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1 – 10 of 176Tyler Aird, Ceara Holditch, Sarah Culgin, Margareta Vanderheyden, Greg Rutledge, Carlo Encinareal, Dan Perri, Fraser Edward and Hugh Boyd
The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute…
Abstract
Purpose
The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report.
Design/methodology/approach
Utilization statistics of the data integration solution were captured at one-month post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group.
Findings
The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts.
Practical implications
A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.
Originality/value
Although there has been a large effort to integrate health data across care levels in the United States and internationally, the groundwork for such integrations between interoperable systems has only just begun in Canada. The implementation of the integration between an enterprise LTC electronic medical record system and an HIS described herein is the first of its kind in Canada. Benefits and lessons learnt from this pilot will be useful for further hospital-to-LTC home interoperability work.
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Tomasz Mucha, Sijia Ma and Kaveh Abhari
Recent advancements in Artificial Intelligence (AI) and, at its core, Machine Learning (ML) offer opportunities for organizations to develop new or enhance existing capabilities…
Abstract
Purpose
Recent advancements in Artificial Intelligence (AI) and, at its core, Machine Learning (ML) offer opportunities for organizations to develop new or enhance existing capabilities. Despite the endless possibilities, organizations face operational challenges in harvesting the value of ML-based capabilities (MLbC), and current research has yet to explicate these challenges and theorize their remedies. To bridge the gap, this study explored the current practices to propose a systematic way of orchestrating MLbC development, which is an extension of ongoing digitalization of organizations.
Design/methodology/approach
Data were collected from Finland's Artificial Intelligence Accelerator (FAIA) and complemented by follow-up interviews with experts outside FAIA in Europe, China and the United States over four years. Data were analyzed through open coding, thematic analysis and cross-comparison to develop a comprehensive understanding of the MLbC development process.
Findings
The analysis identified the main components of MLbC development, its three phases (development, release and operation) and two major MLbC development challenges: Temporal Complexity and Context Sensitivity. The study then introduced Fostering Temporal Congruence and Cultivating Organizational Meta-learning as strategic practices addressing these challenges.
Originality/value
This study offers a better theoretical explanation for the MLbC development process beyond MLOps (Machine Learning Operations) and its hindrances. It also proposes a practical way to align ML-based applications with business needs while accounting for their structural limitations. Beyond the MLbC context, this study offers a strategic framework that can be adapted for different cases of digital transformation that include automation and augmentation of work.
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Peter O’Meara, Gary Wingrove and Michael McKeage
The purpose of this paper is to describe and analyse two approaches to paramedic service clinical governance and quality management from the perspective of two groups of…
Abstract
Purpose
The purpose of this paper is to describe and analyse two approaches to paramedic service clinical governance and quality management from the perspective of two groups of paramedics and paramedic managers working in North America.
Design/methodology/approach
A case study approach was utilised to describe and analyse paramedic service medical direction in North America and contrast this with the professional self-governance and clinical governance systems operating in other high-income countries. Researchers interviewed participants at two remote North American sites, then completed transcription and thematic analysis.
Findings
Participants identified three themes: first, resourcing, regulatory frameworks and fragmentation; second, independent practice facilitators and barriers; and third, paramedic roles and professionalisation. Those trained outside North America tended to identify self-regulation and clinical governance as the preferred approach to quality management. Few participants had considered paramedicine becoming a self-regulating health profession.
Originality/value
In North America, the “medical direction” model is the dominant approach employed to ensure optimal patient outcomes in paramedic service delivery. In contrast, other comparable countries employ paramedic self-regulatory systems combined with clinical governance to achieve the same ends. This is one of two studies to examine medical direction from the perspective of paramedics and paramedic managers.
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The past decade has witnessed a tremendous and progressive growth in the number of Nigerians who engage in medical tourism from Nigeria to India. Various commentators have…
Abstract
Purpose
The past decade has witnessed a tremendous and progressive growth in the number of Nigerians who engage in medical tourism from Nigeria to India. Various commentators have advanced diverse reasons for this trend. However, there is a dearth of research that has sought to provide empirical insights. This paper aims to investigate the decision-making process of Nigerian medical tourists and why they prefer medical tourism to India to medical care locally.
Design/methodology/approach
Eight Nigerian medical tourists are interviewed on a one-on-one basis with open-ended questions using purposive criterion sampling technique from an interpretivist mind-set.
Findings
The paper identifies two major motivators, namely, inadequate medical infrastructure and poor medical, and customer service from health workers in Nigeria, which spurred medical tourism from Nigeria to India. Further, it finds that first timers premise their decisions on advice from reference groups, while previous personal experiences guide decisions on subsequent medical travels. Findings are explained using the template provided by the theory of planned behaviour.
Originality/value
This exploratory nature of this research provides a useful basis to elucidate the course of decision-making of Nigerian patients so that appropriate marketing communication channels can be applied. It improves the process of recruiting and engaging Nigerian patients and nurturing wholesome relationships between Nigerian patients and hospitals.
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This research paper aims to discover the elements of good physician leadership as perceived by physicians and to find out how the findings connect to the leadership theory.
Abstract
Purpose
This research paper aims to discover the elements of good physician leadership as perceived by physicians and to find out how the findings connect to the leadership theory.
Design/methodology/approach
The subjects (n = 50) of this qualitative study are physicians from four hierarchical levels (residents/specialising physicians, specialists, heads of departments and chief physicians). Content analysis with a constructivist-interpretative approach by thematisation was the chosen method, and it was also analysed how major leadership theories relate to good physician leadership.
Findings
Physician leaders are expected to possess the professional skills of physicians, understand how the work affects physicians’ lives and be competent in applying suitable leadership approaches following different situations and people. Trust, fairness, empathy, social skills, two-way communication skills, regular feedback, collegial respect and emotional intelligence are expected. As medical expertise connects leaders and followers, success in medical leadership comes from credibility in medical expertise, making medical leadership an inseparable part of good physician leadership. Subordinates are physician colleagues, who have their informal leadership roles on their hierarchical levels, making physician leadership a multidimensional leadership setting wherein formal leaders lead informal leaders, which blurs the traditional leader–follower boundary. In summary, good physician leadership is leadership through medical expertise combined with good manners, collegiality and traits from different kinds of leadership theories.
Originality/value
This study discovers elements of good physician leadership in a Finnish health-care context in which no similar prior empirical research has been carried out.
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Daicy Vaz, Wardah Qureshi, Yama Temouri and Vijay Pereira
Previous research provides adequate evidence on performance management (PM) for hospitals and healthcare providers; however, less is known about their individual and PM appraisal…
Abstract
Purpose
Previous research provides adequate evidence on performance management (PM) for hospitals and healthcare providers; however, less is known about their individual and PM appraisal process. Additionally, there is limited research exploring PM in the Middle Eastern context. This study investigates PM practices in the Middle Eastern healthcare industry.
Design/methodology/approach
This study adopts the qualitative research methodology through semi-structured interviews of healthcare professionals in Kingdom of Saudi Arabia and the United Arab Emirates. Thematic analysis was adopted for analyzing this qualitative data.
Findings
The main findings have uncovered different facets of appraisal challenges for both the appraiser (i.e. manager) and the appraisee (i.e. employee). These challenges include communication deficits, lack of goal setting standards and regular meeting updates in order to ensure employee satisfaction and motivation in the workplace.
Research limitations/implications
This study has significant implications for policymakers in Middle Eastern hospitals in terms of implementing PM for their staff. Moreover, future studies can conduct in-depth analysis and provide comparison between public and private sectors in the Gulf countries.
Originality/value
This study is one of the first to portray challenges involved in conducting PM in the Middle East healthcare sector specifically in the UAE and Kingdom of Saudi Arabia (KSA), both from the perspectives of the appraiser and appraisee.
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Elizabeth Fisher Turesky, Coby D. Smith and Ted K. Turesky
The purpose of this study is to investigate the leadership behaviors of managers of virtual teams (VTs), particularly in the areas of trust building and conflict management. This…
Abstract
Purpose
The purpose of this study is to investigate the leadership behaviors of managers of virtual teams (VTs), particularly in the areas of trust building and conflict management. This study aims to expand the research of VT performance by offering first-person accounts from VT leaders on the strategies implemented to drive VT performance.
Design/methodology/approach
This study used a grounded theory approach to examine the leadership behaviors through in-depth interviews with eight field managers of VTs employed by different technology companies. Interview questions focused on trust-building and conflict management techniques. This structured qualitative study incorporates elements of narrative inquiry interwoven in the findings.
Findings
Building a high-trust environment was found to be critical to VT performance. VT managers indicated that effective conflict resolution skills were also important.
Research limitations/implications
Although the sample size is within the suggested range for a valid phenomenological study, the results may lack generalizability. Participants were limited to the technology industry; leaders of high-performing VTs in other industries could offer differing results.
Practical implications
This study’s contribution is the exploration and identification of innovative techniques that VT managers implemented to build trust and resolve conflict. A lack of holistic training programs for the VT leader is also considered along with suggestions for future research and implications for the VT managers.
Originality/value
This study’s contribution is the exploration and identification of innovative techniques that VT managers implemented that drive VT performance, particularly related to building high levels of trust and managing conflict effectively. Practices are suggested whereby both the VT leader and the organization take an active role in ensuring that the VT has the opportunity to perform optimally.
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Qinxu Ding, Ding Ding, Yue Wang, Chong Guan and Bosheng Ding
The rapid rise of large language models (LLMs) has propelled them to the forefront of applications in natural language processing (NLP). This paper aims to present a comprehensive…
Abstract
Purpose
The rapid rise of large language models (LLMs) has propelled them to the forefront of applications in natural language processing (NLP). This paper aims to present a comprehensive examination of the research landscape in LLMs, providing an overview of the prevailing themes and topics within this dynamic domain.
Design/methodology/approach
Drawing from an extensive corpus of 198 records published between 1996 to 2023 from the relevant academic database encompassing journal articles, books, book chapters, conference papers and selected working papers, this study delves deep into the multifaceted world of LLM research. In this study, the authors employed the BERTopic algorithm, a recent advancement in topic modeling, to conduct a comprehensive analysis of the data after it had been meticulously cleaned and preprocessed. BERTopic leverages the power of transformer-based language models like bidirectional encoder representations from transformers (BERT) to generate more meaningful and coherent topics. This approach facilitates the identification of hidden patterns within the data, enabling authors to uncover valuable insights that might otherwise have remained obscure. The analysis revealed four distinct clusters of topics in LLM research: “language and NLP”, “education and teaching”, “clinical and medical applications” and “speech and recognition techniques”. Each cluster embodies a unique aspect of LLM application and showcases the breadth of possibilities that LLM technology has to offer. In addition to presenting the research findings, this paper identifies key challenges and opportunities in the realm of LLMs. It underscores the necessity for further investigation in specific areas, including the paramount importance of addressing potential biases, transparency and explainability, data privacy and security, and responsible deployment of LLM technology.
Findings
The analysis revealed four distinct clusters of topics in LLM research: “language and NLP”, “education and teaching”, “clinical and medical applications” and “speech and recognition techniques”. Each cluster embodies a unique aspect of LLM application and showcases the breadth of possibilities that LLM technology has to offer. In addition to presenting the research findings, this paper identifies key challenges and opportunities in the realm of LLMs. It underscores the necessity for further investigation in specific areas, including the paramount importance of addressing potential biases, transparency and explainability, data privacy and security, and responsible deployment of LLM technology.
Practical implications
This classification offers practical guidance for researchers, developers, educators, and policymakers to focus efforts and resources. The study underscores the importance of addressing challenges in LLMs, including potential biases, transparency, data privacy, and responsible deployment. Policymakers can utilize this information to shape regulations, while developers can tailor technology development based on the diverse applications identified. The findings also emphasize the need for interdisciplinary collaboration and highlight ethical considerations, providing a roadmap for navigating the complex landscape of LLM research and applications.
Originality/value
This study stands out as the first to examine the evolution of LLMs across such a long time frame and across such diversified disciplines. It provides a unique perspective on the key areas of LLM research, highlighting the breadth and depth of LLM’s evolution.
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Antti Rautiainen, Toni Mättö, Kari Sippola and Jukka O. Pellinen
This article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.
Abstract
Purpose
This article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.
Design/methodology/approach
In contrast to the majority of earlier studies focusing on special health care, the study was conducted in a Finnish basic health care organization. The empirical data include 36 interviews, accounting reports, budgets, newspaper articles and meeting notes collected 2013–2018.
Findings
The use of accounting techniques in this case did not offer professionals sufficient support under conditions of conflict. The authors suggest that this perceived lack of support intensified the negative emotions toward accounting techniques. These negative emotions aggregated into incompatible professional-level institutional logics, which contributed to the lack of hybridization between such logics. The authors highlight the importance of the cognitive microfoundations, that is, the individual-level interpretations and emotional responses, in the analysis of conflicting institutional logics.
Practical implications
Managerial attention needs to be directed to accounting practices perceived as frustrating or threatening, a perception that can prevent the use of accounting techniques in the creation of professional hybrids. The Finnish basic health care context involves inconsistent political decision-making, multiple tasks, three institutional logics and individual interpretations and emotions in various decision-making situations.
Originality/value
This study develops microfoundational accounting research by illustrating how individual-level cognitive microfoundations such as dissatisfaction with budgeting, aggregate into professional-level institutional logics, and in our case, prevent professional hybridization in a basic health care setting characterized by conflict and three separate institutional logics.
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Fethiye Ozis, Shannon Lynn Isovitsch Parks, Deborah Lynne Sills, Mustafa Akca and Christine Kirby
This paper aims to analyze how a tangram activity improved students’ abilities to explain sustainability, articulate a positive perception of sustainable design and relate…
Abstract
Purpose
This paper aims to analyze how a tangram activity improved students’ abilities to explain sustainability, articulate a positive perception of sustainable design and relate sustainability with innovation in engineering design.
Design/methodology/approach
The concept of paradigm shift was introduced in the classroom by using a tangram activity to help students understand that sustainable design requires out-of-the-box thinking. Instructors from three institutions teaching various levels of sustainability courses to engineering majors used the activity to introduce sustainable design, then measured the understanding and appreciation of the concepts introduced through the tangram activity with pre- and post-activity surveys.
Findings
Findings from the study indicate that students’ perceptions of sustainability significantly improved due to the activity, without regard to the institution. The activity also significantly improved students understanding of the connection between sustainability and innovation, across all three institutions, across all majors and across all years of study except second-year students. Improving engineering students’ views on sustainability may lead, over time, to changes in the industry, in which environmental performance is incorporated into the engineering design process.
Originality/value
Active learning approaches are needed for affective-domain learning objectives in the sustainability field for students to learn the necessary attitudes, values and motivations to implement sustainability in engineering design. Simple, easily implemented active learning techniques, such as the tangram activity presented here, can be implemented across the curriculum or to the public to introduce the paradigm shift necessary with sustainable design.
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