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1 – 10 of over 2000Daniel Samaan and Aizhan Tursunbayeva
This paper demystifies the fluid workforce phenomenon increasingly discussed in the circles of organizational innovators and explores the characteristic aspects of the fluid…
Abstract
Purpose
This paper demystifies the fluid workforce phenomenon increasingly discussed in the circles of organizational innovators and explores the characteristic aspects of the fluid workforce in the healthcare sector.
Design/methodology/approach
We analyze the concept and provide a generic review of definitions of a fluid workforce in relation to other similar concepts established in the academic and practitioner literature, contextualize the fluid workforce phenomenon in healthcare and distinguish relevant drivers and categories of fluid workers in this sector. We also discuss the implications of a fluid workforce for healthcare organizations, drawing on the health labor market and human resource management (HRM) practices frameworks.
Findings
The fluid workforce in healthcare is not new. Today’s main novelties are related to the wide diversity of types of fluid workforce that have emerged, the expanding scale of diffusion of the fluid workforce and the emergence of digital technologies to support HRM decisions. While a fluid workforce may provide solutions to address mismatches in the supply and demand of health workers, it can also worsen working conditions, increase dual practice and have implications for existing HRM practices.
Originality/value
We disentangle a novel term for the public sector, healthcare and HRM literature. We discern similarities and distinctions, presenting a framework for managing and analyzing this workforce at organizational and labor market levels in the healthcare sector. Acknowledging the challenges in estimating the existing fluid workforce labor market size, we offer practical methodologies to empirically estimate its prevalence within the healthcare industry and build an agenda for future research.
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Pauline van Dorssen-Boog, Tinka van Vuuren, Jeroen de Jong and Monique Veld
While both perceived job autonomy and self-leadership are assumed to be important for optimal functioning of healthcare workers, their mutual relationship remains unclear. This…
Abstract
Purpose
While both perceived job autonomy and self-leadership are assumed to be important for optimal functioning of healthcare workers, their mutual relationship remains unclear. This cross-lagged study aims to theorize and test that perceived job autonomy and self-leadership have a reciprocal relationship, which is moderated by need for job autonomy.
Design/methodology/approach
Two-wave panel data were used to measure cross-lagged relationships over a time period of three months. Self-leadership is indicated by both self-leadership strategies and self-leadership behavior. The data were analyzed using hierarchical multiple regression (HMR).
Findings
Job autonomy was not causally nor reverse related to self-leadership strategies, but did relate to self-leadership behavior in both directions. Need for job autonomy did not influence the causal and reverse relationships between job autonomy and self-leadership (strategies and behavior). Instead, need for job autonomy discarded the influence of job autonomy on self-leadership behavior, and predicted self-leadership behavior over time.
Practical implications
For optimizing healthcare jobs, human resource management (HRM) policy makers need to consider other interventions such as training self-leadership, or developing an autonomy supportive work environment, since job autonomy does not lead to more use of self-leadership strategies.
Originality/value
This study used a cross-lagged study design which gives the opportunity to investigate causal relationships between job autonomy and self-leadership. Both self-leadership strategies and self-leadership behavior are included.
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Emmanuel Eze, Rob Gleasure and Ciara Heavin
The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This…
Abstract
Purpose
The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This study addresses the research question: what existing health-related structures, properties and practices are presented by rural areas of developing countries that might inhibit the implementation of mHealth initiatives?
Design/methodology/approach
This study was conducted using a socio-material approach, based on an exploratory case study in West Africa. Interviews and participant observation were used to gather data. A thematic analysis identified important social and material agencies, practices and imbrications which may limit the effectiveness of mHealth apps in the region.
Findings
Findings show that, while urban healthcare is highly structured, best practice-led, rural healthcare relies on peer-based knowledge sharing, and community support. This has implications for the enacted materiality of mobile technologies. While urban actors see mHealth as a tool for automation and the enforcement of responsible healthcare best practice, rural actors see mHealth as a tool for greater interconnectivity and independent, decentralised care.
Research limitations/implications
This study has two significant limitations. First, the study focussed on a region where technology-enabled guideline-driven treatment is the main mHealth concern. Second, consistent with the exploratory nature of this study, the qualitative methodology and the single-case design, the study makes no claim to statistical generalisability.
Originality/value
To the authors' knowledge, this is the first study to adopt a socio-material view that considers existing structures and practices that may influence the widespread adoption and assimilation of a new mHealth app. This helps identify contextual challenges that are limiting the potential of mHealth to improve outcomes in rural areas of developing countries.
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Antoinette Pavithra, Russell Mannion, Neroli Sunderland and Johanna Westbrook
The study aimed to understand the significance of how employee personhood and the act of speaking up is shaped by factors such as employees' professional status, length of…
Abstract
Purpose
The study aimed to understand the significance of how employee personhood and the act of speaking up is shaped by factors such as employees' professional status, length of employment within their hospital sites, age, gender and their ongoing exposure to unprofessional behaviours.
Design/methodology/approach
Responses to a survey by 4,851 staff across seven sites within a hospital network in Australia were analysed to interrogate whether speaking up by hospital employees is influenced by employees' symbolic capital and situated subjecthood (SS). The authors utilised a Bourdieusian lens to interrogate the relationship between the symbolic capital afforded to employees as a function of their professional, personal and psycho-social resources and their self-reported capacity to speak up.
Findings
The findings indicate that employee speaking up behaviours appear to be influenced profoundly by whether they feel empowered or disempowered by ongoing and pre-existing personal and interpersonal factors such as their functional roles, work-based peer and supervisory support and ongoing exposure to discriminatory behaviours.
Originality/value
The findings from this interdisciplinary study provide empirical insights around why culture change interventions within healthcare organisations may be successful in certain contexts for certain staff groups and fail within others.
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Elizabeth Mansfield, Jane Sandercock, Penny Dowedoff, Sara Martel, Michelle Marcinow, Richard Shulman, Sheryl Parks, Mary-Lynn Peters, Judith Versloot, Jason Kerr and Ian Zenlea
In Canada, integrated care pilot projects are often implemented as a local reform strategy to improve the quality of patient care and system efficiencies. In the qualitative study…
Abstract
Purpose
In Canada, integrated care pilot projects are often implemented as a local reform strategy to improve the quality of patient care and system efficiencies. In the qualitative study reported here, the authors explored the experiences of healthcare professionals when first implementing integrated care pilot projects, bringing together physical and mental health services, in a community hospital setting.
Design/methodology/approach
Engaging a qualitative descriptive study design, semi-structured interviews were conducted with 24 healthcare professionals who discussed their experiences with implementing three integrated care pilot projects one year following project launch. The thematic analysis captured early implementation issues and was informed by an institutional logics framework.
Findings
Three themes highlight disruptions to established logics reported by healthcare professionals during the early implementation phase: (1) integrated care practices increased workload and impacted clinical workflows; (2) integrating mental and physical health services altered patient and healthcare provider relationships; and (3) the introduction of integrated care practices disrupted healthcare team relations.
Originality/value
Study findings highlight the importance of considering existing logics in healthcare settings when planning integrated care initiatives. While integrated care pilot projects can contribute to organizational, team and individual practice changes, the priorities of healthcare stakeholders, relational work required and limited project resources can create significant implementation barriers.
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Lilian M. de Menezes and Ana B. Escrig-Tena
This paper aims to improve our understanding of performance measurement systems in the health and care sector, by focussing on employee reactions to core performance measurement…
Abstract
Purpose
This paper aims to improve our understanding of performance measurement systems in the health and care sector, by focussing on employee reactions to core performance measurement practices. Targets and monitoring are hypothesised to be associated with employee perceptions of job control, supportive management and job demands, which in turn, are expected to be linked to employee-wellbeing and organisational commitment.
Design/methodology/approach
Matched employee workplace data are extracted from a nationally representative and publicly available survey. Structural equation models are estimated.
Findings
Performance measurement systems are neither perceived as resources nor additional demands. Setting many targets and a focus on productivity can lead to negative employee outcomes, since these positively correlate with perceptions of job demands, which negatively correlate with employee wellbeing. However, monitoring financial performance and monitoring employee performance may be helpful to managers, as these are positively associated with employee perceptions of job control and supportive management, which positively correlate with job satisfaction and organisational commitment and, negatively, with anxiety. Overall, common criticisms of performance measurement systems in healthcare are questioned.
Originality/value
Given the lack of consensus on how performance measurement systems can influence employee experiences and outcomes, this study combines theories that argue for performance measurement systems in managing operations with models developed by psychologists to describe how perceptions of the work conditions can affect employee attitude and wellbeing. A conceptual model is therefore developed and tested, and potential direct and indirect effects of performance measurement systems in the health sector are inferred.
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Olivia M. Wall and Maura P. Smiddy
Hand hygiene is the single most important intervention to reduce the risk of acquiring infection. All healthcare workers and healthcare students have a responsibility to prevent…
Abstract
Purpose
Hand hygiene is the single most important intervention to reduce the risk of acquiring infection. All healthcare workers and healthcare students have a responsibility to prevent transmission of infection. The purpose of this study is to investigate students’ attitudes to hand hygiene following university-based education and practice placement. Students attended a lecture, completed an e-learning module, participated in a practical session using a ultra-violet light hand inspection cabinet and engaged in clinical placement.
Design/methodology/approach
In all, 64 students participated in a multimodal hand hygiene education programme before clinical placement, with each student completing an in-class questionnaire after placement. Data were analysed using descriptive and comparative statistics. Students rated educational methods that had most influence on them. Their preference was for a practical hand hygiene education session. Students were also influenced by the therapist they were on placement with. They were least influenced by the didactic college presentation.
Findings
This study highlights that students may be influenced by different methods of education at different stages in their course and that placement may be an important influencing factor in the earlier years of occupational therapy education.
Research limitations/implications
This study highlights the importance of the availability of a multimodal educational approach and clinical placement to promote increased compliance with hand hygiene amongst students.
Practical implications
University healthcare course curricula should include multimodal approaches to the education of hand hygiene. While hand hygiene e-learning modules are beneficial, they should be used in conjunction with a multimodal educational strategy that incorporates practical elements. The influence of the therapist on a students’ behaviour should be utilised to improve both student and professionals hand hygiene adherence.
Originality/value
Original piece of work that is not widely discussed in Occupational Therapy literature.
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Emili Vela, Aina Plaza, Gerard Carot-Sans, Joan Carles Contel, Mercè Salvat-Plana, Marta Fabà, Andrea Giralt, Aida Ribera, Sebastià Santaeugènia and Jordi Piera-Jiménez
To assess the effectiveness of an integrated care program for post-acute care of stroke patients, the return home program (RHP program), deployed in Barcelona (North-East Spain…
Abstract
Purpose
To assess the effectiveness of an integrated care program for post-acute care of stroke patients, the return home program (RHP program), deployed in Barcelona (North-East Spain) between 2016 and 2017 in a context of health and social care information systems integration.
Design/methodology/approach
The RHP program was built around an electronic record that integrated health and social care information (with an agreement for coordinated access by all stakeholders) and an operational re-design of the care pathways, which started upon hospital admission instead of discharge. The health outcomes and resource use of the RHP program participants were compared with a population-based matched control group built from central healthcare records of routine care data.
Findings
The study included 92 stroke patients attended within the RHP program and the patients' matched controls. Patients in the intervention group received domiciliary care service, home rehabilitation, and telecare significantly earlier than the matched controls. Within the first two years after the stroke episode, recipients of the RHP program were less frequently institutionalized in a long-term care facility (5 vs 15%). The use of primary care services, non-emergency transport, and telecare services were more frequent in the RHP group.
Originality/value
The authors' analysis shows that an integrated care program can effectively promote and accelerate delivery of key domiciliary care services, reducing institutionalization of stroke patients in the mid-term. The integration of health and social care information allows not only a better coordination among professionals (thus avoiding redundant assessments) but also to monitor health and resource use outcomes of care delivery.
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Jillian Cavanagh, Patricia Pariona-Cabrera and Timothy Bartram
Olusegun Emmanuel Akinwale, Uche C. Onokala and Olayombo Elizabeth Akinwale
This study explored how the Singaporean government responded to the Covid-19 pandemic crisis from early January 2020 to the end of May of the same year. It evaluated the…
Abstract
Purpose
This study explored how the Singaporean government responded to the Covid-19 pandemic crisis from early January 2020 to the end of May of the same year. It evaluated the capability of Singapore's leadership management in a crisis during the peak and ravaging period of the Covid-19 pandemic.
Design/methodology/approach
The study utilised a systematic design analysis approach, analysing Singaporean cases on the Covid-19 crisis using a systematic and narrative approach to underscore the country's response to the pandemic attack from January 2020 to May 2020.
Findings
Against the backdrop of Singapore's peculiar political system of government dominated by the ruling People's Action Party (PAP) and culture of bureaucracy, the government has increasingly executed several control measures, including strict travel bans, contact tracing, the circuit breaker–lockdown, mask-wearing, social distancing orders as well as financial support to businesses and employees from top to the bottom in the country. However, the treatment and health issues of the migrant workers in the dormitories continue to be the major concern among academics and scholars. At the same time, policy inadequacies truncate the excellent measure of Singapore's response to Covid-19. The case point review concluded that the mortality rate in Singapore remains low compared to other nations of the world. Singapore's case points unveil fundamental learning that an excellent leadership-driven harmonised strategic model is essential for crisis management in any society. The finding of the analysis demonstrated that Singapore adopted a contingency and value-based leadership model to advance good governance and tackle the spread of the deadly coronavirus in its country.
Originality/value
The study has demonstrated a profound analysis that has not been conducted hitherto. Investigation of the Singapore case point is not a popular analysis among Nigerian scholars. Therefore, from Nigeria's perspective, the study has showcased the good and the wrong sides of a coin in Singapore's leadership and power dynamic in crisis management.
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