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1 – 10 of 242Alberto Sardi, Enrico Sorano, Vania Tradori and Paolo Ceruzzi
The process of performance measurement provides support to company management to achieve the objectives established in strategic planning. Through the definition of critical…
Abstract
Purpose
The process of performance measurement provides support to company management to achieve the objectives established in strategic planning. Through the definition of critical success factors and related key performance indicators, performance measurement verifies the gap between planned objectives and the results achieved, informing the responsible bodies to enable them to evaluate performance and, if necessary, implement improvement actions. Although many types of companies adopt performance measurement, this process is challenging when applied to national health services. This paper aims to identify the evolution of performance measurement and the critical success factors of national health services.
Design/methodology/approach
The authors conducted an explorative case study of a leading national health service to delineate the evolutionary path of performance measurement and the main critical success factors.
Findings
The results indicate a significant increase in the maturity of performance measurement of a national health service that has been motivated by international reforms and national regulations. This research highlights performance measurement features such as a balanced set of metrics, targets, and incentives linked to strategic objectives and regular and frequent performance reviews. Furthermore, it identifies the performance measurement model of a leading national health service.
Originality/value
The evolution of performance measurement and numerous critical success factors of national health services are described; the critical success factors cover a wide range of financial to operational aspects such as patient safety, organizational appropriateness, and clinical appropriateness.
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Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide…
Abstract
Purpose
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.
Design/methodology/approach
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).
Findings
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.
Originality/value
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.
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Inga-Britt Gustafsson, Lars Wallin, Ulrika Winblad and Mio Fredriksson
A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding…
Abstract
Purpose
A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding financial situation have failed. A decommissioning programme was launched, and two years later, an evaluation indicated positive outcomes. The aim of this study was to explore factors politicians and public servants perceived as enablers to the successful implementation of the programme.
Design/methodology/approach
A deductive content analysis approach using a framework of factors facilitating successful implementation of decommissioning decisions was applied to analyse interviews with 18 informants.
Findings
Important factors were: (1) a review report contributing to the clarity of evidence, which (2) made the clarity of the rationale for change undeniable and (3) strengthened the political support for change. Additional factors were: (4) the strength of executive leadership, (5) the strength of clinical leadership supported by (6) the quality of project management and (7) a cultural and behavioural change seen as an important outcome for the path forward. A way to maximise the potential for a successful implementation of a large-scale decommissioning programme is to build a shared vision and a collaboration grounded in convincing evidence. Include public servants with a clinical background in the executive leadership team to contribute with legitimacy, competence, and trust in the decommissioning programme’s intention.
Originality/value
The paper addresses the limited knowledge of best practices in decommissioning processes and contributes empirical knowledge from a successful case.
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This study investigates the pathways for adopting IoTs and BDA technologies to improve healthcare management.
Abstract
Purpose
This study investigates the pathways for adopting IoTs and BDA technologies to improve healthcare management.
Design/methodology/approach
The study relied on 445 healthcare professionals' perspectives to explore different causal pathways to IoTs and BDA adoption and usage for daily healthcare management. The Fussy-set Qualitative Comparative Analysis was adopted to explore the underlying pathways for healthcare management.
Findings
The empirical analysis revealed six different configural paths influencing the acceptance and use of IoTs and BDA for healthcare improvement. Two key user topologies from the six configural paths, digital literacy and ease of use and social influence and behavioural intentions, mostly affect the paths for using digital health technologies by healthcare physicians.
Research limitations/implications
Despite this study's novel contributions, limitations include the fsQCA methodology, perceptual data and the context of the study. The fsQCA methodology is still evolving with different interpretations, although it reveals new insights and as such further studies are required to explain the configural paths of social phenomena. Additionally, future research should consider other constructs beyond the UTAUT and digital literacy to illustrate configural paths to healthcare technology acceptance and usage. Again, the views of healthcare professionals are perceptual data. Hence future research on operational data will support significant contributions towards pathways to accept and use emerging technologies for healthcare improvement. Lastly, this study is from a developing country perspective where emerging digital healthcare technology is still emerging to support healthcare management. Hence, more investigation from other cross-country analyses of configural paths for digital technology deployment in healthcare will enhance the conversation with IoTs and BDA for healthcare management.
Practical implications
Holistically, the acceptance and use of healthcare technologies and platforms is not solely on their capabilities, but a combination of distinct factors driven by users' perspectives. This offers healthcare administrators and institutions to essentially reflect on the distinct combinations of conditions favourable to health professionals who can use IoTs and BDA for healthcare improvement.
Originality/value
This study is among the few scholarly works to empirically investigate the configural paths to support healthcare improvement with emerging technologies. Using fsQCA is a unique contribution to existing information system literature for configural paths for healthcare improvement with emerging digital technologies.
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Christian Di Falco, Guido Noto, Carmelo Marisca and Gustavo Barresi
This article aims to provide the current state of the art of the literature on the contribution of information and communication technologies (ICTs) on the measurement and…
Abstract
Purpose
This article aims to provide the current state of the art of the literature on the contribution of information and communication technologies (ICTs) on the measurement and management of performance in the healthcare sector. In particular, the work aims to identify current and emerging ICTs and how these relate to the performance measurement and management (PMM) cycle of healthcare organizations.
Design/methodology/approach
To address the research objective, we adopted a systematic literature review. In particular, we used the preferred reporting items for systematic reviews and meta-analysis (PRISMA) methodology to select articles related to the investigated topic. Based on an initial screening of 560 items retrieved from Scopus and ISI Web of Knowledge, we identified and analyzed 58 articles dealing with ICTs and PMM in the healthcare sector. The last update of the dataset refers to February 2024.
Findings
Although we attempted to address a relevant topic for both research and practice, we noticed that a relatively small sample of articles directly addressed it. Through this literature review, in addition to providing descriptive statistics of research on ICTs and PMM in healthcare, we identified six theoretical clusters of scientific streams focusing on the topic and eleven categories of ICTs effectively tackled by the literature. We then provided a holistic framework to link technologies to the different PMM phases and functions.
Practical implications
Nowadays, the availability of ICTs to support healthcare organizations’ processes and services is extensive. In this context, managers at various organizational levels need to understand and evaluate how each ICT can support different activities to benefit most from their adoption. The findings of this study can offer valuable insights to top and line managers of healthcare organizations for planning their investments in both existing and emerging ICTs to support the various stages of development and functions of PMM.
Originality/value
Most of the current literature focusing on ICTs in the healthcare sector refers to the contribution that technology provides to clinical processes and services, devoting limited attention to the impact of ICTs on administrative processes, such as PMM. To the best of the authors’ knowledge, this represents the first literature review on the contribution of ICTs to PMM in the healthcare sector. The review, differently from other research focused on specific ICTs and/or specific PMM functions, provides a holistic perspective to understand how these technologies may support healthcare organizations and systems in measuring and managing their performance.
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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.
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Reza Salehi, Iravan Masoudi-Asl, Hassan Abolghasem Gorji and Hojatolah Gharaee
A healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack…
Abstract
Purpose
A healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack substance. This study analyzed these strategies and found a performance gap.
Design/methodology/approach
This study took a unique mixed-method approach, systematically reviewing both qualitative and quantitative studies that identified strategies to enhance interprofessional teams in healthcare units. To gauge the effectiveness of these strategies, the researcher utilized an Importance-Performance Analysis (IPA) in four specialized clinical training centers in Hamadan province, Iran. The analysis of the IPA involved 35 experts from these centers as the statistical population.
Findings
Based on a systematic review, there are seven categories: contextual, strategic, communication, organizational, individual, Human Resources Management (HRM), and environmental for promoting interprofessional teams with a total of 36 sub-indicator. Based on the IPA, the HRM aspect shows the most extensive performance gap. The individual and organizational aspects fall under resource wastage, and the environmental aspect is within the indifferent zone. Also, some critical sub-indicators, such as incentives/rewards, roles and responsibilities, financial resources, team-initiated innovation, the culture of respect, partner resources, humility, data availability, set expectations, and team availability, are in the weak areas.
Practical implications
This research has identified critical areas for improvement in promoting teamwork in clinical training centers through a comprehensive gap analysis. It also presents practical policy solutions to address these weak points, providing a clear roadmap for enhancing interprofessional teams in healthcare units.
Originality/value
Improving teamwork in healthcare can be challenging, but it is possible with proper strategies and tools. One of the highlights of the recent study was the combination of systematic review studies with IPA to identify areas for improving interprofessional teamwork in clinical training centers.
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Zhening Liu, Alistair Brandon-Jones and Christos Vasilakis
The purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the…
Abstract
Purpose
The purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the significant expansion in this and other forms of telehealth worldwide over the last decade. We use our analysis of the literature to develop a comprehensive framework that incorporates the patient journey, multidimensionality, antecedents and consequences, interventions and improvement options, as well as the cyclic nature of patient engagement. We also propose measures suitable for empirical assessment of different aspects of our framework.
Design/methodology/approach
We undertook a comprehensive review of the extant literature using a systematic review approach. We identified and analysed 63 articles published in peer-reviewed scientific journals between 2003 and 2022.
Findings
We conceptualise patient engagement with remote consultation across three key aspects: dimensions, process, and the antecedents and consequences of engagement. We identify nine contextual categories that influence such engagement. We propose several possible metrics for measuring patient engagement during three stages (before service, at/during service and after service) of remote consultation, as well as interventions and possible options for improving patient engagement therein.
Originality/value
The primary contribution of our research is the development of a comprehensive framework for patient engagement in remote consultation that draws on insights from literature in several disciplines. In addition, we have linked the three dimensions of engagement with the clinical process to create a structure for future engagement assessment. Furthermore, we have identified impact factors and outcomes of engagement in remote consultation by understanding which can help to improve levels of adoption, application and satisfaction, and reduce healthcare inequality. Finally, we have adopted a “cyclic” perspective and identified potential interventions that can be combined to further improve patient engagement in remote consultation.
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Wiljeana Jackson Glover, Sabrina JeanPierre Jacques, Rebecca Rosemé Obounou, Ernest Barthélemy and Wilnick Richard
This study examines innovation configurations (i.e. sets of product/service, social and business model innovations) and configuration linkages (i.e. factors that help to combine…
Abstract
Purpose
This study examines innovation configurations (i.e. sets of product/service, social and business model innovations) and configuration linkages (i.e. factors that help to combine innovations) across six organizations as contingent upon organizational structure.
Design/methodology/approach
Using semi-structured interviews and available public information, qualitative data were collected and examined using content analysis to characterize innovation configurations and linkages in three local/private organizations and three foreign-led/public-private partnerships in Repiblik Ayiti (Haiti).
Findings
Organizations tend to combine product/service, social, and business model innovations simultaneously in locally founded private organizations and sequentially in foreign-based public-private partnerships. Linkages for simultaneous combination include limited external support, determined autonomy and shifting from a “beneficiary mindset,” and financial need identification. Sequential combination linkages include social need identification, community connections and flexibility.
Research limitations/implications
The generalizability of our findings for this qualitative study is subject to additional quantitative studies to empirically test the suggested factors and to examine other health care organizations and countries.
Practical implications
Locally led private organizations in low- and middle-income settings may benefit from considering how their innovations are in service to one another as they may have limited resources. Foreign based public-private partnerships may benefit from pacing their efforts alongside a broader set of stakeholders and ecosystem partners.
Originality/value
This study is the first, to our knowledge, to examine how organizations combine sets of innovations, i.e. innovation configurations, in a healthcare setting and the first of any setting to examine innovation configuration linkages.
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Malwela Joseph Lebea, Justus Ngala Agumba and Oluseyi Julius Adebowale
The United Nations' Sustainable Development Goal of ensuring healthy lives and promoting well-being for people of all ages underscores the vital role of public healthcare…
Abstract
Purpose
The United Nations' Sustainable Development Goal of ensuring healthy lives and promoting well-being for people of all ages underscores the vital role of public healthcare facilities (PHFs) in delivering essential healthcare services. However, these facilities often suffer from inadequate maintenance, exacerbated by the insufficient implementation of maintenance strategies. Recognizing the importance of PHFs in enhancing healthcare services, this paper investigates the Critical Success Factors (CSFs) in the maintenance strategies of PHFs in South Africa.
Design/methodology/approach
Through semi-structured interviews with nineteen purposively selected maintenance personnel from the Limpopo Department of Health (DoH), this study identified and analyzed the CSFs to enhance maintenance operations in PHFs. Thematic content analysis was employed to derive key insights from the collected data.
Findings
The study's findings highlight adequate maintenance planning and effective leadership as the two overarching CSFs in the maintenance of PHFs. These factors play a pivotal role in addressing challenges that hinder the current maintenance team from meeting maintenance requirements to the satisfaction of both staff and patients within PHFs.
Originality/value
The study offers valuable insights for policymakers to improve the effectiveness of maintenance operations in PHFs. By addressing the identified CSFs, policymakers can enhance maintenance operations in PHFs, positively impacting healthcare service delivery and the well-being of both staff and patients.
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