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The article will propose strategic community management as a new management style and innovation technique for large, established companies, that is implemented through…
The article will propose strategic community management as a new management style and innovation technique for large, established companies, that is implemented through the creation of a variety of strategic business communities. The article will take up, as a new model case of the use of strategic community management in business, the expansion of Japan’s multimedia communication market achieved by Nippon Telegraph and Telephone, Inc. (hereafter, NTT), Japan’s largest telecommunications carrier, over roughly the past four years. The article will explain how NTT cultivated this new multimedia market, which was spawned from its creation of business communities (both internal and external, and including communities with customers) using strategic outsourcing and various strategic partnerships with businesses in other industries.
– The purpose of this paper is to identify organisational, technical and individual factors leading to maternal deaths in non-citizen women in Botswana.
The purpose of this paper is to identify organisational, technical and individual factors leading to maternal deaths in non-citizen women in Botswana.
A sub-analysis was conducted comparing non-citizen women to citizens in a case record review of maternal deaths in 2010. Feedback on the results to health professionals was provided and their comments were noted.
In total, 19.6 per cent of 56 case notes reviewed to establish contributory factors to maternal deaths were in non-citizens. This is lower than health professionals perceptions that most maternal deaths are in non-citizens. Non-citizens were significantly less likely to have been tested for HIV and less likely to have received antenatal care, so did not receive interventions to prevent transmission of HIV to their infants or anti-retroviral therapy. They were more likely than citizens to have miscarried or delivered before 28 weeks gestational age at death. Delays in seeking health care were a major contributory factor to death.
Incomplete record keeping and missing details, with 30 per cent of the notes of maternal deaths missing, a common problem with retrospective case-note studies.
Botswana is unlikely to meet Millennium Development Goal five target to reduce the maternal mortality ratio by 75 per cent. To make progress non-citizens must be given the same rights to access maternal health services as citizens. Rationing healthcare for non-citizens is a false economy since treatment of subsequent obstetric emergencies in this group is expensive.
Discrimination against non-citizen women in Botswana, by denying them free access to maternal health services, extends into loss of life because of delays in seeking healthcare especially for obstetric emergencies.
Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research…
Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity.
Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC’s activity or role were included.
In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution.
This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.
The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in…
The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in England, from a justice ministry to a health ministry.
A rapid evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities. The use of a rapid evidence assessment, rather than a systematic review methodology, the use of abstracts (rather than full-text articles) to extract the data, and limiting the search strategy to articles published in the English language only might mean that some relevant research papers and themes were not identified. The need for the evidence to be produced within a limited time frame and with limited resources determined these pragmatic approaches.
The review found that English prison healthcare has undergone “transformation” during this period, leading to increased quality of care through organisational engagement, professionalisation of the healthcare workforce, transparency, use of evidence-based guidance and responsiveness of services. The review also highlighted that there is still room for improvement, for example, relating to the prison regime and the lack of focus on early/preventive interventions, as well as specific challenges from limited resources.
Time and resource constraints meant a rapid evidence review of papers in the English language was undertaken, rather than a systematic review. This might mean relevant papers have been missed. The review also only covered a small number of countries, which may limit the transferability of findings. The lack of quantitative data necessitated the use of qualitative data gathered from key informants. However, this enabled a good understanding of current practice.
The review findings support the World Health Organisation position on the value of integrated prison and public health systems in improving quality of healthcare. It also recommends future policy needs to take account of the “whole prison approach” recognising that healthcare in prisons cannot operate in isolation from the prison regime or the community.
This is unique research which has great value in supporting prison reform in England. It will also be of interest internationally due to the paucity of data in the published peer-reviewed literature on the impact of commissioning models on healthcare or health outcomes.
This paper aims to report on a case study conducted in a private medical partnership of more than 50 specialist physicians where the researcher applied a leadership…
This paper aims to report on a case study conducted in a private medical partnership of more than 50 specialist physicians where the researcher applied a leadership coaching model grounded in existential philosophy. The paper asserts that existential leadership coaching can be a novel and effective means to address leadership development needs in the unique context of a professional partnership.
The qualitative phenomenological study used a bounded case study design using four purposively selected specialist physicians who were involved in four individual structured coaching sessions over an eight-week period. Data came in writing from participants in the form of reflective questions before and after the coaching, and note-taking on index cards during the coaching process. Data also came from the coach/researcher as a participant observer in the form of note-taking and a reflective journal.
Findings indicate that working with perceptions of leadership in existential coaching conversations can provide a mechanism for members of a partnership to find greater purpose, and choose how they can contribute better to leadership development in their collective. Findings indicate that the process of imaging the perceptions of fellow partners can unlock the identification of and choice for developmental actions and contributions to the collective.
For the selected qualitative design, the researcher as the participant observer provided advantages such as insider access and depth of engagement. The study was limited to a small sample in a particular time and context. Findings are thus viewed in the light of this unique case.
Such a qualitative phenomenological case study provides glimpses into the lives of real-life leaders and offers the coaching, academic and medical fraternities an insider understanding of leadership development in the case of professional partnerships.
The paper points to a mechanism which may be a means to unlock potential and facilitate leadership development in the context of professional partnerships.
The purpose of this paper is to present strategies for cultivating internal support, community partnerships and practitioner engagement for Hospital-based Violence…
The purpose of this paper is to present strategies for cultivating internal support, community partnerships and practitioner engagement for Hospital-based Violence Intervention Programs (HVIPs). In response to growing concerns about community violence and calls to engage the community in its solutions, HVIPs have increased in popularity as innovative and transdisciplinary approaches to violence intervention. HVIPs are one strategy under the broad purview of public health approaches to crime and violence – focusing on reaching recent victims of violence in emergency departments and leveraging this “teachable moment” to offer wrap-around services geared toward preventing future violence or revictimization.
This paper uses an autoethnographic and case study approach of Project HEAL (Help, Empower and Lead), a newly established HVIP at Jersey Shore University Medical Center.
While there is no “standard” approach, the importance of strong community partnerships and practitioner engagement prior to and during the HVIP implementation process is second to none.
This case study of Project HEAL’s initial implementation will provide information that can assist other HVIPs in creating and sustaining necessary internal support, community partnerships and practitioner engagement, and potentially help navigate forthcoming statewide and federal efforts.
Development of meaningful community partnerships and achievement of a high level of engagement from practitioners are key to the successful implementation of HVIPs, the processes of which are not always documented in literature.
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…
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.
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.
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.
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.
Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.
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.
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.
This paper aims to describe innovations at the Games + Learning + Society Center to explore the future of education.
This paper is an overview of several published studies and design interventions.
Commercial partnerships, particularly generating copyrightable materials can maximize impact and diversify research funding, but they also run counter to the culture and purpose of many research universities.
Researchers interested in forging new partnerships to maximize impact might explore relationships with commercial entities but be aware that they are running counter to the grain of most institutions and goals. Other universities of different sizes, ages and orientations may have different results.
Building private partnerships requires different staffing and skill sets than traditional research. Guidance for staffing key roles and projects are provided.
This paper is a reflection on unique research initiative that generated revenue and helped shape a subfield of education.
Purpose – This chapter explores the use of adaptive and disruptive change strategies to create an integrated health care delivery system that is both economically…
Purpose – This chapter explores the use of adaptive and disruptive change strategies to create an integrated health care delivery system that is both economically sustainable and patient-centered.
Design/methodology – This case study of Montefiore Medical Center is based on a year of research that included focus-group interviews; individual interviews with executives, frontline staff, and union leaders; site visits; analysis of internal data; and a literature review.
Findings – Montefiore Medical Center is using both adaptive and disruptive strategies to develop an integrated delivery system driven by capitated payments from health insurance companies, a focus on primary care and chronic disease management programs, and community outreach. The growth of these delivery system components in conjunction with Montefiore's Care Management Corporation (to help manage the health plan contracts) has contributed to an affordable cost of care, improved clinical outcomes, and proactive patient and community engagement.
Originality and value – There is a paucity of case studies describing how safety-net hospitals – and health systems in general – can integrate the services they provide to create a positive, seamless, and economical patient experience. The story of Montefiore Medical Center offers an overview of how health care infrastructure and payment methods can be transformed to align financial and clinical incentives and to better serve a patient population that largely depends on government health insurance.
The purpose of this paper is to explore the supply-side factors that determines the quality of global healthcare services from medical tourism healthcare providers’ (MTHP…
The purpose of this paper is to explore the supply-side factors that determines the quality of global healthcare services from medical tourism healthcare providers’ (MTHP) perspective, which provide value-in-medical-travel to foreign patients/medical tourists, who travel to India for medical treatment/surgery.
The thematic content analysis of in-depth interviews with 15 senior MTHP, from 15 private hospitals in India was undertaken, to generate the themes, and identify the supply-side factors necessary for sustainable medical tourism management.
The findings conclude that MTHP ranked in ascending order, less waiting-time for surgery, healthcare quality and accreditation, staff/surgeon’s expertise, healthcare information, hospital facilities and services, patient-safety, travel-risk, surgical costs and holiday opportunity as essential factors for providing sustainable quality and value-in-medical-travel to patients.
The findings are generalised in case of global private hospitals treating foreign patients. Policy implications suggest that private hospitals in developing countries need to focus on providing value-in-medical-travel, such as accreditation quality of healthcare, no waiting-time, patient-safety, qualified and experienced medical and non-medical staff, hospital facilities and post-surgery care with positive healthcare outcomes.
Medical-tour facilitators, hotels and tourism sites need to collaborate with agencies to provide inclusive built environment, first-aid and wheelchair access, to medical tourists, having financial and legal implications for business.
There is little qualitative empirical research on the views of MTHP, regarding management of essential supply-side factors that provide value-in-medical-travel to attract medical tourists to India.
对印度15家私立医院的15家高级医疗旅游保健提供者（MTHP）进行了深度访谈, 对主题内容进行了分析, 以生成主题并确定可持续医疗旅游管理所必需的供应方因素。
研究结果得出结论, MTHP以升序排列的顺序是：手术等待时间, 医疗质量和认证, 工作人员/外科医生的专业知识, 医疗保健信息, 医院设施和服务, 患者安全, 旅行风险, 手术费用和度假时间机会是为患者提供医疗旅行可持续质量和价值的重要因素。
如果全球私立医院为外国医疗游客提供治疗, 那么研究结果将得到概括。政策含义表明, 发展中国家的私立医院需要集中精力提供医疗旅行价值, 例如无需等待时间的医疗保健认证质量和患者安全, 合格和经验丰富的医务人员和非医务人员, 医院设施和后期医疗服务。具有积极医疗效果的手术护理。
旅馆, 医疗旅行促进者和旅游景点需要与机构合作, 为医疗游客提供紧急急救和轮椅通道, 这对企业有财务和法律影响。
印度, 医疗旅游, 全球化 等待时间, 患者安全, 认证质量
Perspectiva del valor de los proveedores del cuidado de la salud en viajes con propositos medicos a la India
El propósito de esta investigación es explorar los factores que del lado de la oferta determinan la calidad de los servicios globales de salud desde el punto de vista del proveedor, el cual agrega valor al viaje con propósitos médicos a pacientes/turistas médicos quienes viajan a la India para tratamientos médicos ó cirugía.
El análisis de contenido temático de las detalladas entrevistas, con-15 proveedores experimentados de asistencia sanitaria de turismo medico, en-15 hospitales de la India, fué realizado para generar los temas é identificar los factores que del lado de la oferta son necesarios para la gestión sostenible del turismo médico.
Los hallazgos concluyen que proveedores experimentados de turismo ranquearon en orden ascendente la reducción en tiempos de espera para cirugías, acreditación de la calidad del cuidado de la salud, experticia del personal no médico y de cirugía, información del cuidado de la salud, servicios é instalaciones de los hospitales, seguridad del paciente, riesgos de viaje, costos de cirugías, y oportunidades vacacionales, como factores esenciales para proveer calidad sostenible y valor en los viajes con propósitos médicos a los pacientes.
Limitaciones de la Investigacion
Muchos representates de los hospitales privados se rehusaron a ser entrevistados debido las políticas de privacidad y confidencialidad del hospitales.
Los hallazgos son generalizables en el caso de hospitales privados globales que tratan a turistas médicos extranjeros. Las implicaciones políticas sugieren que los hospitales privados en los países en vía de desarrollo necesitan enfocarse en agregar valor al viaje médico, por medios como la calidad de acreditación de la atención médica, reduccion de tiempos de espera y la seguridad del paciente, personal médico y no médico calificado y experimentado, instalaciones hospitalarias y servicios posoperatorios con resultados sanitarios positivos.
Los hoteles, los facilitadores de toures médicos y los sitios de turismo necesitan colaborar con las agencias para proveer primeros auxilios de emergencia y acceso en silla de ruedas a los turistas médicos, teniendo esto implicaciones financieras y legales para los negocios.
Originalidad y valor
Existe poca investigación empírica cualitativa sobre los puntos-de vista-de (MTHP) proveedores de asistencia sanitaria de turismo médico con respecto a la gestión de los factores esenciales del lado de la oferta que agregan valor al turismo con fiines médicos para atraer turistas médicos a la India.
India, globalización, turismo médico, tiempo-de-espera, calidad, seguridad-del- paciente
Tipo de investigación
Trabajo de investigación