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1 – 10 of over 8000Grant Beebe, Milorad Novicevic, Ifeoluwa Tobi Popoola and Joseph (Jody) Holland
The purpose of this paper is to develop a 5As framework for entrepreneurial nudge public leadership for health and wellness promotion based on two exemplary cases in Mississippi.
Abstract
Purpose
The purpose of this paper is to develop a 5As framework for entrepreneurial nudge public leadership for health and wellness promotion based on two exemplary cases in Mississippi.
Design/methodology/approach
The authors use a “case within a case” study design to develop the 5As public influence framework for entrepreneurial public leadership.
Findings
Based on the investigated cases of healthcare and wellness promotion in Hernando and Charleston, Mississippi, the authors developed the 5As framework for wellness promotion dimensions of awareness, assistance, alignment, association, and assessment. This framework is applicable to the lived experiences of community members, leaders, healthcare providers, and government.
Research limitations/implications
The study results provide a compelling insight into early-stage formation of entrepreneurial public leadership. However, the study results lack generalizability due to the case study approach used.
Practical implications
This study can assist entrepreneurial public leaders and policy-makers align their strategic wellness goals, initiatives, and policies that motivate community members to seek and receive supporting services.
Originality/value
Developing an original framework for wellness promotion useful to both healthcare practitioners and public leaders, this study contributes to the extant literature on public health leadership and proposes mechanisms for addressing community wellness needs. The framework is designed to address public health concerns by integrating public leadership strategies aimed at linking with existing community wellness and healthcare services.
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Sameer Kumar, Neha S. Ghildayal and Ronak N. Shah
The fundamental concern of this research study is to learn the quality and efficiency of US healthcare services. It seeks to examine the impact of quality and efficiency on…
Abstract
Purpose
The fundamental concern of this research study is to learn the quality and efficiency of US healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the US healthcare system with those of other developed nations.
Design/methodology/approach
The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e. GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in US healthcare.
Findings
At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The US healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology‐induced costs and consumer behavior.
Practical implications
Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the “waste” from the system. Trend analyses are presented that display the crucial relationship between economic growth and healthcare spending.
Originality/value
There are many articles and reports published on the US healthcare system. However, very few articles have explored, in a comprehensive manner, the links between the economic indicators and measures of the healthcare system and how to reform this system. As a result of the US healthcare system's complex structure, process map and cause‐effect diagrams are utilized to simplify, address and understand. This study linked top‐level factors, i.e. the societal, government policies, healthcare system comparison, potential reformation solutions and the enormity of the recent trends by presenting serious issues associated with US healthcare.
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Antonella Fiorillo, Alfonso Sorrentino, Arianna Scala, Vincenzo Abbate and Giovanni Dell'aversana Orabona
The goal was to improve the quality of the hospitalization process and the management of patients, allowing the reduction of costs and the minimization of the preoperative Length…
Abstract
Purpose
The goal was to improve the quality of the hospitalization process and the management of patients, allowing the reduction of costs and the minimization of the preoperative Length of Hospital Stay (LOS).
Design/methodology/approach
The methodology used to improve the quality of the hospitalization process and patient management was Lean Thinking. Therefore, the Lean tools (Value stream map and Ishikawa diagram) were used to identify waste and inefficiencies, improving the process with the implementation of corrective actions. The data was collected through personal observations, patient interviews, brainstorming and from printed medical records of 151 patients undergoing oral cancer surgery in the period from 2006 to 2018.
Findings
The authors identified, through Value Stream Map, waste and inefficiencies during preoperative activities, consequently influencing preoperative LOS, considered the best performance indicator. The main causes were identified through the Ishikawa diagram, allowing reflection on possible solutions. The main corrective action was the introduction of the pre-hospitalization service. A comparative statistical analysis showed the significance of the solutions implemented. The average preoperative LOS decreased from 4.90 to 3.80 days (−22.40%) with a p-value of 0.001.
Originality/value
The methodology allowed to highlight the improvement of the patient hospitalization process with the introduction of the pre-hospitalization service. Therefore, by adopting the culture of continuous improvement, the flow of hospitalization was redrawn. The benefits of the solutions implemented are addressed to the patient in terms of lower LOS and greater service satisfaction and to the hospital for lower patient management costs and improved process quality. This article will be useful for those who need examples on how to apply Lean tools in healthcare.
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Matthew E. Sarkees and M. Paula Fitzgerald
Off-label drug prescribing by healthcare providers is a growing practice. Yet, the US Food and Drug Administration bans the marketing of drugs for off-label uses. In recent years…
Abstract
Purpose
Off-label drug prescribing by healthcare providers is a growing practice. Yet, the US Food and Drug Administration bans the marketing of drugs for off-label uses. In recent years, legal challenges by the pharmaceutical industry have chipped away government restrictions on off-label drug promotion. Although the changing legal landscape has been discussed, this paper aims to examine how key stakeholders and policy-makers might interact to provide a more transparent marketing environment for off-label drug discussions in the patient–provider relationship.
Design/methodology/approach
Drawing on a variety of sources, the authors assess the current marketing landscape of off-label drugs and some of the issues that challenge the healthcare provider–patient relationship. The authors then examine opportunities to improve the off-label promotion environment and the relevant decision-making theories that key stakeholders need to consider when formulating marketing efforts and policies.
Findings
The authors suggest that fewer restrictions on truthful, non-misleading off-label drug promotion provide an opportunity to improve drug knowledge and, importantly, healthcare provider and consumer decision-making. Key stakeholders should consider, among other solutions, criteria for defining truthful information on off-label drugs, alternative methods of approval of off-label uses and ubiquitous icons to identify off-label prescribing to all stakeholders.
Originality/value
Rather than rehash the legal landscape of off-label drug promotion, this paper focuses on how the healthcare provider–patient relationship is impacted and how stakeholders can improve information flow in this changing environment.
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Lynette Mei Lim Goh, Agnes Xiao Yan Wong, Gary Yee Ang and Audrey Siok Ling Tan
The purpose of this paper is to evaluate the impact of delivering healthy eating messages through an interactive health corner (HC) on improving healthy dietary habits in…
Abstract
Purpose
The purpose of this paper is to evaluate the impact of delivering healthy eating messages through an interactive health corner (HC) on improving healthy dietary habits in participants.
Design/methodology/approach
Self-administered questionnaires were administered to participants after the education session. In total, 5,292 valid questionnaires were obtained, yielding a response rate of 93.3 per cent. In the last three months of the pilot study, a random sample of 305 from 1,493 participants was chosen and followed up six months later. Bivariate analysis was used to study the association of knowledge gained and attitude. Behavioural change was measured in terms of whether participants had reported an increase in their consumption of healthier food.
Findings
Majority (>98 per cent) of participants reported that the HC corner was useful, and had helped increase their awareness and knowledge of creating healthier meals and making healthier food choices. 95.7 per cent were willing to make changes after visiting the HC. At six months follow-up, 84 per cent of the participants reported positive changes in their dietary habits. Those who made positive changes were younger (mean age: 58.0 years) compared with those who did not (mean age 61.0 years, p=0.035).
Research limitations/implications
Incorporating cooking demonstrations as part of nutrition education is effective in inculcating healthy eating practices and changing self-reported eating habits in the short term. Further research is needed to verify actual change in eating habits and to determine if this change is sustainable in the long run.
Originality/value
Currently, no similar initiative has been implemented and studied to evaluate the effectiveness of this mode of health promotion in a primary care setting. This study will help the authors to evaluate if the intervention was effective in changing attitudes and behaviours after an education session at the HC.
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Tracey A. LaPierre and Mary K. Zimmerman
The purpose of this paper is to analyze the conditions for career advancement in healthcare management and examine factors that may be impeding gender equity.
Abstract
Purpose
The purpose of this paper is to analyze the conditions for career advancement in healthcare management and examine factors that may be impeding gender equity.
Design/methodology/approach
The authors assess gender differences in the odds of being promoted to senior management by: analyzing the relative impact of individual, organizational and family level variables in accounting for gender inequity; examining gender differences in experiences of perceived gender discrimination and sexual harassment, as well as attitudes regarding gender equity in senior management; and by exploring gender differences in aspirations for senior management. ANOVA, χ2 and logistic regression were used to analyze data from 685 respondents to the 2006 Gender and Careers in Healthcare Management Survey.
Findings
Women were significantly less likely to be promoted to senior management, even after controlling for individual, organizational and family level characteristics. One third of women healthcare managers in our study reported perceived gender discrimination in the past five years. Less than half of male healthcare managers were supportive of increasing the proportion of women in senior management positions, while over 80 percent of women were. Among those not yet promoted women were significantly less likely than their male peers to aspire to senior management positions.
Research limitations/implications
The cross‐sectional nature of the data do not allow for the precise testing of the causal direction of observed relationships.
Originality/value
Objective and subjective measures of gender equity were evaluated. The authors' broad approach demonstrated that factors restraining gender equity operate on multiple levels and highlights the relative importance of family factors.
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Dominique Haughton, Guangying Hua, Danny Jin, John Lin, Qizhi Wei and Changan Zhang
The purpose of this paper is to propose data mining techniques to model the return on investment from various types of promotional spending to market a drug and then use the model…
Abstract
Purpose
The purpose of this paper is to propose data mining techniques to model the return on investment from various types of promotional spending to market a drug and then use the model to draw conclusions on how the pharmaceutical industry might go about allocating promotion expenditures in a more efficient manner, potentially reducing costs to the consumer. The main contributions of the paper are two-fold. First, it demonstrates how to undertake a promotion mix optimization process in the pharmaceutical context and carry it through from the beginning to the end. Second, the paper proposes using directed acyclic graphs (DAGs) to help unravel the direct and indirect effects of various promotional media on sales volume.
Design/methodology/approach
A synthetic data set was constructed to prototype proposed data mining techniques and two analyses approaches were investigated.
Findings
The two methods were found to yield insights into the problem of the promotion mix in the context of the healthcare industry. First, a factor analysis followed by a regression analysis and an optimization algorithm applied to the resulting equation were used. Second, DAG was used to unravel direct and indirect effects of promotional expenditures on new prescriptions.
Research limitations/implications
The data are synthetic and do not incorporate any time autocorrelations.
Practical implications
The promotion mix optimization process is demonstrated from the beginning to the end, and the issue of negative coefficient in promotion mix models are addressed. In addition, a method is proposed to identify direct and indirect effects on new prescriptions.
Social implications
A better allocation of promotional expenditures has the potential for reducing the cost of healthcare to consumers.
Originality/value
The contributions of the paper are two-fold: for the first time in the literature (to the best of the authors’ knowledge), the authors have undertaken a promotion mix optimization process and have carried it through from the beginning to the end Second, the authors propose the use of DAGs to help unravel the effects of various promotion media on sales volume, notably direct and indirect effects.
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Heather L. Rogers, Susana Pablo Hernando, Silvia Núñez - Fernández, Alvaro Sanchez, Carlos Martos, Maribel Moreno and Gonzalo Grandes
This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion…
Abstract
Purpose
This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion intervention in primary care centers in the Basque Country, Spain.
Design/methodology/approach
Seven focus groups were conducted with 49 health professionals from six primary care centers participating in the Prescribing Healthy Life program. Text was analyzed using the Consolidated Framework for Implementation Research (CFIR) focusing on those constructs related to health care organization, management and policy.
Findings
The health promotion intervention was found to be compatible with the values of primary care professionals. However, professionals at all centers reported barriers to implementation related to: (1) external policy and incentives, (2) compatibility with existing workflow and (3) available resources to carry out the program. Specific barriers in these areas related to lack of financial and political support, consultation time constraints and difficulty managing competing day-to-day demands. Other barriers and facilitators were related to the constructs networks and communication, culture, relative priority and leadership engagement. A set of six specific barrier-facilitator pairs emerged.
Originality/value
Implementation science and, specifically, the CFIR constructs were used as a guide. Barriers and facilitators related to the implementation of a health promotion program in primary care were identified. Healthcare managers and policy makers can modify these factors to foster a more propitious implementation environment. These factors should be appropriately monitored, both in pre-implementation phases and during the implementation process, in order to ensure effective integration of health promotion into the primary care setting.
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