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Article
Publication date: 26 April 2013

Jamison V. Kovach, Lee Revere and Ken Black

This study aims to provide healthcare managers with a meaningful synthesis of state of the art knowledge on error proofing strategies. The purpose is to provide a…

Abstract

Purpose

This study aims to provide healthcare managers with a meaningful synthesis of state of the art knowledge on error proofing strategies. The purpose is to provide a foundation for understanding medical error prevention, to support the strategic deployment of error proofing strategies, and facilitate the development and implementation of new error proofing strategies.

Design/methodology/approach

A diverse panel of 40 healthcare professionals evaluated the 150 error proofing strategies presented in the AHRQ research monograph using classification systems developed by earlier researchers. Error proofing strategies were ranked based on effectiveness, cost, and ease of implementation as well as based on their aim/purpose, i.e. elimination, replacement, facilitation, detection, or mitigation of errors.

Findings

The findings of this study include prioritized lists of error proofing strategies from the AHRQ manual based on the preferred characteristics (i.e. effectiveness, cost, ease of implementation) and underlying principles (i.e. elimination, replacement, facilitation, detections mitigation of errors) associated with each strategy.

Research limitations/implications

The results of this study should be considered in light of certain limitations. The sample size of 40 panelists from hospitals, medical practices, and other healthcare related companies in the Gulf Coast region of the USA prevents a stronger generalization of the findings to other groups or settings. Future studies that replicate this approach, but employ larger samples, are appropriate. Through the use of public forums and expanded sampling, it may be possible to further validate research findings in this paper and to expand and build on the results obtained in this study.

Practical implications

Using the error‐proofing strategies identified provides a starting point for researchers seeking to better understand the impact of error proofing on healthcare services, the quality of those services and the potential financial ramifications. Further, the results presented enhance the strategic deployment of error proofing strategies by bringing to light some of the important factors that healthcare managers should consider when implementing error proofing solutions. Most notably, healthcare managers are encouraged to implement effective solutions, rather than those that are merely inexpensive and/or easy to implement, which is more often the case.

Originality/value

This study provides a much‐needed forum for sharing error‐proofing strategies, their effectiveness, and their implementation.

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Article
Publication date: 14 March 2016

Mohammed Mesabbah and Amr Arisha

Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public…

Abstract

Purpose

Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services.

Design/methodology/approach

An extensive review of relevant HSE’s publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented.

Findings

PM and performance measurement systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g. feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals’ management systems.

Research limitations/implications

The HSE delivers several services such as mental health, social inclusion, etc. This study focuses on the HSE’s PM framework, with a particular interest in acute hospitals and emergency services.

Originality/value

This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.

Details

International Journal of Health Care Quality Assurance, vol. 29 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 7 July 2021

Lena Ansmann, Vera Vennedey, Hendrik Ansgar Hillen, Stephanie Stock, Ludwig Kuntz, Holger Pfaff, Russell Mannion and Kira Isabel Hower

Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By…

Abstract

Purpose

Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying resource-dependency-theory (RDT), we explore how healthcare organizations in different settings perceive pressure arising from uncertain access to resources and examine organizational strategies they deploy to secure resources.

Design/methodology/approach

A cross-sectional survey of key decision-makers in different healthcare settings in the metropolitan area of Cologne, Germany, on perceptions of pressure arising from the environment and respective strategies was conducted. For comparisons between settings radar charts, Kruskal–Wallis test and Fisher–Yates test were applied. Additionally, correlation analyses were conducted.

Findings

A sample of n = 237(13%) key informants participated and reported high pressure caused by bureaucracy, time constraints and recruiting qualified staff. Hospitals, inpatient and outpatient nursing care organizations felt most pressurized. As suggested by RDT, organizations in highly pressurized settings deployed the most vociferous strategies to secure resources, particularly in relation to personnel development.

Originality/value

This study is one of the few studies that focuses on the environment's impact on healthcare organizations across a variety of settings. RDT is a helpful theoretical foundation for understanding the environment's impact on organizational strategies. The substantial variations found between healthcare settings indicate that those settings potentially require specific strategies when seeking to address scarce resources and high demands. The results draw attention to the high level of pressure on healthcare organizations which presumably is passed down to managers, healthcare professionals, patients and relatives.

Details

Journal of Health Organization and Management, vol. 35 no. 9
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 24 January 2020

Pradeep Kumar

This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also…

Abstract

Purpose

This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the strategies and contextual influences to attain patient recovery flexibility.

Design/methodology/approach

This paper uses a case study method based on a semi-structured interview with healthcare professionals, observations and informal discussions.

Findings

In the present study, several dimensions of patient recovery flexibility are reported. Different internal and external strategies to exhibit patient recovery flexibility, as well as two contextual influences, are identified. An integrative framework is developed to establish the relationship of patient recovery flexibility with service experience in public healthcare.

Research limitations/implications

The study was conducted in a public healthcare setting in India. The sample size for the semi-structured interview was limited to healthcare professionals, and the patient’s perspective is missing.

Originality/value

This paper contributes to the growing need for patient recovery flexibility as a strategy in the public healthcare delivery system. It offers new insights to address the gap in the literature regarding the linkage of patient recovery flexibility and service experience. The study provides an integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and the impact on the service experience. The framework and propositions presented in the study will guide future research that is needed in this area. This study provides an overview to shape and redesign the after-service support from a flexibility perspective in public healthcare for the improved service experience.

Details

Journal of Asia Business Studies, vol. 14 no. 2
Type: Research Article
ISSN: 1558-7894

Keywords

Content available
Article
Publication date: 1 June 2021

Eline Ree, Louise A. Ellis and Siri Wiig

To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future…

Abstract

Purpose

To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future research and implementation studies can use this to further operationalize the concept and promote healthcare resilience.

Design/methodology/approach

The authors first provide an overview of and discuss the main approaches to healthcare resilience and research on management and resilience. Second, the authors provide examples on how managers work to promote healthcare resilience during a one-year Norwegian longitudinal intervention study following managers in nursing homes and homecare services in their daily quality and safety work. They use this material to propose a model of management and resilience.

Findings

The authors consider managerial strategies to support healthcare resilience as the strategies managers use to engage people in collaborative and coordinated processes that adapt, enhance or reorganize system functioning, promoting possibilities of learning, growth, development and recovery of the healthcare system to maintain high quality care. The authors’ model illustrates how managers influence the healthcare systems ability to adapt, enhance and reorganize, with high quality care as the key outcome.

Originality/value

In this study, the authors argue that managerial strategies should be considered and operationalized as part of a healthcare system's overall resilience. They propose a new model of managers' role in supporting resilience to be used in practice, interventions and future research projects.

Details

International Journal of Health Governance, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2059-4631

Keywords

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Article
Publication date: 1 October 2010

Nebil Achour and Andrew D.F. Price

The purpose of this paper is to explore UK healthcare resilience strategies, define gaps and provide suggestions based on international best practice.

Abstract

Purpose

The purpose of this paper is to explore UK healthcare resilience strategies, define gaps and provide suggestions based on international best practice.

Design/methodology/approach

The study adopted a pluralistic qualitative research approach to achieve its purpose including: research papers, governmental and non‐governmental reports, code and guidance documents and databases. In addition, two case studies were visited in May 2009: the first was one of the major hospitals in the UK; and the second is a major health facility located at the south of Taiwan. Semi‐structured interviews were conducted with the hospitals responsible and/or emergency officers to clarify the strategies setup to respond to emergencies.

Findings

The results show that despite the “robust” emergency planning in the UK, many issues could have been avoided if international experience was reviewed carefully. This is due to the failure of not working closer with multi‐disciplinary experts, who provide technical and tactical help and lessons learned from international best practices, in addition to limiting accessibility of experts to information. The study also suggests that climate change must be addressed comprehensively through fusing resilience and sustainability strategies into a more comprehensive strategy of adaptation.

Originality/value

The paper provides a significant contribution in terms of reducing the fragmentation of healthcare resilience‐related work done previously; constructive criticism of UK healthcare resilience strategies and evidence of better practice from local and international facilities which will help in enhancing the resilience of healthcare facilities in the UK and elsewhere in the world.

Details

International Journal of Disaster Resilience in the Built Environment, vol. 1 no. 3
Type: Research Article
ISSN: 1759-5908

Keywords

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Article
Publication date: 1 July 2003

James E. Hosking and Robert J. Jarvis

With ageing hospital facilities spanning the USA, the healthcare construction business continues to grow. Today, questions about replacing existing facilities are becoming…

Abstract

With ageing hospital facilities spanning the USA, the healthcare construction business continues to grow. Today, questions about replacing existing facilities are becoming more common in hospital boardrooms. Given the above situation, TriBrook Healthcare Consultants were recently retained to determine the market, operational and financial impact which facility redevelopment has had on other hospitals and health systems. Out of that effort came this paper. This paper assesses: the factors which are fuelling replacement facility growth; the impact that redevelopment has on market, operational and financial performance; an integrated development process to help organisations determine the feasibility of designing a new facility; and lessons learned working with clients who have pursued a replacement facility strategy. The objective of this effort is to provide hospital executives and board leaders with information that will be useful in reaching a final decision regarding execution of a replacement strategy.

Content available
Article
Publication date: 24 August 2020

Hui Huang, Daniele Leone, Andrea Caporuscio and Sascha Kraus

The present article aims at rising stream of literature about intellectual capital in healthcare organizations, by exploring how knowledge-based activities are designed to…

Abstract

Purpose

The present article aims at rising stream of literature about intellectual capital in healthcare organizations, by exploring how knowledge-based activities are designed to promote innovation and create value. This process concerns not only buyers and sellers of industrial products/services but, more widely, larger networks of healthcare actors which include patients, payers and health institutions.

Design/methodology/approach

To answer the research question, we adopted a conceptual approach aimed at reaching overall comprehension of healthcare innovation mechanisms. We have tracked the pivotal extant studies for catching the roots and dynamics at the base of diffusion of healthcare innovation. This article demonstrates, based on previous literature and theoretical speculations, the contribution that innovative knowledge-based activities (e.g. market access approach) make to intellectual capital in healthcare organizations to promote innovation and create value.

Findings

The results show that three knowledge-based activities of the healthcare ecosystem shape the basis of the proposed conceptual framework. First, a value co-creation strategy to develop capabilities for each health stakeholder is intended as human capital. Second, the market access approach to promote innovation is reported to the relational capital. Third, a digital servitization strategy is referred to the structural capital.

Research limitations/implications

This paper provides implications for the stream of literature about intellectual capital in healthcare organizations. It aims at exploring three knowledge-based activities as value co-creation, market access and digital servitization that respond to different intellectual capital levels components (human, relational, structural).

Originality/value

This article provides a conceptual framework based on the linkage of two fundamental streams of management studies, which correspond to innovation diffusion and intellectual capital management. This offers a more solid conceptualization for managing intellectual capital in healthcare organizations with respect to previous studies and creates value in the ecosystem.

Details

Journal of Intellectual Capital, vol. 22 no. 2
Type: Research Article
ISSN: 1469-1930

Keywords

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Article
Publication date: 7 November 2016

Olga Matthias and Steve Brown

The purpose of this paper is to investigate how operations strategy and Lean concepts can be applied within a healthcare organisation and the degree to which both Lean and…

Abstract

Purpose

The purpose of this paper is to investigate how operations strategy and Lean concepts can be applied within a healthcare organisation and the degree to which both Lean and operations strategy are understood by senior-level National Health Service (NHS) personnel, based on the process of ongoing longitudinal cases studies. Further interviews and data analysis will examine actual performance of Lean capabilities within the NHS.

Design/methodology/approach

For this explanatory multiple-case study project the authors collected data through semi-structured interviews with executives in the NHS to understand how operations strategies are developed in the NHS and implemented in NHS hospitals. The unit of analysis is the hospital. Multiple (22) interviews took place over 12 months with senior-level personnel responsible for implementing change via operations strategy goals, and incorporating Lean initiatives. In addition, to triangulate data, the authors examined healthcare reports and strategy policy documents from each case hospital. This forms stage 1 of a longitudinal study which will examine the actual performance of Lean within the NHS hospitals across a range of operations parameters and explore links between such capabilities and the role and importance of operations strategy in more detail.

Findings

The findings lead to the conclusion that operations strategies were not fully developed within the hospitals. In addition, the ongoing data capture shows that “Best practice” was not being disseminated across the NHS, for either patient experience or organisational effectiveness and the role of operations strategy was not fully clear other than as a rather vague “umbrella” term. Despite Lean’s attraction for healthcare at a micro-level, significant operational and cultural hurdles must be overcome for the full strategic benefits of Lean to be realised. A much more holistic approach in providing a full service for the whole of the patient journey is needed.

Research limitations/implications

The sample provides an initial snapshot. A larger number of hospitals and/or further longitudinal research will be needed to deepen understanding of embedding strategic change to improve overall performance.

Practical implications

Tackling cultural performance and operational issues at a macro-level could help healthcare providers reconcile the perceived conflicting goals of improving patient care (i.e. service delivery) whilst simultaneously reducing costs. The role of explicit operations strategies could be pivotal in designing and implementing such change.

Originality/value

This research builds on and extends the work of Toussaint and Berry (2013), Seddon and O’Donovan (2010) and Carlborg and Kowalkowski (2013). The authors highlight how some of the apparent contradictions in the requirements of the various stakeholders create operational and strategic tensions. The authors highlight the multi-faceted nature of design and delivery of a multi-touchpoint service within the complexity of a large healthcare provider.

Details

International Journal of Operations & Production Management, vol. 36 no. 11
Type: Research Article
ISSN: 0144-3577

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Article
Publication date: 18 August 2014

Sarah Wall

The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they…

Abstract

Purpose

The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess that facilitate their roles as change agents, what strategies they use to influence change, and what consequences they face for their actions, thus contributing to what is known about organizational change in institutionalized settings such as healthcare.

Design/methodology/approach

Focussed ethnography was used to explore self-employed nurses’ work experiences and elucidate the cultural elements of their social contexts, including customs, ideologies, beliefs, and knowledge and the ways that these impact upon the possibilities for change in the system.

Findings

These self-employed nurses reflected on the shortcomings in the healthcare system and took entrepreneurial risks that would allow them to practice nursing according to their professional values. They used a number of strategies to influence change such as capitalizing on opportunities, preparing themselves for innovative work, managing and expanding the scope of nursing practice, and building new ideas on foundational nursing knowledge and experience. They had high job satisfaction and a strong sense of contribution but they faced significant resistance because of their non-traditional approach to nursing practice.

Originality/value

Despite dramatic restructuring in the Canadian healthcare system, the system remains physician-centered and hospital-based. Nursing ' s professional potential has been largely untapped in any change efforts. Self-employed nurses have positioned themselves to deliver care based on nursing values and to promote alternative conceptions of health and healthcare. This study offers a rare exploration of this unique form of nursing practice and its potential to influence health system reform.

Details

Journal of Health Organization and Management, vol. 28 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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