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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.

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.

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.

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.

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.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

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 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.

This study investigates the effects of top management commitment (TMC) and Kaizen on quality management practices (QMP) and how the latter influence the performance of Jordanian public hospitals in the aftermath of COVID-19.

A survey-based questionnaire was employed to collect data from 222 practitioners and professionals working in public hospitals in Jordan. Partial least squares structural equation modeling (PLS-SEM) was undertaken to analyze data.

Significant and positive effects of TMC and Kaizen (continuous improvement) on QMP are highlighted by the results. The findings also show that QMP has a positive and significant impact on public hospitals' performance. Furthermore, the effects of TMC and Kaizen on performance were also found to be significant.

Practitioners and researchers will gain a greater understanding of how implementing QMP can enhance the performance of public hospitals in the context of the COVID-19 outbreak. The results underline the important role of Kaizen and TMC in the success of QMP and their effect on performance. This research is a cross-sectional study, and there is a need to conduct further empirical investigation based on secondary data or objective measurement of performance.

This research is one of the first studies to investigate the effects of QMP on public hospitals' performance following the COVID-19 outbreak. This study is one of the empirical examinations of QMP and Kaizen in developing countries by investigating Jordanian public hospitals.

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

Previous research has identified associations between quality management and employee health. This study's purpose was to (1) examine those associations in a public healthcare organisation and (2) explore and describe the association between digitalisation and employee health.

An online questionnaire including indices to measure quality management values, employee health and digitalisation was answered by 118 managers in Swedish public healthcare. Correlation analysis was used to analyse the data. Based on the survey results, 12 qualitative, in-depth interviews were conducted with healthcare managers.

The findings show that employee health is associated with quality management and digitalisation. Categories were defined to describe the managers' views of the relationship between digitalisation and health.

Causality was not explicitly tested and cannot be assumed. However, the results strengthen the body of research showing that quality management is related to employee health, and associations between health and digitalisation were identified.

The findings and model should be helpful for healthcare managers in a digitalising environment who aim to preserve or enhance employee health whilst ensuring high service quality.

The results were used to create an integrated conceptual model depicting the association between quality, digitalisation and health. This association has not previously been studied.

While uncertainty has always been a feature of the healthcare environment, its pace and scope are rapidly increasing, fueled by myriad factors such as technological advancements, the threat and frequency of disruptive events, global economic developments, and increasing complexity. Contemporary healthcare organizations thus persistently face what is known as “deep uncertainty,” which obscures their ability to predict outcomes of strategic action and decision-making, presenting them with novel challenges and threatening their survival. Persistent, deep uncertainty challenges us to revisit and reconsider how we think about uncertainty and the strategic actions needed by organizations to thrive under these circumstances. Simply put, how can healthcare organizations thrive in the face of deeply uncertain environments? We argue that healthcare organizations need to employ both adaptive and creative strategic approaches in order to effectively meet patients' needs and capture value in the long-term future. The chapter concludes by offering two ways organizations can build the dynamic capabilities needed to employ such approaches.

Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask whether it has to be that way or whether is possible to nurture an innovative culture in a healthcare organisation. The aim of this paper is to describe and analyse nurturing an innovative culture within a healthcare organisation and how culture can support innovations in such a healthcare organisation.

Based on a qualitative case study of a healthcare unit that changed, within a few years, from having no innovations to repeatedly generating innovations, the authors describe important aspects of how innovative culture can be nurtured in healthcare. Data were analysed using inductive and deductive analysis steps.

The study shows that it is possible to nurture an innovative culture in a healthcare organisation. Relationships and competences beyond healthcare, empowering structures and signalling the importance of innovation work with resources all proved to be important. All are aspects that a manager can influence. In this case, the manager's role in nurturing innovative culture was very important.

This study highlights that an innovative culture can be nurtured in healthcare organisations and that managers can play a key role in such a process.

The paper describes and analyses an innovative culture in a healthcare unit and identifies important conditions and strategies for nurturing innovative culture in healthcare organisations.