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Open Access
Article
Publication date: 9 February 2024

Armando Calabrese, Antonio D'Uffizi, Nathan Levialdi Ghiron, Luca Berloco, Elaheh Pourabbas and Nathan Proudlove

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

Abstract

Purpose

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

Design/methodology/approach

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

Findings

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

Originality/value

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

Details

European Journal of Innovation Management, vol. 27 no. 9
Type: Research Article
ISSN: 1460-1060

Keywords

Article
Publication date: 26 May 2023

Anupama Prashar

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…

Abstract

Purpose

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?

Design/methodology/approach

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.

Findings

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.

Practical implications

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

Originality/value

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

Details

International Journal of Quality & Reliability Management, vol. 41 no. 1
Type: Research Article
ISSN: 0265-671X

Keywords

Open Access
Article
Publication date: 21 August 2023

Joseph Odhiambo Onyango

This study aims to document students’ supply chain solutions developed through the internship hackathon program. The study profiled innovative solutions developed by university…

1168

Abstract

Purpose

This study aims to document students’ supply chain solutions developed through the internship hackathon program. The study profiled innovative solutions developed by university students in Kenya to solve health supply chain logistics challenges during and beyond COVID-19. This is done by exploring students’ experience in developing sustainable logistics and supply chain management capacity-building programs in a low-middle-income country (LMIC).

Design/methodology/approach

This study used a qualitative approach to explore the experiences and perceptions of students and mentors who participated in a hackathon program. The study followed a cross-sectional descriptive survey design, collecting data from the participants through online questionnaires. The data were analyzed and presented using thematic analysis and narrative techniques.

Findings

Findings provide preliminary evidence for narrowing the gap between theory and practice through a hackathon internship blended with a mentorship program. Assessment of this program provides evidence for developing solutions toward ensuring the availability of essential medicine in LMICs during a pandemic such as COVID-19 by students. The profiled solutions demonstrate a broader perspective of innovative solutions of university students, mentors and potential opportunities for a triple helix approach to innovation for health supply chain system strengthening.

Research limitations/implications

This original study provides evidence for advancing contribution to developing innovative solutions through partnerships between investors, universities and industry practitioners interested in mentoring students in the health-care supply chain during COVID-19 in LMICs. Specifically, contingency factors that affect the implementation of innovative programs during and beyond global pandemics such as COVID-19 by students’ innovators are identified, and implications for policy action are discussed based on the praxis of sensemaking.

Practical implications

This study examines a novel approach that combines internship, mentorship and hackathon projects for logistics and supply chain students in LMICs. The approach aims to bridge the gap between theory and practice and to create innovative solutions for essential medicines during and after COVID-19. The study urges more resources for supporting such programs, as they benefit both academia and industry. The study also argues that hackathon internship programs can help the logistics and supply chain industry adapt to the post-pandemic era. The study offers insights for investors, universities and practitioners in the health-care industry.

Originality/value

This study shows how to develop innovative solutions for the health-care supply chain during COVID-19 in an LMIC through partnerships between investors, universities and industry practitioners who mentor students. The study identifies the contingency factors that influence the success of such programs during and beyond global pandemics such as COVID-19 and discusses the policy implications based on the sensemaking praxis of the student innovators.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 14 no. 1
Type: Research Article
ISSN: 2042-6747

Keywords

Article
Publication date: 31 January 2024

Margit Malmmose and Mai Skjøtt Linneberg

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Accounting, Auditing & Accountability Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 26 September 2023

Janet R. McColl-Kennedy, Christoph F. Breidbach, Teegan Green, Mohamed Zaki, Alexandria M. Gain and Mieke L. van Driel

The purpose of this paper is to investigate how and why some service ecosystems are more resilient and, consequently, more sustainable than others during turbulent times, and how…

Abstract

Purpose

The purpose of this paper is to investigate how and why some service ecosystems are more resilient and, consequently, more sustainable than others during turbulent times, and how resilience can be cultivated to enable pathways to service ecosystem sustainability.

Design/methodology/approach

This work integrates disparate literature from multiple service and sustainability literature streams, iterating through constant comparison with findings from 44 semistructured interviews conducted in the context of primary health care clinic service ecosystems.

Findings

The authors offer a novel conceptual framework comprising pillars (shared worldview, individual actor well-being and multiactor interactions), changing practices to cultivate resilience through resilience levers (orchestrators, individual actor effort, actor inclusivity and digitaltech–humanness approach), and pathways to service ecosystem sustainability (volume vs value, volume to value, volume and value). The authors demonstrate that service ecosystems need to change practices, integrating resources differently in response to the turbulent environment, emphasizing the importance of a shared worldview across the ecosystem and assessing different pathways to sustainability.

Originality/value

This paper offers new insights into the important intersection of service marketing, sustainability and health care. The authors provide guidance to practitioners aiming to cultivate resilience in service ecosystems to achieve pathways to sustainability in primary health care clinics. Finally, implications for theory are discussed, and directions to guide future service research offered.

Details

Journal of Services Marketing, vol. 37 no. 9
Type: Research Article
ISSN: 0887-6045

Keywords

Book part
Publication date: 15 November 2023

Thomas R. Martin

This chapter provides an overview of the role of technology and policy in shaping care plans for patients. Historically, healthcare has lagged behind other industry sectors in…

Abstract

This chapter provides an overview of the role of technology and policy in shaping care plans for patients. Historically, healthcare has lagged behind other industry sectors in adopting and deploying useful technologies, and policy surrounding use is an important component of establishing a long-term strategy. This chapter evaluates the current state of technology in the clinical setting and extends the widely adopted policy-based approaches into the palliative care context.

Details

Data Ethics and Digital Privacy in Learning Health Systems for Palliative Medicine
Type: Book
ISBN: 978-1-80262-310-9

Keywords

Article
Publication date: 21 March 2024

Archana Shrivastava and Ashish Shrivastava

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in…

Abstract

Purpose

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in visiting brick-and-mortar clinics or hospitals during the pandemic, Telemedicine had emerged as a potent alternative for seeking redressal to health issues. Based on theory and focus interviews with the telemedicine users, the researchers proposed a model to understand the intent and actual usage of telemedicine in India.

Design/methodology/approach

The cross-sectional study undertaken used a questionnaire designed on a seven-point Likert scale and administered to respondents with the objective of identifying the determinants of intent and actual usage of telemedicine services. Simple random sampling was used to collect primary data. The data was cleaned and finally a sample of 405 responses complete in all respects was considered for analysis. The questionnaire comprised of 34 items and following the recommendation of Hair et al. (2016), which says the minimum sample size in structural equation modeling should be ten times the number of indicator variables, a sample size of 405 was deemed adequate.

Findings

The research paper finds that performance expectancy, attitude, credibility and self-efficacy positively impact the intention of consumers to use telemedicine services. As the effort expectancy or risk perception toward telemedicine increases the intent and actual usage of telemedicine decreases. The intention to use telemedicine emerged as a strong predictor of the actual usage of telemedicine. Intent to use telemedicine was explained 81.4% by its predictors of performance expectancy, effort expectancy, attitude, risk, credibility and self-efficacy, and actual usage was explained 79.9% by its predictors. This study also reports that telemedicine was found to be popular among chronic as well as episodic patients though the preference was skewed in favor of the episodic patients. One of the advantages of telemedicine is its availability round the clock, and the study found that 8 a. m. to 12 noon time slot as the most preferred slot for seeking telemedicine services.

Practical implications

Chang (2004) opined that telemedicine can fulfill the needs of all stakeholders: citizens, health-care consumers, medical doctors and health-care professionals, policymakers, and so on. Considering the promise telemedicine holds, this realm must be studied and leveraged to the full potential. The study found that patients were using telemedicine even for their day-to-day aliments. This indicates a growing popularity of telemedicine and as such an opportunity for telemedicine companies to leverage it. In India, pharmaceutical companies cannot give commercial advertisements for medicines, and the same can only be sold through a registered medical practitioner’s prescription. As such there is total dependency on the medical practitioner for the sale of medicines. Telemedicine companies offer services of home delivering medicines clubbed with medical consultation thus giving them forward integration in their business models. Using telemedicine the patients had control over the timings of the services offered, and as such the waiting time to get a consultation and subsequent treatment was reduced considerably. Best medical advice from across the globe is available to the patient at less cost. Medical practitioners also stand to benefit as they can treat a variety of cases, collaborate among the medical fraternity and give consultation safely in case of fatal contagious diseases.

Originality/value

This study points to a definite growing popularity of telemedicine services not only in episodic patients but also chronic patients. Telemedicine with its unique advantages holds the promise to grow exponentially in the future and is a compelling health-care segment to focus on for delivering health-care solution to the geographically distant consumers.

Details

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

Keywords

Open Access
Article
Publication date: 2 April 2024

Henriikka Anne-Mari Seittu, Anneli Hujala and Minna Kaarakainen

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…

Abstract

Purpose

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).

Design/methodology/approach

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.

Findings

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.

Originality/value

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

Details

Journal of Integrated Care, vol. 32 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 January 2024

Jill Manthorpe, Steve Iliffe and Richard Bourne

It is over 20 years since the publication of the Wanless Report, “Securing our Future Health: Taking a Long-Term View”. The Wanless Report argued that the National Health Service…

Abstract

Purpose

It is over 20 years since the publication of the Wanless Report, “Securing our Future Health: Taking a Long-Term View”. The Wanless Report argued that the National Health Service (NHS) would survive in its current form only if the population became “fully engaged” with it.

Design/methodology/approach

In this discussion paper, the authors explored what “fully engaged” meant to Wanless, what it might mean now (allowing for the impact of the anti-vaxxer movement) and what policymakers could do to enhance public engagement.

Findings

Although the Wanless Report neatly fitted into other long-term thinking about the NHS, it was unique in that it built economic models to predict the costs and impact of different patterns of NHS performance. Wanless predicted that people’s poor levels of health would put considerable pressure on the NHS. This pressure could swamp efforts to meet healthcare targets and improve health outcomes, despite its sizeable investment of money. Wanless set out three possible scenarios for public engagement with the NHS: solid progress, slow uptake and fully engaged.

Practical implications

The authors pose questions for policymakers and practitioners. Would a reboot of the Wanless approach be worth the effort for policymakers? If yes, how would it differ from the original? The NHS faces the whole of society; could it be the vehicle for engaging the anti-vaxxer public with the truthfulness of medical science, and will it be this, that is, Wanless' enduring legacy?

Originality/value

The exploration of the Wanless Report is complicated (at least for the time being) by the rise of the anti-vaxxer movement’s resistance to health promotion and mistrust of part of the NHS.

Details

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

Keywords

Book part
Publication date: 27 November 2023

Cristina Vaz de Almeida

In an era where health professionals are increasingly demanding, and communicative skills are one of the keys to improve the relationship with the patient. The communicative…

Abstract

In an era where health professionals are increasingly demanding, and communicative skills are one of the keys to improve the relationship with the patient. The communicative competencies of assertiveness, clarity in verbal and non-verbal language, and positivity, based on the positive construction of the patient’s health path, improve the therapeutic relationship, as well as the relationship between professionals in the world of health complexity. The ACP Model is validated with extensive application by hundreds of professionals in Portugal who use it daily. Active learning is one of the most effective means of raising awareness and involving the professionals who are learning and implementing the ACP Model.

Details

Technology-Enhanced Healthcare Education: Transformative Learning for Patient-centric Health
Type: Book
ISBN: 978-1-83753-599-6

Keywords

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