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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

Article
Publication date: 25 January 2021

Pouyan Esmaeilzadeh, Spurthy Dharanikota and Tala Mirzaei

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients…

Abstract

Purpose

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

Design/methodology/approach

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

Findings

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

Originality/value

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

Open Access
Article
Publication date: 6 November 2023

Mushtaq Ahmad Darzi, Sheikh Basharul Islam, Suhail Ahmad Bhat and Syed Owais Khursheed

The current study is aimed at identifying the prominent influencers that affect the response behaviour of patients in a hospital environment.

Abstract

Purpose

The current study is aimed at identifying the prominent influencers that affect the response behaviour of patients in a hospital environment.

Design/methodology/approach

The research is based on the data collected through the participant observation method while interviewing patients about the quality of healthcare services in nine community health centres of the Kashmir division. Thematic analysis was performed on the information collected from patients admitted to various hospital sections.

Findings

The analysis of the qualitative data revealed that the presence of hospital staff near respondents, perceived risk of maltreatment, social desirability, the sensitivity of the topic, risk of information sharing and attitude towards surveys are the most frequently observed factors that modulate the patient's tendency to truthfully report critical facts about the problem understudy.

Originality/value

These results can help researchers to exercise caution while communicating with respondents and collecting data related to serious issues in a natural setting.

Details

Rajagiri Management Journal, vol. 18 no. 2
Type: Research Article
ISSN: 0972-9968

Keywords

Open Access
Article
Publication date: 9 February 2024

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.

Details

European Journal of Innovation Management, vol. 27 no. 9
Type: Research Article
ISSN: 1460-1060

Keywords

Article
Publication date: 13 February 2024

Ilkay Cankurtaran and M. Halis Gunel

Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem…

18

Abstract

Purpose

Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem. Additionally, a considerable number of studies have introduced the ‘healing environment concept’ as a substantial input for healthcare buildings. The purpose of this paper is to present a design guide for cancer treatment services that is compatible with the healing environment concept.

Design/methodology/approach

In this context, studies on the healing environment have been analyzed, and the legislation of some selected countries has been assessed. Then, all the filtered data are used to form the design guideline for chemotherapy department, radiation oncology department and inpatient care services under a new series of analysis criteria.

Findings

The resulting principles are revealed according to the criteria of general settlement principles, internal function relations, medical necessities, user experience, interior design, social interaction/privacy, safety, landscape design and outdoor relations by the help of proposed plans, diagrams and schematic drawings.

Originality/value

This research constitutes the first and yet only study in its field that aims to increase efficiency and user satisfaction and provide better patient-centered care while providing a design guide on health-care architecture.

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

Abstract

Details

The Online Healthcare Community
Type: Book
ISBN: 978-1-83549-141-6

Article
Publication date: 9 November 2023

Abraham Ansong, Rhodaline Abena Addison, Moses Ahomka Yeboah and Linda Obeng Ansong

This study aims to investigate the mediation effects of employee voice and employee well-being on the relationship between relational leadership and organizational citizenship…

Abstract

Purpose

This study aims to investigate the mediation effects of employee voice and employee well-being on the relationship between relational leadership and organizational citizenship behavior.

Design/methodology/approach

This study used a Web-based survey method to collect data from 301 respondents in the four public hospitals of the Sekondi-Takoradi Metropolis. This study used PLS-SEM (WarpPLS) to test the study’s hypotheses.

Findings

The findings show that relational leadership has a positive impact on organizational citizenship behavior, and that this link is mediated in part by both employee voice and employee well-being.

Practical implications

This study demonstrates the importance of leaders, paying close attention to employees’ well-being and opinions when attempting to drive organizational citizenship behavior in the health sector.

Originality/value

Based on the review of the extant literature on the impact of leadership on employee behavior and to the best of the authors’ knowledge, it is likely that this study will be the first to show how relational leadership, employee voice, employee well-being and organizational citizenship behavior are related in the health sector, thereby advancing the thrusts of the social exchange and relational leadership theories.

Details

Leadership in Health Services, vol. 37 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Open Access
Article
Publication date: 29 December 2023

Ajimon George and Jobin Sahadevan

This study aims to deal with the paucity of studies in the stages of the development of loyalty behaviour of customers in the healthcare context by incorporating three crucial…

Abstract

Purpose

This study aims to deal with the paucity of studies in the stages of the development of loyalty behaviour of customers in the healthcare context by incorporating three crucial service quality dimensions (physical environment, personnel quality and technical quality) and also investigating trust and commitment as mediating factors.

Design/methodology/approach

Survey data were obtained from 420 respondents admitted to government hospitals in Kerala employing a convenience sampling method. The formulated hypotheses were tested using partial least square structural equation modelling.

Findings

Results indicate that patient satisfaction, trust and commitment can create favourable behavioural intentions amongst patients. When patients reveal higher trust, they are more inclined to value healthcare services and willing to commit to a long-term relationship, resulting in increased patient loyalty.

Practical implications

Organisational efforts should improve trust and commitment and build a good relationship between service providers and patients. Efforts should be taken to raise the standard of technical and personnel aspects, and a focus on physical infrastructure should also be considered to build a favourable behavioural intention to revisit and positive referrals.

Originality/value

This is the first empirical study to analyse technical quality, personnel quality and physical environment along with the mediating effect of trust, and commitment in a four-stage loyalty development model in the healthcare context of Kerala, India.

Details

Rajagiri Management Journal, vol. 18 no. 2
Type: Research Article
ISSN: 0972-9968

Keywords

Article
Publication date: 26 March 2024

Zeba Khanam, Zebran Khan, Mohd Arwab and Ariba Khan

The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI).

Abstract

Purpose

The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI).

Design/methodology/approach

Both online and offline questionnaire was used to collect the data from 387 Indian health-care employees, and the data were analyzed using partial least squares structural equation modeling (PLS-SEM) with the help of SmartPLS 4.

Findings

The study’s findings demonstrated a significant positive association between RL and OJ and a negative association between OJ and employee TI. Furthermore, results also confirmed the mediating role of OJ between RI and TI.

Research limitations/implications

The generalizability of the study‘s data collection is limited because it is based on the responses of Indian health-care sector employees to an online and offline survey. The authors propose that the health-care sector uses RL as an approach that takes a broad view of the parties with a stake and focuses on creating fairness in acts and justice at the workplace to address the major issue of employee turnover.

Originality/value

This study expanded on previous research by demonstrating that the influence of responsible leadership on employee TI is mediated by OJ in the context of India’s health-care sector. It also contributes to the literature regarding RI, OJ and TI. The study also enriched the body of knowledge about using the PLS-SEM approach to predict employee TI.

Details

Leadership in Health Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1751-1879

Keywords

1 – 10 of 132