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The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate how the main reform foci of productivity and quality are represented, with a specific focus on the patient.

Drawing on critical discourse analysis (CDA), the authors conduct a longitudinal study (2007–2018) of healthcare reporting foci across the five administrative regions responsible for public hospitals in Denmark. The study analyses sixty annual reports and draws on contemporary reform documents over this period. CDA enables a micro-textual analysis, combined with macro-insights and discussions on social practice.

The findings show complex webs of presentation strategies, but in particular two changes occur during the period. First, the patient is centred throughout but the framing changes from productivity and waiting lists to quality and dialogue. Second, in the first years, the regions present themselves as actively highlighting financial and quality concerns, which changes to a passive and indirect form of presentation steered by indicators and patient legislation enforced by central government. This enhances passivity and distance in healthcare regional non-financial reporting where the regions seek to conform to such demands. Simultaneously, however, the authors find a tendency to highlight very different local initiatives, which shows an attempt to go beyond a pure automatic mode of reporting found in earlier studies.

Responding to the literature on both healthcare and financial reporting, this study identifies novel links between micro-level texts and macro-level social practices, enabling insights into the potentially intertwined impacts of public-sector reporting. The authors offer insights into the complexity of the construction of non-financial reporting in the public sector, which has a wider impact and different intentions than private-sector reporting.

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.

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.

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.

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.

Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred (PC) IC in practice. This context-specific, small-scale study examines what PC-IC means to older patients who went through joint replacement surgery (JRS).

The data consists of ten in-depth interviews of older patients, focussing on their experiences of care during their patient journey related to joint knee or hip replacement surgery. The data were analysed with thematic analysis.

Three central dimensions of PC-IC for older patients were identified: information sharing, continuity of care and compassionate encountering. Human validation and compassionate encountering were experienced as important aspects of PC-IC. Compassionate encountering was concretised through professionals’ very small everyday practices, which made the patient feel comfortable and respected. Instead, probably due to the medical and quite straight-forward nature of the joint replacement care process, patients seem to be pleased to trust the expertise of professionals and did not necessarily expect an active role or participation in the decision-making.

This Finnish case study focusses on the patients’ authentic perceptions of what is central to person-centred IC in the specific context of JRS.

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

Designing digital artifacts is not a linear, straightforward process. This is particularly true when applying a user-centered design approach, or co-design, with users who are unable to participate in the design process. Although the reduced participation of a particular user group may harm the end result, the literature on solving this issue is sparse. In this article, proxy design is outlined as a method for involving a user group as proxy users to speak on behalf of a group that is difficult to reach. The article investigates the following research question: How can roleplaying be embedded in co-design to engage users as proxies on behalf of those who are unable to represent themselves?

The article presents a design ethnography spanning three years at a cancer rehabilitation clinic, where digital artifacts were designed to be used collaboratively by nurses and patients. The empirical data were analyzed using content analysis and consisted of 20 observation days at the clinic, six proxy design workshops, 21 telephone consultations between patients and nurses, and log data from the digital artifact.

The article shows that simulated consultations, with nurses roleplaying as proxies for patients ignited and initiated the design process and enabled an efficient in-depth understanding of patients. Moreover, the article reveals how proxy design as a method further expanded the design. The study findings illustrate: (1) proxy design as a method for initiating design, (2) proxy design as an embedded element in co-design and (3) six design guidelines that should be considered when engaging in proxy design.

The main contribution is the conceptualization of proxy design as a method that can ignite and initiate the co-design process when important users are unreachable, vulnerable or unable to represent themselves in the co-design process. More specifically, based on the empirical findings from a design ethnography that involved nurses as proxy users speaking on behalf of patients, the article shows that roleplaying in proxy design is a fitting way of initiating the design process, outlining proxy design as an embedded element of co-design.

Over the years, despite the best efforts to evaluate service quality through multiple techniques, the connotation between service deliverance and consumer expectation remains sporadic. In the quest to quantify service quality from an innovative perspective, the current study has leveraged consumer-perceived experiences to unveil the novel intricacies of healthcare quality.

Anchoring on the dimensions of patient experience (PX), field data were collected from 244 patients at different private hospitals operating across India. Further, this study incorporated a fuzzy analytic hierarchy process (F-AHP) to evaluate consumer preferences and prioritised the dimensions of PX in three categories of Indian hospitals, namely nursing homes (NHs), mid-tier corporate hospitals (MCHs) and top-tier corporate hospitals (TCHs).

The results establish a performance ranking by demonstrating that MCHs outperform the rest alternatives on the grounds of perceived experiences. Tukey's honestly significance difference (HSD) test was executed to confirm the heterogeneity among the participants' preferences across three different hospital categories. The results reveal that for most of the alternatives, the mean scores of the criterion were statistically significantly different.

In healthcare studies, PX dawned as an entity with an ability to propel healthcare quality in a better way than the classical techniques did. The study's findings present a comprehensive picture of a care delivery system by identifying relatively significant dimensions of PX, hence improving the quality quotients by adjusting healthcare offerings in alignment with consumer expectations and organisational strategies.

The authors compare perspectives on external evaluation of health service provision between Norway and the USA. External inspection and accreditation are examples of internationally wide-spread external evaluation methods used to assess the quality of care given to patients. Different countries have different national policy strategies and arrangements set up to do these evaluations. Although there is growing attention to the impact and effects on quality and safety from external evaluation, there is still a gap in knowledge to how structures and processes influence these outcomes. Accordingly, the purpose of this article is to describe the structures and processes in external evaluation designed to promote quality improvement in Norway and the USA with attention to comparison of enablers and barriers in external evaluation systems.

Data collection consisted of documentary evidence retrieved from governmental policies, and reviews of the Joint Commission (the US), international guidelines, recommendations and reports from the International Society for Quality in Health Care, and the World Health Organization, and policies and regulations related to Norwegian governmental bodies such as the Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Board of Health Supervision . Data were analyzed inspired by a deductive, direct content analytical framework.

The authors found that both accreditation and inspection are strategies put in place to ensure that healthcare providers have adequate quality systems as well as contributing to the wider risk and safety enhancing management and implementation processes in the organizations subjected to evaluation. The US and the Norwegian external regulatory landscapes are complex and include several policymaking and governing institutions. The Norwegian regulatory framework for inspection has replaced an individual blame logic with a model which “blames” the system for inadequate quality and patient harm. This contrasts with the US accreditation system, which focuses on accreditation visits. Although findings indicate an ongoing turning point in accreditation, findings also demonstrate that involving patients and next of kin directly in adverse event inspections is a bigger part of a change in external inspection culture and methods than in processes of accreditation.

The message of this paper is important for policymakers, and bodies of inspection and accreditation because knowledge retrieved from the comparative document study may contribute to better understanding of the implications from the different system designs and in turn contribute to improving external evaluations.

Although there is a growing attention to the impact and effects on quality and safety from external evaluation, the implications of different regulatory strategies and arrangements for evaluation on quality and safety remain unclear.

Leveraging information technology (IT) to improve the treatment and support of patients is a widely studied topic in healthcare. For chronic diseases, such as diabetes, the use of information technology is even more important since its effect extends from a clinic environment to patients’ daily life. The purpose of this paper is to investigate the impacts of one widely adopted information technology, the mobile phone, on diabetes treatment, specifically on the complicated process of patients’ health, emotions and compliance.

We leverage a unique longitudinal dataset on diabetes patients’ health status in rural areas of China to study the problem. We also cross-link the dataset with mobile carrier data to further differentiate mobile phone use to phone calls and network use. To address the endogeneity concerns, we apply PSM and a series of instrument variables.

We identify clear evidence that mobile phone use can significantly improve patients’ emotions and compliance, where the effect is generally larger on patients in worse health conditions. While mobile phone calls clearly benefit diabetes patients, we do notice that mobile phone network use has a negative moderating effect with patients’ health condition on improving compliance.

This study not only enriches our theoretical understanding of the role of mobile phones in diabetes management, it also shows the economic benefit of promoting patients’ use of mobile phones, which should be considered by medical care providers and medical policymakers.

This paper aims to examine the health technology use in health information seeking, communication and personal health information management, as well as in the effects they may have on his relationship with the physician and on the consumption of medical resources.

An online survey was conducted. The questionnaires were distributed via online health discussion forums using Google's survey software with a summary presentation of the study’s objective. The final selection of 362 individuals was made using social media, direct email and collaboration with community groups. The empirical validation of the causal model was conducted using the partial least square approach.

The results show that the use of e-health strengthens the quality of the patient–physician relationship and patient empowerment while increasing the consumption of medical resources.

The results of this research indicate that the internet has transformed the relationship of patients to health, to their doctors and to the health-care system. In this new context, a reconsideration of the status of the patient must be considered by health service providers.

This paper aims to identify human rights violations of patients during the early periods of the COVID-19 pandemic in Ghana by investigating the experiences of people on how health-care professionals discharged their responsibilities during the time in question.

Explanatory design of the mixed methods approach was adopted, with the intention of collecting both quantitative and qualitative data sequentially, and then integrating the results at the interpretation stage. The approach enriched the quality of data collected as it offered the advantage of shedding light on the primary motivations and reasons for attitudes and behaviours and helped to provide an in-depth understanding of how individuals interpret the happenings around them and their experiences. Thus, although some amount of quantitative method was used in the data collection, the core of this paper is based on the qualitative interpretations.

The study reveals that health-care professionals, especially those in the Tema Metropolis, undermined certain fundamental human rights of patients during the early period of the COVID-19 pandemic. This includes failure to provide information to patients about treatment options and potential risks of medications; failure to seek the informed consent of patients before performing medical procedures; denial of access to medical files of patients for transfer; and inability or failure to provide medical ambulances services to patients on time.

Although many publications on human rights dimensions and health protective issues on COVID-19 pandemic are available on a global scale, still little information pertaining to experiences of individuals with health-care professionals during the early days of the COVID-19 pandemic, especially in Ghana through the lens of patient’s rights exists. This paper, therefore, fills an important gap in health-care management information, critical for policy decision-making processes regarding patient’s rights in times of pandemic control.