Search results

1 – 10 of over 1000
Open Access
Article
Publication date: 11 October 2022

Jon Engström, Olof Norin, Serge de Gosson de Varennes and Aku Valtakoski

The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to…

3557

Abstract

Purpose

The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to facilitate the design of patient-centric services.

Design/methodology/approach

The study was based on a collaborative project with a national healthcare organization following the principles of action design research. The study describes the quantitative segmentation performed during the project, followed by a qualitative interview study of how segments correspond with patient behaviors in an actual healthcare setting, and service design workshops facilitated by segments. A number of design principles are outlined based on the learnings of the project.

Findings

The segmentation approach increased understanding of patient variability within the service provider organization and was considered an effective foundation for modular service design. Patient characteristics and life circumstances were related to specific patterns of health behaviors, such as avoidance or passivity, or a persistent proactivity. These patterns influenced the patients' preferred value co-creation role and what type of support patients sought from the care provider.

Practical implications

The proposed segmentation approach is immediately generalizable to further healthcare contexts and similar services: improved understanding of patients, vulnerable patients in particular, improves the fit and inclusivity of services.

Originality/value

The segmentation approach to service design was demonstrated to be effective in a large-scale context. The approach allows service providers to design service options that improve the fit with individual patients' needs for support and autonomy. The results illuminate how patient characteristics influence health and value co-creation behaviors.

Details

Journal of Service Management, vol. 33 no. 6
Type: Research Article
ISSN: 1757-5818

Keywords

Open Access
Article
Publication date: 13 February 2024

Veronica Ungaro, Laura Di Pietro, Roberta Guglielmetti Mugion and Maria Francesca Renzi

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Journal of Service Theory and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2055-6225

Keywords

Open Access
Article
Publication date: 5 April 2022

Maria Vincenza Ciasullo, Weng Marc Lim, Mohammad Fakhar Manesh and Rocco Palumbo

Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production…

2331

Abstract

Purpose

Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production and value co-creation take center stage. The article endeavors to unpack the state of the literature on the innovations promoting the transition toward patient-centeredness, informing policy and management interventions fostering the reconceptualization of the patient as a prosumer of healthcare services.

Design/methodology/approach

A hybrid review methodology consisting of a bibliometric-interpretive review following the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR) protocol is used. The bibliometric component enabled us to objectively map the extant scientific knowledge into research streams, whereas the interpretive component facilitated the critical analysis of research streams.

Findings

Patient-centeredness relies on a bundle of innovations that are enacted through a cycle of patients' activation, empowerment, involvement and engagement, wherein the omission of any steps arrests the transition toward service co-production and value co-creation. Institutional, organizational and cognitive barriers should be overcome to boost the transition of patients from consumers to prosumers in a patient-centered model of healthcare.

Originality/value

The article delivers the state of the art of the scientific literature in the field of innovations aimed at sustaining the transition toward patient-centeredness and provides some food for thoughts to scholars and practitioners who wish to push forward service co-production and value co-creation in healthcare.

Details

Journal of Health Organization and Management, vol. 36 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 18 December 2023

Francesca Ferrè

Value-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.

Details

The TQM Journal, vol. 36 no. 9
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 18 June 2020

Axel Kaehne, Lucy Bray and Edmund Horowicz

Co-production has received increasing attention from managers and researchers in public services. In the health care sector, co-production has become a by-word for the meaningful…

Abstract

Co-production has received increasing attention from managers and researchers in public services. In the health care sector, co-production has become a by-word for the meaningful engagement of patients yet there is still a lack of knowledge around what works when co-producing services. The paper sets out a set of pragmatic principles which may guide anyone embarking on co-producing health care services, and provides an illustration of a co-produced Young People’s Health Research Group in England. We conclude by outlining some learning points which are useful when establishing co-production projects.

Details

Emerald Open Research, vol. 1 no. 2
Type: Research Article
ISSN: 2631-3952

Keywords

Open Access
Article
Publication date: 24 December 2021

Sabina De Rosis, Chiara Barchielli, Milena Vainieri and Nicola Bellé

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on…

4543

Abstract

Purpose

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.

Design/methodology/approach

65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.

Findings

Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.

Research limitations/implications

Different features referring to different nursing models make the difference in producing an excellent user experience with the service.

Practical implications

These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.

Originality/value

This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.

Highlights

  • This is one of the first studies on the relationship between provision models of nursing care and patient experience.

  • Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

  • Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

  • Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

This is one of the first studies on the relationship between provision models of nursing care and patient experience.

Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

Details

Journal of Health Organization and Management, vol. 36 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 26 September 2023

León Poblete, Erik Eriksson, Andreas Hellström and Russ Glennon

This article aims to examine how users' involvement in value co-creation influences the development and orchestration of well-being ecosystems to help tackle complex societal…

1024

Abstract

Purpose

This article aims to examine how users' involvement in value co-creation influences the development and orchestration of well-being ecosystems to help tackle complex societal challenges. This research contributes to the public management literature and answers recent calls to investigate novel public service governances by discussing users' involvement and value co-creation for novel well-being solutions.

Design/methodology/approach

The authors empirically explore this phenomenon through a case study of a complex ecosystem addressing increased well-being, focussing on the formative evaluation stage of a longitudinal evaluation of Sweden's first support centre for people affected by cancer. Following an abductive reasoning and action research approach, the authors critically discuss the potential of user involvement for the development of well-being ecosystems and outline preconditions for the success of such approaches.

Findings

The empirical results indicate that resource reconfiguration of multi-actor collaborations provides a platform for value co-creation, innovative health services and availability of resources. Common themes include the need for multi-actor collaborations to reconfigure heterogeneous resources; actors' adaptive change capabilities; the role of governance mechanisms to align the diverse well-being ecosystem components, and the engagement of essential actors.

Research limitations/implications

Although using a longitudinal case study approach has revealed stimulating insights, additional data collection, multiple cases and quantitative studies are prompted. Also, the authors focus on one country but the characteristics of users' involvement for value co-creation in innovative well-being ecosystems might vary between countries.

Practical implications

The findings of this study demonstrate the value of cancer-affected individuals, with “lived experiences”, acting as sources for social innovation, and drivers of well-being ecosystem development. The findings also suggest that participating actors in the ecosystem should utilise wider knowledge and experience to tackle complex societal challenges associated with well-being.

Social implications

Policymakers should encourage the formation of well-being ecosystems with diverse actors and resources that can help patients navigate health challenges. The findings especially show the potential of starting from the user's needs and life situation when the ambition is to integrate and innovate in fragmented systems.

Originality/value

The proposed model proposes that having a user-led focus on innovating new solutions can play an important role in the development of well-being ecosystems.

Details

Journal of Health Organization and Management, vol. 37 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 17 August 2021

Stefania M. Maci

This study aims to examine the way in which elderly people, men and women, with a terminal illness use language to construct a narrative about their “living-with-dying” experience.

Abstract

Purpose

This study aims to examine the way in which elderly people, men and women, with a terminal illness use language to construct a narrative about their “living-with-dying” experience.

Design/methodology/approach

This investigation is a secondary analysis based on a corpus of health and illness narratives collected by the Health Experiences Research Group at the University of Oxford and published by the DIPEx charity (available at: http://healthtalk.org/home).

Findings

This study shows that there are qualitative differences in the way in which not only elderly people but also men and women report their experience with terminal illness and their relation to death.

Originality/value

Understanding the different perspectives from which elderly people narrate their experiences of how they live while dying from terminal illness can help health professionals to develop more effective all-inclusive health policies and practices in end-of-life care.

Details

Working with Older People, vol. 25 no. 3
Type: Research Article
ISSN: 1366-3666

Keywords

Open Access
Article
Publication date: 23 December 2021

Jennifer Martin, Maureen A. Flynn, Zuneera Khurshid, John J. Fitzsimons, Gemma Moore and Philip Crowley

The purpose of this study is to present a quality improvement approach titled “Picture-Understanding-Action” used in Ireland to enhance the role of healthcare boards in the…

1696

Abstract

Purpose

The purpose of this study is to present a quality improvement approach titled “Picture-Understanding-Action” used in Ireland to enhance the role of healthcare boards in the oversight of healthcare quality and its improvement.

Design/methodology/approach

The novel and practical “Picture-Understanding-Action” approach was implemented using the Model for Improvement to iteratively introduce changes across three quality improvement projects. This approach outlines the concepts and activities used at each step to support planning and implementation of processes that allow a board to effectively achieve its role in overseeing and improving quality. This approach matured over three quality improvement projects.

Findings

The “Picture” included quantitative and qualitative aspects. The quantitative “Picture” consisted of a quality dashboard/profile of board selected outcome indicators representative of the health system using statistical process control (SPC) charts to focus discussion on real signals of change. The qualitative picture was based on the experience of people who use and work in health services which “people-ised” the numbers. Probing this “Picture” with collective grounding, curiosity and expert training/facilitation developed a shared “Understanding”. This led to “Action(s)” from board members to improve the “Picture” and “Understanding” (feedback action), to ask better questions and make better decisions and recommendations to the executive (feed-forward action). The Model for Improvement, Plan-Do-Study-Act cycles and a co-design approach in design and implementation were key to success.

Originality/value

To the authors’ knowledge, this is the first time a board has undertaken a quality improvement (QI) project to enhance its own processes. It addresses a gap in research by outlining actions that boards can take to improve their oversight of quality of care.

Details

International Journal of Health Governance, vol. 27 no. 1
Type: Research Article
ISSN: 2059-4631

Keywords

Open Access
Article
Publication date: 4 January 2018

Clare S. Allely

Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for…

6269

Abstract

Purpose

Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for forensic services. Given the challenge that individuals with ASD present to forensic services, the suggested increase in the number of this group within this setting and the relatively little amount of research which suggests they face a number of difficulties within the prison environment, the purpose of this paper is to identify and review all the studies which have been carried out investigating any aspect of ASD in relation to secure hospital settings.

Design/methodology/approach

Seven internet-based bibliographic databases were used for the present review. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

Findings

A total of 12 studies were included in this review; 3 looked at the prevalence of ASD in secure psychiatric hospitals. One study evaluated the clinical utility of the AQ screening tool to assess self-reported autistic traits in secure psychiatric settings. Three explored any type of characteristics of patients with ASD detained in secure psychiatric hospitals. One study investigated the experiences or quality of life of patients with an ASD detained in secure psychiatric care. Two studies investigated awareness, knowledge and/or views regarding patients with ASD held by staff working within secure psychiatric hospitals. Lastly, three studies (one of which was also included in the prevalence category above) looked at the effectiveness of interventions or treatment of patients with ASD in secure psychiatric hospitals. Clinical recommendations and future research directions are discussed.

Originality/value

To the author’s knowledge, this is the first review to explore what research has been carried out looking specifically at patients with ASD in relation to secure forensic settings.

Details

Journal of Criminal Psychology, vol. 8 no. 1
Type: Research Article
ISSN: 2009-3829

Keywords

1 – 10 of over 1000