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Article

Larry Hearld, Jeffrey A. Alexander, Laura J. Wolf and Yunfeng Shi

The purpose of this paper is to examine the relationship between different aspects of alliance funding profiles (e.g. range of sources, dependence on specific sources) and…

Abstract

Purpose

The purpose of this paper is to examine the relationship between different aspects of alliance funding profiles (e.g. range of sources, dependence on specific sources) and participant’ perceptions of how well the organization is positioned for the future.

Design/methodology/approach

A mixed method study in the context of eight alliances participating in the Robert Wood Johnson Foundation’s Aligning Forces for Quality program. Data collection approaches included surveys of alliance participants and semi-structured interviews with alliance leaders.

Findings

The findings indicate that dependence on grant revenues, in particular, may be problematic for how well alliances are positioned for sustainability. While a number of approaches were identified to reduce dependence on grants, implementing these strategies presented more of a challenge for alliances due to the contextual demands of their external environment and a need to strike a balance between pursuing alternative revenue sources and fidelity to the mission and identity of the organization.

Practical implications

Alliance leaders need to have not only a broad and accurate understanding of their external environment, but also an appreciation of the alliance’s identity in that environment. Collectively, the findings can help organizational leaders be more informed about their funding choices and the implications those choices have for the future of their organization.

Originality/value

Collaborative forms of organizations (e.g. alliances, coalitions, networks) are increasingly viewed as an effective means of addressing complex, multifaceted health, and social challenges. For collaborative organizations that depend on the coordinated efforts of volunteers, addressing such complex issues is predicated on sustaining programmatic activities as well as the interest and participation of stakeholders over extended periods of time. This study sheds light on how leaders of these organizations may improve their prospects for sustainability.

Details

Journal of Health Organization and Management, vol. 32 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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Article

Larry Hearld, Jeffrey A. Alexander, Laura J. Wolf and Yunfeng Shi

Multisector health care alliances (alliances) are increasingly viewed as playing an important role in improving the health and health care of local populations, in part by…

Abstract

Purpose

Multisector health care alliances (alliances) are increasingly viewed as playing an important role in improving the health and health care of local populations, in part by disseminating innovative practices, yet alliances face a number of challenges to disseminating these practices beyond a limited set of initial participants. The purpose of this paper is to examine how alliances attempt to disseminate innovative practices and the facilitating and inhibiting factors that alliances confront when trying to do so.

Design/methodology/approach

The authors adopted multiple holistic case study design of eight alliances with a maximum variation case selection strategy to reflect a range of structural and geographic characteristics. Semi-structured interviews with staff, leaders and board members were used.

Findings

The findings show that dissemination is a multidirectional process that is closely if not inextricably intertwined with capacity- and context-related factors (of the alliance, partnering organizations and target organizations). Thus, standardized approaches to dissemination are likely the exception and not the rule, and highlight the value of existing frameworks as a starting point for conceptualizing the important aspects of dissemination, but they are incomplete in their description of the “on-the-ground” dissemination processes that occur in the context of collaborative organizational forms such as alliances.

Originality/value

Despite a rapidly expanding evidence base to guide clinical and managerial decision making, this knowledge often fails to make its way into routine practice. Consequently, the search for effective strategies to reduce this gap has accelerated in the past decade. This study sheds light on those strategies and the challenges to implementing them.

Details

Journal of Health Organization and Management, vol. 33 no. 4
Type: Research Article
ISSN: 1477-7266

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Book part

Zo Ramamonjiarivelo, Larry Hearld, Josué Patien Epané, Luceta Mcroy and Robert Weech-Maldonado

Public hospitals have long been major players in the US health care delivery system. However, many public hospitals have privatized during the past few decades. The…

Abstract

Public hospitals have long been major players in the US health care delivery system. However, many public hospitals have privatized during the past few decades. The purpose of this chapter was to investigate the impact of public hospitals' privatization on community orientation (CO). This longitudinal study used a national sample of nonfederal acute-care public hospitals (1997–2010). Negative binomial regression models with hospital-level and year fixed effects were used to estimate the relationships. Our findings suggested that privatization was associated with a 14% increase in the number of CO activities, on average, compared with the number of CO activities prior to privatization. Public hospitals privatizing to for-profit status exhibited a 29% increase in the number of CO activities, relative to an insignificant 9% increase for public hospitals privatizing to not-for-profit status.

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Book part

Larry R. Hearld, Kristine R. Hearld and Tory H. Hogan

Longitudinally (2008–2012) assess whether community-level sociodemographic characteristics were associated with patient-centered medical home (PCMH) capacity among primary…

Abstract

Purpose

Longitudinally (2008–2012) assess whether community-level sociodemographic characteristics were associated with patient-centered medical home (PCMH) capacity among primary care and specialty physician practices, and the extent to which variation in PCMH capacity can be accounted for by sociodemographic characteristics of the community.

Design/methodology/approach

Linear growth curve models among 523 small and medium-sized physician practices that were members of a consortium of physician organizations pursuing the PCMH.

Findings

Our analysis indicated that the average level of sociodemographic characteristics was typically not associated with the level of PCMH capacity, but the heterogeneity of the surrounding community is generally associated with lower levels of capacity. Furthermore, these relationships differed for interpersonal and technical dimensions of the PCMH.

Implications

Our findings suggest that PCMH capabilities may not be evenly distributed across communities and raise questions about whether such distributional differences influence the PCMH’s ability to improve population health, especially the health of vulnerable populations. Such nuances highlight the challenges faced by practitioners and policy makers who advocate the continued expansion of the PCMH as a means of improving the health of local communities.

Originality/value

To date, most studies have focused cross-sectionally on practice characteristics and their association with PCMH adoption. Less understood is how physician practices’ PCMH adoption varies as a function of the sociodemographic characteristics of the community in which the practice is located, despite work that acknowledges the importance of social context in decisions about adoption and implementation that can affect the dissemination of innovations.

Details

Population Health Management in Health Care Organizations
Type: Book
ISBN: 978-1-78441-197-8

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Article

Amy Yarbrough Landry and Larry R. Hearld

The purpose of this study is to examine the prevalence of different workplace learning models in healthcare organizations and examine whether these learning styles and…

Abstract

Purpose

The purpose of this study is to examine the prevalence of different workplace learning models in healthcare organizations and examine whether these learning styles and activities differ across hierarchical level.

Design/methodology/approach

Results of a survey of US healthcare executives and executive‐track employees were analyzed (n=492). The survey asked for information on workplace learning style, hierarchical position, and workplace learning opportunities.

Findings

Employees at all levels of the organization report learning in a variety of ways in the workplace, including through transmission, experience, communities of practice, competence, and activity. However, employees at lower hierarchical levels report fewer workplace learning opportunities than those at higher levels.

Research limitations/implications

The study utilizes cross‐sectional data on healthcare executives who are relatively homogenous with regard to race and gender.

Practical implications

The results of the study are positive in that a variety of workplace learning opportunities are available to executives and executive‐track employees. However, placing more emphasis on the development of director and manager level employees would further enhance the talent pool for executive level leadership in US hospitals.

Originality/value

The study demonstrates differences in learning styles and opportunities for learning across hierarchical level.

Details

Leadership & Organization Development Journal, vol. 34 no. 2
Type: Research Article
ISSN: 0143-7739

Keywords

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Abstract

Details

Population Health Management in Health Care Organizations
Type: Book
ISBN: 978-1-78441-197-8

Content available
Book part

Abstract

Details

Transforming Health Care
Type: Book
ISBN: 978-1-83982-956-7

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Article

Ruiling Guo, Steven D. Berkshire, Lawrence V. Fulton and Patrick M. Hermanson

The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare…

Abstract

Purpose

The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics.

Design/methodology/approach

A cross-sectional study was conducted among US healthcare leaders. Spearman’s correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0.

Findings

One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders’ values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous “use of EBMgt” response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman’s correlation indicated statistically significant relationships between healthcare leaders’ use of EBMgt and healthcare organization bed size (rs = 0.217, n = 152, p < 0.01), attitude towards EBMgt (rs = 0.517, n = 152, p < 0.01), and the number of organization employees (rs = 0.195, n = 152, p = 0.016).

Originality/value

This study generated new research findings on the practice of EBMgt in US healthcare administration decision-making.

Details

Leadership in Health Services, vol. 30 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

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