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Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

The emergence of an evidence-based medicine logic represents a major change in the large and complex field of American healthcare. In this analytical case study, the authors show that the intellectual school of evidence-based medicine became an important meso-structure that facilitated the growth of the new logic in American healthcare. The new intellectual school was a community of scholars who generated shared rules and resources through intergenerational mentoring. The school engaged in advocacy to advance new intellectual paradigms for conceptualizing healthcare quality that, when connected with material practices in the field of American healthcare, came to form a new institutional logic.

As the new Patient Protection and Affordable Care Act (ACA) achieves full implementation in 2014–2015, public perceptions regarding improvement in access and quality of care due to the ACA provide a fertile area for sociological research. The aim of this chapter is to determine if race is independently associated with perceptions of quality of care and access to care after ACA implementation. And, secondarily, we examined if such a relationship remained stable after considering SES (education and income) alone and SES with other relevant individual characteristics.

Data come from a telephone survey of a representative sample of Georgia residents aged 18 years or older. For each domain of the dependent variables (quality of care and access to care), three models were fitted with a nested design. The first model included only race. The second model included only race and SES. Model 3 included race, SES, and the following individual characteristics: (1) self-rated health status; (2) sense of coherence (SOC; a construct used to explain why some people are more disposed than others to illness after stressful situations); (3) travel time to doctor’s office; (4) importance of short wait times as doctor’s office; (5) political affiliation; and (6) geographic location (rural/non-rural).

Race was significantly associated with both the quality of care and the access to care. Non-White respondents were more likely to perceive improvements to both as a result of the ACA. Likewise, respondents with either higher education or income were also more likely to perceive improvements in quality and access as a result of the ACA. However, these associations were partly explained by respondents’ self-reported political affiliations.

Results of this study show that public perceptions toward the ACA and its impact on quality and access to care seem to differ based on an individuals’ race, income level and political affiliation. This may be a reflection of the media blitzkrieg that surrounds the ACA rather than a direct consequence of the policy itself. A concerted effort to develop communication strategies and outreach efforts by race and SES that can better educate the general population on the ACA may alleviate some of the reservations that are inherent to any major policy implementation, especially in terms of healthcare quality and access.

The Stanford School of Organizational Sociology has influenced the development and direction of healthcare organizations as a field of research in several very significant ways. This chapter will provide a focused review of the major paradigms to develop from work at Stanford from 1970 to 2000, much of which involved the study of processes and structures within and surrounding healthcare organizations during this period. As a subarea of organizational theory and health services research, healthcare organizations embrace both theory-based research and applied research, and they borrow concepts, theories, and methods from medical sociology, organizational theory, healthcare administration and management, and (to a more limited extent) health economics and decision theory. The bulk of this chapter will focus on four major themes or paradigms from research on healthcare organizations that grew from work by faculty and students within the Stanford School of Organizational Sociology: Health Care Outcomes, Internal Organizational Dynamics, Organizations and Their Environments, and Organizational Systems of Care and Populations of Care Providers. Following our examination of these four paradigms, we will consider their implications for current and future debates in health services research and healthcare policy.

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established through modification in employee safety perspective and work behavior, human resource (HR) professionals need to contribute to this developing organizational domain. The IOM indicates individual employee behaviors cumulatively provide the primary antecedent for organizational safety and quality outcomes. Yet, many safety culture scholars indicate the concept is neither theoretically defined nor consistently applied and researched as the terms safety culture, safety climate, and safety attitude are interchangeably used to represent the same concept. As such, this paper examines the intersection of organizational culture and healthcare safety by analyzing the theoretical underpinnings of safety culture, exploring the constructs for measurement, and assessing the current state of safety culture research. Safety culture draws from the theoretical perspectives of sociology (represented by normal accident theory), organizational psychology (represented by high reliability theory), and human factors (represented by the aviation framework). By understanding not only the origins but also the empirical safety culture research and the associated intervention initiatives, healthcare professionals can design appropriate HR strategies to address the system characteristics that adversely affect patient outcomes. Increased emphasis on human resource management research is particularly important to the development of safety cultures. This paper contributes to the existing healthcare literature by providing the first comprehensive critical analysis of the theory, research, and practice that comprise contemporary safety culture science.

This chapter examines group communication in medical teams through psychological safety and simulation training research. Research has shown that medical teams are challenged by established hierarchies, power/status differences, temporal stability, changing team memberships, and deeply held beliefs that emphasize individual responsibility. A review of 47 studies (29 psychological safety, 18 simulation) was conducted to understand key findings in relationship to group communication. Results indicate that team leadership promotes team psychological safety, voice, and relationship quality while status differences and hierarchy continue to affect psychological safety within medical teams. Simulation training facilitated interprofessional relationships, attitudes toward teamwork, self-efficacy, and group communication. The findings of this review suggest that psychological safety may be developed through simulation training. The quality of patient care is improved when all members of medical teams have the ability and motivation to communicate effectively.

Early writings about teamwork in healthcare emphasized that healthcare providers needed to evolve from a team of experts into an expert team. This is no longer enough. As patients, accreditation bodies, and regulators increasingly demand that care is coordinated, safe, of high quality, and efficient, it is clear that healthcare organizations increasingly must function and learn not only as expert teams but also as expert multiteam systems (MTSs).

In this chapter, we offer a portrait of the robust, and albeit complex, multiteam structures that many healthcare systems are developing in order to adapt to rapid changes in regulatory and financial pressures while simultaneously improving patient safety, quality, and performance.

The notion of continuous improvement rooted in continuous learning has been embraced as a battle cry from the boardroom to the bedside, and the MTS concept offers a meaningful lens through which we can begin to understand, study, and improve these complex organizational systems dedicated to tackling some of the most important goals of our time.

Digital healthcare once again emerges due to pandemic (Covid-19). Digital healthcare can be minimising the issue of accessibility, availability, accuracy and affordability of healthcare service during a pandemic. Digital healthcare playsa significant role to provide healthcare equity during the pandemic. This article presents the current trends and scenario of digital healthcare with a focus on health equity. The main objective of this chapter is to review the four aces of health equity in the digital healthcare literature. The scope and challenges faced by the policymakers to implementation of digital healthcare to improve health equity. This chapter considers the hybrid literature review based on the bibliometric and the systematic literature based on the various theme, sub-theme, concept and context-related health equity through digital healthcare. This study provides the previous and current research trends and preposition for the future researcher, healthcare professional, policymakers and digital healthcare innovators to invent the tool which leads the health equity through the digital healthcare in the healthcare.

This chapter seeks to investigate the journey of breast and bowel cancer patients at the HMC Antoniushove. It zooms in on specific touch points and the possibilities for improvements. Furthermore, it elucidates the learning process and more particular the dissemination between the hospital (staff and medical students) and hospitality students and professionals and emphasizes that looking from different perspectives and various disciplines is beneficial for all the stakeholders involved in hospitals.

Diseases are increasingly chronic; patients are more demanding and competition between different hospitals is increasing. That is why, in addition to excellent medical treatment, excellent service (referred to here as hospitality) is becoming increasingly important in the healthcare sector, including in hospitals. What does it have to meet? What do patients appreciate, what needs to be improved and how can these improvements be designed and implemented with the involvement of both patients and hospital staff?

Medical and hospitality students collaborated in this project analysing and describing the journey of patients with breast and bowel cancer. They examined the patient journey and elucidated the touch points, which patients indicated as critical during their ‘journey’.

Most important finding resulted from the learning process of this collaboration and the insight gained, a greater awareness and understanding of the non-medical needs and wishes, i.e. hospitality, of patients. Furthermore, the mutual understanding between the evidence-based stance of thinking of medical students and hospital staff at the one side and the more on soft skills–focused attitude of hospitality students on the other hand increased.

Purpose – This study analyzed individual factors of race and dual eligibility on emergency room (ER) utilization of older adult Medicare patients treated by RHCs in CMS Region 4.

Methodology/approach – A prospective, longitudinal design was employed to analyze health disparities that potentially exist among RHC Medicare beneficiary patients (+65) in terms of ER use. The years of investigation were 2010 through 2012, using mixed multilevel, binary logistic regression.

Findings – This study found that dual eligible RHC patients utilized ER services at higher rates than nondual eligible, Medicare only RHC patients at: 77%, 80%, and 66%, in 2010, 2011, and 2012, respectively; and above the White reference group, Black RHC Medicare patients utilized ER services at higher rates of: 18%, 20%, and 34%, in 2010, 2011, and 2012, respectively.

Research limitations/implications – Regarding limitations, cohort data observations within the window of 3 years were only analyzed; regarding generalizability, in different CMS regions, results will likely vary; and linking other variables together in the study was limited by the accessible data. Future research should consider these limitations, and attempt to refine. The findings support that dual Medicare and Medicaid eligibility, as a proxy measure of socioeconomic status, and race continue to influence higher rates of ER utilization in CMS Region 4.

Originality/value – In terms of ER utilization disparities, persistently, as recent as 2012, Black, dual eligible RHC Medicare beneficiary patients age 65 years and over may be twice as likely to utilize ER services for care than their counterparts in the Southeastern United States.