This paper examines the relationship between human resource practices in 173 hospitals in the United Kingdom and four organizational outcome categories – clinical, financial…
Abstract
This paper examines the relationship between human resource practices in 173 hospitals in the United Kingdom and four organizational outcome categories – clinical, financial, employee attitudes and perceptions, and patient attitudes and perceptions. The overarching proposition set forth and examined in this paper is that human resource management (HRM) practices and delivery of care practices have varied effects on each of these outcomes. More specifically, the authors set forth the proposition that specific practices will have positive effects on one outcome category while simultaneously having a negative effect on other performance outcomes, broadly defined.
The paper introduces a broader stakeholder framework for assessing the HR–performance relationship in the healthcare setting. This multi-dimensional framework incorporates the effects of human resource practices on customers (patients), management, and frontline staff and can also be applied to other sectors such as manufacturing. This approach acknowledges the potential for incompatibilities between stakeholder performance objectives. In the healthcare industry specifically, our framework broadens the notion of performance.
Overall, our results provide support for the proposition that different stakeholders will be affected differently by the use of managerial practices. We believe that the findings reported in this paper highlight the importance of examining multiple stakeholder outcomes associated with managerial practices and the need to identify the inherent trade-offs associated with their adoption.
Ann-Charlotte Bivall, Maria Gustavsson and Annika Lindh Falk
Clinical placement is an important formalised student activity for linking healthcare education and healthcare practices. The purpose of this study is to investigate the…
Abstract
Purpose
Clinical placement is an important formalised student activity for linking healthcare education and healthcare practices. The purpose of this study is to investigate the organising of clinical placements by examining conditions for collaboration between higher education and healthcare organisations.
Design/methodology/approach
The study is based on interviews with central actors at a university and two healthcare organisations with official duties of organising clinical placements.
Findings
The findings indicate that collaboration in the organising of clinical placements is a complex matter of interconnected actors in different organisational positions, at both strategic and operative levels. The university and the healthcare organisations approached the clinical placement with a shared commitment.
Practical implications
The findings provide important guidance for improving collaboration in the organising of clinical placements. This may have an impact on how contextual conditions of the educational framing and daily healthcare practices are viewed and how the interdependency between the long-term strategic issues and the short-term needs of healthcare organisations is approached.
Originality/value
This research emphasises the need for careful consideration of the collaborative practices on an organisational level between higher education and healthcare organisations as different needs, motives and logics have to be considered.
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Albi Thomas and M. Suresh
Green transformation is more than simply a trend; it is a way of life, a set of habits, a field of knowledge and a dedication to resource conservation. Going green is surely a…
Abstract
Purpose
Green transformation is more than simply a trend; it is a way of life, a set of habits, a field of knowledge and a dedication to resource conservation. Going green is surely a creative and transformative process for both individuals and organizations. This paper aims to “identify,” “analyse” and “categorise” the readiness factors for green transformation process in health care using total interpretive structural modelling (TISM) and neutrosophic-MICMAC.
Design/methodology/approach
To address the study objectives, the study used TISM and neutrosophic-MICMAC analysis. To identify the readiness factors, a literature study was conducted, and the factors were face-validated by the healthcare experts. The factors influence on one another were captured by using a scheduled interview with a closed ended questionnaire. The TISM addressed the identification and analysing of factors and the categorization and ranking the readiness factors is addressed by using neutrosophic-MICMAC analysis.
Findings
This study identified 11 green transformation process readiness factors for healthcare organizations. The study states that the key factors or driving factors are awareness of green governance principle, environment leadership and management, green gap analysis, information and communication technology and innovation dynamics.
Research limitations/implications
The factor ranking is sensitive to the respondents’ ratings. The study relied on the past literature and experts’ opinion may result in the subjective biases. The complex nature of healthcare ecosystem challenges to capture all the factors. The study focussed on Indian hospitals.
Practical implications
Study significantly impacts the healthcare practitioners, academicians and policymakers by providing critical insights into the readiness factors required for the healthcare green transformation process. The study offers a better understanding of the crucial or key or driving factors that aid in embracing green and sustainable practices.
Originality/value
Identifying a gap in conceptual and theoretical frameworks for green transformation readiness factors in healthcare organizations and in Indian context. The study addresses this gap by aiming to create a thorough theoretical framework and highlighted by its focus on Indian hospitals.
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Renu Agarwal, Roy Green, Neeru Agarwal and Krithika Randhawa
The purpose of this paper is to investigate the determinants of best management practices in an Australian state-run healthcare system, namely New South Wales (NSW), and studies…
Abstract
Purpose
The purpose of this paper is to investigate the determinants of best management practices in an Australian state-run healthcare system, namely New South Wales (NSW), and studies the impact of a range of hospital factors in driving best management practices as a means of enhancing healthcare delivery.
Design/methodology/approach
This study adapts a unique survey instrument globally tested to quantify the multi-dimensional nature of hospital management practices in 42 acute care public hospitals of NSW. The authors then analysed the role of hospital-specific characteristics in driving best management practices, namely hospital size (measured by the number of hospital beds, employees and doctors), level of skill and education, degree of hospital manager autonomy and organisational hierarchy.
Findings
The findings of this study show the areas of strength and potential areas of improvement in NSW hospitals. The authors find a positive association between the adoption of better management practices and hospital size (measured by the number of hospital beds and employees), level of skills and education, degree of hospital manager autonomy and organisational hierarchy. However, hospital size as measured by the number of doctors did not have a statistically significant relationship.
Practical implications
This paper is of interest to both hospital administrators, clinical doctors and healthcare policy-makers who want to improve and develop strategies for better management in the healthcare sector.
Originality/value
This study provides an internationally comparable robust measure of management capability in public hospitals, and contributes to the evidence-base of management practices and performance in hospitals.
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