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Book part
Publication date: 23 February 2015

Maria Cristina Longo

The research analyzes good practices in health care “management experimentation models,” which fall within the broader range of the integrative public–private partnerships…

Abstract

Purpose

The research analyzes good practices in health care “management experimentation models,” which fall within the broader range of the integrative public–private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the “management experimentation models” are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations.

Methodology/approach

In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC – Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies.

Findings

The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable.

Originality/value

The recognition of ISMETT’s good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

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Article
Publication date: 9 March 2015

Gyan Prakash

– The purpose of this paper is to explore regulation in India’s healthcare sector and makes recommendations needed for enhancing the healthcare service.

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1695

Abstract

Purpose

The purpose of this paper is to explore regulation in India’s healthcare sector and makes recommendations needed for enhancing the healthcare service.

Design/methodology/approach

The literature was reviewed to understand healthcare’s regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS).

Findings

Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges.

Research limitations/implications

This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach).

Practical implications

Healthcare pitfalls across the world seem to follow similar follies. India’s complexity and experience is useful for emerging and developed economies.

Originality/value

The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient’s perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 2
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 13 March 2017

Kofi Osei-Frimpong

The purpose of this paper is to deepen the understanding on patient participatory behaviours in co-creation of value drawing from the perspective of self-determination…

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1458

Abstract

Purpose

The purpose of this paper is to deepen the understanding on patient participatory behaviours in co-creation of value drawing from the perspective of self-determination theory (SDT) focussing on motivation in particular.

Design/methodology/approach

A model is proposed to suggest the influence of the various motivation types on a patient’s participatory behaviours drawing from SDT. Following survey design approach, data collected from 345 outpatients from a quasi-government health facility in Accra, Ghana are examined through structural equation modelling using SmartPLS (v. 3.2.3).

Findings

The findings reveal that patient participatory behaviours are influenced by both controlled and autonomous regulations leading to value attainment. External regulation (a more controlled form of extrinsic motivation) and patient participation in clinical encounters have no significant relationship with a patient’s commitment to compliance with medical instructions. The results reveal patient compliance is largely driven by autonomous regulation as proposed by SDT. However, active patient participation in clinical encounters and commitment to compliance with medical instructions positively and significantly influences perceived value outcomes.

Research limitations/implications

This research provides empirical evidence in support of understanding patient participatory behaviours in healthcare service delivery by testing theoretically grounded hypotheses developed from SDT perspective. The study focussed on outpatients from one quasi-government health facility, which could limit the generalisation of the findings reported.

Practical implications

This study illustrates the need for service providers to understand participant’s needs and motivation during the service encounter. This is essential as the various types of motivation influence the nature of the participation throughout the process, which could help improve on the value outcomes from the service.

Originality/value

This study makes a significant contribution to service literature through the application of SDT to explain patient participatory behaviours in healthcare service delivery, production and value outcomes. From a theoretical perspective, the developed model integrates multiple research disciplines (e.g. SDT, participatory behaviours, and value co-creation) and extends research on patient integration, participation, and compliance.

Details

Journal of Service Theory and Practice, vol. 27 no. 2
Type: Research Article
ISSN: 2055-6225

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Article
Publication date: 31 December 2020

Lea Prevel Katsanis, Dennis Pitta and Anne Morinville

The purpose of this study is two-fold: first, to identify the degree of adoption of patient centricity in the pharmaceutical industry and second, to understand how the…

Abstract

Purpose

The purpose of this study is two-fold: first, to identify the degree of adoption of patient centricity in the pharmaceutical industry and second, to understand how the industry operationalizes this strategy. It is an important shift in the industry because of its central focus on the patient.

Design/methodology/approach

A content analysis was used based on publicly available documentation that includes industry publications, company and brand websites and clinical trial publications to identify the frequency of words used to describe patient centricity.

Findings

The key finding of this study is that the leading pharmaceutical firms overwhelmingly use patient support/access programs as the primary method of implementing patient centric strategies.

Research limitations/implications

Future research is needed to identify what impact these strategies have on patients; and whether or not these strategies have an impact on lowering drug prices and improved clinical outcomes for patients.

Practical implications

Future research is needed to identify what impact these strategies have on patients; and whether or not these strategies have an impact on lowering drug prices and improved clinical outcomes for patients. Limitations include the reliance on publicly available documentation.

Social implications

Pharmaceutical firms need to be aware that their publically available profile suggests a one-dimensional approach to patient centricity and this may influence the way patients, physicians and policymakers view their attitudes toward patients. This study is the first to systematically examine the activities of leading pharmaceutical firms with respect to the adoption and implementation of patient-centric strategies in a comprehensive fashion.

Originality/value

This study is the first to systematically examine the activities of leading pharmaceutical firms with respect to the adoption and implementation of patient-centric strategies in a comprehensive fashion.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 15 no. 1
Type: Research Article
ISSN: 1750-6123

Keywords

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Article
Publication date: 4 February 2020

Gyan Prakash and Shefali Srivastava

The purpose of this paper is to explore the antecedents and consequences of a value-dense environment in healthcare service delivery.

Abstract

Purpose

The purpose of this paper is to explore the antecedents and consequences of a value-dense environment in healthcare service delivery.

Design/methodology/approach

A structural model was developed based on a literature review. Circulation of a 31-indicator questionnaire among service receivers in the healthcare system across India generated 279 valid responses. The research model was assessed using a cross-sectional research design, and the data were analyzed by partial least squares-structural equation modeling.

Findings

Integrated supply chain performance (ISCP), internal service quality (ISQ) and coordinated care are antecedents of a value-dense environment, which drives patient-centricity. The leagile supply chain strategy strengthens the relationship between ISCP and coordinated care. Employee trust and commitment acts as a moderator between coordinated care and ISQ.

Research limitations/implications

By adopting the perspective of service receivers, this paper highlights the influence of value-density on patient-centricity in healthcare organizations. Future research should include healthcare professionals’ perceptions of value-dense environment creation.

Practical implications

The study provides suggestions to practitioners for designing patient-centric healthcare services by leveraging ISCP, coordinated care and ISQ in the value-creation process. Recognizing the relationships among these constructs can aid the timely formulation of corrective actions and future policies.

Social implications

This study underscores patient-centric care as a basis for effectively delivering healthcare as a social good.

Originality/value

This paper contributes to the body of knowledge by identifying and empirically validating the relationships between patient-centricity and value co-creation.

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Article
Publication date: 16 March 2020

Harbir Singh, Ajoy Kumar Dey and Arunaditya Sahay

A multispecialty hospital possesses sustainable competitive advantage if it continuously improves performance, repeatedly delivers quality service and unique value to the…

Abstract

Purpose

A multispecialty hospital possesses sustainable competitive advantage if it continuously improves performance, repeatedly delivers quality service and unique value to the patients and the sources of competitive advantage are valuable, rare, inimitable, non-substitutable or causally ambiguous. The term sustainable competitive advantage is vague and ambiguous and the environment in which hospitals operate is dynamic, turbulent and disruptive. Therefore, sources of competitive advantage must change and evolve with time. This paper aims to explore the themes of competitive advantage in a dynamic environment for multispecialty hospitals in India by studying data from secondary sources for five hospitals.

Design/methodology/approach

The findings of the case study were based on the analysis of secondary data that are extracted from the official websites of the hospitals, with the grounded theory approach.

Findings

Five identified themes are as follows: changing and adapting; clinical excellence; creating unique value; managing unpredictable circumstances and patient-centric approach. All the themes supported hospital performance, service and value delivered to patients and therefore may help in building a competitive advantage of the hospital. However, sustainability factors were inconsistent across the themes.

Practical implications

The CXOs and CMOs of hospitals can review the themes periodically and re-align the business strategies to build a sustainable competitive advantage.

Originality/value

The findings of the study uncovered the criticality of re-alignment of resources deployed in the unpredictable and ever-changing environment in which hospitals thrive to build sustainable competitive advantage.

Details

Competitiveness Review: An International Business Journal , vol. 30 no. 5
Type: Research Article
ISSN: 1059-5422

Keywords

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Article
Publication date: 1 September 2020

Shefali Srivastava and Rohit Kr Singh

The paper identifies the antecedents and consequences of integrated supply chain performance (ISCP) in healthcare systems.

Abstract

Purpose

The paper identifies the antecedents and consequences of integrated supply chain performance (ISCP) in healthcare systems.

Design/methodology/approach

Based on a review of the literature constructs of supply chain flexibility (SCF), employee relationships (ERs), organizational orientation (OO) and knowledge exchange (KE) were identified as antecedents of ISCP, and patient centricity (PC) emerged as its consequence. This structural relationship was tested using partial least square structural equation modeling (PLS-SEM).

Findings

ERs, SCF, OO and KE positively impacted the performance of an integrated healthcare supply chain. Furthermore, enhanced ISCP in operational processes of the hospital positively influenced patient centeredness and care quality.

Research limitations/implications

Paper contributes by identifying antecedents and consequences of ISCP. Future researchers may explore the inter-relationships among the antecedents of ISCP.

Practical implications

Insights from this study will help practitioners in enhancing hospital operations by integrating processes along the healthcare service supply chain and developing a patient-centric approach.

Social implications

This paper highlights how PC may be achieved by focusing on a facilitative internal environment. This understanding may help in designing processes that deliver health as a social good in an effective manner.

Originality/value

The empirical evidence from this study can help hospitals integrate their functions, thus, enabling them to deliver quality care.

Details

Benchmarking: An International Journal, vol. 28 no. 1
Type: Research Article
ISSN: 1463-5771

Keywords

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Book part
Publication date: 11 March 2021

Qassim Mahmoud Ahmed Al-hayek and Rana Mohammad Ass’ad Alzaben

One of the most challenging aspects in the health care industry is to understand the nuances and strategies of those companies that provide both B2B and B2C services…

Abstract

One of the most challenging aspects in the health care industry is to understand the nuances and strategies of those companies that provide both B2B and B2C services, apart from being supported by their management team, quality officers, the HR Manager, the clinicians, the doctors, and the holistic support of all staff. This case study focusses on analyzing the various indicators of success of The Health Medical Services (THMS), a major service provider in the health care sector, serving both B2B and B2C markets in the UAE and the organizational factors that drove the service provider to success, creating an exceptional experience for both their internal and external customers. The unique success drivers of THMS, as brought out by the current study include Customer Relationship Management, unique leadership style, employee engagement, market orientation, Quality Circles, patient-centric care, and service innovation in health care that supports their sustainability and scalability. Moreover, a literature review on the success drivers brings out the academic implications of the study.

Details

Corporate Success Stories in the UAE: The Key Drivers Behind Their Growth
Type: Book
ISBN: 978-1-80043-579-7

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Article
Publication date: 10 May 2019

Shefali Srivastava and Gyan Prakash

The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic…

Abstract

Purpose

The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic conditions. Care coordination is defined as a process where physicians, nurses and allied professionals work together to clarify responsibilities, care objectives, treatment plans and discharge plans for delivery of unified care. Patient-centricity is defined as an approach of delivering quality care to patients that focuses on creating a positive experience for them.

Design/methodology/approach

A literature review was used to identify measures of care coordination and then partial least square structural equation modeling was used to assess interrelationship among patient-centricity, measures of care coordination and delivery of quality care.

Findings

Results reveal that care coordinated pathways consist of IT-enabled coordination, interprofessional teamwork, information sharing and facilitative infrastructure requirements and are influenced by patient-centricity. These are deliberate requisites for delivering of quality care. Results of this study present a validated model of care coordination for older people, which may be further explored to refine the concept of care coordination.

Practical implications

Based on these results, practitioners may develop an overarching strategy to deliver seamless care and to achieve better health outcomes. Measures of care coordination may be used as a performance benchmarking tool and will also help in the process mapping of hospitals.

Social implications

This paper highlights how patient-centricity may be achieved by focusing on coordinated care processes. This understanding may help in designing processes, which in turn deliver health as a social good in an effective manner.

Originality/value

Results of this study present such a validated model for care coordination, which can be used by researchers.

Details

Journal of Indian Business Research, vol. 11 no. 4
Type: Research Article
ISSN: 1755-4195

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Article
Publication date: 14 October 2013

James Ducharme

– The purpose of this paper is to define best practice, while identifying the impediments to its implementation.

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539

Abstract

Purpose

The purpose of this paper is to define best practice, while identifying the impediments to its implementation.

Design/methodology/approach

The paper takes the form of a commentary.

Findings

There is as of yet no accepted definition of best practice that has both face and construct validity.

Practical implications

Defining what best practice means for health systems around the world will require a collaborative approach, adapting recommendations to local culture and resources. Avoiding a silo approach that could result in unintended consequences and conflicting recommendations can only be achieved with a patient-centric approach. Holistic patient care with consideration of varying societies' needs as a whole is the only way to truly offer best practice recommendations. Emergency medicine needs to be a leader in stepping away from the silo approach and establishing what truly is best in patient care.

Originality/value

Practical application of concepts of best practice will be difficult. Of necessity they will vary from country to country and from one level of care to another.

Details

Clinical Governance: An International Journal, vol. 18 no. 4
Type: Research Article
ISSN: 1477-7274

Keywords

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