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1 – 10 of over 1000Maria Vincenza Ciasullo, Alexander Douglas, Emilia Romeo and Nicola Capolupo
Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.
Practical implications
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.
Originality/value
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.
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Yee-man Tsui and Ben Y.F. Fong
The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial…
Abstract
Purpose
The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.
Design/methodology/approach
The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.
Findings
The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.
Originality/value
The over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals.
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Carla Freire and Adriano Azevedo
In recent decades, human resource management (HRM) in health organizations has faced several problems associated with employees' efficiency and happiness, which has been…
Abstract
Purpose
In recent decades, human resource management (HRM) in health organizations has faced several problems associated with employees' efficiency and happiness, which has been particularly exacerbated after the pandemic crisis. In this scenario, this study seeks to analyze nurses' turnover intention by comparing Portuguese public and private healthcare organizations. As determining factors, transformational leadership, perceived organizational support and organizational commitment were considered.
Design/methodology/approach
A survey was digitally applied to 277 nurses from Portuguese public and private healthcare organizations.
Findings
Results suggested that there are differences in nurses' turnover intentions: there is a greater likelihood of nurses in the private sector planning to leave the healthcare organizations the nurses work for when compared to public hospital nurses. Furthermore, nurses in public hospitals perceive lower levels of transformational leadership, organizational support and organizational commitment than those in the private sector. The underlying cause as to the intention of leaving the public sector resides in normative commitment. On the other hand, lower affective commitment explains the intention to abandon the private sector.
Practical implications
This study is relevant for human resource managers and administrators in public and private hospitals since it enables a diagnosis of the situation, as well as a definition of the most appropriate policies for each of the sectors as a strategy to attract and retain health professionals.
Originality/value
This study is significant as the study provides a better understanding of the reasons which lead nurses to consider leaving the organization where the nurses work and the difference between nursing professionals in public and private hospitals.
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Mauro Paoloni, Giorgia Mattei, Niccolò Paoloni and Giuseppe Modaffari
This paper aims to analyse the roles of relational capital (RC) and knowledge management (KM) during the COVID-19 in Italian public and private hospitals, considering that…
Abstract
Purpose
This paper aims to analyse the roles of relational capital (RC) and knowledge management (KM) during the COVID-19 in Italian public and private hospitals, considering that intangible elements are essential during periods of uncertainty.
Design/methodology/approach
Authors used a qualitative design in a case study on two Italian hospitals that have different ownership structures, which are located in the epicentre of the pandemic in Lombardy. The study was carried out using the CAOS (“caratteristiche personali”, “ambiente”, “organizzazione” and “start-up”) model (Paoloni, 2021), which allows for comprehending and commenting on RC because of the connections between typical factors that influence an organisation. The model also allows for discussion of the use of a network and how it supports organisations.
Findings
Findings of the analysis showed that during the management of the COVID-19 health emergency, ownership structure was not a discriminating factor, the created relationships were similar and they were considered in the same way. The relationships were mainly formal (except for contributions by associations or individuals) and temporary. The RC's reactive role in overcoming crises was confirmed, and the findings indicated that this result was possible also, thanks to the KM's role played within the organisation.
Originality/value
Theoretical implications of the work are that it contributes to the sparse healthcare literature on intellectual capital (IC) and on RC and its relationships with KM. The practical implications are related to the creation of new relationships during the healthcare emergency between hospitals and the central government, which can be considered a useful lesson for the future. The theoretical implications derived from the analysis are generalisable to all organisations regardless of their type and location, as well as the practical implications are applicable to the entire national territory.
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Valeria Naciti, Guido Noto, Carlo Vermiglio and Gustavo Barresi
Recently, the relationship between gender representation and organizational performance has been the focus of various studies. However, some research gaps still exist. First, in…
Abstract
Purpose
Recently, the relationship between gender representation and organizational performance has been the focus of various studies. However, some research gaps still exist. First, in the healthcare sector, this relationship has been poorly explored. Moreover, in public management studies, researchers focusing on performance tend to focus exclusively on gender differences at the top and/or middle management level. This research aims at exploring the relationship between women's representation and performance in public hospitals at all organizational levels.
Design/methodology/approach
To achieve the research objective, 63 healthcare organisations were analysed through ordinary least squares regressions on panel data from 2012 to 2018.
Findings
Results show that, in the hospital setting, gender diversity and financial performance are related at every organizational level.
Originality/value
To the authors' knowledge, this is one of the first studies focusing on the link between gender and performance at every level of professional and employment category; avoiding focusing exclusively on top management, which was the case in previous studies on the topic. Moreover, it contributes to a poorly explored literature which is gender studies in public healthcare management.
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Rune Ottosen and Steen Steensen
This chapter analyses the Norwegian authorities’ presence on Twitter during the 22 July 2011 terrorist attacks. Twitter activity by two official institutions is analysed in…
Abstract
This chapter analyses the Norwegian authorities’ presence on Twitter during the 22 July 2011 terrorist attacks. Twitter activity by two official institutions is analysed in particular, namely, the blood bank at Oslo University Hospital and the Norwegian Police Security Services (PST). Our findings show that the Norwegian authorities were almost completely absent on Twitter during the critical hours of the terrorist attack, and that there was no coordination and synchronisation of communication from the authorities. This official silence allowed the diffusion of speculation and misinformation to take place; these were neither corrected nor addressed, as the analysed PST case shows. In contrast, the blood bank used Twitter to mobilise blood donors to address an acute problem: a shortage of blood to treat casualties. The chapter concludes by offering recommendations to the authorities for future major incidents.
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Mohammad Yasser Arafat and Sonal Atreya
The study investigates the relationship between hospital environmental factors and the well-being of geriatric in-patients. It aims to identify the impact of architectural design…
Abstract
Purpose
The study investigates the relationship between hospital environmental factors and the well-being of geriatric in-patients. It aims to identify the impact of architectural design on comfort, safety, privacy and stress levels experienced by elderly patients during their hospital stays.
Design/methodology/approach
Employing a mixed-methods approach, the research assesses the experiences of 100 geriatric in-patients across various hospital types through surveys, observational checklists and state anxiety measurements. The methodology involves examining architectural features, patient perceptions and correlations among environmental variables and patient experiences. Statistical analyses, including correlations and chi-square tests, were employed to discern associations between environmental variables and patient experiences.
Findings
The research identified key architectural features significantly impacting geriatric patients' experiences. Factors such as sturdy beds, furniture quantity, lighting conditions, proximity to facilities and ward occupancy levels were found to influence spatial, sensory and social comfort. Notably, proximity to facilities and control over the immediate environment were crucial for self-control and safety perceptions. Privacy, highly valued by patients, correlated with the presence of curtains and ward occupancy. Moreover, patient stress levels exhibited correlations with autonomy, privacy and ward occupancy.
Originality/value
This research offers significant insights into the criticality of specific architectural elements in enhancing comfort and reducing stress for geriatric in-patients. These findings hold substantial value for healthcare facility design, emphasizing the need to prioritize certain design aspects to promote the well-being of elderly patients during hospitalization.
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Cristina Piedade Silva and Rita Martins de Sousa
The purpose of this paper is to study how budgetary constraints can have ethical implications on patient treatment options.
Abstract
Purpose
The purpose of this paper is to study how budgetary constraints can have ethical implications on patient treatment options.
Design/methodology/approach
By applying a qualitative methodological approach (interviews) and participant observation, this paper studies the behaviour of surgeons in scenarios of financial restriction.
Findings
The empirical findings show that despite the conflict between the economy and the leges artis, surgeons maintain the ethical and deontological principles of their profession with fair rules of orientation.
Practical implications
The importance of this study can be realised by its continuity. One of the authors is already implicated on a wider research to investigate the influence of the economic scarcity of resources on general surgeons’ ethical behaviours.
Social implications
This paper is a contribution to understanding the rules that restrain the activities of surgeons. Politicians sometimes do not have a full understanding of the pressures that the medical profession faces in their day-to-day activities. Currently, with the addition of problems relate to COVID-19, politicians and populations seem to better understand the importance of the Serviço Nacional de Saúde (SNS), This paper hopes that this understanding will be not only a conjectural moment.
Originality/value
In conjunction with the economic recession that began in the first decade of this century, health institutions have long faced budgetary constraints that condition their material and human resources and correspondingly shape the scope of health professional activities. Until now, it has not been studied the impact of economic crises on the ethical behaviour of Portuguese surgeons. Therefore, this research is a first step and a useful contribution to understanding the rules that can restrain (or not) the ethical conduct of these health professionals.
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Fauziah Rabbani, Farah Naz Hashmani, Aftab A Ali Mukhi, Xaher Gul, Nousheen Pradhan, Peter Hatcher, Mounir Farag and Farhat Abbas
The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems…
Abstract
Purpose
The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems are the hospitals. The purpose of this paper is to review the need for formalized training in hospital management to improve the quality of care.
Design/methodology/approach
Literature review and hands on experience of conducting a regional training in hospital management for Eastern Mediterranean Region (EMR) countries.
Findings
Majority of patients in EMR bypass Primary Health Care facilities due to inadequate quality of services and prefer seeking specialized care at a tertiary level. There is mounting evidence of mediocre to poor patient satisfaction due to inefficient health care practices in hospitals of EMR. Strengthening the management capacity of the hospitals through a formal training programme is therefore necessary for improving the performance of health care delivery and the overall health system. Hospital management encompasses hospital planning and operational activities including development and implementation of organizational strategies to ensure adequate numbers and quality of trained human resources and effective financial management, disaster management, health management information system utilization, support services, biomedical engineering, transport and waste management. Such training will prepare health care professionals with leadership skills to deliver quality hospital services.
Originality/value
This is one of the first papers emphasizing the need for a formal structured regional training in hospital management for the countries of EMR. A modular incremental training approach developing an EMR Credit Transfer and Accumulation system is proposed.
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Giuseppe Nicolò, Diana Ferullo, Natalia Aversano and Nadia Ardito
The present study aims to extend the knowledge of intellectual capital disclosure (ICD) disclosure practices in the Italian Healthcare Organisations (HCOs) context. The ultimate…
Abstract
Purpose
The present study aims to extend the knowledge of intellectual capital disclosure (ICD) disclosure practices in the Italian Healthcare Organisations (HCOs) context. The ultimate goal of the study is to provide fresh insight into the possible explanatory factors that may drive the extent of ICD provided by Italian HCOs via the web.
Design/methodology/approach
The present study applies a manual content analysis on the websites of a sample of 158 HCOs to determine the level of voluntary ICD. A multivariate regression model is estimated to test the association between different variables – size, gender diversity in top governance positions, financial performance and indebtedness – and the level of ICD provided by sampled HCOs through their official websites.
Findings
Content analysis results reveal that – in the absence of mandatory requirements – Italian HCOs tend to use websites to disclose information about IC. Particular attention is devoted to Structural and Relational Capital. The statistical analysis pinpoints that size and indebtedness negatively influence the level of ICD. In contrast, the presence of a female General Manager (GM) positively drives ICD. Also, it is observed that Research and University HCOs and those located in the Italian Northern Regions are particularly prone to discharge accountability on IC through websites.
Originality/value
To the best of the authors’ knowledge, this is the first study that examines voluntary ICD practices through websites in the Italian HCOs' context. Also, since prior studies on IC in the healthcare context are mainly descriptive or normative, this is the first study examining the potential determinants of ICD provided by HCOs in terms of size, gender diversity in top governance positions, financial performance and indebtedness.
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