Search results
1 – 10 of over 61000Patience Aseweh Abor and Anton Bouwer
The purpose of this paper is to examine the medical waste management practices of a hospital in Southern Africa.
Abstract
Purpose
The purpose of this paper is to examine the medical waste management practices of a hospital in Southern Africa.
Design/methodology/approach
A case study methodology was utilised.
Findings
The results revealed that the hospital does not quantify medical waste. Segregation of medical waste into infectious waste and non‐infectious waste is not conducted according to definite rules and standards. Separation of medical waste and municipal waste is however practiced to a satisfactory extent. Wheeled trolleys are used for on‐site transportation of waste. Off‐site transportation of waste is outsourced to a private firm. Incineration is used in the final disposal of infectious waste. Non‐infectious waste is disposed using land disposal method. There is no policy and plan in place for managing medical waste. A number of problems were identified with respect to medical waste management.
Originality/value
The paper gives recommendations with the aim of improving medical waste management in hospitals.
Details
Keywords
Marco Sartirana, Anna Prenestini and Federico Lega
As a consequence of new public management reforms, leading professionals in public service organizations have increasingly been involved in management roles. The phenomenon of…
Abstract
Purpose
As a consequence of new public management reforms, leading professionals in public service organizations have increasingly been involved in management roles. The phenomenon of clinical directors in the healthcare sector is particularly representative of this, as this medical manager role has been adopted in many countries around the world. However, professionals’ managerial role taking still falls quite short of expectations. While most research has searched for the causes of this gap at the individual level by exploring the clash between management and professionalism, the purpose of the paper is to argue that a contextualized understanding of the antecedents at the organizational level, and particularly the existing medical management roles, provides a more thorough picture of the reality.
Design/methodology/approach
The paper adopts an institutional perspective to study the development of existing medical management roles and the rise of new ones (clinical directors). The analysis focuses on the case of Italy, a country with a tradition in medical management where, following the example of other countries, clinical director roles were introduced by law; yet they were not incisive. The paper is based on a review of the existing literature and extensive field research on Italian clinical directorates.
Findings
The paper shows how in contexts in which doctors in management roles exist and are provided with legitimacy deriving from legal norms, historical settlements between professions and taken for granted arrangements, medical management becomes institutionalized, stability prevails and change towards new doctor-in-management roles is seriously hampered.
Originality/value
The paper contributes to existing knowledge on professionals’ managerial role taking, underlining the relevance of contextual and nation-specific factors on this process. It provides implications for research and for policy making in healthcare and other professional public services.
Details
Keywords
Ngoako Solomon Marutha and Mpho Ngoepe
This study aims to develop a framework for the management of medical records in support of health-care service delivery in the hospitals in the Limpopo province of South Africa.
Abstract
Purpose
This study aims to develop a framework for the management of medical records in support of health-care service delivery in the hospitals in the Limpopo province of South Africa.
Design/methodology/approach
The study was predominantly quantitative and has used the questionnaires, system analysis, document analysis and observation to collect data in 40 hospitals of Limpopo province. The sample of 49 per cent (306) records management officials were drawn out of 622 (100 per cent) total population. The response rate was 71 per cent (217) out of the entire sample.
Findings
The study discovered that a framework for management of medical records in the public hospitals is not in place because of several reasons and further demonstrates that public health-care institutions need an integrative framework for the proper management of medical records of all forms and in all media.
Originality/value
The study develops and suggests a framework to embed medical records management into the health-care service delivery workflow for effective records management and ease of access. It is hoped that such a framework will help hospitals in South Africa and elsewhere to improve their medical records management to support health-care service provision.
Details
Keywords
Shiaw‐Wen Tien, Chiu‐Yen Liu, Yi‐Chan Chung, Chih‐Hung Tsai and Ching‐Piao Chen
Since the execution of National Health Insurance system in Taiwan, the competition of medical industry is becoming more and more severe. The ways the hospital operate knowledge…
Abstract
Since the execution of National Health Insurance system in Taiwan, the competition of medical industry is becoming more and more severe. The ways the hospital operate knowledge management (KM) concept, combine current human resources and professional knowledge by information techniques and upgrade the competitiveness through reinvention of organizational culture have become the important issues. This research is based on the relationship between KM and organizational operation, integrates the characteristic of medical institutions and framework of medical knowledge cycle and starts the research subject by questionnaires from three dimensions: current situation of KM construction in medical organizations, executive effect of KM activities and the challenges faced by KM; subsequently, from qualitative interview, this research attempts to understand how a medical organization executes and adjusts in the consideration of theory and reality as well as quality and costs when actually operates the organization. This research accesses to KM system application of medical institutions and the empirical executive benefits and difficulties through questionnaires. The research results are as follows: (1) having initial understanding toward current KM establishment of medical institutions; (2) confirming the most important items of KM establishment of medical organizations; (3) understanding the most difficulty which the medical organizations encounter when executing KM; (4) establishing medical knowledge cycle figure of the hospitals receiving interviews. Through case interview, this research profoundly accessed to the actual operation of KM application of medical organizations. The target hospitals intended to try many medical KM measures; however, during to complicated hospital organizations and cultural characteristics, the promotion was not successful and the results were not apparent. The most difficulty was to change the employees’ behavior. The targets believed that only the continuous promotion of KM can allow it to be an important aspect of organizational culture and the competitiveness could constant be upgraded.
Details
Keywords
The perpose of this paper is to analyse recent changes in the management of French public hospitals, following a reform enacted in 2009 and aimed at bolstering the managerial…
Abstract
Purpose
The perpose of this paper is to analyse recent changes in the management of French public hospitals, following a reform enacted in 2009 and aimed at bolstering the managerial roles of doctors.
Design/methodology/approach
The paper is exploratory and is based on both the analysis of French literature dealing with the results of the 2009 reform, and ten semi-directed interviews with clinical managers and top leaders in the public hospital sector.
Findings
The author reports on the major hospital management reforms of 2009 and analyse the implications for the medical profession and management. The author shows that the involvement of the classical clinical leaders has become less regulated as the units no longer have a clear legal basis. The governance of the newly introduced “medical poles” appears to be shaped by various factors: there is high correlation between centrality, prestige and “clan involvement”, which suggests that professionals holding new responsibilities obtain power and legitimacy by consolidating pre-existing networks. While it is often argued that high-quality clinical leadership is a key factor of organisational success, the findings suggest that the performance of clinical managers relies on this network and legitimacy acquired from it.
Originality/value
Drawing on the “sociology of translation” and actor-network theory (Callon and Latour, 1991), this paper provides a new conceptual framework for the analysis of the transformation of the role of clinical leaders, arguing that this transformation depends highly on their abilities to build and use networks. The findings challenge the French tradition of public management that presupposes a clear division of power between doctors and administrative staff.
Details
Keywords
Emmanuel Adjei and Monica Mensah
The purpose of this study is to determine the extent to which total quality management (TQM) initiatives can improve the quality of services delivery at the medical records unit…
Abstract
Purpose
The purpose of this study is to determine the extent to which total quality management (TQM) initiatives can improve the quality of services delivery at the medical records unit of the Korle-Bu Teaching Hospital (KBTH) to help meet the expectations and aspirations of patients and customers of the hospital.
Design/methodology/approach
This research adopted the survey strategy as its research design. The total study population consisted of 114 medical records staff of the KBTH. Questionnaires and personal observations were employed as the data collection instruments. The study recorded a response rate of 98 per cent. Data gathered from respondents were analysed in qualitative terms.
Findings
The overall finding of this study was that, although the medical records department of the KBTH had a fair degree of understanding on the benefits of TQM to records management service delivery, the exiting values for TQM did not meet the framework of good TQM practice, principles and standards.
Research limitations/implications
Even though the subjects for the study were from the biggest hospital in Ghana, the findings of this study may not be generalised to the whole country.
Practical implications
The study has demonstrated the need for the medical records department of the KBTH to have and develop good TQM standards to improve the quality of services to patients and varied customers of the hospital.
Originality/value
The literature reviewed indicated that this study is a maiden attempt to examine how TQM initiatives including sensitivity, customer satisfaction, commitment of top management, team work, effective leadership and participatory management, people development and effective and open communication can improve the quality of medical records service delivery at the KBTH in Ghana.
Details
Keywords
Rona Bahreini, Leila Doshmangir and Ali Imani
Effective maintenance management of medical equipment is one of the major issues for quality of care and cost-effectiveness especially in modern hospitals. An effective medical…
Abstract
Purpose
Effective maintenance management of medical equipment is one of the major issues for quality of care and cost-effectiveness especially in modern hospitals. An effective medical equipment maintenance management (MEMM) consists of adequate planning, management and implementation. This is essential for providing good health services and saving scarce resources. Considering the importance of the subject, the purpose of this paper is to extract the influential factors on MEMM using a qualitative approach.
Design/methodology/approach
Documents review and interviews were main methods for data collection. Semi structured interviews were conducted with a purposive sample of 14 clinical engineers with different degree of education and job levels. Interviews were voice recorded and transcribed verbatim. Qualitative data were analyzed using a content analysis approach (inductive and deductive) to identify the underlying themes and sub-themes.
Findings
Factors influencing an effective and efficient MEMM system categorized in seven themes and 19 sub-themes emerged. The themes included: “resources,” “quality control,” “information bank,” “education,” “service,” “inspection and preventive maintenance” and “design and implementation.”
Originality/value
The proposed framework provides a basis for a comprehensive and accurate assessment of medical equipment maintenance. The findings of this study could be used to improve the profitability of healthcare facilities and the reliability of medical equipment.
Details
Keywords
Richard Walker and Philip Morgan
Reports the results of a survey of 209 senior registrars and 269 consultants throughout Wales to identify the management development needs of doctors and ascertain their views of…
Abstract
Reports the results of a survey of 209 senior registrars and 269 consultants throughout Wales to identify the management development needs of doctors and ascertain their views of the value and utility of current management development course offerings in Wales. Finds that, currently, management development for doctors in Wales is unstructured and unco‐ordinated but, despite this, many doctors, especially senior registrars, appeared keen to increase their future involvement in management and held positive views regarding management and management development. The questionnaire also required doctors to rank order six managerial topics and their elements: financial, human resource, strategic, operational, service quality and self‐management. Of these, self‐management issues were rated highest and there was some congruity in the rankings of the six topics by senior registrars and the other three consultant categories. Overall, managing a budget, medical and clinical audit, negotiating skills and leadership skills were ranked highest for inclusion in management development while project management, quality circles and equal opportunities received the lowest ratings.
Details
Keywords
Lawton Robert Burns, Jeff C. Goldsmith and Aditi Sen
Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these…
Abstract
Purpose
Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.
Design/Methodology Approach
We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.
Findings
The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.
Research Limitations
While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.
Research Implications
Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.
Practical Implications
Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.
Originality/Value
This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.
Details
Keywords
Izatul Hamimi Abdul Razak, Shahrul Kamaruddin, Ishak Abdul Azid and Indra Putra Almanar
The purpose of this paper is to provide an understanding on implementation and operation of ISO 13485:2003 – “Medical Devices – Quality Management System – Requirements for…
Abstract
Purpose
The purpose of this paper is to provide an understanding on implementation and operation of ISO 13485:2003 – “Medical Devices – Quality Management System – Requirements for Regulatory Purposes” – in the perspective of medical device industries in Malaysia. The study is focused on the Malaysian Small and Medium Enterprises (SMEs) which currently have accredited to ISO 9001:2000 quality management systems.
Design/methodology/approach
Literature research and comparative analysis between ISO 13485:2003 and ISO 9001:2000 standard and requirements. A reference model is developed to assist the Malaysian SMEs towards ISO 13485:2003 accreditation.
Findings
Unlike ISO 9001:2000, ISO 13485:2003 stresses the safety and efficacy of medical devices that are being produced. For this reason risk management is an essential process that needs to be adopted into the ISO 13485:2003 quality management system. Moreover, to demonstrate the effectiveness of the ISO 13485:2003 implementation, this standard has placed great emphasis on documentation requirements which are more prescriptive in insisting on the use of formal procedures.
Originality/value
The paper provides guidelines to ISO 13485:2003 implementations as well as risk management approaches for small and medium‐sized businesses of Malaysian medical device manufacturers, which at the same time maintains its ISO 9001:2000 certification.
Details