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Open Access
Article
Publication date: 9 February 2024

Armando Calabrese, Antonio D'Uffizi, Nathan Levialdi Ghiron, Luca Berloco, Elaheh Pourabbas and Nathan Proudlove

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

Abstract

Purpose

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

Design/methodology/approach

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

Findings

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

Originality/value

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

Details

European Journal of Innovation Management, vol. 27 no. 9
Type: Research Article
ISSN: 1460-1060

Keywords

Open Access
Article
Publication date: 5 March 2024

Thanduxolo Elford Fana and Jane Goudge

In this paper, the authors examine the strategies used to reduce labour costs in three public hospitals in South Africa, which were effective and why. In the democratic era, after…

Abstract

Purpose

In this paper, the authors examine the strategies used to reduce labour costs in three public hospitals in South Africa, which were effective and why. In the democratic era, after the revelations of large-scale corruption, the authors ask whether their case studies provide lessons for how public service institutions might re-make themselves, under circumstances of austerity.

Design/methodology/approach

A comparative qualitative case study approach, collecting data using a combination of interviews with managers, focus group discussions and interviews with shop stewards and staff was used.

Findings

Management in two hospitals relied on their financial power, divisions between unions and employees' loyalty. They lacked the insight to manage different actors, and their efforts to outsource services and draw on the Extended Public Works Program failed. They failed to support staff when working beyond their scope of practice, reducing employees' willingness to take on extra responsibilities. In the remaining hospital, while previous management had been removed due to protests by the unions, the new CEO provided stability and union–management relations were collaborative. Her legitimate power enabled unions and management to agree on appropriate cost cutting strategies.

Originality/value

Finding an appropriate balance between the new reality of reduced financial resources and the needs of staff and patients, requires competent unions and management, transparency and trust to develop legitimate power; managing in an authoritarian manner, without legitimate power, reduces organisational capacity. Ensuring a fair and orderly process to replace ineffective management is key, while South Africa grows cohorts of competent managers and builds managerial experience.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 24 January 2024

Bonnie Poksinska and Malin Wiger

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…

Abstract

Purpose

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

Design/methodology/approach

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

Findings

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

Practical implications

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

Originality/value

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 22 November 2023

Ngatindriatun Ngatindriatun, Muhammad Alfarizi and Rafialdo Arifian

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department…

Abstract

Purpose

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

Design/methodology/approach

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Findings

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

Originality/value

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

Details

Journal of Modelling in Management, vol. 19 no. 3
Type: Research Article
ISSN: 1746-5664

Keywords

Article
Publication date: 23 April 2024

Albi Thomas and M. Suresh

The purpose of this study is to identify organisational homeostasis factors in the context of healthcare organisations and to develop a conceptual model for green transformation.

Abstract

Purpose

The purpose of this study is to identify organisational homeostasis factors in the context of healthcare organisations and to develop a conceptual model for green transformation.

Design/methodology/approach

The organisational homeostasis factors were determined by review of literature study and the opinions of healthcare experts. Scheduled interviews and closed-ended questionnaires are employed to collect data for this research. This study employed “TISM methodology” and “MICMAC analysis” to better comprehend how the components interact with one another and prioritise them based on their driving and dependence power.

Findings

This study identified 10 factors of organisational homeostasis in healthcare organisation. Recognition of interdependence, hormesis, strategic coalignment, consciousness on dependence of healthcare resources and cybernetic principle of regulations are the driving or key factors of this study.

Research limitations/implications

The study's primary focus was on the organisational homeostasis factors in healthcare organisations. The methodological approach and structural model are used in a healthcare organisation; in the future, these approaches can be applied to other industries as well.

Practical implications

The key drivers of organisational homeostasis and the identified factors will be better comprehended and understood by academic and important stakeholders in healthcare organisations. Prioritizing the factors helps the policymakers to comprehend the organisational homeostasis for green transformation in healthcare.

Originality/value

In this study, the TISM and MICMAC analysis for healthcare is proposed as an innovative approach to address the organisational homeostasis concept in the context of green transformation in healthcare organisations.

Details

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

Keywords

Article
Publication date: 17 November 2023

Deske W. Mandagi, Derby Chriestofle Rampen, Tonny Irianto Soewignyo and Ronny H. Walean

The purpose of this investigation is to scrutinize the unexplored realm concerning the interplay of hospital brand gestalt on patient satisfaction and revisit intentions.

Abstract

Purpose

The purpose of this investigation is to scrutinize the unexplored realm concerning the interplay of hospital brand gestalt on patient satisfaction and revisit intentions.

Design/methodology/approach

A self-administered online survey was conducted with 227 patients who had stayed at and received health-care services from a private hospital in the city of Manado, Indonesia, within the past 12 months. The quantitative data were subsequently analyzed using a structural equation model with the assistance of Smart PLS statistical software.

Findings

The results suggest that the hospital brand gestalt significantly and positively influences patient satisfaction, which, in turn, leads to patients’ intentions to revisit. Furthermore, patient satisfaction serves as a significant mediator in the relationship between brand gestalt and revisit intentions.

Research limitations/implications

This study enhances the comprehension of brand gestalt’s influence on customer attitudes and behaviors within the health-care context, contributing to the expanding body of literature concerning holistic brand perception. For health-care providers, the study underscores the significance of creating a uniform and distinctive brand experience to boost patient satisfaction and cultivate loyalty. In summary, this study paves the way for strategic branding initiatives in health care, ultimately enhancing patient experiences and organizational outcomes.

Practical implications

For health-care providers, this study emphasizes the importance of crafting a consistent and differentiated brand experience to enhance patient satisfaction and foster loyalty. Overall, this study opens avenues for strategic branding efforts in health care, ultimately improving patient experiences and organizational outcomes.

Originality/value

While there is a growing interest in the role of brand gestalt in marketing research, there is still a need for more empirical research to explore the link between brand gestalt, customer satisfaction and revisit intention. Surprisingly, to the best of the authors’ knowledge, no previous studies have investigated the role of brand gestalt in the context of health care.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 18 no. 2
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 9 June 2023

Pierre-Luc Fournier, Lionel Bahl, Desirée H. van Dun, Kevin J. Johnson and Jean Cadieux

The complexity and uncertainty of healthcare operations increasingly require agility to safeguard a high quality of care. Using a microfoundations of dynamic capabilities…

Abstract

Purpose

The complexity and uncertainty of healthcare operations increasingly require agility to safeguard a high quality of care. Using a microfoundations of dynamic capabilities perspective, this study investigates the effects of nurses' implicit voice theories (IVTs) on the behaviors that influence their individual agility.

Design/methodology/approach

This research uses quantitative survey data collected from 2,552 Canadian nurses during the fourth wave of the Covid-19 pandemic in the fall of 2021. Structural equation modeling is used to test a conceptual model that hypothesizes the effects of three different IVTs on nurses' creativity, spontaneity, agility and the quality of care they deliver to patients.

Findings

The results reveal that voice-inhibiting cognitions (like “suggestions are criticisms for higher-ups”, “I first need a solution or solid data”, and “speaking up has negative repercussions”) negatively impact nurses' creativity and spontaneity in crafting solutions to problems they face daily. In turn, this affects nurses' individual agility as they attempt to adapt to changing circumstances and, ultimately, the quality of care they provide to their patients.

Practical implications

Even if organizations have little control over employees' pre-held beliefs regarding voice, they can still reverse them by developing and nurturing a voice-welcoming culture to boost their workers' agility.

Originality/value

This study combines two theoretical frameworks, voice theory and dynamic capabilities theory, to study how individual-level factors (cognitions and behaviors) contribute to nurses' individual agility and the quality of care they provide to their patients. It answers the recent calls of scholars to study the mechanisms through which healthcare operations can develop and sustain dynamic capabilities, such as agility, and better face the “new normal”.

Details

International Journal of Operations & Production Management, vol. 44 no. 5
Type: Research Article
ISSN: 0144-3577

Keywords

Open Access
Article
Publication date: 15 April 2024

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.

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 19 April 2024

Mengqiu Guo, Minhao Gu and Baofeng Huo

Due to the rapid development of artificial intelligence (AI) technology, increasing the use of AI in healthcare is critical, but few studies have explored the extent to which…

Abstract

Purpose

Due to the rapid development of artificial intelligence (AI) technology, increasing the use of AI in healthcare is critical, but few studies have explored the extent to which physicians cooperate with AI in their work to achieve productive and innovative performance, which is a key issue in operations management (OM). We conducted empirical research to answer this question.

Design/methodology/approach

We developed a conceptual model based on the ambidextrous perspective. To test our model, we collected data from 200 Chinese hospitals. One senior and one junior physician from each hospital participated in this research so that we could get a more comprehensive view. Based on the sample of 400 participants and the conceptual model, we examined whether different types of AI use have distinct impacts on physicians’ productivity and innovation by conducting hierarchical regression and post hoc tests. We also introduced team psychological safety climate (TPSC) and AI technology uncertainty (AITU) as moderators to investigate this topic in further detail.

Findings

We found that augmentation AI use is positively related to overall productivity and innovative job performance, while automation AI use is negatively related to these two outcomes. Furthermore, we focused on the impacts of the ambidextrous use of AI on these two outcomes. The results highlight the positive impacts of complementary use on both outcomes and the negative impact of balance on innovative job performance. TPSC enhances the positive impacts of complementary use on productivity, whereas AITU inhibits the negative impacts of automation and balanced use on innovative job performance.

Originality/value

In the age of AI, organizations face greater trade-offs between performance and technology management. This study contributes to the OM literature from the perspectives of operational performance and technology management in three ways. First, it distinguishes among different AI implementations and their diverse impacts on productivity and innovative performance. Second, it identifies the different conditions under which automation AI use and augmentation are superior. Third, it extends the ambidextrous perspective by becoming an early adopter of this approach to explore the implications of different types of AI use in light of contingency factors.

Details

International Journal of Operations & Production Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0144-3577

Keywords

Article
Publication date: 19 September 2023

Manoj Chatpibal, Wornchanok Chaiyasoonthorn and Singha Chaveesuk

This study aims to develop a conceptual framework for the role of chief financial officer (CFO) in an ever-changing environment. As previous research focused on responding to…

Abstract

Purpose

This study aims to develop a conceptual framework for the role of chief financial officer (CFO) in an ever-changing environment. As previous research focused on responding to specific crises, there have been theoretical and practical gaps in the role of CFO. The study's goal is to fill a critical gap by developing a comprehensive and integrated set of roles to assist the CFO in a constantly changing environment.

Design/methodology/approach

Using a grounded theory approach, semi-structured interviews and observations were conducted with 21 CFOs from various industries in Thailand, including foreign multinational corporations and domestic companies with international operations. CFOs were asked how they frame their roles in the face of an ever-changing environment and how they prepare for the future.

Findings

The iCFO model is developed, which identifies the critical “core” roles of the CFO in securing the business foundation, as well as the “future opportunities” roles that function as growth engines for long-term business strength. The research delves into the importance of integrity, ethical mindset and corporate governance in the role of the CFO. The iCFO model is designed to help guide future research and provide practical applications for CFOs in both domestic and international contexts. The term “core” refers to the CFO’s primary responsibilities, which include driving profitability, managing risks and optimizing business performance. The “future opportunities” component focuses on the roles that CFOs can play in strengthening the future of business by optimizing investment efficiency, driving digital transformation and being the CEO’s business partner. The findings also emphasized “integrity,” which must encompass all decisions, actions or recommendations made by the CFO.

Originality/value

The study offers unique perspectives on an emerging economy, providing new insights. Through interviews with 21 CFOs, it contributes empirical evidence on the development of roles in accounting and finance, emphasizing good governance practices. The findings highlight the integrated role of the CFO and their self-reflection on their value within the company. Significantly, the study's implications are relevant and applicable to a global audience, particularly in developing economies that prioritize growth. Future studies could incorporate integrated thinking into the iCFO model to address social, environmental and economic factors, making it more universally relevant. Additionally, exploring the adoption of the chief value officer context in developing markets could enable CFOs to expand their focus beyond financial metrics, embracing a comprehensive approach to value creation. By integrating these concepts into the iCFO model, CFOs can effectively drive sustainable and impactful business outcomes on a global scale.

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