Search results

1 – 10 of 32
To view the access options for this content please click here
Article
Publication date: 3 July 2017

Vincent Cassar, Frank Bezzina and Sandra C. Buttigieg

The purpose of this paper is to explore the role of social identity and the psychological contract as plausible frameworks of transformational leadership (TL)-attitudes…

Downloads
1540

Abstract

Purpose

The purpose of this paper is to explore the role of social identity and the psychological contract as plausible frameworks of transformational leadership (TL)-attitudes relationship.

Design/methodology/approach

A cross-sectional study was conducted amongst 134 employees. All variables were measured using self-report measures and multiple mediator analysis was used to test the hypotheses.

Findings

Both social identity and psychological contract acted as significant mediators between leadership and attitudinal outcomes. However, social identity emerged as the stronger mediator.

Research limitations/implications

This study provides evidence on the relative significance of social identity over the psychological contract in explaining TL-attitudes relationship at work. Further longitudinal work is warranted.

Practical implications

The results suggest providing internal work environments and practices which enable employees to experience a high degree of fairness and, above all, a sense of identity with the organization can link better their perceptions of their leaders with work attitudes.

Originality/value

This study contributes to the literature by highlighting the importance of TL not only on work attitudes but also on the value of important mediators like social identity and the psychological contract as feeding into this relationship. It therefore promotes and raises awareness of the need to explore the explanatory power of these two mediators in understanding the effects of leadership on followers.

Details

Leadership & Organization Development Journal, vol. 38 no. 5
Type: Research Article
ISSN: 0143-7739

Keywords

To view the access options for this content please click here
Article
Publication date: 10 October 2016

Sandra C. Buttigieg, Dorothy Gauci and Prasanta Dey

The purpose of this paper is to present the application of logical framework analysis (LFA) for implementing continuous quality improvement (CQI) across multiple settings…

Abstract

Purpose

The purpose of this paper is to present the application of logical framework analysis (LFA) for implementing continuous quality improvement (CQI) across multiple settings in a tertiary care hospital.

Design/methodology/approach

This study adopts a multiple case study approach. LFA is implemented within three diverse settings, namely, intensive care unit, surgical ward, and acute in-patient psychiatric ward. First, problem trees are developed in order to determine the root causes of quality issues, specific to the three settings. Second, objective trees are formed suggesting solutions to the quality issues. Third, project plan template using logical framework (LOGFRAME) is created for each setting.

Findings

This study shows substantial improvement in quality across the three settings. LFA proved to be effective to analyse quality issues and suggest improvement measures objectively.

Research limitations/implications

This paper applies LFA in specific, albeit, diverse settings in one hospital. For validation purposes, it would be ideal to analyse in other settings within the same hospital, as well as in several hospitals. It also adopts a bottom-up approach when this can be triangulated with other sources of data.

Practical implications

LFA enables top management to obtain an integrated view of performance. It also provides a basis for further quantitative research on quality management through the identification of key performance indicators and facilitates the development of a business case for improvement.

Originality/value

LFA is a novel approach for the implementation of CQI programs. Although LFA has been used extensively for project development to source funds from development banks, its application in quality improvement within healthcare projects is scant.

To view the access options for this content please click here
Article
Publication date: 10 April 2017

Adriana Pace and Sandra C. Buttigieg

The purpose of this paper is to analyse hospital dashboards’ visibility of information at different management levels to improve quality and performance in an acute…

Abstract

Purpose

The purpose of this paper is to analyse hospital dashboards’ visibility of information at different management levels to improve quality and performance in an acute general hospital.

Design/methodology/approach

Data were generated via 21 semi-structured interviews across different management levels.

Findings

All management levels had greater visibility of information, could make informed decisions, and registered performance improvement. Specifically, waiting time improved, however since introduction of hospital dashboards was work-in-progress at time of study, managers could not record improvement in terms of cost reductions, clinical effectiveness, patient safety and patient satisfaction. Different managerial levels had different visibility with top management having the greatest.

Research limitations/implications

In single case studies, where only one context is used, the findings cannot be reproduced in different contexts; even though most of the results could be matched with the current literature.

Practical implications

The need to have balanced key performance indicators that take into account other facets of improvements, apart from time, has been emphasised. Furthermore, if middle and departmental managers have greater visibility, this would allow them to work towards a strategic fit between the departments that they manage with the rest of the hospital.

Originality/value

There is scant literature regarding performance dashboards’ enhancement of visibility of information at different management levels. Furthermore, according to the authors’ knowledge, no other paper has tried to identify and discuss the different levels of information, which should be visible from bedside to board namely to management, clinicians and public.

Details

Journal of Health Organization and Management, vol. 31 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Article
Publication date: 1 August 2018

Sandra C. Buttigieg, Kevin Agius, Adriana Pace and Maria Cassar

The purpose of this paper is to identify the extent to which immigrant nurses have integrated within the Maltese healthcare system.

Abstract

Purpose

The purpose of this paper is to identify the extent to which immigrant nurses have integrated within the Maltese healthcare system.

Design/methodology/approach

This research consisted of a qualitative case study approach which was conducted within Malta’s four public entities in the secondary care sector. In this case study, data were collected through 34 semi-structured interviews with ten nursing managers, 12 Maltese nurses and 12 immigrant nurses. The data were analysed using content analysis. Data were collected between June 2015 and July 2015.

Findings

Four themes emerged from the data. These were: human resources management, language barrier, cultural differences and discrimination. The recruitment of nurses to Malta from other countries translated into several positive and favourable outcomes, such as the sharing of knowledge. However, a number of negative and unfavourable outcomes are also indicated in the data including language barrier and discrimination.

Research limitations/implications

This paper presents a discussion of the issues experienced within a healthcare system in relation to the mobility of nurses. Increasingly, the nursing workforce across the globe comprises of professionals from various nationality, origin, training, culture and professional ethos. The findings are presented in an effort to inform policy makers, management and administrative structures regarding the issues pertaining to the prevalent growing reality of mobility in nurse populations.

Originality/value

This research study provides a unique contribution to the literature regarding the phenomenon of nurse mobility because it embraces the integration of nurses as a two-way process. Since data was collected from immigrant nurses as well as from local nurses and nursing managers, this study hopes to offer a different point of view from previous studies which largely focused on the views of immigrant nurses only.

Details

International Journal of Migration, Health and Social Care, vol. 14 no. 3
Type: Research Article
ISSN: 1747-9894

Keywords

To view the access options for this content please click here
Article
Publication date: 20 September 2019

Lorraine Abela, Adriana Pace and Sandra C. Buttigieg

Hospital length of stay (LOS) is not only a function of patient- and disease-related factors, but is also determined by other health system-wide variables. Managers and…

Abstract

Purpose

Hospital length of stay (LOS) is not only a function of patient- and disease-related factors, but is also determined by other health system-wide variables. Managers and clinicians strive to achieve the best possible trade-off between patients’ needs and efficient utilisation of hospital resources, while also embracing ethical decision making. The purpose of this paper is to explore the perceptions of the hospital’s major stakeholders as to what affects the duration of LOS of inpatients.

Design/methodology/approach

Using a data-triangulated case study approach, 50 semi-structured interviews were performed with management, doctors, nurses and patients. Additionally, the hospitals’ standard operating procedures, which are pertinent to the subject, were also included in the thematic analysis.

Findings

This study shows that LOS is a multi-dimensional construct, which results from a complex interplay of various inputs, processes and outcomes.

Research limitations/implications

The findings emerging from a single case study approach cannot be generalised across settings and contexts, albeit being in line with the current literature.

Practical implications

The study concludes that a robust hospital strategy, which addresses deficient organisational processes that may unnecessarily prolong LOS, is needed. Moreover, the hospital’s strategy must be sustained by providing good primary care facilities within the community set-up, as well as by providing more long-term care and rehabilitation beds to support the hospital turnover.

Originality/value

The subject of LOS in hospitals has so far been tackled in a fragmented manner. This paper provides a comprehensive and triangulated account of the complexities surrounding the duration in which patients are kept in hospital by key stakeholders, most of whom were hands-on in the day-to-day running of the hospital under study.

Details

Journal of Health Organization and Management, vol. 33 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Article
Publication date: 15 May 2017

Sandra C. Buttigieg, Adriana Pace and Cheryl Rathert

The purpose of this paper is to give a comprehensive and updated analysis of the available literature on hospital dashboards.

Downloads
1916

Abstract

Purpose

The purpose of this paper is to give a comprehensive and updated analysis of the available literature on hospital dashboards.

Design/methodology/approach

A search of the current literature was performed by searching electronic databases, including Google Scholar, EBSCO and Medline, as well as books.

Findings

In all, 48 manuscripts consisting of peer reviewed articles, conference proceedings, case reports and text books were included in this review.

Practical implications

Despite the numerous advantages of performance dashboards, several authors have mentioned a number of challenges. It was evident from the literature that any setting requires significant effort, especially to ensure the quality of data being collected. In fact, significant investment, both in terms of financial and human resources, is required to achieve an effective dashboard. Furthermore, most of the studies available in the literature were individual case reports or anecdotal accounts rather than empirical studies. Thus, further research is required to ascertain the effectiveness of performance dashboards. In view of these findings, each organisation should make its own decisions whether or not to adopt performance dashboards.

Originality/value

Most of the literature is fragmented as it reports the use of different types of dashboards, namely strategic, tactical and operational, as separate tools. This literature review contributes to knowledge as it brings together the different types of dashboards and the cascading effect of one dashboard onto another in order to achieve and retain organisational alignment with the overall strategic goals.

Details

Journal of Health Organization and Management, vol. 31 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Article
Publication date: 29 June 2018

Sandra C. Buttigieg, Dorothy Gauci, Frank Bezzina and Prasanta K. Dey

Length of stay (LOS) in hospital after surgery varies for each patient depending on surgeon’s decision that considers criticality of the surgery, patient’s conditions…

Abstract

Purpose

Length of stay (LOS) in hospital after surgery varies for each patient depending on surgeon’s decision that considers criticality of the surgery, patient’s conditions before and after surgery, expected time to recovery and experience of the surgeon involved. Decision on patients’ LOS at hospital post-surgery affects overall healthcare performance as it affects both cost and quality of care. The purpose of this paper is to develop a model for deriving the most appropriate LOS after surgical interventions.

Design/methodology/approach

The study adopts an action research involving multiple stakeholders (surgeon, patients/patients’ relatives, hospital management and other medics). First, a conceptual model is developed using literature and experts’ opinion. Second, the model is applied in three surgical interventions in a public hospital in Malta to demonstrate the effectiveness of the model. Third, the policy alternatives developed are compared to a selection of current international standards for each surgical intervention. The proposed model analyses three LOS threshold policies for three procedures using efficiency and responsiveness criteria. The entire analysis is carried out using 325 randomly selected patient files along with structured interactions with more than 50 stakeholders (surgeon, patients/patients’ relatives, hospital management and other medics). A multiple criteria decision-making method is deployed for model building and data analysis. The method involves combining the analytic hierarchy process (AHP) for verbal subjective judgements on prioritizing the four predictors of surgical LOS—medical, financial, social and risk, with pairwise comparisons of the sub-criteria under each criterion in line with the concerned interventions—the objective data of which are obtained from the patients’ files.

Findings

The proposed model was successfully applied to decide on the best policy alternative for LOS for the three interventions. The best policy alternatives compared well to current international benchmarks.

Research limitations/implications

The proposed method needs to be tested for other interventions across various healthcare settings.

Practical implications

Multi-criteria decision-making tools enable resource optimization and overall improvement of patient care through the application of a scientific management technique that involves all relevant stakeholders while utilizing both subjective judgements as well as objective data.

Originality/value

Traditionally, the duration of post-surgery LOS is mainly based on the surgeons’ clinical but also arbitrary decisions, with, as a result, having insufficiently explicable variations in LOS amongst peers for similar interventions. According to the authors’ knowledge, this is the first attempt to derive post-surgery LOS using the AHP, a multiple criteria decision-making method.

Details

Journal of Health Organization and Management, vol. 32 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Article
Publication date: 24 June 2019

Sandra C. Buttigieg, Gianpaolo Tomaselli, Vivienne Byers, Maria Cassar, Trond Tjerbo and Aldo Rosano

The aim of this paper was to explore the linkage between corporate social responsibility (CSR) and person-centered care (PCC). The scope of the review was, therefore, to…

Abstract

Purpose

The aim of this paper was to explore the linkage between corporate social responsibility (CSR) and person-centered care (PCC). The scope of the review was, therefore, to identify whether – as a result of such linkage – CSR may be a potential vehicle for delivering PCC within health-care organizations.

Design/methodology/approach

Data were retrieved by searching multiple keywords on PubMed, Medline and Scopus databases with inclusion/exclusion criteria based on years of publication from 2001 to 2018, language, no geographic restrictions, paper focus, research and document types. A total of 56 articles (N =56) were selected and reviewed. Thematic analysis was conducted to identify and compare the main features of PCC and CSR.

Findings

The findings revealed that while CSR and PCC are interrelated, CSR features are not being exploited in their entirety in formalizing PCC as part of the CSR strategy. In particular, the two salient CSR features explicitly referred to in conjunction with explicit PCC characteristics are quality of care and health communication. Furthermore, patients’ rights and dignity were the leading implicit CSR features mentioned in conjunction with both explicit and implicit PCC characteristics.

Research limitations/implications

Subjectivity of researchers, limited number of databases and publication types included are the main limitations of this research.

Originality/value

To the best of the authors’ knowledge, this is the first paper analyzing CSR and PCC in an interrelated way.

Details

Journal of Global Responsibility, vol. 10 no. 4
Type: Research Article
ISSN: 2041-2568

Keywords

To view the access options for this content please click here
Article
Publication date: 11 April 2018

Sandra C. Buttigieg, Lorraine Abela and Adriana Pace

Tertiary hospitals have registered an incremental rise in expenditure mostly because of the increasing demands by ageing populations. Reducing the length of stay (LOS) of…

Abstract

Purpose

Tertiary hospitals have registered an incremental rise in expenditure mostly because of the increasing demands by ageing populations. Reducing the length of stay (LOS) of patients within tertiary hospitals is one of the strategies, which has been used in the last decades to ensure health care systems’ sustainability. Furthermore, LOS is one of the key performance indicators, which is widely used to assess hospital efficiency. Hence, it is crucial that policy makers use evidence-based practices in health care to aim for optimal LOS. The purpose of this paper is to identify and summarize empirical research that brings together studies on the various variables that directly or indirectly impact on LOS within tertiary hospitals so as to develop a LOS causal systems model.

Design/methodology/approach

This scoping review was guided by the following research question: “What is affecting the LOS of patients within tertiary-level health care?” and by the guidelines specified by Arksey and O’Malley (2005), and by Armstrong et al. (2011). Relevant current literature was retrieved by searching various electronic databases. The PRISMA model provided the process guidelines to identify and select eligible studies.

Findings

An extensive literature search yielded a total of 30,350 references of which 46 were included in the final analysis. These articles yielded variables, which directly/indirectly are linked to LOS. These were then organized according to the Donabedian model – structure, processes and outcomes. The resultant LOS causal model reflects its complexity and confirms the consideration by scholars in the field that hospitals are complex adaptive systems, and that hospital managers must respond to LOS challenges holistically.

Originality/value

This paper illustrates a complex LOS causal model that emerged from the scoping review and may be of value for future research. It also highlighted the complexity of the construct under study.

Details

Journal of Health Organization and Management, vol. 32 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Book part
Publication date: 23 February 2015

Abstract

Details

International Best Practices in Health Care Management
Type: Book
ISBN: 978-1-78441-278-4

1 – 10 of 32