Search results

This paper aims to “identify,” “analyse” and “categorise” the readiness factors of lean sustainability in health-care organisation using total interpretive structural modelling (TISM).

To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview. To identify how the factors interact, the TISM approach was used, and the matriced’ impacts croise’s multiplication applique’e a UN classement (MICMAC) analysis was used to rank and categorise the lean sustainability readiness factors.

This study identified ten lean sustainability readiness factors for health-care organisation. The identified factors are resources utilization practice (F1), management commitment and leadership (F2), operational flexibility (F3), workforce engagement and time commitment (F4), sustainability motivational factors (F5), awareness of lean and sustainable practice (F6), hospital design (F7), energy efficiency practices in hospitals (F8), responsible autonomy (F9) and new system adoptability training (F10). The key/driving factors are identified in this study are operational flexibility, sustainability motivational factors, management commitment and leadership, new system adoptability training.

The study focussed primarily on lean sustainability factors for the health-care sector.

This research will aid key stakeholders and academics in the better understanding the readiness factors that influence lean sustainability in health-care organisation. This study emphasises the factors that must be considered when applying lean sustainable practices in health care as a real-world application in a health-care organisation. These readiness factors for lean sustainability can be used by an organization to comprehend more about the concept and the components that contribute to health-care lean sustainability.

This study proposes the TISM technique for health care, which is a novel attempt in the subject of lean sustainability in this sector.

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.

Refugees and asylum seekers worldwide face numerous barriers in accessing health systems. The evidence base regarding who and what helps refugees and asylum seekers facilitate access to and the navigation of the health system in the UK is small. This study aims to address this gap by analysing 14 semi-structured, in-depth interviews with refugees and asylum seekers of different countries of origin in the UK to identify where, when and how they came into contact with the health-care system and what the outcome of these interactions was.

Semi-structured, in-depth interviews were chosen as the key method for this study. In total, 14 individual interviews were conducted. A trauma-informed research approach was applied to reduce the risk of re-traumatising participants.

The paper identifies key obstacles as well as “facilitators” of refugees’ and asylum seekers’ health-care experience in the UK and suggests that host families, friends and third-party organisations all play an important role in ensuring refugees and asylum seekers receive the healthcare they need.

To the best of the authors’ knowledge, this is the first qualitative study in the UK that looks at comprehensive health journeys of refugees from their first encounter with health services through to secondary care, highlighting the important role along the way of facilitators such as host families, friends and third-party organisations.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.

This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.

Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.

This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.

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.

Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions.

We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs.

This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India.

Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries.

Idea of circular economy defies the classical “make-use-dispose” approach of linear economic model. In the context of health-care industry, it relies heavily on the supply chain practices implemented by industry stakeholders. The purpose of this study is to explore such relationships, study their structure and put it across for attaining sustainability at large.

This study is an empirical research conducted on 145 health-care firms. The collected data is analysed to develop structural and measurement model. The five constructed hypotheses are examined and tested through structural equation modelling.

The study illustrates the latent relationships that exist among the stakeholders involvement, sustainable supply chain practices, sustainable performance and circular economy for health-care industry. It is found that the adoption of sustainable supply chain practices improves health-care performance, which, in turn, have positive influence on circular economy.

The structural and measurement model is developed in the context of circular health-care economy. It can be validated or improvised by conducting similar research in other industry using different methods. This research work fulfils the long existing gap in research by offering a linkage between various constructs to achieve health-care circular economy. Based on the research results, future researchers can build theories of circular economy and sustainability for health-care industry.

The study attempts to study the supply chain ways to achieve circular economy for Indian health-care sector. It considered latent relationships among the set of constructs, which are needed for theory building at later stage.

This study explored how organizational leaders at different hierarchical levels may communicatively enhance employees' health and well-being. Drawing on interdisciplinary research, it proposed a model that connects health-oriented leadership communication at supervisory and executive levels with remote workers' self-care and stress levels during the COVID-19 pandemic.

Data collected through a survey of 363 full-time United States (US) employees were analyzed to test the model.

Results showed health-oriented communication at the two leadership levels directly influenced employees' self-care, which in turn reduced their stress levels. Further, executive leaders' health-oriented leadership communication indirectly impacted remote workers' self-care through its positive association with supervisors' health-oriented leadership communication.

This study offers much-needed guidelines for executive leaders, supervisors and communication practitioners seeking to meet employees' growing expectations for a healthy work environment in today's post-pandemic era.

Although the literature has established organizational leadership as a vital determinant for a healthy workforce, few studies have explored leaders' health-specific communication to enhance employee health. This study is the first to conceptualize health-oriented leadership communication at dual hierarchical levels and uncover its influence on employees. The results suggested the importance of health-oriented leadership communication across hierarchical levels in building a healthy workplace.

Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.

In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.

We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.

Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.

There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.