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Open Access
Article
Publication date: 7 August 2020

Elizabeth Mansfield, Jane Sandercock, Penny Dowedoff, Sara Martel, Michelle Marcinow, Richard Shulman, Sheryl Parks, Mary-Lynn Peters, Judith Versloot, Jason Kerr and Ian Zenlea

In Canada, integrated care pilot projects are often implemented as a local reform strategy to improve the quality of patient care and system efficiencies. In the qualitative study…

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Abstract

Purpose

In Canada, integrated care pilot projects are often implemented as a local reform strategy to improve the quality of patient care and system efficiencies. In the qualitative study reported here, the authors explored the experiences of healthcare professionals when first implementing integrated care pilot projects, bringing together physical and mental health services, in a community hospital setting.

Design/methodology/approach

Engaging a qualitative descriptive study design, semi-structured interviews were conducted with 24 healthcare professionals who discussed their experiences with implementing three integrated care pilot projects one year following project launch. The thematic analysis captured early implementation issues and was informed by an institutional logics framework.

Findings

Three themes highlight disruptions to established logics reported by healthcare professionals during the early implementation phase: (1) integrated care practices increased workload and impacted clinical workflows; (2) integrating mental and physical health services altered patient and healthcare provider relationships; and (3) the introduction of integrated care practices disrupted healthcare team relations.

Originality/value

Study findings highlight the importance of considering existing logics in healthcare settings when planning integrated care initiatives. While integrated care pilot projects can contribute to organizational, team and individual practice changes, the priorities of healthcare stakeholders, relational work required and limited project resources can create significant implementation barriers.

Details

Journal of Integrated Care, vol. 29 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 20 July 2021

Elena Bellio and Luca Buccoliero

Delivering patient-centered healthcare is now seen as one of the basic requirements of good quality care. In this research, the impact of the perceived quality of three…

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Abstract

Purpose

Delivering patient-centered healthcare is now seen as one of the basic requirements of good quality care. In this research, the impact of the perceived quality of three experiential dimensions (Physical Environment, Empowerment and Dignity and Patient–Doctor Relationship) on patient's Experiential Satisfaction is assessed.

Design/methodology/approach

259 structured interviews were performed with patients in private and public hospitals across Italy. The research methodology is based in testing mediation and moderation effects of the selected variables.

Findings

The study shows that: perceived quality of Physical Environment has a positive impact on patient's Experiential Satisfaction; perceived quality of Empowerment and Dignity and perceived quality of Patient–Doctor Relationship mediate this relationship reinforcing the role of Physical Environment on Experiential Satisfaction; educational level is a moderator in the relationship between perceived quality of Patient–Doctor Relationship and overall Satisfaction: more educated patients pay more attention to relational items. Subjective Health Frailty is a moderator in all the tested relationships with Experiential Satisfaction: patients who perceive their health as frail are more reactive to the quality of the above-mentioned variables.

Originality/value

Physical Environment items are enablers of both Empowerment and Dignity and Patient–Doctor Relationship and these variables must be addressed all together in order to improve the value proposition provided to patients. Designing a hospital, beyond technical requirements that modern medicine demands and functional relationships between different medical departments, means dealing with issues like the anxiety of the patient, the stressful working environment for the hospital staff and the need to build a sustainable and healing building.

Details

The TQM Journal, vol. 33 no. 7
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 9 January 2024

Rania Ahmed Aly El Garem, Amira Fouad and Hassan Mohamed

This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating…

Abstract

Purpose

This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating role of the sociodemographic factors.

Design/methodology/approach

The data were gathered from 462 patients via a structured questionnaire, while structural equation modeling was utilized for the analysis.

Findings

Results indicated that trust, perceived value and patient satisfaction have important roles in shaping the patient loyalty, while patient satisfaction was found to fully mediate the patient’s perceived service quality. Loyalty relationship was also found to partially mediate the trust–loyalty relationship. Nonetheless, the patient’s satisfaction–loyalty relationship was found to be only moderated by the age factor.

Practical implications

Implications are provided to the Egyptian private hospitals in order for them to formulate improvement plans as well as set higher standards of conduct.

Originality/value

This original research is the first one, up to the researcher knowledge, that explores the drivers of patient satisfaction in the private hospitals in Egypt.

Details

Journal of Humanities and Applied Social Sciences, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2632-279X

Keywords

Open Access
Article
Publication date: 17 October 2023

Kiran Bharatam Kaundinya

Healthcare systems receive criticism from both providers and recipients. The diversity in these systems throughout the world makes innovation and change difficult. However, a…

Abstract

Purpose

Healthcare systems receive criticism from both providers and recipients. The diversity in these systems throughout the world makes innovation and change difficult. However, a structured analysis of healthcare systems is crucial to identify areas for improvement and to share best practices for the betterment of healthcare throughout the world.

Design/methodology/approach

The paper uses organizational theory as an unbiased tool for evaluating healthcare systems. This theory analyses healthcare systems across five dimensions: environment, culture, social structure, physical structure and technology. This analysis provides an in-depth understanding of the organization's surroundings, formation and function. It offers a lens through which healthcare systems can be envisioned and establishes a vocabulary for communication.

Findings

Organizational theory presents a multifaceted approach to initiate assessments aiming to enhance existing healthcare systems and customize them to serve all stakeholders within the focused ecosystem. It alters the dynamics of criticism and presents an opportunity to sustainably address unforeseen healthcare challenges in the future. As the author proceeds to understand healthcare organizations through the perspective of organizational theory, the author also uncovers subtle yet crucial issues such as resource dependence, cultural clashes, organizational silence, bureaucracy, hierarchy, ethics, values, engagement and burnout.

Originality/value

This paper was crafted from a collaborative paper for the final of a master's degree. A collaboration was conceptualized using organisation theory as the tool to align processes and achieve successful outcome. The narrative of the collaboration has been edited and paper presented highlighting the importance of the tool of organisation theory in healthcare systems.

Details

Journal of Business and Socio-economic Development, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2635-1374

Keywords

Open Access
Article
Publication date: 2 September 2021

Heather L. Rogers, Susana Pablo Hernando, Silvia Núñez - Fernández, Alvaro Sanchez, Carlos Martos, Maribel Moreno and Gonzalo Grandes

This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion…

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Abstract

Purpose

This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion intervention in primary care centers in the Basque Country, Spain.

Design/methodology/approach

Seven focus groups were conducted with 49 health professionals from six primary care centers participating in the Prescribing Healthy Life program. Text was analyzed using the Consolidated Framework for Implementation Research (CFIR) focusing on those constructs related to health care organization, management and policy.

Findings

The health promotion intervention was found to be compatible with the values of primary care professionals. However, professionals at all centers reported barriers to implementation related to: (1) external policy and incentives, (2) compatibility with existing workflow and (3) available resources to carry out the program. Specific barriers in these areas related to lack of financial and political support, consultation time constraints and difficulty managing competing day-to-day demands. Other barriers and facilitators were related to the constructs networks and communication, culture, relative priority and leadership engagement. A set of six specific barrier-facilitator pairs emerged.

Originality/value

Implementation science and, specifically, the CFIR constructs were used as a guide. Barriers and facilitators related to the implementation of a health promotion program in primary care were identified. Healthcare managers and policy makers can modify these factors to foster a more propitious implementation environment. These factors should be appropriately monitored, both in pre-implementation phases and during the implementation process, in order to ensure effective integration of health promotion into the primary care setting.

Details

Journal of Health Organization and Management, vol. 35 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 7 April 2020

Berhanu Endeshaw

The purpose of this study was to review existing healthcare service quality-measurement models.

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Abstract

Purpose

The purpose of this study was to review existing healthcare service quality-measurement models.

Design/methodology/approach

A review of the literature was conducted utilizing keywords “healthcare’’, “service quality’’, “measurement models”, “SERVQUAL”, “SERVPERF”, “HEALTHQUAL”, “PubHosQual” and “HospitalQual”. These investigations were selected from the “Emerald’’, “ABI/Inform”, “ScienceDirect” and “EBSCOhost” databases. A range of studies used in the makeup of the healthcare quality-measurement model for a 36 years period (1979 to 2015) were examined in an exhaustive survey of the literature. Of 137 studies reviewed, 74 studies were selected for analysis.

Findings

As yet, no consensus has been reached among scholars on the definition and indicators and factors of the quality of the healthcare services. Moreover, most of the current models are of Western origin and incongruent with the cultural and economic contexts of developing countries. The previous studies create scales resembling the generic measures of service quality, which may not be completely appropriate for assessing the perceived quality of healthcare services. Furthermore, previous studies were too narrow, overemphasizing the quality of healthcare only as far as the functional aspect of the services were concerned and paying too little attention to the technical aspects, using the experience of healthcare providers. These results have much room for failures. This is therefore advising healthcare organizations that need to develop their own models for measuring the quality of their services.

Originality/value

Generic models no longer suffice in measuring the quality of healthcare services. Developing countries should try and develop their own models for measuring the quality of healthcare services.

Details

Journal of Health Research, vol. 35 no. 2
Type: Research Article
ISSN: 0857-4421

Keywords

Open Access
Article
Publication date: 3 April 2017

Elke Höfler, Claudia Zimmermann and Martin Ebner

The purpose of this paper is to share the lessons learned in implementing specific design patterns within the “Dr Internet” massive open online course (MOOC).

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Abstract

Purpose

The purpose of this paper is to share the lessons learned in implementing specific design patterns within the “Dr Internet” massive open online course (MOOC).

Design/methodology/approach

MOOCs are boasting considerable participant numbers, but also suffer from declining participant activity and low completion rates. Learning analytics results from earlier xMOOCs indicate that this might be alleviated by certain instructional design patterns – critical aspects include shorter course duration, narrative structures with suspense peaks, and a course schedule that is diversified and stimulating. To evaluate their impact on retention, the authors have tried to implement these patterns in the design of the “Dr Internet” MOOC.

Findings

Statistical results from the first run of the case study MOOC do not indicate any strong influences of these design patterns on the retention rate.

Research limitations/implications

With inconclusive statistical results from this case study, more research with higher participant numbers is needed to gain insight on the effectiveness of these design patterns in MOOCs. When interpreting retention outcomes, other influencing factors (course content, pacing, timing, etc.) need to be taken into account.

Originality/value

This publication reports about a case study MOOC and gives practical hints for further research.

Details

Journal of Research in Innovative Teaching & Learning, vol. 10 no. 1
Type: Research Article
ISSN: 2397-7604

Keywords

Open Access
Article
Publication date: 4 July 2018

Yvonne van Zaalen, Mary McDonnell, Barbara Mikołajczyk, Sandra Buttigieg, Maria del Carmen Requena and Fred Holtkamp

The purpose of this paper is to focus on ethical and judicial themes related to technology and the older adults.

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Abstract

Purpose

The purpose of this paper is to focus on ethical and judicial themes related to technology and the older adults.

Design/methodology/approach

Different consecutive phases in technology design and allocation will be discussed from a range of perspectives.

Findings

Longevity is one of the greatest achievements of contemporary science and a result of development of social relations. Currently, various non-communicable diseases affect older adults and impose the greatest burden on global health. There is a great emphasis across Europe on caring for the older person in their own homes. Technology has a mediating role in determining the possibilities for good quality of life (QOL). The concept of assisting the older adult through the use of technology so as to access healthcare services has enormous potential. Although the potential of technology in healthcare is widely recognised, technology use can have its downsides. Professionals need to be aware of the risks, namely, those related to the privacy of the older person, which may accompany technology use.

Research limitations/implications

By 2050, there will be more people aged over 65 than there are children. This phenomenon of global ageing constitutes a massive challenge in the area of health protection.

Practical implications

Professionals need to be aware of the risks, for example, related to the privacy of the older person, that may accompany technology use.

Social implications

There is a great emphasis across Europe on caring for the older person in their own homes. Technology has a mediating role in determining the possibilities for QOL.

Originality/value

The concept of assisting the older adult through the use of technology to avail of healthcare has enormous potential. Assistive technology, social media use and augmentative and alternative communication can have a positive effect on the QOL of older people, as long as they are supported enough in use of these technologies. However, ethical and juridical considerations are at stake as well.

Details

Journal of Enabling Technologies, vol. 12 no. 2
Type: Research Article
ISSN: 2398-6263

Keywords

Open Access
Article
Publication date: 17 January 2022

Emmanuel Eze, Rob Gleasure and Ciara Heavin

The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This…

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Abstract

Purpose

The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This study addresses the research question: what existing health-related structures, properties and practices are presented by rural areas of developing countries that might inhibit the implementation of mHealth initiatives?

Design/methodology/approach

This study was conducted using a socio-material approach, based on an exploratory case study in West Africa. Interviews and participant observation were used to gather data. A thematic analysis identified important social and material agencies, practices and imbrications which may limit the effectiveness of mHealth apps in the region.

Findings

Findings show that, while urban healthcare is highly structured, best practice-led, rural healthcare relies on peer-based knowledge sharing, and community support. This has implications for the enacted materiality of mobile technologies. While urban actors see mHealth as a tool for automation and the enforcement of responsible healthcare best practice, rural actors see mHealth as a tool for greater interconnectivity and independent, decentralised care.

Research limitations/implications

This study has two significant limitations. First, the study focussed on a region where technology-enabled guideline-driven treatment is the main mHealth concern. Second, consistent with the exploratory nature of this study, the qualitative methodology and the single-case design, the study makes no claim to statistical generalisability.

Originality/value

To the authors' knowledge, this is the first study to adopt a socio-material view that considers existing structures and practices that may influence the widespread adoption and assimilation of a new mHealth app. This helps identify contextual challenges that are limiting the potential of mHealth to improve outcomes in rural areas of developing countries.

Details

Information Technology & People, vol. 35 no. 8
Type: Research Article
ISSN: 0959-3845

Keywords

Open Access
Article
Publication date: 12 July 2023

Nicola Cobelli and Emanuele Blasioli

The purpose of this study is to introduce new tools to develop a more precise and focused bibliometric analysis on the field of digitalization in healthcare management…

Abstract

Purpose

The purpose of this study is to introduce new tools to develop a more precise and focused bibliometric analysis on the field of digitalization in healthcare management. Furthermore, this study aims to provide an overview of the existing resources in healthcare management and education and other developing interdisciplinary fields.

Design/methodology/approach

This work uses bibliometric analysis to conduct a comprehensive review to map the use of the unified theory of acceptance and use of technology (UTAUT) and the unified theory of acceptance and use of technology 2 (UTAUT2) research models in healthcare academic studies. Bibliometric studies are considered an important tool to evaluate research studies and to gain a comprehensive view of the state of the art.

Findings

Although UTAUT dates to 2003, our bibliometric analysis reveals that only since 2016 has the model, together with UTAUT2 (2012), had relevant application in the literature. Nonetheless, studies have shown that UTAUT and UTAUT2 are particularly suitable for understanding the reasons that underlie the adoption and non-adoption choices of eHealth services. Further, this study highlights the lack of a multidisciplinary approach in the implementation of eHealth services. Equally significant is the fact that many studies have focused on the acceptance and the adoption of eHealth services by end users, whereas very few have focused on the level of acceptance of healthcare professionals.

Originality/value

To the best of the authors’ knowledge, this is the first study to conduct a bibliometric analysis of technology acceptance and adoption by using advanced tools that were conceived specifically for this purpose. In addition, the examination was not limited to a certain era and aimed to give a worldwide overview of eHealth service acceptance and adoption.

Details

The TQM Journal, vol. 35 no. 9
Type: Research Article
ISSN: 1754-2731

Keywords

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