Search results

A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate.

The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes.

In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem.

The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes.

This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

The purpose of this paper is to gain insight into how population health management (PHM) strategies can successfully integrate and reorganize public health, health care, social care and community services to improve population health and quality of care while reducing costs growth, this study compared four large-scale transformation programs: Greater Manchester Devolution, Vancouver Healthy City Strategy, Gen-H Cincinnati and Gesundes Kinzigtal.

Following the realist methodology, this explorative comparative case-study investigated PHM initiatives' key features and participants' experiences of developing such initiatives. A semi-structured interview guideline based on a theoretical framework for PHM guided the interviews with stakeholders (20) from different sectors.

Five initial program theories important to the development of PHM were formulated: (1) create trust in a shared vision and understanding of the PHM rationale to establish stakeholders' commitment to the partnership; (2) create shared ownership for achieving the initiative's goals; (3) create shared financial interest that reduces perceived financial risks to provide financial sustainability; (4) create a learning environment to secure initiative's credibility and (5) create citizens' and professionals' awareness of the required attitudes and behaviours.

The study highlights initial program theories for the implementation of PHM including different strategies and structures underpinning the initiatives. These insights provide a deeper understanding of how large-scale transformation could be developed.

In healthcare, organizational boundaries are often viewed as barriers to change. The purpose of this paper is to show how middle managers create inter-organizational change by doing boundary work: the dual act of redrawing boundaries and coordinating work in new ways.

Theoretically, the paper draws on the concept of boundary work from Science and Technology Studies. Empirically, the paper is based on an ethnographic investigation of middle managers that participate in a Dutch reform program across health, social care, and housing.

The findings show how middle managers create a sense of urgency for inter-organizational change by emphasizing “fragmented” service provision due to professional, sectoral, financial, and geographical boundaries. Rather than eradicating these boundaries, middle managers change the status quo gradually by redrawing composite boundaries. They use boundary objects and a boundary-transcending vocabulary emphasizing the need for societal gains that go beyond production targets of individual organizations. As a result, work is coordinated in new ways in neighborhood teams and professional expertise is being reconfigured.

Since boundary workers create incremental change, it is necessary to follow their work for a longer period to assess whether boundary work contributes to paradigm change.

Organizations should pay attention to conditions for boundary work, such as legitimacy of boundary workers and the availability of boundary spaces that function as communities of practice.

By shifting the focus from boundaries to boundary work, this paper gives valuable insights into “how” boundaries are redrawn and embodied in objects and language.

The purpose of this paper is to improve the general operationalization of an “active patient,” by examining the specific activities and skills expected of active patients.

Expected activities and necessary skills were studied through a qualitative case study into the development and use of an assistive technology (i.e. web site) aimed at stimulating active patient-ship. Interviews, observations and document analysis were used to capture and explore designers’ inscribing practices and their consequences regarding expected competences and activities of patients using the web site.

Designers inscribed two “co-design roles” that active patients were expected to perform on the web site (co-designing their own healthcare and co-designing the healthcare of peers), for which at least eight different competencies were needed. The absence of skills or facilities to apply these skills resulted in incomplete use, a different use than intended by designers and non-use of the web site.

Technological choices and inscribing processes determine who is able or facilitated to become active and who is not. Due to inscribed co-design roles, it also influences the extent to which already active peers are able to perform health-related activities. Different users with different conditions should be taken into account in the design as specific group characteristics can influence level of individual activity.

This study is, as far as the authors know, the first that examines the “active patient” concept by studying an assistive technology and using scripting literature, resulting in an improved understanding of what it means to become “active” in terms of skills and activities.

Nowadays, organizations have to resist the rising competition more effectively than their competitors and take a step closer to excellence in offering the product to customer demands. To do this, organizations need agile leaders in order to implement agility principles and practices. Especially in the health sector, health managers must be agile because of the specific characteristics of health services. From this view, this chapter aims to develop a theoretical agile leadership model in healthcare organizations. First, the authors define agile leadership and its sub-dimensions based on previous literature. Then, the antecedents and outcomes of agile leadership have been analyzed. “Drivers of agile leadership,” “organizational factors affecting agile leadership” and “individual factors affecting agile leadership” are identified as the antecedents of agile leadership. “Organizational outcomes” and “individual outcomes” are determined as the outcomes of agile leadership in the health sector.

This paper aims to look at the exchange context of peer-to-peer (P2P) collaborative consumption (e.g. Uber and Airbnb). Specifically, the paper examines the effect that the sharing of a personal possession, such as a car or apartment, may have on the consumer.

Two studies were conducted via online surveys. The surveys used vignettes that asked participants to imagine service experiences in either a P2P or a business-to-consumer (B2C) context. The participants then answered questions, including their perceptions of social closeness to the service provider, as well as willingness to pay (Study 1) and expectations of satisfaction (Study 2). The analysis used bootstrapping regression models to examine the relationships.

In both studies, the participants in the P2P conditions reported significantly greater perceived social closeness to the service provider than did those in the B2C condition. The P2P condition also resulted in significant indirect effects (i.e. mediated by social closeness) on willingness to pay (Study 1) and expectations of satisfaction (Study 2).

This paper extends the work on social distance to show that the effects are activated by the P2P exchange context. Also demonstrated here is that social closeness acts as an important mediator in the P2P context, affecting outcomes in the consumption and pre-consumption stages. Finally, construal level effects are extended to show that trend interpretation can be influenced by social distance.

The purpose of this paper is to identify the location of sport brands in sport consumers’ minds using a perceptual map of multiple positions; and examine whether there is congruence between the sport brands’ purported images and the targeted consumers’ perception of the brands’ images.

A mixed method was used. Four steps of data collections (i.e. face-to-face, focus group interviews, and questionnaires) and analyses (i.e. content analysis, MDS analysis, PROXSCAL analysis, multiple regressions analysis, frequency analysis, and congruence score) were performed.

Four positioning typologies (i.e. great quality equipment, equipment for professionals, innovation, and tradition) were identified; each brand’s positions in consumers’ minds were distinctly portrayed in the perceptual map; and the congruence between intended and perceived positions was found in two brands – Titleist and Ping – implying they established a high position-congruity and providing evidence of positioning effectiveness.

The findings will aid practitioners and scholars in positioning and its effectiveness: the results provide information for managers to select, implement, and manage effective positioning strategies and the study provides initial evidence about whether companies and their brands are well-positioned in the sport consumer’s perception.

The authors attempt to examine how consumers perceive brands and how effectively brand positions are portrayed in consumers’ minds. The effectiveness and competitiveness of positioning strategies were examined via a perceptional map.

Persistent change has placed considerable pressure on organizations to keep up or fade into obscurity. Firms that remain viable, or even thrive, are staffed with decision-makers who capably steer organizations toward opportunities and away from threats. Accordingly, leadership development has never been more critical. In this chapter, the authors propose that leader development is an inherently dyadic process initiated to communicate formal and informal expectations. The authors focus on the informal component, in the form of organizational politics, as an element of leadership that is critical to employee and company success. The authors advocate that superiors represent the most salient information source for leader development, especially as it relates to political dynamics embedded in work systems. The authors discuss research associated with our conceptualization of dyadic political leader development (DPLD). Specifically, the authors develop DPLD by exploring its conceptual underpinnings as they relate to sensemaking, identity, and social learning theories. Once established, the authors provide a refined discussion of the construct, illustrating its scholarly mechanisms that better explain leader development processes and outcomes. The authors then expand research in the areas of political skill, political will, political knowledge, and political phronesis by embedding our conceptualization of DPLD into a political leadership model. The authors conclude by discussing methodological issues and avenues of future research stemming from the development of DPLD.