Search results

Lean Six Sigma (LSS) implementation follows a structured approach called define-measure-analyze-improve-control (DMAIC). Earlier research about its application in emergency healthcare services shows that it requires organizational transformation, which many healthcare setups find difficult. The Kotter change management model facilitates organizational transformation but has not been attempted in LSS settings till now. This study aims to integrate the LSS framework with the Kotter change management model to come up with an integrated framework that will facilitate LSS deployment in emergency health services.

Two-stage Delphi method was conducted by using a literature review. First, the success factors and barriers of LSS are investigated, especially from an emergency healthcare point of view. The features and benefits of Kotter's change management models are then reviewed. Subsequently, they are integrated to form a framework specific to LSS deployment in an emergency healthcare set-up. The elements of this framework are analyzed using expert opinion ratings. A new framework for LSS deployment in emergency healthcare has been developed, which can prevent failures due to challenges faced by organizations in overcoming resistance to changes.

The eight steps of the Kotter model such as establishing a sense of urgency, forming a powerful guiding coalition, creating a vision, communicating the vision, empowering others to act on the vision, planning for and creating short-term wins, consolidating improvements and producing still more change, institutionalizing new approaches are derived from the eight common errors that managers make while implementing change in the institution. The study integrated LSS principles and Kotter’s change management model to apply in emergency care units in order to reduce waste and raise the level of service quality provided by healthcare companies.

The present study could contribute knowledge to the literature by providing a framework to integrate lean management and Kotter's change management model for the emergency care unit of the healthcare organization. This framework guides decision-makers and organizations as proper strategies are required for applying lean management practices in any system.

The proposed framework is unique and no other study has prescribed any integrated framework for LSS implementation in emergency healthcare that overcomes resistance to change.

Theory of Constraints (TOC), though a well-established process improvement methodology in manufacturing, is still a novel philosophy for healthcare and an exhaustive review of literature is needed to summarize the key findings of various researchers. Such a review can provide a direction to the researchers and academicians interested in exploring the application of TOC in the healthcare sector. This paper aims to review the existing literature of TOC tools and techniques applied to the healthcare environment, and to investigate motivating factors, benefits and key gaps for identifying directions for future research in the domain of healthcare.

In this paper, different electronic repositories were searched using multiple keywords. The current study identified 36 articles published between January 1999 to mid-2021 to conceptualize and summarize the research questions used in the study. Descriptive analysis along with pictorial representations have been used for better visualization of work.

This paper presents a thorough literature review of TOC in healthcare and identifies the evolution, current trends, tools used, nature of services chosen for application and research gaps and recommends future direction for research. A variety of motivating factors and benefits of TOC in healthcare are identified. Another key finding of this study is that almost all implementations listed in literature reported positive outcomes and substantial improvements in the performance of the healthcare unit chosen for study.

This paper provides valuable insight to researchers, practitioners and policymakers on the potential of TOC to improve quality of services, flow of patients, revenues, process efficiency and cost reduction in different health care settings. A number of findings and suggestions compiled in the paper from literature study can be used for diagnosing, learning and making substantial changes in healthcare. The methodologies used by different researchers were analysed and combined to propose a generic step by step procedure to apply TOC. This methodology will guide the practising managers about the appropriate tools of TOC for their specific need.

Good health is always the first desire of all men and women around the globe. The global aim of healthcare is to quickly cure more patients and ensure healthier population both today and in future. This article will work as a foundation for future applications of TOC in healthcare and guide upcoming applications in the booming healthcare sector. The paper will help the healthcare managers in serving a greater number of patients with limited available resources.

This paper provides original collaborative work compiled by the authors. Since no comprehensive systematic review of TOC in healthcare has been reported earlier, this study would be a valuable asset for researchers in this field. A model has been presented that links various benefits with one another and clarifies the need to focus on process improvement which naturally results in these benefits. Similarly, a model has been presented to guide the users in implementation of TOC in healthcare.

The study aims to have adults discuss experiences, practices needs and feelings related to health management, diet and food security.

A total of 22 immigrants were recruited from the Open School of Immigrants in Piraeus, Attica, Greece, to participate in focus group discussions. The discussions were audio recorded and thematically analyzed. Three major themes were developed: pathways to health care, nutrition management and experiences related to food shortages.

Most of the participants identified internet as the most commonly used way to obtain health advice; they also stated that unexpected ill-health is usually accompanied by feelings of fear, anxiety and loneliness. Immigrants, who had visited a public hospital in Greece, identified the language barrier as the most challenging issue, followed by the long waiting lists. Fear and anxiety of hospital visits was an important factor in their decision to vaccinate against COVID-19. Lack of time, high cost of healthy food and lack of knowledge were the most common obstacles to a healthy diet. One in two immigrants reported that they have faced food insecurity issues in the past. Stress, psychological distress and irritation were reported, due to food shortages, especially during the first few years of arriving in Greece. The exclusion of some foods, reduced portion sizes and buying cheaper foods were among the coping strategies to address food shortages.

The study offers an insight into immigrant’s experiences, practices and feelings about managing health issues and could be useful for health-care practitioners, researchers and policymakers.

This study aims to gain insights from peer support workers (PSWs) on the unseen mechanisms of peer support work that may be applied to implementing a child and youth mental health peer support program in a children’s hospital emergency department (ED).

This study used a critical realist perspective with a qualitative research design. Eight participants, all PSWs in health, community and social services working with adults, adolescents and children, were recruited from Alberta, Canada. Data were collected through in-person semi-structured interviews and analyzed using Braun and Clarke’s reflexive thematic analysis.

The results generated interrelated patterns of meaning among PSWs that were grouped into three main themes: inside out and outside in, no one leaves empty-handed and sculpting health system softness.

All participants were trained by the same organization and may have similar understandings and approaches to the peer support role. Participants were predominantly of a similar demographic; thus, participants with minoritized identities may have challenges not represented.

Using nontraditional staffing models in an acute center may facilitate a shift to meet the chronic and complex issues of the 21st century.

Youth peer support roles may reduce stigma by challenging stereotypes and myths, reduce social isolation and improve meaning, connection and belonging for individuals with mental illness who are often dislocated and disconnected from society.

This study exemplified the positive impacts peer support could make by improving child, youth and family experiences; reducing stigma; providing hope and help; and embedding the recovery model directly into the ED.

Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.

Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.

Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.

This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.

Doctor–medical institution collaboration (DMIC) services are an emerging service mode in focal online health communities (OHCs). This new service mode is anticipated to affect user satisfaction and doctors' engagement behaviors. However, whether and how DMIC occurs is still ambiguous because the topic is rarely examined. To bridge this gap, this study explores doctors' participation in DMIC services and its effects on their online performance, as well as its effect on patients' evaluation of them on OHC platforms.

The authors propose hypotheses based on structural holes theory. A unique dataset obtained from one of the most popular OHCs in China is used to test the hypotheses, and difference-in-differences estimation is adopted to test the causality of the relationship.

The results demonstrate that providing DMIC services improves doctors' online consultation performance and patients' evaluations of them but has no significant effect on doctors' knowledge-sharing performance on OHC platforms. Doctors' knowledge-sharing performance and consultation performance mediate the relationship between participation in DMIC services and patients' evaluation of doctors. Regarding doctors' participation in DMIC services, its impact on doctors' consultation performance and patients' evaluation of them is weaker for doctors with higher professional titles than for doctors with lower professional titles.

The findings clarify the value creation mechanisms of online collaboration between doctors and medical institutions and thereafter facilitate doctors' participation in DMIC services and enhance the sustainable development of OHCs.

The purpose of this study is to explore the determinants of needle stick injuries (NSIs) suffering in terms of occupational health and safety (OHS) coverage critically for health-care workers’ rights in Pakistan.

This is a qualitative study involving the designing of a questionnaire followed by the World Health Organization’s NSI prevention assessment tool and nationally published reports covering health-care workers’ OHS rights protection. A total of 17 public and private hospitals were surveyed with a two-stage sampling method. Descriptive and inferential statistics (one-way analysis of variance with multiple comparison tests) were applied and significant results were discussed (p = 0.05 & p = 0.01). The results were discussed critically in the context of the OHS rights of health-care workers.

Analysis revealed the following significant relationships: job type and safety behavior; age group of health-care workers and safety management; injection usage per day and safety behavior; past year’s needle sticks injuries cases with safety behavior and occupational exposure; work shift and work experience with safety knowledge, safety awareness and work experience with safety management. It was also found there is no specific OHS law in the country for health-care workers.

This study is limited in terms of sampling size and quantification of NSI burden among health-care workers.

Improved OHS management practices among health-care workers can control NSIs that ultimately ensure their workplace OHS rights. Health-care workers need OHS coverage in terms of awareness about potential workplace hazards and job training accordingly. Findings from extensive studies of a similar kind can give useful policy directions for workplace health management in health-care setup at the national level.

This study highlights the importance of OHS coverage for health-care workers in hospitals. It reports different determinants of NSIs suffering causing health-care worker’s rights violations at the workplace in Pakistan.

In mental health care the peer support workers (PSWs) are, by their experience based expertise, supporting the recovery of people using services and have also been shown to stimulate interprofessional learning (IPL) but which, due to hierarchical teams, is challenged. Therefore, to prepare the teams for IPL that includes PSWs, this study aims to suggest an interprofessional education (IPE) for mental health professions and PSWs. What would such an education look like?

The base, in the development of the IPE, is two earlier studies of teams’ inclusion of PSWs and the IPL.

The present study suggests Knowledge base 1 with three categories: different roles, expertise and perspectives, and Knowledge base 2 with two categories: teamwork and IPL. The conclusion is that such online IPE offers a readiness for mental health professions and PSWs, in teamwork, to exchange their different expertise to facilitate IPL. This is important to improve the quality of mental health services.

One limitation is that the empirical study, this paper is based on, is a small-scaled study. Nevertheless, the main results from this study and the other were considered useful as a ground for the development of the IPE.

By suggesting an IPE for mental health professions and PSWs, this paper adds to the literature on peer support as well as IPL.

This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process.

Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software.

This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process.

This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge.

Disaster management and humanitarian logistics (HT) play crucial roles in large-scale events such as earthquakes, floods, hurricanes and tsunamis. Well-organized disaster response is crucial for effectively managing medical centres, staff allocation and casualty distribution during emergencies. To address this issue, this study aims to introduce a multi-objective stochastic programming model to enhance disaster preparedness and response, focusing on the critical first 72 h after earthquakes. The purpose is to optimize the allocation of resources, temporary medical centres and medical staff to save lives effectively.

This study uses stochastic programming-based dynamic modelling and a discrete-time Markov Chain to address uncertainty. The model considers potential road and hospital damage and distance limits and introduces an a-reliability level for untreated casualties. It divides the initial 72 h into four periods to capture earthquake dynamics.

Using a real case study in Istanbul’s Kartal district, the model’s effectiveness is demonstrated for earthquake scenarios. Key insights include optimal medical centre locations, required capacities, necessary medical staff and casualty allocation strategies, all vital for efficient disaster response within the critical first 72 h.

This study innovates by integrating stochastic programming and dynamic modelling to tackle post-disaster medical response. The use of a Markov Chain for uncertain health conditions and focus on the immediate aftermath of earthquakes offer practical value. By optimizing resource allocation amid uncertainties, the study contributes significantly to disaster management and HT research.