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1 – 10 of over 3000Miguel Vega and Joao Vieira da Cunha
The purpose of this study is to examine the management perceptions towards calculative practices behind the reconstruction of a mandatory hospital accreditation (HA) system that…
Abstract
Purpose
The purpose of this study is to examine the management perceptions towards calculative practices behind the reconstruction of a mandatory hospital accreditation (HA) system that transforms multiple facets of health-care quality into a single performance index.
Design/methodology/approach
This study contributes to the sociology of quantification mobilising the concept of commensuration as a social process to reflect on contemporary changes in managing HA systems. Data are collected adopting a case study of a Spanish public hospital drawing on semi-structured interviews, observation and documentary review.
Findings
Findings emphasise a shift from standards’ compliance to a more comprehensive view encouraging continuous quality improvement. Accreditation acts as a tin opener to facilitate external inspection removing contextual differences amongst hospitals and reducing organisational practices into controllable objects. It also reveals underlying ethical concerns as the system was built as a care quality measure that promptly developed into an attainment goal.
Practical implications
The valuable role of HA to enhance quality standards and the limitations resulting from its commensuration practices will be of interest to policymakers, organisational managers and researchers.
Originality/value
Despite a growing emphasis on audit and valuation practices in health care, accounting studies examining the capacity of public hospitals to manage quality improvement are scarce. This study inspires further research on accreditation to overcome commensuration flaws regarding external transparency, evaluation ambiguity and extra incentives.
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The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that…
Abstract
Purpose
The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.
Design/methodology/approach
This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.
Findings
The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.
Research limitations/implications
The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.
Originality/value
The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.
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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…
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.
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P.G. Saleeshya and Priya Harikumar
The purpose of the study is to measure the performance of Indian hospitals, both operationally and financially, by using hospital KPI's. The assessment is predominantly done by…
Abstract
Purpose
The purpose of the study is to measure the performance of Indian hospitals, both operationally and financially, by using hospital KPI's. The assessment is predominantly done by linking it to the existing Lean practices in Indian hospitals.
Design/methodology/approach
An empirical study based on cross-sectional survey of hospital managers and specialists in various private healthcare facilities across India was conducted to validate the proposed Lean framework. From an extensive literature survey, the authors identified quality, delivery, efficiency, accessibility and patient centeredness to be the main operational performance (OP) indicators for hospitals. Business or financial performance was measured based on parameters which are average revenue per occupied bed (ARPOB), earnings before interest, tax, depreciation and amortization (EBITDA) and operating revenue. Confirmatory Factor Analysis (CFA) was carried out using a specialized technique, called Structural Equation Modelling(SEM) and an explicit factor structure was hypothesized.
Findings
Management commitment towards Lean in hospitals is statistically proven to have impacted operational and financial performance. However, leanness in technology and business processes showed no statistical significance on either operational or financial performance parameters. Hospital stakeholders showed statistical significance on though it had no impact on the financial performance. Results obtained from the statistical analysis indicate a positive impact of hospital Lean practices on timely delivery of services and improved service quality. Efficiency, accessibility of services and patient centered behavior in hospital operations could not be statistically proven to have impacted the financial performance.
Social implications
Effectiveness of Lean management (LM) principles in improving hospital operations is largely dependent on patient centered behavior. Empowered employees who are trained to add value from a customer view point, make hospital operations safe and improved. Properly trained and communicated employees who are committed to quality improvements can make a positive impact on patients' quality of life and thus positively impact the society. The study lists ways to attain the required outcomes.
Originality/value
This paper is among the very few that has attempted to suggest ways to link implementation of Lean practices more effectively in Indian hospitals to improve hospital performance at operational and financial levels.
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Armando Calabrese, Antonio D'Uffizi, Nathan Levialdi Ghiron, Luca Berloco, Elaheh Pourabbas and Nathan Proudlove
The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.
Abstract
Purpose
The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.
Design/methodology/approach
The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.
Findings
The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.
Originality/value
The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.
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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.
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Maike Tietschert, Sophie Higgins, Alex Haynes, Raffaella Sadun and Sara J. Singer
Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e.…
Abstract
Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.
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Suebsakul Tonjang and Natcha Thawesaengskulthai
This research aimed to create inventive principles in managing quality and innovation systems that can be used as a guide for the development of effective innovation projects in…
Abstract
Purpose
This research aimed to create inventive principles in managing quality and innovation systems that can be used as a guide for the development of effective innovation projects in hospitals.
Design/methodology/approach
Total quality and innovation management in healthcare (TQIM-H) framework and theory of inventive problem-solving (TRIZ) were integrated with results from in-depth interviews with 30 healthcare experts, resulting in TQIM-H inventive principle. The developed inventive principle was validated using 50 effective innovation projects from one of the largest healthcare conglomerates in Southeast Asia.
Findings
The TQIM-H inventive principle consisted of 7 dimensions and 72 procedures for creating innovation in hospitals under the medical quality framework. The principle effectively helps innovators develop innovative solutions that still strictly comply with medical guidelines.
Originality/value
Innovation is recognized as a critical factor that helps organizations adapt to global changes and increases the potential for competition, especially in hospitals. However, creating innovation in hospitals has a lower success rate than in other industries because, in general, ineffective innovation development strategies are used and the created innovation is not aligned with regulations and restrictions regarding healthcare quality in the healthcare system.
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Maria Vincenza Ciasullo, Alexander Douglas, Emilia Romeo and Nicola Capolupo
Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are…
Abstract
Purpose
Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.
Design/methodology/approach
A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.
Findings
The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.
Research limitations/implications
This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.
Practical implications
This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.
Originality/value
This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.
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The purpose of this study is to propose a hybrid model integrating the expectation-confirmation model with the views of cognitive absorption (CA) theory and updated DeLone and…
Abstract
Purpose
The purpose of this study is to propose a hybrid model integrating the expectation-confirmation model with the views of cognitive absorption (CA) theory and updated DeLone and McLean information system success model to examine whether quality factors as antecedents to medical professionals’ beliefs can affect their continuance intention of the cloud-based e-learning system.
Design/methodology/approach
This study’s sampling frame was taken from among medical professionals working in hospitals with over 300 beds in Taiwan which had implemented the cloud-based learning management system (LMS) with a blend of asynchronous and synchronous technologies. Sample data for this study were collected from medical professionals at six hospitals in Taiwan. The data for this study were gathered by means of a paper-and-pencil survey, and each sample hospital that participated in this study was asked to identify a contact person who could distribute the survey questionnaires to medical professionals who had experience in using the cloud-based LMS in their learning. A total of 600 questionnaires were distributed, and 378 (63.0%) usable questionnaires were analyzed using structural equation modeling in this study.
Findings
This study proved that medical professionals’ perceived learner–content interaction quality, learner–system interaction quality, service quality, cloud storage service quality and learner–human interaction quality all positively caused their perceived usefulness, confirmation and CA elicited by the cloud-based e-learning system, which jointly explained their satisfaction with the system, and resulted in their continuance intention of the system.
Research limitations/implications
Several limitations and suggestions may open avenues for future research. First, the limitation of self-reported measures should be considered; future research may combine with qualitative data (e.g. semi-structured, narrative, in-depth interviews, focus group interviews and open-ended questions) to get more complete interpretations of medical professionals’ cloud-based e-learning continuance intention. Next, this study’s data were collected from hospitals in Taiwan only; given this study’s limited scope, future research may generalize this study’s sample to the respondents of other national cultural backgrounds and make cross-country comparisons to enhance the completeness of this study. Finally, this study’ results were based on cross-sectional data; future research may use a longitudinal analysis by taking into account the evolution of medical professionals’ cloud-based e-learning continuance intention over time.
Originality/value
This study fully evaluates interaction-related and cloud-related quality determinants through an understanding of medical professionals’ state of CA in explaining their cloud-based e-learning system continuance intention that is difficult to expound with only their utilitarian perception of the system. Hence, the results contribute to deep insights into an all-round quality evaluation in the field of medical professionals’ cloud-based e-learning continuance intention, and extrinsic and intrinsic motivators are both taken into consideration in this study’s theoretical development of medical professionals’ cloud-based e-learning continuance intention to acquire a more comprehensive and robust analysis.
Details
Keywords
- Cloud-based e-learning system
- Continuance intention
- Expectation-confirmation model
- Cognitive absorption
- Updated DeLone and McLean information system success model
- Learner–content interaction quality
- Learner–system interaction quality
- Service quality
- Cloud storage service quality
- Learner–human interaction quality
- Structural equation modeling
- Training
- behavior
- Cognition
- Distance learning
- E-Learning
- Communication technologies