Search results

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

Diabetes is a chronic and challenging disease and requires personal daily self-management decisions and skills. For that, it is necessary that patients have sufficient information and health literacy to make the right choices and decisions in their self-care. Sequentially, health literacy has great relevance and influence in the daily lives of people with diabetes, since it encompasses the necessary skills to manage disease and health. Health literacy can be a relevant factor to consider when tackling diabetes self-management. Thus, for the prevention and treatment of diabetes, it is essential to promote individual health literacy. The quality of communication and patient-centred communication style seems to be a key aspect for the health literacy.

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.

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).

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.

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.

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.

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.

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.

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.

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.

To explore Finnish experts' perceptions of the forms of digital healthcare that are anticipated to be the most utilised in healthcare in the medium-term future (year 2035) and anticipated healthcare workforce impacts those forms will have.

A total of 17 experts representing relevant interest groups participated in a biphasic online Delphi study. The results for each round were analysed using descriptive statistical methods and inductive content analysis.

The forms of digital healthcare that the experts perceived as most likely to be utilised were those enabling patient participation, efficient organisation of services and automated data collection and analysis. The main impacts on the healthcare workforce were seen as being the redirection of workforce needs within the healthcare sector and need for new skills and new professions. The decrease in the need for a healthcare workforce was seen as less likely. The impacts were perceived as being constructed through three means: impacts within healthcare organisations, impacts on healthcare professions and impacts via patients.

The results are not necessarily transferable to other contexts because the experts anticipated local futures. Patients' views were also excluded from the study.

Healthcare organisations function in complex systems where drivers, such as regional demographics, legislation and financial constraints, dictate how digital healthcare is utilised. Anticipating the workforce effects of digital healthcare utilisation has received limited attention; the study adds to this discussion.

Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under pharma, medical, biotechnology, and nursing. Also, other fields may be aligned with these primary fields. Healthcare amasses the contemporary trends and knowledge of upcoming techniques to improve healthcare processes. The practitioners are primarily doctors, nurses, specialists and health professionals, hospital administrators, and health insurance.

It is a fundamental attribute needed for any society to attain good quality of life and well-being in mental and physical health. It is a fundamental right of people to receive good healthcare where drug treatment and hospitalization are available at a nominal cost, as a requirement of today’s modern era. There appears to be a significant disparity in the availability of good healthcare in rural areas compared to urban in India. Even though we enter the digital era with the facilities offered in Industry 4.0 and other advanced technologies brings about a significant change of overall processing within healthcare systems. During the pandemic of COVID-19, there has been digital transformation with success globally. Healthcare cooperatives are a new norm to support the healthcare systems globally. The chapter discusses Gampaha healthcare cooperative and reviews Ayushman Sahakar scheme in India. The reforms require time to evolve.

This purpose of the study is to investigate enablers of building agility capabilities in healthcare organisations in developing countries. The key research questions are: (1) What are the key enablers for building healthcare agility? (2) Is there an interdependence among the enablers of healthcare agility? (3) What is the driving and dependence power of the enabling factors of healthcare agility?

The enablers for building capabilities of organisational agility were identified from the extant literature. Perceptual responses for pair-wise comparison of identified enablers were collected from 17 clinical and non-clinical professionals working in Indian hospitals through online interviews. Participants were selected from India which supposedly represents the socioeconomic contexts and healthcare systems in developing economies. Next, the data was analysed using multicriteria decision-making (MCDM) techniques to develop a structural framework depicting the enablers and their interdependence.

The TISM framework showed that the two most influential enablers of healthcare agility in developing countries are policy and regulatory support and strategic commitment and resource availability. The results were based on the analysis of four enablers identified from the literature. The results of MICMAC analysis revealed the driving and dependence power of each enabler and classified the enablers into driving, autonomous, dependence and linkage groups.

The study will help stakeholders and academics in the healthcare domain in devising effective strategies for building agility within healthcare systems and processes.

The study contributes to the service operations literature on building agile systems for dynamic and complex service environments.

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.