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Article
Publication date: 16 April 2024

Venkataramanaiah Saddikuti, Surya Prakash, Vijaydeep Siddharth, Kanika Jain and Sidhartha Satpathy

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the…

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Abstract

Purpose

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

Design/methodology/approach

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

Findings

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

Research limitations/implications

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

Practical implications

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

Originality/value

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

Details

Journal of Advances in Management Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0972-7981

Keywords

Article
Publication date: 17 April 2024

Niluh Putu Dian Rosalina Handayani Narsa, Lintang Lintang Merdeka and Kadek Trisna Dwiyanti

The primary aim of this research was to investigate the mediating effect of the decision-making structure on the relationship between perceived environmental uncertainty and…

Abstract

Purpose

The primary aim of this research was to investigate the mediating effect of the decision-making structure on the relationship between perceived environmental uncertainty and hospital performance.

Design/methodology/approach

Online and manual survey questionnaires were used to collect data in this study. The target population of this study consists of all middle managers within 11 COVID-19 referral hospitals in Surabaya. A total of 189 responses were collected, however, 27 incomplete responses were excluded from the final dataset. Data was analyzed using SEM-PLS.

Findings

The study's findings indicate that decision-making structure plays a role in mediating the link between perceived environmental uncertainty and hospital performance assessed via the Balanced Scorecard, highlighting the significance of flexible decision-making processes during uncertain periods. Moreover, based on our supplementary test, respondents' demographic characteristics influence their perceptions of hospital performance.

Practical implications

Hospital administrators can consider the significance of decision-making structures in responding to environmental uncertainties like the COVID-19 pandemic. By fostering adaptable decision-making processes and empowering middle managers, hospitals may enhance their performance and resilience in challenging situations. Additionally, based on supplementary tests, it is found that differences in the perception of the three Balanced Scorecard perspectives imply that hospitals categorized as types A, B, C, and D should prioritize specific areas to improve their overall performance.

Originality/value

This research adds substantial originality and value to the existing body of knowledge by exploring the interplay between decision-making structures, environmental uncertainty, and hospital performance. It contributes to the literature by specifically focusing on the Covid-19 pandemic, a unique and unprecedented global crisis.

Details

International Journal of Productivity and Performance Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1741-0401

Keywords

Article
Publication date: 12 March 2024

Utkarsh Shrivastava, Bernard Han, Ying Zhou and Muhammad Razi

Sharing patient health information (PHI) among hospitals has been much slower than the adoption of health record systems. This paper aims to investigate if privacy regulation (PR…

Abstract

Purpose

Sharing patient health information (PHI) among hospitals has been much slower than the adoption of health record systems. This paper aims to investigate if privacy regulation (PR) or security measures (SMs) influence hospitals’ use of health information exchange (HIE) to share PHI with other providers (e.g. physicians, labs, hospitals). The study specifically focuses on how multiple PRs can impede and a strong national security infrastructure (NSI) can support HIE.

Design/methodology/approach

The study uses secondary data from a multi-national and multi-hospital survey administered by the European Union. The multi-level structure of the cross-sectional panel data is used to test the influence of both hospital-level (e.g. PR) and national-level variables (e.g. NSI) on HIE. A total of nine types of HIE, three types of PRs, nine SMs and other relevant control variables are considered. This study uses a two-level random intercept generalized linear model to test the hypothesis proposed in the study.

Findings

The study finds that national-level PRs (NLPR) have the strongest positive influence on HIE in comparison to regional (RLPR) and hospital-level (HLPR) PRs. Moreover, the study finds evidence that the presence of RLPR and HLPR, on average, decreases the positive impact of NLPR by 264%. The SMs also have a significant and positive impact on HIE. Adoption of an additional SM can increase the odds of engaging in a certain type of HIE between 21% and 61%. On the other hand, a strong NSI can also amplify the positive impact of SM on certain types of HIE.

Originality/value

This study extends prior research on the role of PRs in enabling HIE by considering the complexities brought up by adopting multiple PRs. NLPRs have the strongest impact on HIE in comparison to RLPRs or HLPRs. Moreover, public infrastructure initiatives such as those related to secure communications can also complement SMs adopted by the providers by encouraging HIE.

Details

Digital Policy, Regulation and Governance, vol. 26 no. 3
Type: Research Article
ISSN: 2398-5038

Keywords

Open Access
Article
Publication date: 1 April 2024

Annika Eklund and Maria Skyvell Nilsson

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in…

Abstract

Purpose

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators’ perspectives on implementing a transition program for newly graduated nurses.

Design/methodology/approach

An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.

Findings

The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.

Originality/value

This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 5 March 2024

Thanduxolo Elford Fana and Jane Goudge

In this paper, the authors examine the strategies used to reduce labour costs in three public hospitals in South Africa, which were effective and why. In the democratic era, after…

Abstract

Purpose

In this paper, the authors examine the strategies used to reduce labour costs in three public hospitals in South Africa, which were effective and why. In the democratic era, after the revelations of large-scale corruption, the authors ask whether their case studies provide lessons for how public service institutions might re-make themselves, under circumstances of austerity.

Design/methodology/approach

A comparative qualitative case study approach, collecting data using a combination of interviews with managers, focus group discussions and interviews with shop stewards and staff was used.

Findings

Management in two hospitals relied on their financial power, divisions between unions and employees' loyalty. They lacked the insight to manage different actors, and their efforts to outsource services and draw on the Extended Public Works Program failed. They failed to support staff when working beyond their scope of practice, reducing employees' willingness to take on extra responsibilities. In the remaining hospital, while previous management had been removed due to protests by the unions, the new CEO provided stability and union–management relations were collaborative. Her legitimate power enabled unions and management to agree on appropriate cost cutting strategies.

Originality/value

Finding an appropriate balance between the new reality of reduced financial resources and the needs of staff and patients, requires competent unions and management, transparency and trust to develop legitimate power; managing in an authoritarian manner, without legitimate power, reduces organisational capacity. Ensuring a fair and orderly process to replace ineffective management is key, while South Africa grows cohorts of competent managers and builds managerial experience.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 27 February 2024

Siva Shaangari Seathu Raman, Anthony McDonnell and Matthias Beck

Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing…

Abstract

Purpose

Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.

Design/methodology/approach

Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.

Findings

We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.

Research limitations/implications

Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.

Practical implications

Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.

Social implications

Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.

Originality/value

The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 20 December 2023

Abhishek Raj, Vinaytosh Mishra, Ajinkya Tanksale and Cherian Samuel

The purpose of this study is to solve the problem of healthcare waste management in developing countries. The buildup of medical waste has attracted the attention of all spheres…

Abstract

Purpose

The purpose of this study is to solve the problem of healthcare waste management in developing countries. The buildup of medical waste has attracted the attention of all spheres of society due to the expanding population and developing economy. Timely collection and processing of medical waste are extremely important due to its potential hazards. Although the problem of planning medical waste management has been addressed in developed countries, it persists in several developing countries. This research is motivated by an example of a city in India characterized by a dense population, abundant health-care facilities and a lack of planning for managing large medical waste generated daily.

Design/methodology/approach

The authors address the problem of designing the network of collection and processing facilities for medical waste and optimizing the vehicle route that collects and transfers the waste between facilities. Due to distinct topographic restrictions in the considered city, the collection and transfer process needs to be conducted in two echelons – from hospitals to collection centers using smaller vehicles and then to the processing facilities using trucks. This work addresses these two problems as a two-echelon location-routing problem.

Findings

A mixed-integer programming model is developed to minimize the cost of opening the facilities and transporting medical waste. Several managerial insights are drawn up to assist planners and decision-makers.

Originality/value

This study follows a case study approach to provide a descriptive and prescriptive approach to hospital waste management in the ancient city of Varanasi. The city has witnessed unplanned growth over the years and is densely populated. The health-care facilities in the city have a large catchment area and attract patients from neighboring districts. The situation analysis based on secondary data and unstructured interviews of the stakeholders suggests that the ad hoc approach prevails in present hospital waste management in the city.

Details

Facilities , vol. 42 no. 5/6
Type: Research Article
ISSN: 0263-2772

Keywords

Book part
Publication date: 5 April 2024

Zhichao Wang and Valentin Zelenyuk

Estimation of (in)efficiency became a popular practice that witnessed applications in virtually any sector of the economy over the last few decades. Many different models were…

Abstract

Estimation of (in)efficiency became a popular practice that witnessed applications in virtually any sector of the economy over the last few decades. Many different models were deployed for such endeavors, with Stochastic Frontier Analysis (SFA) models dominating the econometric literature. Among the most popular variants of SFA are Aigner, Lovell, and Schmidt (1977), which launched the literature, and Kumbhakar, Ghosh, and McGuckin (1991), which pioneered the branch taking account of the (in)efficiency term via the so-called environmental variables or determinants of inefficiency. Focusing on these two prominent approaches in SFA, the goal of this chapter is to try to understand the production inefficiency of public hospitals in Queensland. While doing so, a recognized yet often overlooked phenomenon emerges where possible dramatic differences (and consequently very different policy implications) can be derived from different models, even within one paradigm of SFA models. This emphasizes the importance of exploring many alternative models, and scrutinizing their assumptions, before drawing policy implications, especially when such implications may substantially affect people’s lives, as is the case in the hospital sector.

Article
Publication date: 22 November 2023

Ngatindriatun Ngatindriatun, Muhammad Alfarizi and Rafialdo Arifian

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department…

Abstract

Purpose

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

Design/methodology/approach

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Findings

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

Originality/value

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

Details

Journal of Modelling in Management, vol. 19 no. 3
Type: Research Article
ISSN: 1746-5664

Keywords

Article
Publication date: 9 December 2022

Ying Zhou, Yu Wang, Chenshuang Li, Lieyun Ding and Cong Wang

This study aimed to propose a performance-oriented approach of automatically generative design and optimization of hospital building layouts in consideration of public health…

586

Abstract

Purpose

This study aimed to propose a performance-oriented approach of automatically generative design and optimization of hospital building layouts in consideration of public health emergency, which intended to conduct reasonable layout design of hospital building to meet different performance requirements for both high efficiency during normal periods and low risk in the pandemic.

Design/methodology/approach

The research design follows a sequential mixed methodology. First, key points and parameters of hospital building layout design (HBLD) are analyzed. Then, to meet the requirements of high efficiency and low risk, adjacent preference score and infection risk coefficient are constructed as constraints. On this basis, automatic generative design is conducted to generate building layout schemes. Finally, multi-objective deviation analysis is carried out to obtain the optimal scheme of hospital building layouts.

Findings

Automatic generative design of building layouts that integrates adjacent preferences and infection risks enables hospitals to achieve rapid transitions between normal (high efficiency) and pandemic (low risk) periods, which can effectively respond to public health emergencies. The proposed approach has been verified in an actual project, which can help systematically explore the solution for better decision-making.

Research limitations/implications

The form of building layouts is limited to rectangles, and future work can explore conducting irregular layouts into optimization for the framework of generative design.

Originality/value

The contribution of this paper is the developed approach that can quickly and effectively generate more hospital layout alternatives satisfying high operational efficiency and low infection risk by formulating space design rules, which is of great significance in response to public health emergency.

Details

Engineering, Construction and Architectural Management, vol. 31 no. 4
Type: Research Article
ISSN: 0969-9988

Keywords

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