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1 – 10 of 70Value-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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Sérgio Antônio Pulzi Júnior, Claudia Affonso Silva Araujo and Mônica Ferreira da Silva
This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social…
Abstract
Purpose
This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.
Design/methodology/approach
Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.
Findings
Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.
Research limitations/implications
All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents’ profiles, demographic variables were not analyzed.
Practical implications
This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.
Originality/value
This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.
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The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that…
Abstract
Purpose
The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.
Design/methodology/approach
This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.
Findings
The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.
Research limitations/implications
The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.
Originality/value
The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.
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Pouyan Esmaeilzadeh, Spurthy Dharanikota and Tala Mirzaei
Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients…
Abstract
Purpose
Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.
Design/methodology/approach
The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).
Findings
The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.
Originality/value
The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.
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David P. Wood, Rajan Nathan, Catherine A. Robinson and Rebecca McPhillips
The current national patient safety strategy for the National Health Service (NHS) in England states that actions need to be taken to support the development of a patient safety…
Abstract
Purpose
The current national patient safety strategy for the National Health Service (NHS) in England states that actions need to be taken to support the development of a patient safety culture. This includes that local systems should seek to understand staff perceptions of the fairness and effectiveness of serious incident management. This study aims to explore the perspectives of patient safety professionals about what works well and what could be done better to support a patient safety culture at the level of Trust strategy and serious incident governance.
Design/methodology/approach
A total of 15 professionals with a role in serious incident management, from five mental health trusts in England, were interviewed using a semi-structured interview guide. Thematic analysis and qualitative description were used to analyse the data.
Findings
Participants felt that actions to support a patient safety culture were challenging and required long-term and clinical commitment. Broadening the scope of serious incident investigations was felt to be one way to better understand patient safety culture issues. Organisational influences during the serious incident management process were highlighted, informing approaches to maximise the fairness and objectivity of investigation findings.
Originality/value
The findings of this study offer original insights that the NHS safety system can use to facilitate progression of the patient safety culture agenda. In particular, local mental health trusts could consider the findings in the context of their current strategic objectives related to patient safety culture and operational delivery of serious incident management frameworks.
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Govinda Prasad Dhungana, Dwij Raj Bhatta and Wei-Hong Zhang
Family planning (FP) services through the lens of human rights are not well known in Nepal. This study aims to assess Family Planning 2020: Rights and Empowerment Principles for…
Abstract
Purpose
Family planning (FP) services through the lens of human rights are not well known in Nepal. This study aims to assess Family Planning 2020: Rights and Empowerment Principles for Family Planning and identify factors affecting contraceptive use among HIV-infected women living in rural Far Western Nepal.
Design/methodology/approach
This study conducted a cross-sectional survey using self-designed proforma. To assess the association between contraceptive use and independent variables, this study calculated adjusted odd ratio (AOR) with 95% confidence interval (CI) using statistical package for social sciences (SPSS) V.20.
Findings
Only 37.8% of participants had access to full range of contraceptive methods, and only 57.5% of participants received proper counseling. Agency/autonomy, transparency/accountability and voice/participation were practiced by 43.7%, 23.4% and 19.7% of participants, respectively. Husband’s support (AOR = 4.263; 95% CI: 1.640–11.086), availability of FP services in their locality (AOR = 2.497; 95% CI: 1.311–4.754), employment (AOR = 3.499; 95% CI: 1.186–10.328) and postpartum period (AOR = 0.103; 95% CI: 0.023–0.475) were significantly associated with contraceptive use.
Research limitations/implications
Health-care providers’ and program managers’ perspectives were not examined.
Practical implications
Findings of this study will be useful for making strategic plan on human rights-based approach to FP.
Social implications
Expanding access to contraceptive information and services and strengthening autonomy, accountability and participation are key to human rights-based approach to FP.
Originality/value
This study identified that inadequate counselling, nonavailability of full range of contraceptive methods, low level of autonomy, accountability and participation were key bottlenecks in fulfilling human rights-based approach to FP.
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Ricardo Santa, Diego Morante, Thomas Tegethoff and Luis Berggrun
The purpose of this study is to determine the interactions between factors such as organizational learning, feedback about errors, punitive response to errors and communication…
Abstract
Purpose
The purpose of this study is to determine the interactions between factors such as organizational learning, feedback about errors, punitive response to errors and communication quality in hospitals in the Kingdom of Saudi Arabia and Colombia when adopting a culture of quality and safety (CQS) in patient care.
Design/methodology/approach
Based on a literature review, a self-administered questionnaire was developed and used to collect data from 417 Saudi respondents affiliated with hospitals and 483 Colombian respondents at the beginning of the pandemic. Structural equation modeling is used in this study to test the hypothesized relationships.
Findings
The results show a solid and significant predictive relationship between feedback about errors and the CQS in both countries (Colombia: b = 0.55, p < 0.001; KSA: b = 0.44, p < 0.001), but a very low and insignificant predictive relationship between no punitive response to errors and CQS (Colombia: b = –0.02, p > 0.05; KSA: b = 0.05, p > 0.05).
Practical implications
This study demonstrates the importance of organizational learning in fostering a CQS in the health-care sector in the Kingdom of Saudi Arabia and Colombia. Recent unprecedented policy actions motivated by the COVID-19 pandemic, such as social distancing, lockdowns and safety practices enforcement, have further highlighted this concern. Moreover, attention to the dimensions addressed in this study is required for accreditation purposes in organizations seeking to promote a CQS. Overall, this research highlights the vital role of safety and quality practices among health-care organizations, which has significant policy implications, especially in the current period of high uncertainty.
Originality/value
This paper contributes to the theory and practice in the health-care sector by extending the current knowledge of the impact of the quality of communications, non-punitive response to errors and feedback about errors in organizational learning and safety culture, and by presenting a novel, quantitative methodology seldom used for these topics.
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David Phillip Wood, Catherine A. Robinson, Rajan Nathan and Rebecca McPhillips
The need to develop effective approaches for responding to healthcare incidents for the purpose of learning and improving patient safety has been recognised in current national…
Abstract
Purpose
The need to develop effective approaches for responding to healthcare incidents for the purpose of learning and improving patient safety has been recognised in current national policy. However, research into this topic is limited. This study aims to explore the perspectives of professionals in mental health trusts in England about what works well and what could be done better when implementing serious incident management systems.
Design/methodology/approach
This was a qualitative study using semi-structured interviews. In total, 15 participants were recruited, comprising patient safety managers, serious incident investigators and executive directors, from five mental health trusts in England. The interview data were analysed using a qualitative-descriptive approach to develop meaningful themes. Quotes were selected and presented based on their representation of the data.
Findings
Participants were dissatisfied with current systems to manage serious incidents, including the root cause analysis approach, which they felt were not adequate for assisting learning and improvement. They described concerns about the capability of serious incident investigators, which was felt to impact on the quality of investigations. Processes to support people adversely affected by serious incidents were felt to be an important part of incident management systems to maximise the learning impact of investigations.
Originality/value
Findings of this study provide translatable implications for mental health trusts and policymakers, informed by insights into how current approaches for learning from healthcare incidents can be transformed. Further research will build a more comprehensive understanding of mechanisms for responding to healthcare incidents.
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A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional…
Abstract
Purpose
A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional consequences. The purpose of this article is to discuss new approaches to performance management in health care services when the purpose is to support innovative changes in the delivery of services.
Design/methodology/approach
The article represents cross-boundary work as the theoretical and empirical material used to discuss and reconsider performance management comes from several relevant research disciplines, including systematic reviews of audit and feedback interventions in health care and extant theories of human motivation and organizational control.
Findings
An enabling approach to performance management in health care services can potentially contribute to innovative changes. Key design elements to operationalize such an approach are a formative and learning-oriented use of performance measures, an appeal to self- and social-approval mechanisms when providing feedback and support for local goals and action plans that fit specific conditions and challenges.
Originality/value
The article suggests how to operationalize an enabling approach to performance management in health care services. The framework is consistent with new governance and managerial approaches emerging in public sector organizations more generally, supporting a higher degree of professional autonomy and the use of nonfinancial incentives.
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Mukaram Ali Khan, Jeetesh Kumar, Muhammad Haroon Shoukat and Kareem M. Selem
This paper aims to explore the role of perceived organizational injustice (POI) leading to workplace conflict in determining organizational performance (OP) among healthcare…
Abstract
Purpose
This paper aims to explore the role of perceived organizational injustice (POI) leading to workplace conflict in determining organizational performance (OP) among healthcare employees. This paper also examines the serial mediating effects of moral disengagement (MD) and knowledge hiding (KH).
Design/methodology/approach
In all, 244 public and private hospital employees in Pakistan provided the data set.
Findings
According to partial least squares-structural equation modeling findings, the negative association between POI and OP was serially mediated by KH and MD. The recovery process underlying the linkage between POI and OP is tested and highlighted in this paper as a first step in unraveling it.
Research limitations/implications
The findings highlight the significance of taking moral and KH models into account when attempting to understand the moral cognitive processes that employees go through when they see injustice. Organizations should guarantee the equitable distribution of incentives and resources, as distributive and procedural justices are concerned with organizations.
Originality/value
By directing actions meant to prevent MD and KH, the findings may potentially inspire new, more focused treatments to safeguard patient safety and avoid losses in the healthcare industry. One way to reduce unethical conduct and MD is to have people declare or agree to a code of ethics.
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