Search results

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

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.

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).

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.

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.

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.

In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.

Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.

This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.

The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.

This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

The purpose of this paper is to describe how first-line managers (FLMs) in home care (HC) reason about the opportunities and obstacles to lead the work according to the individual’s needs and goals.

In this participatory appreciative action reflection project, eight managers within one Swedish municipality were interviewed. The data were analysed using a thematic analysis.

The results showed a polarization between two different systems that FLMs struggle to balance when attempting to lead HC that adapts to the needs and goals of individuals. One system was represented by the possibilities of a humane system, with human capital in the form of the individual, older persons and the co-workers in HC. The second system was represented by obstacles in the form of the economic needs of the organization in which the individual receiving HC often felt forgotten. In this system, the organization’s needs and goals governed, with FLMs needing to adapt to the cost-effectiveness principle and keep a balanced budget. The managers had to balance an ethical conflict of values between the human value and needs-solidarity principles, with that of the cost-effectiveness principle.

The FLMs lack the opportunity to lead HC according to the needs and goals of the individuals receiving HC. There is a need for consensus and a value-based leadership model based on ethical principles such as the principles of human value and needs-solidarity to lead the HC according to the individual’s needs and goals.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

With the rapid development of the economy in China, the wealth of residents has continued to increase, and most families have gradually been aware of the importance of commercial insurance. The family purchase of insurance in China was still not optimistic. Many scholars focus on wealth allocation, but the attention to the commercial insurance market was still less. Based on previous research studies, this study aims to investigate the impact of education and financial literacy on the commercial insurance purchase in China.

China Household Finance Survey data was used to investigate the purchase of commercial insurance in Mainland Chinese families. Factor analysis was used to construct financial literacy, and the education data were combined to analyze the commercial insurance purchase using the Probit model and the Tobit model. Finally, the contributions of education and financial literacy to commercial insurance purchases were analyzed.

Both education and financial literacy exerted a positive impact on the purchase of commercial insurance in China. Individual characteristics such as gender, age, marital status, risk attitude, purchase of social insurance and consultation with a financial advisor possessed significant effects; household factors like household size and assets, macro factors such as the density of financial institutions and the density of financial industry staff, and regional factors as local unemployment rate excreted influences on the commercial insurance purchase.

Based on the current economic development in China, this study investigated and expressed opinions on the public and insurance companies regarding commercial insurance purchases. It accentuated financial literacy and education as factors that facilitated commercial insurance development.

The purpose of this study is to examine the underexplored link between entrepreneurship education (EE) and graduate employability in the higher education (HE) sector in the United Kingdom (UK).

The study draws on a thematic content analysis of semi-structured interviews with 45 professionals in UK HE, representing the “supply” side of EE.

The findings demonstrate a unidirectional link between EE and employability outcomes. This link is affected by societal, stakeholder-related, and teaching and learning-related factors.

Although the value of universities’ initiatives connecting EE and employability for economic development is emphasized, the study does not provide direct empirical evidence for this effect. Macroeconomic research is needed.

EE and employability would benefit from knowledge exchange between universities’ stakeholders and a broader understanding of what constitutes a valuable graduate outcome.

The study reveals the benefits of EE on a micro level. Participation in EE supports the connection between individual investments in HE and employability.

Based on human capital theory, many policymakers regard EE as a vehicle through which the relationship between investments in HE and career success on a micro level and economic growth on a macro level can be nurtured. Challenging this logic, the study highlights the potential of institutional theory to explain a contextualization of the link between EE and employability on a national level.

This paper aims to map the research on management accounting (MA), clarifying its current role and identifying gaps and opportunities for future research.

In this paper, 784 papers were reviewed for the 1958–2019 period, published in 220 scientific journals indexed on Clarivate Analytics’ Web of Science (Science Citation Index Expanded [SCI-EXPANDED] and Social Sciences Citation Index [SSCI]). In the process, content analysis, regression analysis and bibliometric analysis were used.

The most relevant journals, authors and topics in MA, along with trends and patterns in the literature, were identified. Seven clusters that represent the overall thematic research structure of the MA field were also identified. This study shows that MA is becoming a multidimensional management decision-support instrument covering all organizational dimensions. As such, the research on MA is following the recent concerns with the sustainable development and digitalization of business processes.

Based on the findings of this research study, theoretical and practical implications for MA researchers were provided. These findings could also be useful to industry practitioners to improve their knowledge of emerging trends in MA practices, strategies and concepts.

Based on bibliometric and content analysis, a framework that shows an organizational, market and social context for the evolution of MA over the past 60 years was provided. It highlights the dynamics of MA alignment with organizational and external environment changes. Future research opportunities and implications for researchers and practitioners were also identified.

Cotton fibre lots are graded and selected for yarn spinning based on their quality value which is a function of certain fibre properties. Cotton grading and selection has created a domain of emerging interest among the researchers. Several researchers have addressed the said issue using a few exponents of multi-criteria decision-making (MCDM) technique. The purpose of this study is to demonstrate a cotton selection problem using a recently developed measurement of alternatives and ranking according to compromise solution (MARCOS) method which can handle almost any decision problem involving a finite number of alternatives and multiple conflicting decision criteria.

The MARCOS method of the MCDM technique was deployed in this study to rank 17 cotton fibre lots based on their quality values. Six apposite fibre properties, namely, fibre bundle strength, elongation, fineness, upper half mean length, uniformity index and short fibre content are considered as the six decision criteria assigning weights previously determined by an earlier researcher using analytic hierarchy process.

Among the 17 alternatives, C9 secured rank 1 (the best lot) with the highest utility function (0.704) and C7 occupied rank 17 (the worst lot) with the lowest utility function (0.596). Ranking given by MARCOS method showed high degree of congruence with the earlier approaches, as evidenced by high rank correlation coefficients (Rs > 0.814). During sensitivity analyses, no occurrence of rank reversal is observed. The correlations between the quality value-based ranking and the yarn tenacity-based rankings are better than many of the traditional methods. The results can be improved further by adopting other efficient method of weighting the criteria.

The properties of raw cotton have significant impact on the quality of final yarn. Compared to the traditional methods, MCDM is reported as the most viable solution in which fibre parameters are given their due importance while formulating a single index known as quality value. The present study demonstrates the application of a recently developed exponent of MCDM in the name of MARCOS for the first time to address a cotton fibre selection problem for textile spinning mills. The same approach can also be extended to solve other decision problems of the textile industry, in general.

Novelty of the present study lies in the fact that the MARCOS is a very recently developed MCDM method, and this is a maiden application of the MARCOS method in the domain of textile, in general, and cotton industry, in particular. The approach is very simple, highly effective and quite flexible in terms of number of alternatives and decision criteria, although highly robust and stable.