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1 – 10 of 256Maria Qvarfordt, Stefan Lagrosen and Lina Nilsson
The purpose of this mixed-methods study was to explore how medical secretaries experience digital transformation in a Swedish healthcare organisation, with a focus on workplace…
Abstract
Purpose
The purpose of this mixed-methods study was to explore how medical secretaries experience digital transformation in a Swedish healthcare organisation, with a focus on workplace climate and health.
Design/methodology/approach
Data were collected using a sequential exploratory mixed-methods design based on grounded theory, with qualitative data collection (a Quality Café and individual interviews) followed by quantitative data collection (a questionnaire).
Findings
Four categories with seven underlying factors were identified, emphasising the crucial need for effective organisation of digital transformation. This is vital due to the increased knowledge and skills in utilising technology. The evolving roles and responsibilities of medical secretaries in dynamic healthcare settings should be clearly defined and acknowledged, highlighting the importance of professionality. Ensuring proper training for medical secretaries and other occupations in emerging techniques is crucial, emphasising equal value and knowledge across each role. Associations were found between some factors and the health of medical secretaries.
Research limitations/implications
This study adds to the knowledge on digital transformation in healthcare by examining an important occupation. Most data were collected online, which may be a limitation of this study.
Practical implications
Several aspects of the medical secretaries’ experiences were identified. Knowledge of these is valuable for healthcare managers to make digital transformation more effective while avoiding excessive strain on medical secretaries.
Originality/value
Medical secretaries are expected to contribute to the digitalisation of healthcare. However, minimal research has been conducted on the role of medical secretaries in workplace digitalisation, focusing on workplace roles and its dynamics.
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Abdullah H. Alnasser, Mohammad A. Hassanain, Mustafa A. Alnasser and Ali H. Alnasser
This study aims to identify and assess the factors challenging the integration of artificial intelligence (AI) technologies in healthcare workplaces.
Abstract
Purpose
This study aims to identify and assess the factors challenging the integration of artificial intelligence (AI) technologies in healthcare workplaces.
Design/methodology/approach
The study utilized a mixed approach, that starts with a literature review, then developing and testing a questionnaire survey of the factors challenging the integration of AI technologies in healthcare workplaces. In total, 46 factors were identified and classified under 6 groups. These factors were assessed by four different stakeholder categories: facilities managers, medical staff, operational staff and patients/visitors. The evaluations gathered were examined to determine the relative importance index (RII), importance rating (IR) and ranking of each factor.
Findings
All 46 factors were assessed as “Very Important” through the overall assessment by the four stakeholder categories. The results indicated that the most important factors, across all groups, are “AI ability to learn from patient data”, “insufficient data privacy measures for patients”, “availability of technical support and maintenance services”, “physicians’ acceptance of AI in healthcare”, “reliability and uptime of AI systems” and “ability to reduce medical errors”.
Practical implications
Determining the importance ratings of the factors can lead to better resource allocation and the development of strategies to facilitate the adoption and implementation of these technologies, thus promoting the development of innovative solutions to improve healthcare practices.
Originality/value
This study contributes to the body of knowledge in the domain of technology adoption and implementation in the medical workplace, through improving stakeholders’ comprehension of the factors challenging the integration of AI technologies.
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Halil Kiymaz and Carlos Humberto Munoz Valdez
Blockchain technology and its applications have recently received the attention of practitioners and academics. Visualizing the full impact these technologies will have on the…
Abstract
Blockchain technology and its applications have recently received the attention of practitioners and academics. Visualizing the full impact these technologies will have on the world is challenging since their adoption is still in the early stages. This chapter explores how blockchain can disrupt the general business and financial world. Blockchain offers information transparency, live data synchronization, and immutable records that prevent fraud. Digital contracts and digital asset management may heavily depend on the development of blockchain and the adoption of smart contracts. Smart contracts can execute financial transactions automatically and enforce all parties' obligations without needing an intermediary and its cost. They can increase speed and simplify processes, reducing licensing ticketing costs and overhead charges. Blockchain also offers technology adoption solutions, like fair payment, cloud storage, smart contracts for financial assets, and international transactions with bilateral double taxation. It has further facilitated the creation of decentralized finance.
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China’s healthcare system is being burdened by the increasing prevalence of chronic diseases. Therefore, this study investigated the health service requirements of mobile health…
Abstract
Purpose
China’s healthcare system is being burdened by the increasing prevalence of chronic diseases. Therefore, this study investigated the health service requirements of mobile health applications (mHealth apps) users in Hangzhou, China. This study aimed to propose suggestions and theoretical references to improve mHealth apps and promote their development, thereby meeting public medical and health needs and creating an efficient medical service system.
Design/methodology/approach
We constructed a model of health service demands using a literature review, network survey, and semi-structured interviews. We analyzed the demand attributes using the Kano model and Better-Worse index and obtained the priority ranking of demands.
Findings
The results revealed 25 demand elements in four dimensions: must-be (M), one-dimensional (O), attractive (A), and indifferent (I) requirements. The findings suggest that mHealth app developers can optimize health services by categorizing and managing health services, focusing on middle-aged users, enhancing the professionalism of health service providers, and improving the feedback mechanism.
Originality/value
Studies on mHealth apps user demands, particularly on health service needs, remain scarce. This study employed a mixed-methods approach, integrating both qualitative and quantitative research techniques, to establish a priority ranking of user health service needs for mHealth apps. The study offers recommendations and theoretical references to optimize and improve mHealth app services.
Highlights
Construct a better health service requirements model for mHealth app users.
Obtain the prioritization of demand elements in the model.
Propose some management suggestions to improve mHealth apps.
Construct a better health service requirements model for mHealth app users.
Obtain the prioritization of demand elements in the model.
Propose some management suggestions to improve mHealth apps.
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Märt Vesinurm, Inka Sylgren, Annika Bengts, Paulus Torkki and Paul Lillrank
This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and…
Abstract
Purpose
This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.
Design/methodology/approach
The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.
Findings
PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.
Research limitations/implications
This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.
Practical implications
We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.
Originality/value
Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.
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Armando Calabrese, Antonio D'Uffizi, Nathan Levialdi Ghiron, Luca Berloco, Elaheh Pourabbas and Nathan Proudlove
The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.
Abstract
Purpose
The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.
Design/methodology/approach
The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.
Findings
The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.
Originality/value
The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.
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Upasana Singh, Shilpee Dasgupta and Deepak Yaduvanshi
MBA.
Abstract
Subject area of the teaching case
MBA.
Student level and proposed courses the teaching case can be used on
Master’s level in Change Management, Organizational Leadership and Human Resource Management.
A brief overview of the teaching case
Mr Sharma, the dynamic and entrepreneurial Chief Executive Officer (CEO) of the newly formed Soni Manipal Hospital (SMH), Jaipur, and Unit Head, Manipal Hospitals [Manipal Health Enterprises Pvt Ltd. (MHEPL)], in a meeting with SMH’s Head of Human Resources and the Head of the Nursing Management, Mr Yaduvanshi realised the exponential growth of employee resistance, their lack of skills and technological advancements for documentation hindering the hospital's transformation goal. The case study highlighted the challenges the protagonist faced when taking charge as the CEO after nine months of acquisition and the factors contributing to them.
Expected learning outcomes
Students reading this case are expected to understand leadership theories, strategic and quality management approaches, and theories of social behaviour, such as Herzberg’s two-factor theory and social exchange theory (SET) and the application of these concepts in acquired organisations to develop healthy leadership–employee relations and change management theories.
Supplementary materials
Teaching notes are available for educators only.
Subject code
CSS 6: Human resource management.
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Rui M. Lima, Erik Teixeira Lopes, Derek Chaves Lopes, Bruno S. Gonçalves and Pedro G. Cunha
This work aims to integrate the concepts generated by a systematic literature review on patient flows in emergency departments (ED) to serve as a basis for developing a generic…
Abstract
Purpose
This work aims to integrate the concepts generated by a systematic literature review on patient flows in emergency departments (ED) to serve as a basis for developing a generic process model for ED.
Design/methodology/approach
A systematic literature review was conducted using PRISMA guidelines, considering Lean Healthcare interventions describing ED patients’ flows. The initial search found 141 articles and 18 were included in the systematic analysis. The literature analysis served as the basis for developing a generic process model for ED.
Findings
ED processes have been represented using different notations, such as value stream mapping and workflows. The main alternatives for starting events are arrival by ambulance or walk-in. The Manchester Triage Scale (MTS) was the most common protocol referred to in the literature. The most common end events are admission to a hospital, transfer to other facilities or admission to an ambulatory care system. The literature analysis allowed the development of a generic process model for emergency departments. Nevertheless, considering that several factors influence the process of an emergency department, such as pathologies, infrastructure, available teams and local regulations, modelling alternatives and challenges in each step of the process should be analysed according to the local context.
Originality/value
A generic business process model was developed using BPMN that can be used by practitioners and researchers to reduce the effort in the initial stages of design or improvement projects. Moreover, it’s a first step toward the development of generalizable and replicable solutions for emergency departments.
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Moataz Jamil, Hala Sweed, Rania Abou-Hashem, Heba Shaltoot and Khalid Ali
Ageing is associated with multi-morbidity, polypharmacy and medication-related harm (MRH). There is limited published literature on MRH in older Egyptian adults. This study aims…
Abstract
Purpose
Ageing is associated with multi-morbidity, polypharmacy and medication-related harm (MRH). There is limited published literature on MRH in older Egyptian adults. This study aims to determine the incidence and risk factors associated with MRH in an Egyptian cohort of older patients in the 8-weeks period after hospital discharge.
Design/methodology/approach
This study recruited 400 Egyptian patients, aged = ≥ 60 years from 3 hospitals in Cairo and followed them up 8 weeks after discharge using a semi-structured telephone interview to verify MRH events (type, probability, severity and preventability) and related factors.
Findings
The participants’ ages ranged from 60 to 95 years with 53% females. In the final cohort of 325 patients analyzed, MRH occurred in 99 patients (incidence of 30.5%), of which 26 MRH cases (26.2%) were probable, serious and preventable. MRH included adverse drug reactions (ADRs), non-adherence and medication errors. Multivariate regression analysis showed that non-adherence and inappropriate prescription had highly significant association with MRH (P < 0.001), history of previous ADR, living alone and presence of paid caregiver had significant association (P 0.008, 0.012, 0.02 respectively), while age, medications number, length of stay (LOS) and cognitive impairment were not significantly associated with MRH.
Practical implications
These findings demonstrate the magnitude of MRH in Egypt affecting almost a third of older adults after leaving the hospital. These original data could guide decision-makers to enhance older patients’ medication safety through education, quality improvement and policy.
Originality/value
MRH in Egyptian older adults post-hospital discharge has not been adequately reported in scientific literature.
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Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide…
Abstract
Purpose
Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.
Design/methodology/approach
Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).
Findings
The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.
Originality/value
Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.
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