Search results

The purpose of this paper is to identify if aspects of organizational culture may indicate a new terrain in the cultural influences‐quality healthcare relationship. This research stems from the author's belief that viewing the role of head of department or directorate as pivotal to health care management is critical to health care planning and quality healthcare delivery.

Interviews were undertaken among 50 professional clinician and non‐clinician managers working in the role of head of department, in acute care hospitals in Ireland. The sample was drawn from the total population of 850 managers, utilized in a previous survey study.

Organizational culture is more complex than was previously thought. Several cultural influences such as excellence in care delivery, ethical values, involvement, professionalism, value‐for‐money, cost of care, commitment to quality and strategic thinking were found to be key cultural determinants in quality care delivery.

Health care managers perceive that in order to deliver quality focused care they need to act in a professional, committed manner and to place excellence at the forefront of care delivery, whilst at the same time being capable of managing the tensions that exist between cost effectiveness and quality of care. These tensions require further research in order to determine if quality of care is affected in a negative manner by those tensions.

Originality relates to the new cultural terrain presented in this paper that recognizes the potential of health service managers to influence the organizations' culture and through this influence to take a greater part in ensuring that quality health care is delivered to their patients. It also seems to be important that value‐for‐money is viewed as an ethical means of delivering healthcare, and not as a conflict between quality and cost.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

This paper aims to explore the influence of dimensions of organizational culture, namely, development culture, group culture, rational culture and hierarchical culture, on healthcare supply chain resilience (HCRES). Further, the study explored the moderating role of technology orientation on organizational culture dimensions and healthcare resilience linkages.

The study adopted a multi-unit study of different hospital supply chains (SCs). Consequently, perceptual data were gathered from seven dominant entities in a typical medical/hospital SC: hospitals, hotels, chemistry and pharmaceutical, marketing/public relations/promotion, medical equipment manufacturers and surgical suppliers, food and beverage providers (i.e. restaurants) and insurance providers. The responses were gathered using online survey and were analyzed using structural equation modeling.

Based on 276 completed responses, positive influences were found for development, group and rational cultures on HCRES. As expected, a negative influence of hierarchical culture was found on HCRES. Further, technological orientation was found to enhance the positive effects of development, group and rational cultures on HCRES. However, no prominent moderation was noted for hierarchical culture’s influence on HCRES. The findings suggested managers to focus more on developing competing values framework (CVF)-based dimensions of organizational culture dimensions for effective risk mitigation so as to provide healthcare services in a timely manner to patients.

The study is the first to investigate the effects of organizational culture’s dimensions on resilience. The study has empirically established the association between CVF view and dynamic capabilities. The study underlined the importance of resilience in healthcare SCs. Resilience is an important dynamic capability in healthcare SCs to provide uninterrupted treatments and services to patients. Any failure in such a service can be fatal. Further, the study developed the measures of development, group, rational and hierarchical culture for further investigation in healthcare. This study is also the first to develop a measure for resilience in the healthcare sector.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established through modification in employee safety perspective and work behavior, human resource (HR) professionals need to contribute to this developing organizational domain. The IOM indicates individual employee behaviors cumulatively provide the primary antecedent for organizational safety and quality outcomes. Yet, many safety culture scholars indicate the concept is neither theoretically defined nor consistently applied and researched as the terms safety culture, safety climate, and safety attitude are interchangeably used to represent the same concept. As such, this paper examines the intersection of organizational culture and healthcare safety by analyzing the theoretical underpinnings of safety culture, exploring the constructs for measurement, and assessing the current state of safety culture research. Safety culture draws from the theoretical perspectives of sociology (represented by normal accident theory), organizational psychology (represented by high reliability theory), and human factors (represented by the aviation framework). By understanding not only the origins but also the empirical safety culture research and the associated intervention initiatives, healthcare professionals can design appropriate HR strategies to address the system characteristics that adversely affect patient outcomes. Increased emphasis on human resource management research is particularly important to the development of safety cultures. This paper contributes to the existing healthcare literature by providing the first comprehensive critical analysis of the theory, research, and practice that comprise contemporary safety culture science.

Health service organizations and professionals are under increasing pressure to work together to deliver integrated patient care. A common understanding of integration strategies may facilitate the delivery of integrated care across inter‐organizational and inter‐professional boundaries. This paper aims to build a framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration.

The authors draw from the literature on shared mental models, strategic management and change, framing, stakeholder management, and systems theory to develop a new construct, Mental Models of Integrated Care (MMIC), which consists of three types of mental models, i.e. integration‐task, system‐role, and integration‐belief.

The MMIC construct encompasses many of the known barriers and enablers to integrating care while also providing a comprehensive, theory‐based framework of psychological factors that may influence inter‐organizational and inter‐professional relations. While the existing literature on integration focuses on optimizing structures and processes, the MMIC construct emphasizes the convergence and divergence of stakeholders' knowledge and beliefs, and how these underlying cognitions influence interactions (or lack thereof) across the continuum of care.

MMIC may help to: explain what differentiates effective from ineffective integration initiatives; determine system readiness to integrate; diagnose integration problems; and develop interventions for enhancing integrative processes and ultimately the delivery of integrated care.

Global interest and ongoing challenges in integrating care underline the need for research on the mental models that characterize the behaviors of actors within health systems; the proposed framework offers a starting point for applying a cognitive perspective to health systems integration.

Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to enhance the value of investments in quality improvement programs. The nature and organizational form of such improvements is still a subject of debate within the public-sector literature. Place-based collaboration has been proposed as a possible solution. In response, the purpose of this study is to present the results and findings of a place-based collaborative network, highlighting challenges and insights.

This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used and data collected in three different stages over a two-year period.

The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality.

Regardless of the tensions and challenges with place-based networks, they could still be a solution in maximizing the public value required by government investments in the healthcare sector, as they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This study is limited by the use of a single case study.

Across countries health systems are moving away from markets to collaborative models for healthcare delivery and from individual services to population-based approaches. This study provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations.

As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This study provides insights into the new partnership between health institutions and communities, providing opportunities for more social- and solidarity-based healthcare models which place patients and the public at the heart of change.

The city place-based network is the first of such organizational form in healthcare collaboration in the UK.

The purpose of this paper is to explore effective leadership based on information collected from leaders in the healthcare delivery system within the Caribbean. It assesses leadership challenges and the ability to perform based on balancing limited resources.

The authors used grounded theories as the basis for data gathering and formulating a strategy for thematic analysis. The researchers analyzed the data through identifying, synthesizing and evaluating codes. The sample comprised 20 senior officials from 7 ministries of health, 7 permanent secretaries and 6 chief medical officers across the 12 island states in the Caribbean region.

The findings are broken down into two main areas: first of these is the competency areas and the second part is the personal characteristics. The first part highlighted the Leader's ability to lead others or projects. The second part assessed the leaders' personality traits and distinguishing qualities that are embodied in the individual leaders.

The study is exploratory; given that this is the first time that such research has been done within the healthcare sector of the Caribbean region. Because of the chosen research approach, interviewees' comments within the paper may be biased based on their specific situation and exposure.

The study highlights that there is a need for more training in leadership and other management competencies to assist in the decision-making process within the healthcare section of the public sector.

The study highlights that there is a need for better understanding of the inter-connectivity of the public service culture, global health governance and healthcare delivery. This paper provides a basis to help academics and practitioners think through leadership styles and strategies; plus, identify suitable best practices to lead more effectively in a social care field.

The study assesses the effectiveness of the leadership styles in the healthcare sector within the context of the Caribbean and it contributes by adapting and extending the literature on leadership in the study. Further, the paper contributes to the discourse on the demands on leadership for developing countries.

Healthcare systems receive criticism from both providers and recipients. The diversity in these systems throughout the world makes innovation and change difficult. However, a structured analysis of healthcare systems is crucial to identify areas for improvement and to share best practices for the betterment of healthcare throughout the world.

The paper uses organizational theory as an unbiased tool for evaluating healthcare systems. This theory analyses healthcare systems across five dimensions: environment, culture, social structure, physical structure and technology. This analysis provides an in-depth understanding of the organization's surroundings, formation and function. It offers a lens through which healthcare systems can be envisioned and establishes a vocabulary for communication.

Organizational theory presents a multifaceted approach to initiate assessments aiming to enhance existing healthcare systems and customize them to serve all stakeholders within the focused ecosystem. It alters the dynamics of criticism and presents an opportunity to sustainably address unforeseen healthcare challenges in the future. As the author proceeds to understand healthcare organizations through the perspective of organizational theory, the author also uncovers subtle yet crucial issues such as resource dependence, cultural clashes, organizational silence, bureaucracy, hierarchy, ethics, values, engagement and burnout.

This paper was crafted from a collaborative paper for the final of a master's degree. A collaboration was conceptualized using organisation theory as the tool to align processes and achieve successful outcome. The narrative of the collaboration has been edited and paper presented highlighting the importance of the tool of organisation theory in healthcare systems.

The purpose of this paper is to develop a total quality management (TQM) model for healthcare organisations and validate it using a sample of Iranian healthcare organisations.

A validated questionnaire was used to collect data from all healthcare organisations that implemented TQM in Isfahan province, Iran.

Using the proposed model, TQM implementation was measured in healthcare organisations. The level of TQM success in Isfahan healthcare organisations was medium. The highest score was achieved in the dimension of “customer management”, followed by “leadership” and “employee management”. Employee management, information management, customer management, process management and leadership had the most positive effect on TQM success. Using a series of quality management techniques had “synergistic” effect on TQM success.

Top management support, effective management of human resources, full involvement of the entire workforce including physicians, education and training, team working, continuous improvement, a corporate quality culture, customer focus and using a combination of management techniques under a quality management system are necessary for TQM successful implementation.

A healthcare context-specific model of TQM was developed and tested and suggestions were provided for its successful implementation.