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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

Content available
Article
Publication date: 20 February 2024

Anna Urbaniak

Abstract

Details

Quality in Ageing and Older Adults, vol. 25 no. 1
Type: Research Article
ISSN: 1471-7794

Open Access
Article
Publication date: 5 October 2023

Maria Vincenza Ciasullo, Alexander Douglas, Emilia Romeo and Nicola Capolupo

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are…

Abstract

Purpose

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

Design/methodology/approach

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

Findings

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

Research limitations/implications

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

Practical implications

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

Originality/value

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

Details

International Journal of Quality & Reliability Management, vol. 41 no. 3
Type: Research Article
ISSN: 0265-671X

Keywords

Article
Publication date: 12 July 2023

Karen Humphries, Caroline Clarke, Kate Willoughby and Jake Smithson

The purpose of this paper is to develop an understanding of the experience of secure care from the patients’ perspective.

Abstract

Purpose

The purpose of this paper is to develop an understanding of the experience of secure care from the patients’ perspective.

Design/methodology/approach

A systematic review of qualitative literature was conducted. The data was sourced from the electronic databases: PsychINFO, CINAHL, Medline and the Web of Science Core Collection using pre-defined search terms. A total of 17 studies, conducted in various countries worldwide and covering high, medium and low secure inpatient settings, were included for review. The analysis involved integrating findings from across the literature and was guided by thematic synthesis.

Findings

A total of eight themes were generated from the data, three of which provided an understanding of the experience of forensic secure care, and the remaining five themes provided an understanding of the factors which may influence the experience of secure care.

Practical implications

Developing understanding of patient experience can lead to service improvements, potentially impacting patients’ motivation and engagement and thus reducing admission times, potential recalls and recidivism.

Originality/value

To the best of the authors’ knowledge, this is the first systematic review to date to exclusively explore the broad topic of the patient experience of secure mental health care.

Details

The Journal of Forensic Practice, vol. 25 no. 4
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 19 October 2023

Rajat Kumar Behera, Pradip Kumar Bala, Prabin Kumar Panigrahi and Shilpee A. Dasgupta

Despite technological advancements to enhance patient health, the risks of not discovering the correct interactions and trends in digital health are high. Hence, a careful policy…

Abstract

Purpose

Despite technological advancements to enhance patient health, the risks of not discovering the correct interactions and trends in digital health are high. Hence, a careful policy is required for health coverage tailored to needs and capacity. Therefore, this study aims to explore the adoption of a cognitive computing decision support system (CCDSS) in the assessment of health-care policymaking and validates it by extending the unified theory of acceptance and use of technology model.

Design/methodology/approach

A survey was conducted to collect data from different stakeholders, referred to as the 4Ps, namely, patients, providers, payors and policymakers. Structural equation modelling and one-way ANOVA were used to analyse the data.

Findings

The result reveals that the behavioural insight of policymakers towards the assessment of health-care policymaking is based on automatic and reflective systems. Investments in CCDSS for policymaking assessment have the potential to produce rational outcomes. CCDSS, built with quality procedures, can validate whether breastfeeding-supporting policies are mother-friendly.

Research limitations/implications

Health-care policies are used by lawmakers to safeguard and improve public health, but it has always been a challenge. With the adoption of CCDSS, the overall goal of health-care policymaking can achieve better quality standards and improve the design of policymaking.

Originality/value

This study drew attention to how CCDSS as a technology enabler can drive health-care policymaking assessment for each stage and how the technology enabler can help the 4Ps of health-care gain insight into the benefits and potential value of CCDSS by demonstrating the breastfeeding supporting policy.

Details

Journal of Systems and Information Technology, vol. 25 no. 4
Type: Research Article
ISSN: 1328-7265

Keywords

Open Access
Article
Publication date: 19 July 2023

Ronan Henry

Efficient delivery of integrated healthcare requires solid alliances and collaboration with stakeholders on a regular basis. Due to coronavirus disease 2019 (COVID-19), it has…

Abstract

Purpose

Efficient delivery of integrated healthcare requires solid alliances and collaboration with stakeholders on a regular basis. Due to coronavirus disease 2019 (COVID-19), it has become necessary to explore new ways of delivering integrated healthcare, and virtual clinics have offered one solution and are likely to continue due to the uncertainty with COVID-19. This study aims to explore clinicians’ experiences of how efficient virtual elective knee clinics (VEKC) are in an orthopaedic setting in comparison to traditional face-to-face clinics.

Design/methodology/approach

The study utilised a mixed-methods study to obtain qualitative and quantitative data. This involved an anonymous online survey in addition to in-depth qualitative interviews conducted with a purposive sample of multidisciplinary colleagues who work with the VEKC in an acute hospital.

Findings

Three overarching themes and nine sub-themes emerged in the qualitative analysis. Overall, clinicians in both the quantitative and qualitative aspects of the study highlighted several ways that virtual clinics are efficient from both the patient and health service perspective. However, participants also highlighted barriers in relation to virtual clinics not being suitable for certain cohorts of patients and pathologies.

Originality/value

This is the first study in Ireland to provide valuable insights into the experiences of multidisciplinary clinicians using VEKC and their efficiency compared to traditional face-to-face clinics.

Details

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 25 January 2024

Veronika Šlapáková Losová and Ondřej Dvouletý

The resource crisis in healthcare can be alleviated by engaging external stakeholders and resources in healthcare delivery. The authors use value and open innovation concepts to…

Abstract

Purpose

The resource crisis in healthcare can be alleviated by engaging external stakeholders and resources in healthcare delivery. The authors use value and open innovation concepts to understand what motivates the stakeholders to join the healthcare innovation ecosystem and what value such an ecosystem brings to healthcare.

Design/methodology/approach

A systematic literature review following the PRISMA framework method was applied to reach the research objective. Out of a total of 509 identified articles published till 2021, 25 were selected as relevant for this review.

Findings

Six categories of actors were identified, including innovation intermediaries, which were so far neglected in the healthcare innovation literature. Furthermore, patients, healthcare providers, innovation suppliers, investors and influencers were described. The authors also distinguished internal and external stakeholders. The authors show why and how open innovation projects contribute to involving external stakeholders and resources in healthcare delivery by contributing to patient autonomy, relationship building, knowledge transfer, improving collaborative mindset and culture, advancing know-how and bringing additional finances.

Originality/value

This article is the first one to systematically describe the value of open innovation in healthcare. The authors challenge the positivist approach in value presented by value-based healthcare. The authors show how openness contributes to addressing the resource crisis by involving new stakeholders and resources in the care delivery process.

Details

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

Keywords

Article
Publication date: 25 January 2024

Dorte Wiwe Dürr, Linda Hindsgaul Mikkelsen and Grete Moth

Research-based knowledge on homecare nursing is scarce and further information is warranted about citizens’ perceptions of receiving home care under existing conditions. The…

Abstract

Purpose

Research-based knowledge on homecare nursing is scarce and further information is warranted about citizens’ perceptions of receiving home care under existing conditions. The purpose of this study was to investigate citizen experiences with health-care professionals in the time allotted for home care.

Design/methodology/approach

A questionnaire survey was distributed to 348 citizens receiving home care. The questionnaire consisted of questions whether the citizens experienced that enough time was available during the homecare visit and how the conversation and care relationship with the health-care professionals were experienced. The differences in responses were analysed using Fisher’s Exact Tests.

Findings

Overall, 94% of the citizens reported that sufficient time had been available and that care relationship and conversation with the health-care professionals had been positive during the homecare visit. However, the findings indicated that citizens aged more than +76 years and citizens with a high educational level were more prone to report that the nurses did not spend enough time during the home visit.

Originality/value

The findings offer useful insights for the professionals in delivering appropriate home care. Listening to citizens’ wishes and needs for home care could lead to better individualised care. Especially the youngest and oldest of the citizens seem to have specific experiences that call for further investigation.

Details

Working with Older People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 22 November 2023

Erica Falkenström and Anna T. Höglund

The purpose of this paper is to contribute knowledge on ethical issues and reasoning in expert reports concerning healthcare governance, commissioned by the Swedish healthcare…

Abstract

Purpose

The purpose of this paper is to contribute knowledge on ethical issues and reasoning in expert reports concerning healthcare governance, commissioned by the Swedish healthcare system.

Design/methodology/approach

An in-depth analysis of ethical issues and reasoning in 36 commissioned expert reports was performed. Twenty-seven interviews with commissioners and producers of the reports were also carried out and analysed.

Findings

Some ethical issues were identified in the reports. But ethical reasoning was rarely evident. The meaning of ethical concepts could be devalued and changed over time and thereby deviate from statutory ethical goals and values. Several ethical issues of great concern for the Swedish public healthcare were also absent.

Practical implications

The commissioner of expert reports needs to ensure that comprehensive ethical considerations and ethical analysis are integrated in the expert reports.

Originality/value

Based on an extensive data material this paper reveals an ethical void in expert reports on healthcare governance. By avoiding ethical issues there is a risk that the expert reports could bring about reforms and control models that have ethically undesirable consequences for people and society.

Details

Journal of Health Organization and Management, vol. 38 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 4 April 2023

Ingela Bäckström, Pernilla Ingelsson, Lilly-Mari Sten and Marie Häggström

The purpose of this study is to develop a model describing different factors that affect quality and efficiency in transitional care.

Abstract

Purpose

The purpose of this study is to develop a model describing different factors that affect quality and efficiency in transitional care.

Design/methodology/approach

A meta-synthesis focusing on the transitions between wards was conducted within a research project. The results from eight studies within that research project have been combined and analysed from a holistic view.

Findings

The findings are a model with a description of seven different categories consisting of the identified factors affecting quality and efficiency in transitional care. Those categories are (1) learning organisation, (2) standardising and structuring, (3) applying a holistic view, (4) understanding organisational culture in a health care context, (5) management and leadership, (6) for whom value is created and (7) working together. The results from the study have been verified in previous research.

Research limitations/implications

The result of the completed meta-synthesis is based on studies conducted at two medium-sized hospitals in Sweden. The developed model can be used in a similar context to improve quality and efficiency in patient transfers by management and employees working based on the various factors.

Originality/value

This model describes factors (success factors, prerequisites, conditions and lack thereof) affecting the ability to achieve quality and efficiency in transitional care that can be used in future research as well as for practical improvements.

Details

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

Keywords

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