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Article
Publication date: 28 April 2023

Yelda Durgun Şahin, Osman Metin Yavuz and Erol Kesiktaş

This study discusses that the necessary criteria and the solution approach taken to resolve the main spatial infection problems with a burn center design should be evaluated…

116

Abstract

Purpose

This study discusses that the necessary criteria and the solution approach taken to resolve the main spatial infection problems with a burn center design should be evaluated holistically to achieve spatial infection control in a burn center. The burn center design plays an important role in protecting severely burned patients from infection because the microbial flora of the hospital can affect the infection risk. In hospitals, sterilization and disinfection are the basic components of infection prevention; however, the prevention and control of infection for burn patients also requires the design of burn centers that adhere to a specific set of criteria that considers spatial infection control in addition to appropriate burn treatment methods and treatments. In this study, a burn facility converted from a burn unit into a burn center is introduced and the necessary design inputs for the transformation are discussed because there is no holistic study in the literature that delas with all the spaces that should be in a burn center and relations between spaces. This study aims to define the functional relations between each of the units and the spaces that change according to different sterilization demands in the burn center for ensuring spatial infection control. Furthermore, it aims to propose a method for ensuring continuity in the control of spatial infections.

Design/methodology/approach

The burn care and health facilities guidelines are examined within the framework of spatial standards, together with a comprehensive literature review. The design method was based on the spread of microorganisms and the effect of human movement on space and spatial transitions in the burn center, according to all relevant literature reviews. To determine the extent to which the differences in treatment protocols of burn care guidelines were reflected in the space, interviews were conducted with burn facility officials. The plan–do–check–act (PDCA) method is also modeled to ensure the continuity of infection control in the burn center.

Findings

The burn center design findings are classified under three main headings, namely, location of the burn center in the hospital, spatial organization and physical features of the burn center and the air flowing system. The importance of the interactions among the criteria for spatial infection control has been revealed. Due to the physical space characteristics and air flow characteristics that change according to human movement and the way microorganisms spread, it has been seen that designing the air flow and architectural aspects together has an effective role in providing spatial infection control. Accordingly, a functional relation scheme for the center has been suggested. It is also proposed as a model to ensure the continuity of infection control in the burn center.

Practical implications

This research presents spatial measures for infection control in burn centers for practitioners in health-care settings such as designers, engineers, doctors and nurses. The PDCA method also leads to continuity of infection control for hospital management.

Originality/value

This is the first study, to the best of the authors’ knowledge, to focus on developing the criteria for spatial infection control in burn center. Moreover, the aim is to create a function chart that encompasses the relationships between the units within the burn center design so that infection control can be coordinated spatially.

Details

Facilities , vol. 41 no. 9/10
Type: Research Article
ISSN: 0263-2772

Keywords

Article
Publication date: 1 February 1999

Mahmoud M. Yasin and Jafar Alavi

The utilization of total quality management (TQM) is advocated by some experts, as a partial remedy to the ills of the health care industry. However, some healthcare…

1501

Abstract

The utilization of total quality management (TQM) is advocated by some experts, as a partial remedy to the ills of the health care industry. However, some healthcare administrators are not yet sold on TQM. Some healthcare administrators still question the impact of TQM on the operational, financial and strategic health of their institutions. They consider the investment in TQM as unjustifiable because the return on such investment in their mind is questionable. This study illustrates how the constant market share model can be utilized to show the competitive benefits of TQM. Based on the results of this study, it is concluded that the fears of some healthcare administrators are unfounded. Not only that TQM does not compromise organizational effectiveness, but it actually improves it, as it contributes to increasing market share.

Details

International Journal of Health Care Quality Assurance, vol. 12 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Book part
Publication date: 12 June 2017

Jason Rodriquez

This article examines how a profit-centered restructuring of labor relations in an academic medical center undermined team-based care practices in its intensive care unit. The…

Abstract

This article examines how a profit-centered restructuring of labor relations in an academic medical center undermined team-based care practices in its intensive care unit. The Institute of Medicine has promoted team-based care to improve patient outcomes, and the staff in the intensive care unit researched for this paper had established a set of practices they defined as teamwork. After hospital executives rolled out a public relations campaign to promote its culture of teamwork, they restructured its workforce to enhance numerical and functional flexibility in three key ways: implementing a “service line” managerial structure; cutting a range of staff positions while combining others; and doubling the capacity of its profitable and highly regarded intensive care unit. Hospital executives said the restructuring was necessitated by changes to payment models brought forth by the Affordable Care Act. Based on 300 hours of participant-observation and 35 interviews with hospital staff, findings show that the restructuring lowered staff resources and intensified work, which limited their ability to practice care they defined as teamwork and undermined the unit’s collective identity as a team. Findings also show how staff members used teamwork as a sensitizing concept to make sense of what they did at work. The meanings attached to teamwork were anchored to positions in the hospitals’ organizational hierarchy. This paper advances our understanding of he flexible work arrangements in the health care industry and their effects on workers.

Details

Emerging Conceptions of Work, Management and the Labor Market
Type: Book
ISBN: 978-1-78714-459-0

Keywords

Article
Publication date: 18 May 2018

Ashley Y. Metcalf, Yong Wang and Marco Habermann

Hospitals throughout the USA are facing increasing patient demand and employee shortages. This capacity issue has led to understaffing in some hospital areas. The purpose of this…

2464

Abstract

Purpose

Hospitals throughout the USA are facing increasing patient demand and employee shortages. This capacity issue has led to understaffing in some hospital areas. The purpose of this paper is to examine the understaffing in hospital-unit respiratory care and the impact to error rates, specifically missed treatments rates. The moderating effects of teamwork and standardized, integrated information systems are also considered.

Design/methodology/approach

Survey methodology is used for data collection of respiratory care managers within hospital units. Regression is used to test the hypotheses in this study.

Findings

The regression results show that higher rates of understaffing are associated with more missed treatments. In addition, both teamwork and integrated information systems are associated with lower missed treatments. Finally, the moderating effect of teamwork is also highly significant within the model while integrated information systems are not a significant moderator.

Practical implications

Managers working within understaffed hospital units can try to reduce missed treatment rates by both integrated information systems and teamwork among employees. Additional benefits can be gained from teamwork due to the indirect effects (moderating effects) as well. This indicates teamwork training can be useful for quality initiatives.

Originality/value

Understaffing is associated with higher missed treatments in hospital units. Standardized, integrated information systems within a hospital are associated with less missed treatments. Furthermore, employee teamwork within a hospital unit is associated with a direct effect on missed treatment rates as well as an indirect effect by weakening the negative impact of understaffing.

Details

Management Decision, vol. 56 no. 10
Type: Research Article
ISSN: 0025-1747

Keywords

Book part
Publication date: 23 February 2015

Deirdre McCaughey, Jami DelliFraine and Cathleen O. Erwin

Hospitals in North America consistently have employee injury rates ranking among the highest of all industries. Organizations that mandate workplace safety training and emphasize…

Abstract

Purpose

Hospitals in North America consistently have employee injury rates ranking among the highest of all industries. Organizations that mandate workplace safety training and emphasize safety compliance tend to have lower injury rates and better employee safety perceptions. However, it is unclear if the work environment in different national health care systems (United States vs. Canada) is associated with different employee safety perceptions or injury rates. This study examines occupational safety and workplace satisfaction in two different countries with employees working for the same organization.

Methodology/approach

Survey data were collected from environmental services employees (n = 148) at three matched hospitals (two in Canada and one in the United States). The relationships that were examined included: (1) safety leadership and safety training with individual/unit safety perceptions; (2) supervisor and coworker support with individual job satisfaction and turnover intention; and (3) unit turnover, labor usage, and injury rates.

Findings

Hierarchical regression analysis and ANOVA found safety leadership and safety training to be positively related to individual safety perceptions, and unit safety grade and effects were similar across all hospitals. Supervisor and coworker support were found to be related to individual and organizational outcomes and significant differences were found across the hospitals. Significant differences were found in injury rates, days missed, and turnover across the hospitals.

Originality/value

This study offers support for occupational safety training as a viable mechanism to reduce employee injury rates and that a codified training program translates across national borders. Significant differences were found between the hospitals with respect to employee and organizational outcomes (e.g., turnover). These findings suggest that work environment differences are reflective of the immediate work group and environment, and may reflect national health care system differences.

Details

International Best Practices in Health Care Management
Type: Book
ISBN: 978-1-78441-278-4

Keywords

Article
Publication date: 19 June 2009

Patricia Khokher, Ivy Lynn Bourgeault and Ivan Sainsaulieu

This paper sets out to explore health professionals' views and experiences regarding the work culture that exists in their hospital units, and further how patients influence these…

1305

Abstract

Purpose

This paper sets out to explore health professionals' views and experiences regarding the work culture that exists in their hospital units, and further how patients influence these experiences.

Design/methodology/approach

The paper employs a qualitative approach involving individual interviews with 60 health professionals in Canada employed in what is conceptualised as “open” (emergency room and maternity care) and “closed” (intensive care, head and neck surgery) units.

Findings

The paper finds that the influence of the hospital unit outweighs the influence of professional boundaries but for some groups more than for others. Health professionals in more open units tend to be less satisfied with their work, have more difficult relations with patients, and experience tensions with co‐workers and management. Those in closed units tend to be more satisfied with their work, have relatively better relations with patients and co‐workers, and tend to have more cooperative relations with management. The different structural conditions of work in open and closed units are also clearly important.

Research limitations/implications

The sample for the study was self‐selected from one hospital, which may limit the generalisability of some of the findings.

Practical implications

The insights garnered from the study may help professionals and managers to develop unit‐specific policies to create a more positive workplace culture.

Originality/value

There is a growing body of research on professional culture and oganisational culture that often does not clearly delineate how the two exist concurrently. The paper explicitly investigates this issue by examining work culture across various health professional groups and also across hospital units, and further how patients figure in these experiences.

Details

Journal of Health Organization and Management, vol. 23 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 11 February 2021

Kaisu Jansson, Juha Tuunainen and Tuija Mainela

While previous health-care-related hybridity research has focused on macro- and micro-level investigations, this paper aims to study hybridization at the organizational level…

Abstract

Purpose

While previous health-care-related hybridity research has focused on macro- and micro-level investigations, this paper aims to study hybridization at the organizational level, with a specific focus on decision-making. The authors investigate how new politico-economic expectations toward a university hospital as a hybrid organization become internalized via organizational decision-making, resulting in the establishment of a new business collaboration and innovation-oriented unit.

Design/methodology/approach

The authors employed a social systems theoretical framework to explore organizational decision-making processes involved in the establishment of the new hybrid hospital unit. Drawing on 15 interviews and nine organizational documents, the authors describe and analyze three decision-making cycles using the concepts of complexity, decision and justification.

Findings

The findings reveal the challenging nature of decision-making during hybridization, as decisions regarding unprecedented organizational structures and activities cannot be justified by traditional decision premises. The authors show that decision-makers use a combination of novel justification strategies, namely, justification by problems, by examples and by obligations, to legitimize decisions oriented at non-traditional activities. Further, the analysis reveals how expectations of several societal systems, i.e. health care, education, science, law, economy and politics, are considered in decision-making taking place in hybrid organizations.

Originality/value

The study draws attention to the complexity of decision-making in a hybrid context and highlights the role of justification strategies in partially reducing complexity by concealing the paradoxical nature of decision-making and ensuring the credibility of resulting decisions. Also, the study presents a move beyond the dualism inherent in many previous hybridity studies by illustrating the involvement of several societal systems in hybridization.

Details

Journal of Health Organization and Management, vol. 35 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 9 August 2011

Horacio Soriano‐Meier, Paul L. Forrester, Sibi Markose and Jose Arturo Garza‐Reyes

The purpose of this paper is to investigate the impact of layout configurations in a hospital on the implementation of lean management initiatives, to include different units of…

1958

Abstract

Purpose

The purpose of this paper is to investigate the impact of layout configurations in a hospital on the implementation of lean management initiatives, to include different units of care. The research concentrated on the impact, the physical distance between dependent units could have on staff perception, use of staff time, time spent in the system by patients, and performance.

Design/methodology/approach

The research examined the relationship between clinical units allocated within Northampton General Hospital and their internal providers. In addition, an adapted version of the SERVPERF questionnaire was used to measure the quality perception of staff.

Findings

The transit distances from each clinical unit to their internal providers have: a negative relationship with the staff quality provision of care; a positive relationship with the time the patient spends in the system; and no discernable direct correlation with performance.

Practical implications

These findings will help hospital managers to understand the impact of the layout of a hospital on the implementation of service improvement activities, and will assist them in planning improved relocation of clinical units. This facilitates future service improvements whilst optimising the use of available and constrained resources within the present hospital facilities.

Originality/value

The ideas and results presented in this study are original and valuable to the study of hospital layouts, services improvements and the implementation of lean operation initiatives and quality improvement programmes in hospitals. The study also successfully tested the application of SERVPERF in a hospital setting.

Details

International Journal of Lean Six Sigma, vol. 2 no. 3
Type: Research Article
ISSN: 2040-4166

Keywords

Article
Publication date: 1 August 2020

Odessa Petit dit Dariel and Paula Cristofalo

The persistent challenges that healthcare organizations face as they strive to keep patients safe attests to a need for continued attention. To contribute to better understanding…

Abstract

Purpose

The persistent challenges that healthcare organizations face as they strive to keep patients safe attests to a need for continued attention. To contribute to better understanding the issues currently defying patient safety initiatives, this paper reports on a study examining the aftermath of implementing a national team training program in two hospital units in France.

Design/methodology/approach

Data were drawn from a longitudinal qualitative study analyzing the implementation of a French patient safety program aimed at improving teamwork in hospitals. Data collection took place over a four-year period (2015–2019) in two urban hospitals in France and included multiple interviews with 31 participants and 150 h of observations.

Findings

Despite explicit efforts to improve inter-professional teamwork, three main obstacles interfered with healthcare professionals' attempts at safeguarding patients: perspectival variations in what constituted “patient safety”, a paradoxical injunction to do more with less and conflicting organizational priorities.

Originality/value

This paper exposes patient safety as misleadingly consensual and identifies a lack of alignment between stakeholders in the complex system that is a hospital. This ultimately interferes with patient safety objectives and highlights that even well-equipped, frontline actors cannot achieve long-term results without more systemic organizational changes.

Details

Journal of Health Organization and Management, vol. 34 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 4 September 2020

Ni Made Dwi Ratnadi, Ashiva Martunis, Dodik Aryanto and Anak Agung Gde Putra Widanaputra

This study aims to determine hospital management responses in implementing transformational leadership style, organizational commitment, budget business plan, work motivation…

Abstract

Purpose

This study aims to determine hospital management responses in implementing transformational leadership style, organizational commitment, budget business plan, work motivation, uniqueness of resources, and hospital performance.

Design/methodology/approach

The method used in this research is a quantitative research method with a deductive mindset approach. The population in this research is all organizational units under the Regional Public Hospital Dr. Zainoel Abidin with its observation unit. The obtained data will be processed by using inferential statistics, namely Structural Equation Modelling (SEM) by using Smart Partial Least Square (Smart PLS) software.

Findings

The overall results of the performance appraisal using the Balanced Scorecard approach seen from the financial, internal business, customer, and training and learning perspectives are right. Regional public Hospital Dr. Zainoel Abidin has provided excellent services, and the performance of its departments has generated the expected outcome and is realized by the hospital.

Originality/value

This research contains some innovation. First, the predictor variables used are transformational leadership, organizational commitment, budget business plans and the implementation of unique resources. Second, the response variable used is a performance in the service industry associated with hospital outpatient units (especially organizational units) and inpatient classes of public hospital hospitals. Third, the research location is at Dr. Hospital. Zainoel Abidin, Indonesia. The combination of the three originalities has never been done in previous studies. The object of research to be examined is hospital management, especially the management of outpatient and inpatient units in hospitals. So far, only employees in business units and educational institutions have been studied, and it only has been partially examined variables that affect leadership, resources, and organizational commitment.

Details

International Journal of Public Leadership, vol. 16 no. 4
Type: Research Article
ISSN: 2056-4929

Keywords

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