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1 – 10 of over 42000A new model of multidisciplinary team working with health and social care is being developed in Exeter. This article describes how inclusion of a domiciliary pharmacist in the…
Abstract
A new model of multidisciplinary team working with health and social care is being developed in Exeter. This article describes how inclusion of a domiciliary pharmacist in the team has improved medicines management for patients with long‐term conditions and for adult patients identified as needing support with their medicines. Initial results are discussed, case studies are described and future developments for the service are outlined.
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Victoria Ahlqvist, Nonhlanhla Dube, Marianne Jahre, Jin Soo Lee, Tsegaye Melaku, Andreas Farstad Moe, Max Olivier, Kostas Selviaridis, Joe Viana and Christine Aardal
This paper links supply chain risk management to medicine supply chains to explore the role of policymakers in employing supply chain risk management strategies (SCRMS) to reduce…
Abstract
Purpose
This paper links supply chain risk management to medicine supply chains to explore the role of policymakers in employing supply chain risk management strategies (SCRMS) to reduce generic medicine shortages.
Design/methodology/approach
Using secondary data supplemented with primary data, the authors map and compare seven countries' SCRMS for handling shortage risks in their paracetamol supply chains before and during the first two waves of the COVID-19 pandemic.
Findings
Consistent with recent research, the study finds that policymakers had implemented few SCRMS specifically for responding to disruptions caused by COVID-19. However, shortages were largely avoided since multiple strategies for coping with business-as-usual disruptions had been implemented prior to the pandemic. The authors did find that SCRMS implemented during COVID-19 were not always aligned with those implemented pre-pandemic. The authors also found that policymakers played both direct and indirect roles.
Research limitations/implications
Combining longitudinal secondary data with interviews sheds light on how, regardless of the level of preparedness during normal times, SCRMS can be leveraged to avert shortages in abnormal times. However, the problem is highly complex, which warrants further research.
Practical implications
Supply chain professionals and policymakers in the healthcare sector can use the findings when developing preparedness and response plans.
Social implications
The insights developed can help policymakers improve the availability of high-volume generic medicines in (ab)normal times.
Originality/value
The authors contribute to prior SCRM research in two ways. First, the authors operationalize SCRMS in the medicine supply chain context in (ab)normal times, thereby opening avenues for future research on SCRM in this context. Second, the authors develop insights on the role policymakers play and how they directly implement and indirectly influence the adoption of SCRMS. Based on the study findings, the authors develop a framework that captures the diverse roles of policymakers in SCRM.
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Duan Li‐zhong, Duan Gu‐na, Zhai Guang‐Qian, Zhang Ying, Xuan Chun‐Yu and Geng Hao
The purpose of this paper is to strengthen and standardize general hospital use of traditional Chinese medicine, strengthen the inner construction, highlight the characteristics…
Abstract
Purpose
The purpose of this paper is to strengthen and standardize general hospital use of traditional Chinese medicine, strengthen the inner construction, highlight the characteristics and advantages of Chinese medicine and improve Chinese medicine services' capacity and competitiveness.
Design/methodology/approach
Through data analysis and face‐to‐face interviews, the influential factors for Chinese medicine use in general hospitals are found and the extent and impact of these factors are researched. Based on survey results, grey relational analysis is used to analyze the actual factors.
Findings
Based on the results of grey relational analysis, a clear order of these factors on the degree of influence is obtained and suggestions are offered which can promote the development of traditional Chinese medicine in general hospitals.
Originality/value
The grey system theory was applied in medical management. The influential factors for Chinese medicine use in general hospitals was analyzed by using grey relational analysis, to offer the relevant departments several operational recommendations which can accelerate the development of general hospital use of traditional Chinese medicine.
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This special “Anbar Abstracts” issue of the Journal of Management in Medicine is split into six sections covering abstracts under the following headings: General Management;…
Abstract
This special “Anbar Abstracts” issue of the Journal of Management in Medicine is split into six sections covering abstracts under the following headings: General Management; Personnel and Training; Quality in Health Care; Health Care Marketing; Financial Management; Information Technology.
This special “Anbar Abstracts” issue of the Journal of Management in Medicine is split into seven sections covering abstracts under the following headings: General Management;…
Abstract
This special “Anbar Abstracts” issue of the Journal of Management in Medicine is split into seven sections covering abstracts under the following headings: General Management; Personnel and Training; Quality in Health Care; Health Care Marketing; Financial Management; Information Technology; Leadership, management styles and decision making.
– The purpose of this paper is to determine how best to reduce, reuse and dispose of household waste medicines in the National Health Service (NHS) (UK).
Abstract
Purpose
The purpose of this paper is to determine how best to reduce, reuse and dispose of household waste medicines in the National Health Service (NHS) (UK).
Design/methodology/approach
Through a combination of literature review and empirical work, this research investigates the existing household waste medicines reverse logistics (RL) system and makes recommendations for improvement by benchmarking it against household waste batteries RL. The viability and feasibility of these recommendations are evaluated through in-depth interviews with healthcare professionals and end user surveys.
Findings
The batteries RL system appears to be a more structured and effective system with more active engagement from actors/stakeholders in instigating RL practices and for this very reason is an excellent comparator for waste medicines RL practices. Appropriate best practices are recommended to be incorporated into the waste medicines RL system, including recapturing product value, revised processing approaches, system cooperation and enforcement, drivers and motivations and system design and facilitation.
Research limitations/implications
This study offers academics and professionals an improved insight into the current household waste medicines RL system and provides a step towards reducing an existing gap in this under-researched area. A limitation is that only a small sample of healthcare professionals were involved in subjectively evaluating the feasibility of the recommendations, so the applicability of the recommendations needs to be tested in a wider context and the cost effectiveness of implementing the recommendations needs to be analysed.
Practical implications
Reducing, reusing and properly disposing of waste medicines contribute to economic sustainability, environmental protection and personal and community safety. The information retrieved from analysing returned medicines can be used to inform prescribing practice so as to reduce unnecessary medicine waste and meet the medicine optimisation agenda.
Originality/value
This paper advocates learning from best practices in batteries RL to improve the waste medicines RL design and execution and supports the current NHS agenda on medicine waste reduction (DoH, 2012). The recommendations made in the paper not only aim to reduce medicine waste but also to use medicines effectively, placing the emphasis on improving health outcomes.
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Sineenart Krichanchai and Bart L. MacCarthy
The purpose of this paper is to investigate vendor managed inventory (VMI) for the supply of medicines between distributors and hospitals to identify factors that may affect VMI…
Abstract
Purpose
The purpose of this paper is to investigate vendor managed inventory (VMI) for the supply of medicines between distributors and hospitals to identify factors that may affect VMI adoption.
Design/methodology/approach
Two contrasting VMI initiatives involving five organizations (three hospitals, one distributor and one manufacturer/supplier) are studied. A case study method with semi-structured interviews is used with triangulation in data collection, site visits and document analysis to enhance reliability and validity. The cases are analyzed and compared with respect to hospital, supplier, product and supply chain integration characteristics.
Findings
A successful public sector VMI initiative and an unsuccessful private sector VMI initiative are identified. The public sector supplier focuses on improving service level while the private sector supplier seeks to strengthen relationships with a key customer. Hospital characteristics, including type of hospital, top management perspectives and the hospital’s willingness to share information, are critical in decisions on VMI initiation or termination. Relatively stable demand products are preferred for a VMI approach. Hospitals may perceive risks in VMI adoption for medicines as it involves relinquishing control of critical supplies and may result in “lock-in” with a particular supplier.
Research limitations/implications
The cases have been conducted in one country, which may affect generalization of the findings. Wider empirical evidence from other countries in both developed and less developed regions will be beneficial.
Practical implications
VMI is advocated as being beneficial in many supply contexts. However, it is challenging to implement. The study identifies factors that affect the adoption of VMI for hospital pharmaceuticals and provides guidance on initiating VMI in a hospital context.
Social implications
The potential for VMI in public health projects to enable greater access to critical medicines is highlighted.
Originality/value
The paper provides supply side and demand side perspectives on VMI adoption in an important sector. It highlights the need for greater understanding of the perceived and actual risks in VMI from the perspective of both the hospital and the supplier and for much clearer advice on which pharmaceutical products are appropriate for VMI control in a hospital context.
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Ramatu Abdulkadir, Dante Benjamin Matellini, Ian D. Jenkinson, Robyn Pyne and Trung Thanh Nguyen
This study aims to determine the factors and dynamic systems behaviour of essential medicine stockout in public health-care supply chains. The authors examine the constraints and…
Abstract
Purpose
This study aims to determine the factors and dynamic systems behaviour of essential medicine stockout in public health-care supply chains. The authors examine the constraints and effects of mental models on medicine stockout to develop a dynamic theory of medicine availability towards saving patients’ lives.
Design/methodology/approach
This study uses a mixed-method approach. Starting with a survey method, followed by in-depth interviews with stakeholders within five health-care supply chains to determine the dynamic feedback leading to stockout and conclude by developing a network mental model for medicines availability.
Findings
The authors identified five constraints and developed five case mental models. The authors develop a dynamic theory of medicine availability across cases and identify feedback loops and variables leading to medicine availability.
Research limitations/implications
The need to include mental models of stakeholders like manufacturers and distributors of medicines to understand the system completely. Group surveys are prone to power dynamics and bias from group thinking. This survey’s quantitative output could minimize the bias.
Originality/value
This study uniquely uses a mixed-method of survey method and in-depth interviews of experts to assess the essential medicine stockout in Nigeria. To improve medicine availability, the authors develop a dynamic network mental model to understand the system structure, feedback and behaviour driving stockouts. This research will benefit public policymakers and hospital managers in designing policies that reduce medicine stockout.
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Internationally, management in medicine has become a topical issue in health care research and policy. Against this background, the purpose of this paper is to examine the…
Abstract
Purpose
Internationally, management in medicine has become a topical issue in health care research and policy. Against this background, the purpose of this paper is to examine the changing role of doctors in the management of German hospitals.
Design/methodology/approach
The paper is based on a literature review on the one hand, explorative research drawing on field document and expert interviews, on the other. In the light of basic assumptions of neo-institutionalist and contingency theory, major developments regarding the relationship between medicine and management in Germany are sketched.
Findings
In the German health care sector, the importance of management in medicine is generally increasing, with more managerial (administrative) functions included in the clinicians’ activity. However, the current situation proves complex. On the one hand, there is more management within medicine, materializing, e.g. in further education schemes embracing economic training or in a general expectation that physicians striving for higher ranks within a hospital's hierarchy should exhibit economic knowledge. On the other hand, the authors see a hesitant attitude of the medical profession toward a greater involvement in management. In addition, policies of hospital owners affecting management roles prove diverse. They range from organizing medical departments as autonomous profit centers to ensuring strong hierarchical control by top management, with this entailing different demands regarding a doctor's managerial skills. Due to the advent of powerful non-clinician managers in part of the sector, moreover, medics are losing influence at top level. Altogether, there seems to be a polarization within the hospital system concerning the role of doctors in hospital management. This, to some extent, sits uneasy with key propositions from neo-institutionalist and contingency theory.
Originality/value
The paper retraces general developments concerning the involvement of German hospital doctors in management. Given the paucity of research in this field, it provides preliminary insights on the dynamics that influence the way and degree of this involvement. The major result is that there is structural polarization within an environment which, though streamlining both institutional mind-maps and organizational structures, leaves considerable discretion to the organizational level.
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Melanie Kazman Kohn, Whitney Berta, Ann Langley and David Davis
The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of…
Abstract
The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of evidence-based medicine. The result has been several comparisons in the literature between the use of evidence in health care management decisions and the use of evidence in medical decision making. Direct comparison, however, may be problematic, given the differences between medicine and management as they relate to (1) the nature of evidence that is brought to bear on decision making; (2) the maturity of empirical research in each field (in particular, studies that have substantiated whether or not and how evidence-based decision making is enacted); and (3) the context within which evidence-based decisions are made. By simultaneously reviewing evidence-based medicine and management, this chapter aims to inform future theorizing and empirical research on evidence-based decision making in health care settings.