Search results

This study aims to fully assess the readiness for Lean Six Sigma (LSS) and Quality Performance Improvement (QPI) in an Italian Public Healthcare ecosystem.

Drawing from previously established survey development and adaptation protocols, a replication study was carried out; Lean, Six Sigma and QPI were extracted and validated through confirmatory factor analysis in an Italian Public Healthcare setting, with a sample of health professionals from the Campania region.

This study reports the adaptation of an existing scale for measuring LSS and QPI in an Italian public healthcare organisation. This analysis extracts six conceptual domains and constitutes an original adaptation of an existing scale to assess the readiness to adopt Lean, Six Sigma and Quality Performance in Italian Public Health Organizations. The constructs show strong levels of internal consistency, as demonstrated by each item factor loading and each subscale reliability.

Managers, policymakers and academics can employ the proposed tool to assess the public healthcare ecosystem’s capability to implement LSS initiatives and strategies to improve quality performance.

This is one of the first studies to assess cross-regional organisational readiness for LSS and QPI in an Italian Public Healthcare environment at this scope and level.

This study aims to investigate the adoption and use of electronic health record systems (EHRS) in Tanzanian public primary healthcare institutions. The study’s objectives include understanding the factors that affect EHRS adoption, identifying implementation challenges and evaluating the effect of EHRS usage on healthcare delivery. By addressing these research goals, the study aims to contribute insightful information on the current level of EHRS adoption in Tanzanian primary healthcare facilities and contribute to developing strategies to improve EHRS deployment and healthcare in the nation.

This study combined quantitative and qualitative data using a mixed-methods methodology. Both data types were collected and analysed concurrently using a concurrent triangulation approach. The study aimed to comprehend the variables that affect the adoption and use of EHRS in Tanzanian public primary healthcare institutions. Eleven regions spanning various geographic locations and urban–rural dynamics were chosen as research sites. A survey of 122 healthcare employees was conducted with a sample of 31 healthcare facilities. The questionnaire had closed-ended and open-ended questions to gather quantitative and qualitative data. Descriptive statistics and thematic analysis were used in data analysis. Throughout the investigation, ethical standards and confidentiality precautions were observed.

Several factors affect the adoption and use of EHRS. Perceived usefulness and use, support and training, interoperability, data security and privacy, business culture and leadership are all factors. Inadequate infrastructure, power interruptions, duplication of effort and a lack of data analytic expertise were among the difficulties. Among the effects were improvements in data management, service delivery and coordination, productivity and efficiency, medical supply inventory control, billing and revenue collection.

This study, which complements earlier research that has concentrated chiefly on specialised healthcare settings, gives new insights by investigating the adoption and utilisation of EHRS, especially in primary healthcare institutions. The findings give policymakers and healthcare professionals in Tanzania and other nations vital information to help them decide whether to embrace and use EHRS in primary healthcare.

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.

This paper aims to identify the key issues that healthcare knowledge-intensive organizations (KIPOs) should focus on to define themselves as socioenvironmentally and governance responsible for integrating environmental, social, and governance (ESG) logic into their business strategy. At the same time, this provides an understanding of how healthcare KIPOs contribute to achieving the Sustainable Development Goals of the 2030 Agenda.

Taking a cue from the model developed by the World Economic Forum, an “ESG Processing Map” was constructed to identify qualitative disclosures that a healthcare company should consider when implementing sustainability logic. The aspects investigated were processed, considering national and international standards, frameworks and disclosures. The social network analysis technique was used to systemize and combine the outcomes of these processes and analyze their consistency with sustainable development.

Through the “ESG Processing Map,” 13 areas of action and 27 topics specific to the health sector were defined on which to intervene in sustainability in order to concretely help HCOs to place specific corrective and improvement actions over time concerning socioenvironmental and governance aspects.

The paper provides contribute, on the one hand, to enriching and updating the academic literature on ESG logic in a still underexplored field and, on the other hand, to provide these types of organizations with a “compass” to guide and orient their business strategies towards sustainability.

Quality improvement has developed and spread, and today, all Swedish Regions emphasize that their strategies are based on systematic improvement. This paper aims to describe and illuminate the development of Quality Improvement (QI) in Swedish healthcare and welfare organizations by using publications in a Swedish context.

The overview synthesis is inspired by a scoping literature review approach of relevant literature. All publications relevant to Swedish healthcare and welfare settings between 1992 until 2020 were included.

In all, 213 papers, 29 books and chapters and 34 dissertations related to QI and research in Swedish healthcare and welfare context were identified. From 2011 to 2020, the publication rate increased rapidly. Six different focus areas emerged: systematic and value-creating improvement work; collaboration between organizations and healthcare providers; use of improvement methods and (theoretical) models; leadership and learning; measurements, quality registers and follow-up; and involvement and patient safety. Further QI development in Swedish healthcare and welfare points to an increased importance of collaboration between organizations and coproduction with beneficiaries for the healthcare and welfare services.

This paper is one of the first to describe and illuminate the QI development in the healthcare and welfare sector in a country. The trajectory also points to a need for coproduction to handle future challenges.

In France, telemedicine was integrated into the Code of Public Health in 2009, but adoption and use were slow until the beginning of the COVID-19 health crisis, when telemedicine arguably became the only way to ensure continuity of care for non-COVID patients, reduce viral transmission and streamline strained medical resources. Despite growing enthusiasm, criticism persists.

User satisfaction will be essential for the sustainability and development of telemedicine, yet this remains an under-researched area. Framed by the first lockdown in France (March–May 2020), this two-step mixed-methods study uses secondary quantitative data (n users = 2,511; n doctors = 254; n nurses = 248) and primary qualitative interviews (n = 5) among healthcare professionals and patients in France to analyse satisfaction levels among telemedicine users. Implementing an inductive approach, it identifies key themes in the adoption and use of telemedicine, the impact on user satisfaction and evolution in perceptions over time.

The findings contribute to the literature by identifying and explaining the shift in telemedicine practices and offering recommendations for addressing ongoing obstacles through pragmatic strategies.

This research addresses a gap in knowledge to examine the impact of the COVID-19 pandemic on the uptake, perception and satisfaction of telemedicine experienced by users. Recognising telemedicine as a complex innovation in conceptual and practical terms, this paper investigates the degree of acceptance among users and the process of assimilation in the system.

Healthcare organizations have been facing challenges due to high costs and low efficiency in health services. The growth of costs and losses caused by avoidable mistakes lead to the search for solutions, and Health Lean Management appears as a potential solution to help in solving service quality problems, as well as reducing risks. This study aims to analyse the state of the art in the literature centred on the Lean approach in the context of risk management in healthcare organizations, and to identify new research opportunities, highlighting possible lines of future research.

Following a systematic literature review approach, 51 papers were considered relevant for this research, and reviewed to explore the development of literature in this area.

Based on the results, five main research streams were identified: (1) risk management oriented towards patient safety; (2) risk management oriented towards employee safety; (3) importance of attitudes and behaviours in risk reduction projects; (4) Lean tools used in healthcare risk management and (5) Integration of approaches. Moreover, several shortcomings were identified in literature.

Identified shortcomings represent significant opportunities for further research development.

This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive care performance.

A case study method was adopted to examine how a hospital integrates its limited resources which leads to the need for resource bundles and an understanding of IS capabilities development to understand how they contribute to the delivery of preventive care in a Malaysian hospital.

This research proposes a comprehensive framework outlining resource-bundling and IS capabilities development to improve preventive care.

We acknowledge that the problem of transferring and generalizing results has been a common criticism of a single case study. However, our objective was to enhance the reader’s understanding by including compelling, detailed narratives demonstrating how our research results offer practical examples that can be generalized theoretically. The findings also apply to similar-sized public hospitals in Malaysia and other developing countries, facing challenges like resource constraints, HIS adoption levels, healthcare workforce shortages, cultural and linguistic diversity, bureaucratic hurdles, and specific patient demographics and health issues. Further, lessons from this context can be usefully applied to non-healthcare service sector domains.

This study provides a succinct strategy for enhancing preventive care in Malaysian public hospitals, focusing on system integration and alignment with hospital strategy, workforce diversity through recruitment and mentorship, and continuous training for health equity and inclusivity. This approach aims to improve resource efficiency, communication, cultural competence, and healthcare outcomes.

Efficiently using limited resources through HIS investment is essential to improve preventive care and reduce chronic diseases, which cause approximately nine million deaths annually in Southeast Asia, according to WHO. This issue has significantly impacted the socioeconomic development of developing countries.

This research refines resource orchestration theory with new mechanisms for resource mobilization, extends IS literature by identifying how strategic bundling forms specialized healthcare IS capabilities, enriches preventive care literature through actionable resource-bundling activities, and adds to HIS literature by advocating for an integrated, preventive care focus from the alignment of HIS design, people and institutional policies to address concerns raised by other research regarding the utilization of HIS in improving the quality of preventive care.

The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a comprehensive conceptual model for practitioners and researchers.

This research employs a comprehensive review of available literature by using multiple keywords on different electronic repositories using the recommendations of the PRISMA approach for the selection of articles. A critical analysis of available studies helped in compiling a list of core service quality dimensions in healthcare services.

This paper presents a comprehensive account of different dimensions and their measurement items used by various researchers to assess service quality in healthcare systems. Most of the researchers have used SERVQUAL model either in its original or modified form while the others have proposed and used totally different dimensions to assess the service quality in healthcare. Many dimensions are just an existing dimension of SERVQUAL that has undergone a name change while others are completely new. The dimensions used by many researchers have items drawn from more than one dimension of SERVQUAL model. The availability of so many dimensions and models adds to the confusion that researchers and practicing managers experience when determining the appropriate model to be used in their work. To mitigate this confusion, there is a need to develop a comprehensive model; the current work is an attempt to meet this need. Through our analysis, we identify four major service quality dimensions: clinical quality, infrastructural quality, relationship and managerial quality and propose a model named CIRMQUAL.

After exploring all available models in the domain of healthcare, this research presents the best possible areas to enhance the quality of healthcare services. It also enhances the research insights for academicians and working professionals by developing and proposing a comprehensive model for measuring healthcare service quality. The proposed model covers almost all of the service quality dimensions used by other researchers and will make the choice of dimensions/model easy for the future researchers/practitioners interested in measuring and improving the quality of services offered by their healthcare units. Such a comprehensive model has not been developed by any researcher thus far.

Workflow optimisation is crucial for establishing a viable acute stroke (AS) intervention programme in a large tertiary care centre. This study aims to utilise Lean Six Sigma (LSS) principles to enhance the hospital's workflow.

The Action Research methodology was used to implement the project and develop the case study. The study took place in a large tertiary care academic hospital in India. The Define-Measure-Analyse-Improve-Control approach optimised the workflow within 6 months. Lean tools such as value stream mapping (VSM), waste audits and Gemba were utilised to identify issues involving various stakeholders in the workflow. Sigma-level calculations were used to compare baseline, improvement and sustainment status. Additionally, statistical techniques were effectively employed to draw meaningful inferences.

LSS tools and techniques can be effectively utilised in large tertiary care hospitals to optimise workflow through a structured approach. Sigma ratings of the processes showed substantial improvement, resulting in a five-fold increase in clinical outcomes. Specifically, there was a 43% improvement in outcome for patients who underwent acute stroke revascularisation. However, certain sigma ratings deteriorated during the control and extended control (sustainment) phases. This indicates that ensuring the sustainability of quality control interventions in healthcare is challenging and requires continuous auditing.

The article presents a single case study deployed in a hospital in India. Thus, the generalisation of outcomes has a significant limitation. Also, the study encounters the challenge of not having a parallel control group, which is a common limitation in quality improvement studies in healthcare. Many studies in healthcare quality improvement, including this one, are limited by minimal data on long-term follow-up and the sustainability of achieved results.

This study pioneers the integration of LSS methodologies in a large Indian tertiary care hospital, specifically targeting AS intervention. It represents the first LSS case study applied in the stroke department of any hospital in India. Whilst most case studies discuss only the positive aspects, this article fills a critical gap by unearthing the challenges of applying LSS in a complex healthcare setting, offering insights into sustainable quality improvement and operational efficiency. This case study contributes to the theoretical understanding of LSS in healthcare. It showcases its real-world impact on patient outcomes and process optimisation.