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.

This article investigates how the healthcare sector can reorganize its procurement network to better balance its resilience and cost-minimization objectives.

A single case study was conducted on the procurement of personal protective equipment (PPE) during the first COVID-19 pandemic wave in the Quebec public healthcare network. Interviews were conducted with stakeholders from the supply chain management (SCM) departments at eight public healthcare institutions.

Two major challenges in the early months of the pandemic impacted the development of resilience in the healthcare network. First, peripheral actors’ decisions, which orient procurement objectives, limited the deployment of resilience measures in the supply chain (SC). Second, SC resilience included hundreds of products other than PPE that are critical to the delivery of care. The article illustrates the challenges of SCR, which will inevitably be accompanied by additional costs when purchasing in the public healthcare sector is often focused on the lowest price.

Drawing from the network perspective model, this article examines the actions of Quebec supply network stakeholders through the three phases of SCR: anticipation, response to disruption, and recovery. Finally, the article suggests that decision-makers remove the cost of resilience measures from the purchase price of products, in order to maintain these measures over the long term.

This study aims to identify several perspectives that affect the adoption of blockchain technology in India (BCTA) and evaluate their impact. To study the sector’s influence on adoption and the impact of BCTA on the performance of the Indian healthcare supply chain (HSCP) using BCTA as a mediating variable.

In this study, we first developed a conceptual model based on Organizational Information Processing Theory and Technology-Organization-Environment, then formulated hypotheses. Based on this, a questionnaire was developed, and data were gathered from experts in the Indian healthcare industry who were familiar with blockchain technology. AMOS 19 was used to analyze data using structural equation modelling.

All the factors have a significant positive influence on BCTA. Healthcare supply chain factors influenced the adoption most dominantly, followed by technological, environmental, organizational and record-keeping unit factors. Both the public and private sectors of HSCP benefited significantly from BCTA.

This research work is fruitful for healthcare practitioners, top management, academicians and policymakers in assessing BCTA’s impact on the HSCP.

We have attempted to evaluate the possible BCTA impact on HSCP. BCTA as a mediating variable and considering different perspectives for a holistic view of adoption in the Indian context add to this work’s originality.

The purpose of this study is to scrutinize the connection between creativity and innovation in the context of public healthcare. This is achieved by applying the theoretical concept of employee-driven innovation (EDI) to explore employees’ perceptions of their creative engagement in innovation processes, as well as to capture the managerial implications of setting up such processes in the sector.

A critical discourse analysis (CDA) is applied as a methodological lens to capture the interaction between the macro-level production and meso-level distribution of innovation discourse (top-down), and the micro-level perception of, and response to, the same (bottom-up). This study is based on a qualitative approach and is set in the public healthcare system of the Autonomous Province of Trento, Northeast Italy. In total, 26 semi-structured interviews were conducted with 22 healthcare professionals. For triangulation purposes, observation and document analysis were also performed.

The findings of this study reveal that tensions are present between the macro-level discourses and the meso-level strategies around innovation, and the micro-level perceptions of employees’ creative engagement in innovation processes. Healthcare professionals’ creative efforts are not easily recognized and supported by top management, which in turn does not receive a framework of reference in policies acknowledging the importance of human skills and creativity in innovation processes.

That this is a single case study implies a limitation on the generalizability of its results, but the results may nevertheless be transferable to similar empirical contexts. Therefore, a multiple case study design would be preferable in future studies in order to study EDI strategies and policies across various types of organizations in the public sector. Moreover, apart from CDA, other theoretical and methodological lenses can be applied to investigate the interaction between top-down organizing and bottom-up responses to innovation.

This study contributes to the EDI literature by providing a more integrative understanding of EDI in the public sector, demonstrating the importance of scrutinizing the interactions between employees and top-level management.

COVID-19 has profoundly shaped human interactions, and, within public healthcare systems, care relations. Through the lens of social suffering, this study explores how employee innovation is shaped by the pandemic crisis and different managerial approaches in the context of public geriatric care in Northeast Italy.

This study adopts a qualitative methodology. A total of 29 semi-structured, open-ended interviews were conducted with 23 healthcare professionals involved in geriatric care, with managerial and without managerial positions. Observation was integrated as auxiliary research to further capture on an operational level the interactions among the actors involved.

The COVID-19 crisis significantly shaped employee innovation for healthcare professionals, as the suffering it provoked in the system motivated and urged them to engage in innovative initiatives. Where employees’ engagement in innovation was recognized by the management, it was found that the suffering was mitigated, and creativity and solidarity emerged in the innovation process. Where top-down approaches did not recognize employees’ efforts and innovative initiatives, need-driven innovation and greater tensions came forward, enhancing the overall suffering in care relations and resulting in some employees considering leaving their profession.

This study is based on a single case study.

This study further highlights the employee participation in innovation as a crucial practical implication for sustaining the quality of public care and assistance. A practical implication emerging from this study suggests that “ordinary” healthcare professionals’ engagement in innovative initiatives and in their operationalization should be encouraged by the organization. In a system as complex as the public healthcare one, valuing the bottom-up, clinical inputs appears fundamental if innovation is to move away from mere technological adaptation to embrace a more comprehensive process, involving the professionals who are engaging in innovative endeavors. From a managerial point of view, adopting an approach that recognizes, supports and provides coordination to employee innovation seems instrumental to nurture an environment where employee voices feel heard, and creativity, solidarity and overall positive collaboration can occur. Thus, another significant practical implication includes the retention of healthcare professionals in the public sector in times of crisis.

With the outbreak of the COVID-19 pandemic, the necessity to explore the “human side” of innovation and its connection to emerging human needs during a crisis is growing. This study focuses on employee participation in innovation processes due to COVID-19, thus contributing to the employee-driven innovation (EDI) literature. Through the lens of social suffering, it scrutinizes the interactions between bottom-up perceptions and responses and top-down strategies in a public healthcare setting. Hence, this study addresses two major gaps present in EDI literature, for the most part focused on the private sector and on the managerial structures, tools and interventions.

Our study investigates the role of the Human Resources Management (HRM) system strength in supporting Italian healthcare managers during times of uncertainty and change. The perceived HRM system strength and its relationship with managers’ taking charge behaviors, perceived procedural constraints, and work engagement were examined.

Two surveys were conducted to gather empirical data from a pooled sample of 121 healthcare managers located in hospitals across Italy. We use regression analysis to test our hypotheses.

The data show that strong HRM systems facilitate managers taking charge behaviors and work engagement. Additionally, the findings highlight the mitigating effect of a strong HRM system on procedural constraints, such as red tape, in public healthcare organizations.

Emphasizing the positive outcomes associated with strong HRM systems, the findings suggest that public health organizations should make efforts to put in place robust HR practices to bolster engagement and proactive behaviors among healthcare managers in times of uncertainty and change.

Analyzing a unique data set, the study extends the understanding of HRM system strength in the public sector, specifically in post-pandemic healthcare organizations. Overall, the study contributes to the growing literature on HRM system strength by offering novel insights into its nomological network.

The author studies the determinants of public trust in government doctors and hospitals (DH) – a crucial indicator of the quality of a country's healthcare system – in India by analyzing the India Human Development Survey (IHDS) 2011–2012.

The author uses descriptive statistics and a set of ordered probit regression models controlling for a set of individual-specific, household-level and other covariates and analyze across heterogeneous contexts (national/rural/urban/male heads/female heads/social groups).

Across contexts, people reporting a great deal of trust in private DH (PDH) are significantly more likely to report a great deal of trust in government DH. Those people with a great deal of trust in government schools to provide good education (vis-à-vis people with only some trust in government school) have significantly higher likelihood of reporting a great deal of trust in government DH. Visiting a private doctor last time (vis-à-vis a government doctor) makes reporting higher trust levels in government DH less likely.

India's healthcare system is afflicted with several resource allocation problems and low public trust issues are indicative of misgovernance. In presence of limited state capacity, ubiquitous corruption and underwhelming institutional trust, understanding the factors influencing public trust in healthcare providers is critical to designing appropriate trust-enhancing public health policies.

Given the sparse empirical literature on public trust in healthcare systems in the developing countries such as India, this study is a pertinent contribution as the study explains the determinants of public trust in DH using a comprehensive unit-recorded household survey dataset.

The aim of this paper is to analyse how technological innovations in performance measurement systems make it possible to overcome some of the challenges that public healthcare organizations face where management and control are concerned. The changes that could be applied to the performance measurement system of healthcare organisations were analysed together with an evaluation of the responses developed in order to achieve these changes.

The paper contains an in-depth case-study of a public university hospital which utilises an innovative information system.

The case-study highlights how technological innovations in performance measurement systems impact the management and monitoring information system in a public university hospital, through the implementation of a multidimensional management dashboard.

The limitation of this paper is that only one case-study is analysed, albeit in depth, while it would be interesting to consider more public university hospitals.

The paper highlights the fundamental role of middle management in change processes in the healthcare sector.

The case-study highlights how critical the active involvement of middle management is in performance measurement and management, and how this is achieved thanks to the adoption of a simple, clear method which ensures comprehensible communication of the objectives, as well as the measurement of performance by means of radar plots.

Many countries struggled to respond to the pandemic burden; in fact, most suffer from healthcare incapacity generally. Therefore, they need to find innovative systems to compensate for their deficiencies in dealing with current and future problems. One such goes down the public-private partnership (PPP) route. It is important to note, however, that PPP is not a magic wand, and some of these projects have been criticized for overruns that exceed the value created. Aiming to promote the value created in healthcare PPP projects, this study aims to identify factors and critical points related to their implementation.

A two-stage literature review was conducted to shape semi-structured interviews. Based on this, the questions to be asked in the interviews were prepared. The interviews were conducted with twelve experts. The transcripts of the twelve semi-structured interviews were analyzed using manual thematic analysis to reveal the most critical value-creation factors (VCFs). The VFCs were validated by comparing them with the studies in the literature and by having focus group discussions (FGDs) with the experts. Finally, in an FGD, the experts discussed how these factors affect value creation in healthcare PPP projects.

The findings show that VFCs can be categorized into four dimensions: assets, partnership synergy, cooperation environment and processes. Based on the frequency of codes during the thematic analysis, the most frequently addressed VFCs in each category were identified. These were complementary skills and resources, attitude, early establishment of the operational body and effective design development, respectively.

This research contributes to both society and practice by unveiling VCFs and effective ways to achieve them in healthcare PPP projects. Thus, practitioners can generate more value and bring value to the forefront of healthcare PPPs, which can then enhance the value gained by society.

Studies to date have offered little about VCFs and how to realize value in PPP projects by considering the factors involved in them. Moreover, value creation in PPP healthcare projects has largely remained unexplored, despite PPPs being adopted and investigated quite commonly.

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.