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21 – 30 of over 17000
Article
Publication date: 2 October 2019

M. Ángeles López-Cabarcos, Analía López-Carballeira and Carlos Ferro-Soto

The nature of public healthcare highlights not only the need of understanding the role of emotional exhaustion in the relationship between employees’ job demands and desirable…

Abstract

Purpose

The nature of public healthcare highlights not only the need of understanding the role of emotional exhaustion in the relationship between employees’ job demands and desirable employees’ job attitudes, but also to adequate the combination of certain job resources and other organisational variables to moderate the employees’ feelings of emotional exhaustion. The paper aims to discuss this issue.

Design/methodology/approach

This viewpoint designs the theoretical approach that aims to understand the mediating role of emotional exhaustion among healthcare professionals and the capacity of certain variables to moderate it. The nature of the variables considered and the design of the theoretical model proposed highlights structural equation modelling as an optimal methodology to be used among a sample of European healthcare professionals.

Findings

Managers should be able to design strategies to mitigate, eliminate and prevent the causes of emotional exhaustion in public healthcare with the objective to improve the health and quality of life of healthcare professionals, and consequently the quality of the service provided to patients and their families.

Originality/value

This viewpoint highlights the importance of analysing the influence of employees’ emotional exhaustion on their attitudes in public healthcare. Direct relationships between emotional exhaustion and certain antecedents or consequences have been studied previously; however, studies analysing the mediating role of emotional exhaustion are very scarce and show mixed results. There are also few studies analysing the moderating role of certain job resources and other organisational variables in the relationships between employees’ job demands, employees’ emotional exhaustion and employees’ job attitudes.

Details

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

Keywords

Open Access
Article
Publication date: 16 August 2019

Rosemary J. Hollick, Alison J. Black, David M. Reid and Lorna McKee

Using a complexity-informed approach, we aim to understand why introduction of a mobile service delivery model for osteoporosis across diverse organisational and country contexts…

2019

Abstract

Purpose

Using a complexity-informed approach, we aim to understand why introduction of a mobile service delivery model for osteoporosis across diverse organisational and country contexts in the UK National Health Service (NHS) met with variable success.

Design/methodology/approach

Six comparative case studies; three prospectively in Scotland using an action research-informed approach; and three retrospectively in England with variable degrees of success. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework explored interactions between multi-level contextual factors and their influence on efforts to introduce and sustain services.

Findings

Cross-boundary service development was a continuous process of adaptation and evolution in rapidly shifting healthcare context. Whilst the outer healthcare policy context differed significantly across cases, inner contextual features predominated in shaping the success or otherwise of service innovations. Technical and logistical issues, organisational resources, patient and staff actions combined in unpredictable ways to shape the lifecycle of service change. Patient and staff thoughts about place and access to services actively shaped service development. The use of tacit “soft intelligence” and a sense of “chronic unease” emerged as important in successfully navigating around awkward people and places.

Practical implications

“Chronic unease” and “soft intelligence” can be used to help individuals and organisations “tame” complexity, identify hidden threats and opportunities to achieving change in a particular context, and anticipate how these may change over time. Understanding how patients think and feel about where, when and how care is delivered provides unique insights into previously unseen aspects of context, and can usefully inform development and sustainability of patient-centred healthcare services.

Originality/value

This study has uniquely traced the fortunes of a single service innovation across diverse organisational and country contexts. Novel application of the NASSS framework enabled comparative analysis across real-time service change and historical failures. This study also adds to theories of context and complexity by surfacing the neglected role of patients in shaping healthcare context.

Details

Journal of Health Organization and Management, vol. 33 no. 7/8
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 15 November 2019

Åsa Robinson, Caterina Finizia and Susanne Gustavsson

The purpose of this paper is to illuminate strengths and limitations in quality improvement work, when involving patients.

Abstract

Purpose

The purpose of this paper is to illuminate strengths and limitations in quality improvement work, when involving patients.

Design/methodology/approach

The experience-based co-design (EBCD) method was used when improving care for patients undergoing otosclerosis surgery. Individual interviews and focus groups were interpreted using qualitative content analysis.

Findings

Strengths mentioned by patients were that their participation made a difference. The first steps were found effective in giving an in-depth view of patients’ experiences and the staff got an increased understanding about specific patient needs. However, weaknesses were found in the latter phases, those of improving and follow-up, health care staff had difficulties to keep their focus on patients’ experiences and invite patients to be involved. Patients’ participation decreased, and there was a lack of tools to support the process.

Research limitations/implications

The content in this paper is mainly based on one case. However, the findings are in congruence with earlier research and add further knowledge to the research area.

Practical implications

The findings can be used in healthcare when involving patients in improvement work.

Originality/value

There is no earlier study which involves patients with otosclerosis when using EBCD. Furthermore, this paper illuminates that there is a need to increase collaboration with patients. The latter phases often seem to be handled by health care professionals without involving patients; this paper suggest a development using dedicated quality tools.

Details

The TQM Journal, vol. 32 no. 2
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 30 June 2020

Steven Cranfield

The purpose of this paper is to describe a qualitative observational study of how middle managers in healthcare in the UK on a work-based masters programme in leadership were…

1305

Abstract

Purpose

The purpose of this paper is to describe a qualitative observational study of how middle managers in healthcare in the UK on a work-based masters programme in leadership were introduced to foundational aspects of creativity and delivering innovation through an assignment on contemporary architectural design.

Design/methodology/approach

The assignment involved individual research of a recent architectural design followed by group poster presentations of findings and structured analysis. No prior knowledge of design was required. An activity theory approach was used to explore common principles of creativity and leading innovation, key features of design processes and tools for facilitating implementation.

Findings

A total of 89 managers in seven cohorts completed the assignment. Data from process records and group work, artefacts and follow-up evaluation questionnaires were analysed within an interpretive approach. Analysis of data lent support for the view that exploring architectural design as an activity system helped participants to develop conceptual and applied links between management performance, creative collaboration and delivering innovation in their own, different field of practice. Where participants expressed limited self-efficacy regarding the capacity for fostering creativity, this was usually ascribed to systemic inhibitors.

Practical implications

Exploring architectural design could provide a relatively low-cost, highly stimulating component of management development programmes seeking to harness the contribution of creative industries to foster work-based creativity and innovation.

Originality/value

This study explores a novel use of architectural design within the context of work-applied development programmes for healthcare managers.

Details

Journal of Work-Applied Management, vol. 12 no. 2
Type: Research Article
ISSN: 2205-2062

Keywords

Article
Publication date: 22 August 2019

Daniel Tyskbo

The purpose of this paper is to contribute to the understanding of how talent management (TM) unfolds in practice in a public organization.

1392

Abstract

Purpose

The purpose of this paper is to contribute to the understanding of how talent management (TM) unfolds in practice in a public organization.

Design/methodology/approach

An exploratory single case study was conducted of a Swedish public hospital, based on interviews, observations and documents.

Findings

The findings illustrate that despite a highly egalitarian and collectivist context, the hospital adopted an exclusive approach to TM, and a talent was not considered or identified through formal performance appraisals, but through informal criteria. The rationale behind this approach is influenced by the surrounding context, including the implementation of an innovative and strategically important practice, and the highly professionalized context.

Research limitations/implications

The study offered a rich view of how TM unfolds in practice, which may not always be possible using large sample, survey studies; however, it limited the generalizability.

Practical implications

The study points to important issues when designing TM.

Originality/value

The paper addresses two main shortcomings in the TM literature: the under-researched context of public organizations and the lack of contextual awareness. The empirically driven analysis constitutes an important step for further theory development regarding exclusive/inclusive approaches in TM.

Details

Personnel Review, vol. 48 no. 6
Type: Research Article
ISSN: 0048-3486

Keywords

Article
Publication date: 26 June 2019

Shamika Almeida, Mario Fernando, Albert Munoz and Susan Cartwright

The purpose of this paper is to identify key personal and organisational resources that influence the engagement, well-being and job satisfaction of healthcare professionals

Abstract

Purpose

The purpose of this paper is to identify key personal and organisational resources that influence the engagement, well-being and job satisfaction of healthcare professionals working in Australia.

Design/methodology/approach

Using the job demands–resources model, this study investigates how employee resources and organisation resources influence engagement, well-being and job satisfaction of health professionals in Australian hospitals. The authors collected survey data from a sample of healthcare professionals (n=217) working in three hospitals in New South Wales, Australia.

Findings

The results confirm the importance of the emotional health of employees on their well-being. The results concur with existing research that employees with higher levels of emotional health have more positive emotional and social interactions, and thus exhibit higher levels of well-being at work. The study also uncovers certain aspects of emotional health that can influence a range of employee outcomes.

Practical implications

The findings link human resource management practices to unique motivators of healthcare professionals which, in turn, are likely to improve engagement, well-being and job satisfaction.

Originality/value

The study highlights specific resources that support greater levels of well-being, engagement and job satisfaction in Australian hospitals.

Details

Journal of Organizational Effectiveness: People and Performance, vol. 6 no. 2
Type: Research Article
ISSN: 2051-6614

Keywords

Open Access
Article
Publication date: 23 January 2023

Floriana Fusco, Marta Marsilio and Chiara Guglielmetti

Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have…

5565

Abstract

Purpose

Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.

Design/methodology/approach

A structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.

Findings

This study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.

Research limitations/implications

This study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.

Practical implications

The framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.

Originality/value

This is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.

Details

Journal of Service Management, vol. 34 no. 6
Type: Research Article
ISSN: 1757-5818

Keywords

Article
Publication date: 14 September 2012

Outi Simonen, Elina Viitanen and Marja Blom

The aim of this study is to produce information concerning factors which may hamper or promote the use of effectiveness data in secondary health care middle and upper management…

1226

Abstract

Purpose

The aim of this study is to produce information concerning factors which may hamper or promote the use of effectiveness data in secondary health care middle and upper management. Additionally, the study aims to acquire knowledge of the ways in which the managers would generate effectiveness data for use in their own work.

Design/methodology/approach

The study was conducted by interviewing department directors, chief medical officers and directors of nursing (n=38) in the surgical, medical and psychiatric divisions of the five largest hospital districts in Finland.

Findings

The use of effectiveness data in management was hampered by factors relating to research, managerial work and the organization. Factors relating to the production of effectiveness data, managerial behaviour and a universal demand for evidence‐based operations were considered conducive to the use of such information. Managers would cultivate the use of effectiveness data by improving its accessibility, usability and visibility.

Practical implications

The findings may help healthcare organizations in developing the use of effectiveness data in their decision‐making.

Originality/value

The paper addresses managers’ willingness to apply effectiveness data in decision‐making although the present quality, reliability and accessibility of effectiveness data do not meet the managers’ needs. The use of effectiveness data in management can be influenced by enhancing organizational patterns of action and supporting managerial decision‐making.

Details

International Journal of Productivity and Performance Management, vol. 61 no. 7
Type: Research Article
ISSN: 1741-0401

Keywords

Open Access
Article
Publication date: 3 December 2019

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…

2343

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.

Details

Journal of Health Organization and Management, vol. 33 no. 7/8
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 10 April 2017

Rick Iedema, Raj Verma, Sonia Wutzke, Nigel Lyons and Brian McCaughan

To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI)…

Abstract

Purpose

To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI), and the multiple networks and enabling resources that it encompasses, govern, manage and extend the potential of networks for healthcare practice improvement.

Design/methodology/approach

This is a case study investigation which took place over ten months through the first author’s participation in network activities and discussions with the agency’s staff about their main objectives, challenges and achievements, and with selected services around the state of New South Wales to understand the agency’s implementation and large system transformation activities.

Findings

The paper demonstrates that ACI accommodates multiple networks whose oversight structures, self-organisation and systems change approaches combined in dynamic ways, effectively yield a diversity of network governances. Further, ACI bears out a paradox of “centralised decentralisation”, co-locating agents of innovation with networks of implementation and evaluation expertise. This arrangement strengthens and legitimates the role of the strategic hybrid – the healthcare professional in pursuit of change and improvement, and enhances their influence and impact on the wider system.

Research limitations/implications

While focussing the case study on one agency only, this study is unique as it highlights inter-network connections. Contributing to the literature on network governance, this paper identifies ACI as a “network of networks” through which resources, expectations and stakeholder dynamics are dynamically and flexibly mediated and enhanced.

Practical implications

The co-location of and dynamic interaction among clinical networks may create synergies among networks, nurture “strategic hybrids”, and enhance the impact of network activities on health system reform.

Social implications

Network governance requires more from network members than participation in a single network, as it involves health service professionals and consumers in a multi-network dynamic. This dynamic requires deliberations and collaborations to be flexible, and it increasingly positions members as “strategic hybrids” – people who have moved on from singular taken-as-given stances and identities, towards hybrid positionings and flexible perspectives.

Originality/value

This paper is novel in that it identifies a critical feature of health service reform and large system transformation: network governance is empowered through the dynamic co-location of and collaboration among healthcare networks, particularly when complemented with “enabler” teams of people specialising in programme implementation and evaluation.

Details

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

Keywords

21 – 30 of over 17000