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1 – 10 of 146Value-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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Anu Helkkula, Alexander John Buoye, Hyeyoon Choi, Min Kyung Lee, Stephanie Q. Liu and Timothy Lee Keiningham
The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with…
Abstract
Purpose
The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.
Design/methodology/approach
Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.
Findings
Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.
Practical implications
Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.
Originality/value
This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.
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Lena Ansmann, Vera Vennedey, Hendrik Ansgar Hillen, Stephanie Stock, Ludwig Kuntz, Holger Pfaff, Russell Mannion and Kira Isabel Hower
Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying…
Abstract
Purpose
Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying resource-dependency-theory (RDT), we explore how healthcare organizations in different settings perceive pressure arising from uncertain access to resources and examine organizational strategies they deploy to secure resources.
Design/methodology/approach
A cross-sectional survey of key decision-makers in different healthcare settings in the metropolitan area of Cologne, Germany, on perceptions of pressure arising from the environment and respective strategies was conducted. For comparisons between settings radar charts, Kruskal–Wallis test and Fisher–Yates test were applied. Additionally, correlation analyses were conducted.
Findings
A sample of n = 237(13%) key informants participated and reported high pressure caused by bureaucracy, time constraints and recruiting qualified staff. Hospitals, inpatient and outpatient nursing care organizations felt most pressurized. As suggested by RDT, organizations in highly pressurized settings deployed the most vociferous strategies to secure resources, particularly in relation to personnel development.
Originality/value
This study is one of the few studies that focuses on the environment's impact on healthcare organizations across a variety of settings. RDT is a helpful theoretical foundation for understanding the environment's impact on organizational strategies. The substantial variations found between healthcare settings indicate that those settings potentially require specific strategies when seeking to address scarce resources and high demands. The results draw attention to the high level of pressure on healthcare organizations which presumably is passed down to managers, healthcare professionals, patients and relatives.
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Tuomas Hujala and Harri Laihonen
This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform…
Abstract
Purpose
This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform and service integration as a knowledge management (KM) issue and analyse how KM appears and contributes in the context of integrated care, specifically in the process of integrating social and health care.
Design/methodology/approach
The article analyses the case organisation's KM initiatives in light of the integrated care literature and recognises the tasks and requirements for effective KM when building integrated health and social care system. The empirical research material for this qualitative study consisted of the case organisation's strategy documents, the results of an external maturity assessment, KM workshop materials and publicly available documentation of the Finnish health and social care reform.
Findings
This study identifies the mechanisms by which KM can support health and social services integration. At the macro level, national coordination and regional co-operation require common information structures. At the meso level, a shared regional strategy with shared objectives guides both organisational decision-making and collaboration between professionals. At the micro level, technology supported and data-driven planning of service chains complements the experiences of professionals and may help remove obstacles to integration.
Originality/value
This study contributes to the literature on integrated care by providing a more comprehensive view of the role and tasks of knowledge and KM when reforming health and social services than approaches focussing solely on health informatics and internal efficiency.
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Francesco Schiavone, Maria Cristina Pietronudo, Annamaria Sabetta and Marco Ferretti
Total quality management is a valuable approach to continuously improve the quality of organizations; however, scholars debate its applicability to services, which require…
Abstract
Purpose
Total quality management is a valuable approach to continuously improve the quality of organizations; however, scholars debate its applicability to services, which require specific best practices that are different from those related to manufacturing. Moreover, digitization is pervading all kinds of services, but little has been written about total quality service practices in digital-based companies. For this purpose, the authors provide a holistic model of total quality service that reflects the peculiarities of such companies, guided by the question: how do total quality service practices change in digital-based service organizations?
Design/methodology/approach
The authors conduct an illustrative case study on Healthware Group, a global integrated digital health organization, to evaluate theoretical assumptions about total quality service practices in the digital environment.
Findings
The findings allow to validate the model provided. In addition, the study enables them to observe the changes the authors are witnessing in service provision in the digital era and the consequent transformation of best practices. To be accurate, the authors cannot refer to a full transformation in digital-based companies but rather to the enrichment and extension of TQS practices. The best illustration of these conclusions has been summarized in a set of propositions corresponding to seven of the key levers of a TQS model.
Originality/value
The paper represents the first attempt to discuss the relationship between total quality service and digitalization, offering a set of propositions for academics and insights for practitioners. The model can be used as a tool to visualize the different levers that successful implementation of TQS in digital-based services companies can rely on.
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Tuomas Hujala and Harri Laihonen
The purpose of this study is twofold. First, it suggests that knowledge management (KM), as an academic discipline and managerial practice, provides valuable perspectives and…
Abstract
Purpose
The purpose of this study is twofold. First, it suggests that knowledge management (KM), as an academic discipline and managerial practice, provides valuable perspectives and tools to help health and social care management cope with both existing and future challenges. Second, it reviews the existing evidence on the effects of KM on the management of health and social care. Based on the results of the review, an evaluation framework for the effects of KM is proposed.
Design/methodology/approach
The literature review was conducted using the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to search the Web of Science and SCOPUS databases. The search terms included “knowledge management”, “healthcare” and “effect.” Academic articles published between 2010 and 2020 were included.
Findings
The study identifies six main categories among the effects of KM on the management of health and social care as follows: enhanced understanding of customer needs, improved organizational performance, better targeted decision-making, improved quality of service, behavioral or cultural change and improved risk management.
Originality/value
This study contributes by summarizing the literature on the effects of KM on the management of health and social care and proposing avenues for future research in this area.
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Ingrid Marie Leikvoll Oskarsson and Erlend Vik
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Practical implications
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.
Originality/value
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.
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Pauline van Dorssen-Boog, Tinka van Vuuren, Jeroen de Jong and Monique Veld
While both perceived job autonomy and self-leadership are assumed to be important for optimal functioning of healthcare workers, their mutual relationship remains unclear. This…
Abstract
Purpose
While both perceived job autonomy and self-leadership are assumed to be important for optimal functioning of healthcare workers, their mutual relationship remains unclear. This cross-lagged study aims to theorize and test that perceived job autonomy and self-leadership have a reciprocal relationship, which is moderated by need for job autonomy.
Design/methodology/approach
Two-wave panel data were used to measure cross-lagged relationships over a time period of three months. Self-leadership is indicated by both self-leadership strategies and self-leadership behavior. The data were analyzed using hierarchical multiple regression (HMR).
Findings
Job autonomy was not causally nor reverse related to self-leadership strategies, but did relate to self-leadership behavior in both directions. Need for job autonomy did not influence the causal and reverse relationships between job autonomy and self-leadership (strategies and behavior). Instead, need for job autonomy discarded the influence of job autonomy on self-leadership behavior, and predicted self-leadership behavior over time.
Practical implications
For optimizing healthcare jobs, human resource management (HRM) policy makers need to consider other interventions such as training self-leadership, or developing an autonomy supportive work environment, since job autonomy does not lead to more use of self-leadership strategies.
Originality/value
This study used a cross-lagged study design which gives the opportunity to investigate causal relationships between job autonomy and self-leadership. Both self-leadership strategies and self-leadership behavior are included.
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Luís Irgang, Magnus Holmén, Fábio Gama and Petra Svedberg
Facilitation activities support implementation of evidence-based interventions within healthcare organizations. Few studies have attempted to understand how facilitation…
Abstract
Purpose
Facilitation activities support implementation of evidence-based interventions within healthcare organizations. Few studies have attempted to understand how facilitation activities are performed to promote the uptake of evidence-based interventions in hospitals from resource-poor countries during crises such as pandemics. This paper aims to explore facilitation activities by infection prevention and control (IPC) professionals in 16 hospitals from 9 states in Brazil during the COVID-19 pandemic.
Design/methodology/approach
Primary and secondary data were collected between March and December 2020. Semi-structured interviews were conducted with 21 IPC professionals in Brazilian hospitals during the COVID-19 pandemic. Public and internal documents were used for data triangulation. The data were analyzed through thematic analysis technique.
Findings
Building on the change response theory, this study explores the facilitation activities from the cognitive, behavioral and affective aspects. The facilitation activities are grouped in three overarching dimensions: (1) creating and sustaining legitimacy to continuous and rapid changes, (2) fostering capabilities for continuous changes and (3) accelerating individual commitment.
Practical implications
During crises such as pandemics, facilitation activities by IPC professionals need to embrace all the cognitive, behavioral and affective aspects to stimulate positive attitudes of frontline workers toward continuous and urgent changes.
Originality/value
This study provides unique and timely empirical evidence on the facilitation activities that support the implementation of evidence-based interventions by IPC professionals during crises in hospitals in a resource-poor country.
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Iris Wallenburg, Anne Marie Weggelaar and Roland Bal
The purpose of this paper is to empirically explore and conceptualize how healthcare professionals and managers give shape to the increasing call for compassionate care as an…
Abstract
Purpose
The purpose of this paper is to empirically explore and conceptualize how healthcare professionals and managers give shape to the increasing call for compassionate care as an alternative for system-based quality management systems. The research demonstrates how quality rebels craft deviant practices of good care and how they account for them.
Design/methodology/approach
Ethnographic research was conducted in three Dutch hospitals, studying clinical groups that were identified as deviant: a nursing ward for infectious diseases, a mother–child department and a dialysis department. The research includes over 120 h of observation, 41 semi-structured interviews and 2 focus groups.
Findings
The research shows that rebels’ quality practices are an emerging set of collaborative activities to improving healthcare and meeting (individual) patient needs. They conduct “contexting work” to achieve their quality aims by expanding their normative work to outside domains. As rebels deviate from hospital policies, they are sometimes forced to act “under the radar” causing the risk of groupthink and may undermine the aim of public accounting.
Practical implications
The research shows that in order to come to more compassionate forms of care, organizations should allow for more heterogeneity accompanied with ongoing dialogue(s) on what good care yields as this may differ between specific fields or locations.
Originality/value
This is the first study introducing quality rebels as a concept to understanding social deviance in the everyday practices of doing compassionate and good care.
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