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1 – 10 of 60Kari-Pekka Tampio, Harri Haapasalo and Farooq Ali
This study primarily aims to analyse stakeholder management challenges and how these emerge in the stakeholder landscape in a large hospital project. From this analysis, the…
Abstract
Purpose
This study primarily aims to analyse stakeholder management challenges and how these emerge in the stakeholder landscape in a large hospital project. From this analysis, the authors aim to identify the implications that stakeholder management has on value creation in a hospital project.
Design/methodology/approach
The research method is qualitative. Empirical data were collected in three cycles: project internal documentation, thematic interviews and survey. The literature related to hospital projects, stakeholder analysis and management, stakeholder salience and landscape is summarised, informing the qualitative design of the study.
Findings
The authors noted the importance of project-specific stakeholder identification, salience analysis and landscape description. The regulatory, formal and contractual stakeholders give an over-simplistic picture on stakeholder map. The operative stakeholder map and landscape describe the complexity, uncertainty, dynamism and institutional context inducing the challenges for the stakeholder management. There is an evident potential of utilising the stakeholder landscape and its elements in the resulting collaborative value creation in hospital projects. Multiple and changing stakeholders with differing expectations are an important opportunity to improve the value creation process.
Originality/value
Stakeholder management has recently attracted much attention in the industrial project setting. This research attempts to identify the operative stakeholder landscape in a large hospital project, not to mention its impact on value creation. This study offers a framework that can help academics and project management practitioners tackle the challenges amongst project stakeholders.
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Daicy Vaz, Wardah Qureshi, Yama Temouri and Vijay Pereira
Previous research provides adequate evidence on performance management (PM) for hospitals and healthcare providers; however, less is known about their individual and PM appraisal…
Abstract
Purpose
Previous research provides adequate evidence on performance management (PM) for hospitals and healthcare providers; however, less is known about their individual and PM appraisal process. Additionally, there is limited research exploring PM in the Middle Eastern context. This study investigates PM practices in the Middle Eastern healthcare industry.
Design/methodology/approach
This study adopts the qualitative research methodology through semi-structured interviews of healthcare professionals in Kingdom of Saudi Arabia and the United Arab Emirates. Thematic analysis was adopted for analyzing this qualitative data.
Findings
The main findings have uncovered different facets of appraisal challenges for both the appraiser (i.e. manager) and the appraisee (i.e. employee). These challenges include communication deficits, lack of goal setting standards and regular meeting updates in order to ensure employee satisfaction and motivation in the workplace.
Research limitations/implications
This study has significant implications for policymakers in Middle Eastern hospitals in terms of implementing PM for their staff. Moreover, future studies can conduct in-depth analysis and provide comparison between public and private sectors in the Gulf countries.
Originality/value
This study is one of the first to portray challenges involved in conducting PM in the Middle East healthcare sector specifically in the UAE and Kingdom of Saudi Arabia (KSA), both from the perspectives of the appraiser and appraisee.
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Veronica Ungaro, Laura Di Pietro, Roberta Guglielmetti Mugion and Maria Francesca Renzi
The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting…
Abstract
Purpose
The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.
Design/methodology/approach
Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.
Findings
The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.
Originality/value
This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.
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Geraldine Robbins, Breda Sweeney and Miguel Vega
This study examines how an externally imposed management control system (MCS) – hospital accreditation – influences the salience of organisational tensions and consequently…
Abstract
Purpose
This study examines how an externally imposed management control system (MCS) – hospital accreditation – influences the salience of organisational tensions and consequently attitudes of management towards the system.
Design/methodology/approach
Data are collected using a case study of a large public hospital in Spain. In-depth interviews were conducted with 27 senior and middle managers across different functions. Relying on the organisational dualities classification in the literature, tensions are unpacked and analysed.
Findings
Evidence is presented of how hospital accreditation increases the salience of organisational tensions arising from exposition of the organisational dualities of learning, performing, organising and belonging. Salient tensions were evident in the ambivalent attitudes of management towards the hospital accreditation system.
Practical implications
The role of mandatory external control systems in exposing ambivalence and tensions will be of interest to organisational managers.
Originality/value
The study extends the management control literature by identifying an active role for an external MCS (accreditation) in increasing the salience of organisational tensions and triggering ambivalence. Contrary to the prior literature, the embedding of both poles of an organisational duality into the MCS is not a necessary precondition for increased tension salience. The range of attitudes towards MCSs beyond those specified in the previous literature (positive/negative/neutral) is extended to include ambivalence.
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In 2017, the opioid epidemic was declared a public health emergency in the United States. The federal and state governments are still struggling to contain the crisis through…
Abstract
Purpose
In 2017, the opioid epidemic was declared a public health emergency in the United States. The federal and state governments are still struggling to contain the crisis through various legislations and to stem the tide of overdoses and deaths. This paper looks specifically at the issue of high prescriptions of opioids disbursed to patients by physicians.
Design/methodology/approach
This paper evaluates this evolving policy issue through a critical review and synthesis of academic literature, government policy documents (at states and national levels) and articles in the popular press.
Findings
Over-prescription is a legal problem because it inevitably leads to diversion of these substances for non-medical usage. The Prescription Drug Monitoring Program (PDMP) laws have been passed by all 50 states and the main policy responses are covered. However, there are hindrances to their effectiveness, which have to be addressed. Two state level policy alternatives are discussed as potential solutions — PDMP mandates and Pain Management Clinic Laws (PMCLs). After a comparative evaluation, it is recommended that all states should pass the mandatory PDMP review and usage laws urgently.
Originality/value
This is the first detailed policy evaluation on the specific and time-sensitive aspect of physician over-prescribing, within the larger opioid abuse problem. Moreover, critique on the public health leadership issue is raised.
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August Österle, Carina Diesenreiter, Barbara Glinsner and Eva Reichel
The purpose of this paper is twofold: First, it analyzes demand and supply-side factors that influence patient flows to and from Austria. Second, building on the empirical…
Abstract
Purpose
The purpose of this paper is twofold: First, it analyzes demand and supply-side factors that influence patient flows to and from Austria. Second, building on the empirical research and existing conceptualizations, the study offers a general extended framework to guide future comparative analysis.
Design/methodology/approach
The paper draws on multiple data sources including a literature review, secondary data, website analysis and semi-structured interviews with patients and health providers. Content analysis was carried out to identify common motives for seeking care abroad and providers' orientation towards medical travel.
Findings
Outbound medical travel is largely determined by factors of access, affordability and vicinity, while inbound medical travel is predominately driven by a lack of adequate medical infrastructure in source countries and quality, both in terms of medical and service quality. Providers distinguish themselves according to the extent they take part in medical travel.
Research limitations/implications
The findings emerging from a single country case study approach cannot be generalized across settings and contexts, albeit contributing to a better understanding of current medical travel patterns in Europe.
Originality/value
Unlike most recent contributions, this study focuses both on inbound and outbound medical travel in Austria and investigates patient flows for distinctive treatments and drivers. While analysis of the supply-side of medical travel is often limited to tourism studies, this study provides a critical insight into developments in Europe from a health policy perspective, acknowledging that diverse medical travel patterns in Europe coexist.
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The paper aims to considering quality that comes from quality employees taking discretionary efforts, having right perception towards quality, getting satisfied from their…
Abstract
Purpose
The paper aims to considering quality that comes from quality employees taking discretionary efforts, having right perception towards quality, getting satisfied from their contribution. Exploring the relationship of engagement, perception and satisfaction, and mapping the levels and identifying managerial implications for improving the levels.
Design/methodology/approach
William Kahn’s employee engagement dimensions, Parasuraman and Zeithaml’s quality dimensions and Harter et al.’s satisfaction dimensions applied and variables framed in health-care context, tested and applied. Survey data collected from randomly selected medical and non-medical employees from south Indian state Tamil Nadu health-care organizations, using structured questionnaire.
Findings
Age, experience and roles of the respondents in work have a significant association with the levels. It explores a significant positive relationship of perception, engagement and satisfaction. The study explores an average 28% of employees have high level of engagement, perception (18%) and satisfaction (22%), and the rest fall under moderate and low levels. The roles of the respondents significantly predict the levels.
Originality/value
The study focuses on engagement, perception and satisfaction of employees, not of patients. It registered the responses of trained physicians, nurses and administrative staff. It illustrates human resource strategic importance to improve the levels concerning quality measures.
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Rod Sheaff, Joyce Halliday, Mark Exworthy, Alex Gibson, Pauline W. Allen, Jonathan Clark, Sheena Asthana and Russell Mannion
Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and…
Abstract
Purpose
Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons?
Design/methodology/approach
An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above.
Findings
The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways.
Research limitations/implications
This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations.
Practical implications
Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary.
Originality/value
Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.
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This paper aims to emphasize the need for a strategic approach to employee retention beyond financial benefits. This is directly proportional to employee retention. Bringing out…
Abstract
Purpose
This paper aims to emphasize the need for a strategic approach to employee retention beyond financial benefits. This is directly proportional to employee retention. Bringing out the retention measures preferred by employees, depicting the relationship of demographic profile with employee retention tendency and exploring implications giving importance to beyond paycheque factors are the objectives of the study.
Design/methodology/approach
This study uses applied qualitative approach with a realistic view to collect the details of retention measures and practices from purposively selected 36 health-care experts by the conduct of interview using a one-to-one discussion with written notes. With quantitative approach, opinion survey was administered to receive the perceived opinion of randomly selected 350 health-care employees on paycheque and on beyond paycheque factors boosting their intention to stay. Bhattacharya and Ramachandran’s health-care study framework on retention was applied for the identification of the factors.
Findings
Both paycheque and beyond paycheque benefits are important for retention. Most respondents prefer beyond paycheque factors practiced at sampled hospital. Age, marital status and residence of employees are significantly associated with retention. The strategic initiatives of the sampled hospital to retention concerning motivational needs of employees in the workplace are thank you board, camp head, ad act camp, success corner and so forth.
Research limitations/implications
Addressing health-care work and relationship-related issues in terms of employee retention giving importance to beyond paycheque benefits – remedy for compassion fatigue health-care employees face in routine works, meeting promises made by management regarding paycheque or beyond paycheque benefits, employees participative in decisions in medical, clinical and in functional areas, reducing workload and role stress by the conduct of role analysis.
Originality/value
Many research studies are emphasizing the contribution of financial benefits to employee retention. Only a few studies have been carried out exploring and emphasizing the importance of beyond financial benefits motivating employee retention. This is the study of evidence from a hospital that gives strategic importance to beyond paycheque elements as well as paycheque elements.
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Antoinette Pavithra, Russell Mannion, Neroli Sunderland and Johanna Westbrook
The study aimed to understand the significance of how employee personhood and the act of speaking up is shaped by factors such as employees' professional status, length of…
Abstract
Purpose
The study aimed to understand the significance of how employee personhood and the act of speaking up is shaped by factors such as employees' professional status, length of employment within their hospital sites, age, gender and their ongoing exposure to unprofessional behaviours.
Design/methodology/approach
Responses to a survey by 4,851 staff across seven sites within a hospital network in Australia were analysed to interrogate whether speaking up by hospital employees is influenced by employees' symbolic capital and situated subjecthood (SS). The authors utilised a Bourdieusian lens to interrogate the relationship between the symbolic capital afforded to employees as a function of their professional, personal and psycho-social resources and their self-reported capacity to speak up.
Findings
The findings indicate that employee speaking up behaviours appear to be influenced profoundly by whether they feel empowered or disempowered by ongoing and pre-existing personal and interpersonal factors such as their functional roles, work-based peer and supervisory support and ongoing exposure to discriminatory behaviours.
Originality/value
The findings from this interdisciplinary study provide empirical insights around why culture change interventions within healthcare organisations may be successful in certain contexts for certain staff groups and fail within others.
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