Search results
1 – 10 of over 6000Mia 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
Keywords
Christian Gadolin and Thomas Andersson
The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work.
Abstract
Purpose
The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work.
Design/methodology/approach
Qualitative case study based on interviews (n=27) and observations (n=10).
Findings
The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute.
Practical implications
Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed.
Originality/value
Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.
Details
Keywords
Alba Barbarà-i-Molinero, Cristina Sancha and Rosalia Cascón-Pereira
The purpose of this paper is to analyse and compare the level of professional identity strength between healthcare and social sciences students.
Abstract
Purpose
The purpose of this paper is to analyse and compare the level of professional identity strength between healthcare and social sciences students.
Design/methodology/approach
Based on a sample of 339 students, the authors conduct an ANOVA analysis in order to compare students’ professional identity strength across the abovementioned groups.
Findings
The authors’ results show that there are significant differences in professional identity strength between healthcare and social sciences students. In particular, healthcare sciences students show stronger professional identity than social sciences students.
Originality/value
This study contributes to the existing literature on professional identity in higher education by being the first study comparing student’s professional identity between bachelor degrees from different professional fields of study and by showing the relevance of discipline as a contextual variable in the study of students’ professional identity.
Details
Keywords
Halcyon St Hill and Hulya Julie Yazici
The purpose of this paper is to present an integrated model of didactic, practice and interdisciplinary service learning in healthcare education, and determine the students’…
Abstract
Purpose
The purpose of this paper is to present an integrated model of didactic, practice and interdisciplinary service learning in healthcare education, and determine the students’ perceptions on the benefits of this integration.
Design/methodology/approach
A pre and post survey design was utilized to examine health professions students’ perspectives with respect to learning outcomes relevant to professional benefits of a service learning capstone. The surveys consisted of 36 items for measuring the interdisciplinary course characteristics and perceived benefits of the integrated approach. The required interdisciplinary (used interchangeably with interprofessional) course was constructed as an integrated didactic, practice interdisciplinary service learning model. The sample consisted of undergraduate students (n=53) who completed the interdisciplinary senior seminar capstone course taught by one faculty member in one of three course sections. Structural equation modeling based on partial least squares was used to analyze the significance of constructs. Students’ reflections on interdisciplinary service learning were also collected and summarized.
Findings
The study demonstrated the significance of interdisciplinary course and team preparation on perceived professional benefits and positive community service learning experience.
Research limitations/implications
Further studies are needed and being pursued to address practitioners’ perceptions of interdisciplinary education. To fully complete the assessment of interdisciplinary education, longitudinal studies must be pursued with graduates and their employers. A larger sample size could be used to repeat this study.
Practical implications
The model employed in this study may be utilized as a component of practice education and clinical practice to address accreditation requirements, quality patient-centred care, and engaging students in valuing interprofessionalism and service.
Originality/value
This study presents an integrated model of didactic, practice and interdisciplinary service learning in health professions education, and demonstrates the benefits of the model with health profession students’ perceptions of interprofessional education (IPE). This study contributes to professional learning research as the impact of IPE has been questionable due to lack of rigorous evidence.
Details
Keywords
Liisa Lee, Mira Hammarén and Outi Kanste
To explore Finnish experts' perceptions of the forms of digital healthcare that are anticipated to be the most utilised in healthcare in the medium-term future (year 2035) and…
Abstract
Purpose
To explore Finnish experts' perceptions of the forms of digital healthcare that are anticipated to be the most utilised in healthcare in the medium-term future (year 2035) and anticipated healthcare workforce impacts those forms will have.
Design/methodology/approach
A total of 17 experts representing relevant interest groups participated in a biphasic online Delphi study. The results for each round were analysed using descriptive statistical methods and inductive content analysis.
Findings
The forms of digital healthcare that the experts perceived as most likely to be utilised were those enabling patient participation, efficient organisation of services and automated data collection and analysis. The main impacts on the healthcare workforce were seen as being the redirection of workforce needs within the healthcare sector and need for new skills and new professions. The decrease in the need for a healthcare workforce was seen as less likely. The impacts were perceived as being constructed through three means: impacts within healthcare organisations, impacts on healthcare professions and impacts via patients.
Research limitations/implications
The results are not necessarily transferable to other contexts because the experts anticipated local futures. Patients' views were also excluded from the study.
Originality/value
Healthcare organisations function in complex systems where drivers, such as regional demographics, legislation and financial constraints, dictate how digital healthcare is utilised. Anticipating the workforce effects of digital healthcare utilisation has received limited attention; the study adds to this discussion.
Details
Keywords
Sarah Wise, Christine Duffield, Margaret Fry and Michael Roche
The desirability of having a more flexible workforce is emphasised across many health systems yet this goal is as ambiguous as it is ubiquitous. In the absence of empirical…
Abstract
Purpose
The desirability of having a more flexible workforce is emphasised across many health systems yet this goal is as ambiguous as it is ubiquitous. In the absence of empirical studies in healthcare that have defined flexibility as an outcome, the purpose of this paper is to draw on classic management and sociological theory to reduce this ambiguity.
Design/methodology/approach
The paper uses the Weberian tool of “ideal types”. Key workforce reforms are held against Atkinson’s model of functional flexibility which aims to increase responsiveness and adaptability through multiskilling, autonomy and teams; and Taylorism which seeks stability and reduced costs through specialisation, fragmentation and management control.
Findings
Appeals to an amorphous goal of increasing workforce flexibility make an assumption that any reform will increase flexibility. However, this paper finds that the work of healthcare professionals already displays most of the essential features of functional flexibility but many widespread reforms are shifting healthcare work in a Taylorist direction. This contradiction is symptomatic of a failure to confront inevitable trade-offs in reform: between the benefits of specialisation and the costs of fragmentation; and between management control and professional autonomy.
Originality/value
The paper questions the conventional conception of “the problem” of workforce reform as primarily one of professional control over tasks. Holding reforms against the ideal types of Taylorism and functional flexibility is a simple, effective way the costs and benefits of workforce reform can be revealed.
Details
Keywords
Moutasem A. Zakkar, Samantha B. Meyer and Craig R. Janes
Social media has made a revolutionary change in the relationship between the customers and business or service providers by enabling customers to publish and share feedback and…
Abstract
Purpose
Social media has made a revolutionary change in the relationship between the customers and business or service providers by enabling customers to publish and share feedback and views about product or service quality. This revolutionary change has not been echoed in some healthcare systems. This study analyses the social media policies of healthcare regulatory authorities in Ontario and explores how these policies encourage or discourage healthcare professionals' use of social media for collecting patient stories and understanding patient experience.
Design/methodology/approach
The study used qualitative content analysis to analyse the policy documents, focusing on the manifest themes in these documents. It used convenient sampling to select 12 organizations, including regulating and licensing bodies and health service delivery organizations in Ontario. The authors collected 24 documents from these organizations, including policies, practice standards and social media learning materials.
Findings
In Ontario's healthcare system, social media is perceived as a source of risks to the healthcare professions and professionals. Healthcare regulators emphasize that the codes of conduct and professional standards extend to social media. The study found no systematic recognition of patient stories on social media as a source of information on healthcare quality that can be useful for healthcare professionals.
Originality/value
The study identifies potential unintended consequences of social media policies in the healthcare system and calls for policy and cultural changes to enable the development of safe social media platforms that can facilitate interaction between healthcare providers and patients, when necessary, without the fear of legal consequences or privacy breaches.
Details
Keywords
Anne Koskiniemi, Hanna Vakkala and Ville Pietiläinen
The purpose of this study is to take an existential-phenomenological perspective to understand and describe the experienced leader identity development of healthcare leaders…
Abstract
Purpose
The purpose of this study is to take an existential-phenomenological perspective to understand and describe the experienced leader identity development of healthcare leaders working in dual roles. Leader identity development under the influence of strong professional identities of nurses and doctors has remained an under-researched phenomenon to which the study contributes.
Design/methodology/approach
Existential-phenomenology serves as a perspective underpinning the whole research, and an existential-phenomenological method is applied in the interview data analysis.
Findings
The study showed leader identity development in healthcare to be most strongly influenced and affected by clinical work and its meanings and followers’ needs and leader–follower relationships. In addition, four other key categories were presented as meaningful in leader identity development; leader identity development is an ongoing process occurring in relations of the key categories.
Originality/value
The existential-phenomenological approach and analysis method offer a novel way to understand leader identity development and work identities as experienced.
Details
Keywords
Kristina Schoemmel, Thomas Skriver Jønsson and Hans-Jeppe Jeppesen
In order to contribute to the understanding of affective commitment towards distinct workplace targets, the purpose of this paper is to develop and validate a Multitarget…
Abstract
Purpose
In order to contribute to the understanding of affective commitment towards distinct workplace targets, the purpose of this paper is to develop and validate a Multitarget Affective Commitment Scale (MACS) through two data collections. The MACS uses similarly worded items for distinct targets and reflects the most recent theoretical development of affective commitment.
Design/methodology/approach
In the first data collection, items from previous commitment scales were tested through the social network service Facebook (n=305). The second data collection was conducted in the healthcare system of Denmark (n=496) using survey questionnaires.
Findings
In Study 1, exploratory factor analyses were conducted to reduce the items based on the Facebook data. In Study 2, the authors confirm the findings of Study 1 and further reduce the items based on the healthcare sample. The healthcare sample is also used in Study 3, where the authors validate the MACS by investigating its relationship with predictors, correlates, and outcomes.
Originality/value
The results suggest that the MACS are a reliable and valid measure of affective commitment compatible with the diverse targets to which affective commitment often occurs. Consequently, the MACS is applicable for research investigating multiply affective commitments, thereby advancing the understanding of interactions between affective commitments and diverse targets, among other applications.
Details
Keywords
Conor Norris, Edward Timmons, Ethan Kelley and Troy Carneal
This paper aims to discuss a new source of data detailing state level occupational licensing requirements for 50 professions.
Abstract
Purpose
This paper aims to discuss a new source of data detailing state level occupational licensing requirements for 50 professions.
Design/methodology/approach
This study's research team gathered state level licensing requirements for 50 profession in all 50 states and DC from 2022 to 2023. The authors include the type of regulation, entry requirements like fees, education, training, good moral character provisions and renewal requirements. The authors include Standard Occupational Classification industry codes to allow researchers to merge it with other publicly available data sources. Finally, the authors present descriptive statistics and provide a comparison of licensing requirements for audiologists, an occupation with variation in entry requirements.
Findings
The mean number of the 50 professions licensed in states is 36. On average, these professions require a bachelor's degree, $271 in licensing fees and 26 h of continuing education to renew. For the audiologist profession, there is considerable variation between states in entry requirements like fees and education.
Originality/value
Despite a large body of work on occupational licensing, data limitations still exist. Most analysis focuses on whether a profession is licensed or not. However, there is considerable variation between states for the same profession, providing an avenue for work estimating the effects of specific licensing requirements. A new source of data is introduced and discussed for researchers to use in future analyses of occupational licensing.
Details