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Article
Publication date: 15 February 2021

Chiara Pomare, Kate Churruca, Janet C. Long, Louise A. Ellis and Jeffrey Braithwaite

Hospitals are constantly redeveloping to improve functioning and modernise the delivery of safe and high-quality care. In Australia, it is expected that different…

Abstract

Purpose

Hospitals are constantly redeveloping to improve functioning and modernise the delivery of safe and high-quality care. In Australia, it is expected that different stakeholders have the opportunity to contribute to the design and planning of hospital redevelopment projects. The purpose of this study is to examine the potential for misalignment between policy (“work as imagined”) and staff experiences of a hospital redevelopment (“work as done”).

Design/methodology/approach

A case study of a large Australian hospital in a capital city undergoing redevelopment. Forty-six semi-structured interviews were conducted with hospital staff. Staff experiences were identified in corroboration with additional data: key-informant discussions with members of the hospital executive; document analysis (e.g. hospital and government documents) and survey responses about experiences of the hospital redevelopment.

Findings

A disjuncture was identified between policy and the experiences of hospital staff. Over one in every three (36.0%) staff felt uninformed about the redevelopment and 79.4% were not involved in decisions throughout the process of design and redevelopment, which contradicted the procedure laid out in policy for hospital development.

Originality/value

Despite the seemingly “good news story” of allocating billions of dollars to redeveloping and modernising health services in Australia, the experiences of staff on the front lines suggest a lack of consultation. Rectifying these concerns may be integral to avoid fragmentation during the challenging circumstances of hospital redevelopment.

Details

Journal of Health Organization and Management, vol. 35 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 1 June 2021

Eline Ree, Louise A. Ellis and Siri Wiig

To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future…

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1206

Abstract

Purpose

To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future research and implementation studies can use this to further operationalize the concept and promote healthcare resilience.

Design/methodology/approach

The authors first provide an overview of and discuss the main approaches to healthcare resilience and research on management and resilience. Second, the authors provide examples on how managers work to promote healthcare resilience during a one-year Norwegian longitudinal intervention study following managers in nursing homes and homecare services in their daily quality and safety work. They use this material to propose a model of management and resilience.

Findings

The authors consider managerial strategies to support healthcare resilience as the strategies managers use to engage people in collaborative and coordinated processes that adapt, enhance or reorganize system functioning, promoting possibilities of learning, growth, development and recovery of the healthcare system to maintain high quality care. The authors’ model illustrates how managers influence the healthcare systems ability to adapt, enhance and reorganize, with high quality care as the key outcome.

Originality/value

In this study, the authors argue that managerial strategies should be considered and operationalized as part of a healthcare system's overall resilience. They propose a new model of managers' role in supporting resilience to be used in practice, interventions and future research projects.

Details

International Journal of Health Governance, vol. 26 no. 3
Type: Research Article
ISSN: 2059-4631

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Article
Publication date: 27 May 2021

Zeyad Mahmoud, Nathalie Angelé-Halgand, Kate Churruca, Louise A Ellis and Jeffrey Braithwaite

Millions around the world still cannot access safe, timely and affordable surgery. Considering access as a function of efficiency, this paper examines how the latter can…

Abstract

Purpose

Millions around the world still cannot access safe, timely and affordable surgery. Considering access as a function of efficiency, this paper examines how the latter can be improved within the context of operating theatres. Carried out in France and Australia, this study reveals different types of waste in operating theatres and a series of successful tactics used to increase efficiency and eliminate wastefulness.

Design/methodology/approach

Data for this qualitative study were collected through 48 semi-structured interviews with operating theatre staff in France (n = 20) and Australia (n = 28). Transcripts were coded using a theory-driven thematic analysis to characterise sources of waste in operating theatres and the tactics used to address them.

Findings

The study confirmed the prominence of seven types of waste in operating theatres commonly found in industry and originally identified by Ohno, the initiator of lean: (1) underutilised operating rooms; (2) premature or delayed arrival of patients, staff or equipment; (3) need for large onsite storage areas and inventory costs; (4) unnecessary transportation of equipment; (5) needless staff movements; (6) over-processing and (7) quality defects. The tactics used to address each of these types of waste included multiskilling staff, levelling production and implementing just-in-time principles.

Originality/value

The tactics identified in this study have the potential of addressing the chronic and structurally embedded problem of waste plaguing health systems' operating theatres, and thus potentially improve access to surgical care. In a global context of resource scarcity, it is increasingly necessary for hospitals to optimise the ways in which surgery is delivered.

Details

Journal of Health Organization and Management, vol. 35 no. 5
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 30 August 2019

Jeffrey Braithwaite, Kristiana Ludlow, Kate Churruca, Wendy James, Jessica Herkes, Elise McPherson, Louise A. Ellis and Janet C. Long

Much work about health reform and systems improvement in healthcare looks at shortcomings and universal problems facing health systems, but rarely are accomplishments…

Abstract

Purpose

Much work about health reform and systems improvement in healthcare looks at shortcomings and universal problems facing health systems, but rarely are accomplishments dissected and analyzed internationally. The purpose of this paper is to address this knowledge gap by examining the lessons learned from health system reform and improvement efforts in 60 countries.

Design/methodology/approach

In total, 60 low-, middle- and high-income countries provided a case study of successful health reform, which was gathered into a compendium as a recently published book. Here, the extensive source material was re-examined through inductive content analysis to derive broad themes of systems change internationally.

Findings

Nine themes were identified: improving policy, coverage and governance; enhancing the quality of care; keeping patients safe; regulating standards and accreditation; organizing care at the macro-level; organizing care at the meso- and micro-level; developing workforces and resources; harnessing technology and IT; and making collaboratives and partnerships work.

Practical implications

These themes provide a model of what constitutes successful systems change across a wide sample of health systems, offering a store of knowledge about how reformers and improvement initiators achieve their goals.

Originality/value

Few comparative international studies of health systems include a sufficiently wide selection of low-, middle- and high-income countries in their analysis. This paper provides a more balanced approach to consider where achievements are being made across healthcare, and what we can do to replicate and spread successful examples of systems change internationally.

Details

Journal of Health Organization and Management, vol. 34 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 20 April 2015

Louise A. Ellis, Kathryn McCabe, Tracey Davenport, Jane M. Burns, Kitty Rahilly, Mariesa Nicholas and Ian B Hickie

This paper aims to describe the development of WorkOut, an Internet-based program designed to help young men overcome the barriers towards help-seeking and to build the…

Abstract

Purpose

This paper aims to describe the development of WorkOut, an Internet-based program designed to help young men overcome the barriers towards help-seeking and to build the skills they need to understand and manage their own mental health. Information and communication technologies (ICT) hold great potential to significantly improve mental health outcomes for hard-to-reach and traditionally underserved groups. Internet-based programs and mobile phone applications may be particularly appealing to young men due to their convenience, accessibility and privacy and they also address the strong desire for independence and autonomy held by most men.

Design/methodology/approach

In this paper, we describe the design process itself, and the strategies used for multi-disciplinary collaboration. The initial evaluation process and results are also described which consisted of three distinct phases: website statistics; one-on-one user testing; and pilot interviews.

Findings

The results suggest that WorkOut has the potential to attract young men. However, further work is needed to ensure that users remain engaged with the program.

Originality/value

The difficulties encountered and lessons learned provide an insight into the factors that should be considered in the design and evaluation of future ICT-based strategies within the mental health domain, as well as their potential applicability to clinical and educational settings.

Details

Interactive Technology and Smart Education, vol. 12 no. 1
Type: Research Article
ISSN: 1741-5659

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Details

Reference Reviews, vol. 31 no. 5
Type: Research Article
ISSN: 0950-4125

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Article
Publication date: 20 March 2017

Louise Ellis-Barrett

Abstract

Details

Reference Reviews, vol. 31 no. 3
Type: Research Article
ISSN: 0950-4125

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Article
Publication date: 19 March 2018

Louise Ellis-Barrett

Abstract

Details

Reference Reviews, vol. 32 no. 3
Type: Research Article
ISSN: 0950-4125

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Article
Publication date: 15 May 2017

Louise Ellis-Barrett

Abstract

Details

Reference Reviews, vol. 31 no. 4
Type: Research Article
ISSN: 0950-4125

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Article
Publication date: 20 February 2017

Louise Ellis-Barrett

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152

Abstract

Details

Reference Reviews, vol. 31 no. 2
Type: Research Article
ISSN: 0950-4125

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