Search results

The aim of this paper is to analyse how technological innovations in performance measurement systems make it possible to overcome some of the challenges that public healthcare organizations face where management and control are concerned. The changes that could be applied to the performance measurement system of healthcare organisations were analysed together with an evaluation of the responses developed in order to achieve these changes.

The paper contains an in-depth case-study of a public university hospital which utilises an innovative information system.

The case-study highlights how technological innovations in performance measurement systems impact the management and monitoring information system in a public university hospital, through the implementation of a multidimensional management dashboard.

The limitation of this paper is that only one case-study is analysed, albeit in depth, while it would be interesting to consider more public university hospitals.

The paper highlights the fundamental role of middle management in change processes in the healthcare sector.

The case-study highlights how critical the active involvement of middle management is in performance measurement and management, and how this is achieved thanks to the adoption of a simple, clear method which ensures comprehensible communication of the objectives, as well as the measurement of performance by means of radar plots.

Based on the dynamic capabilities view, the current study aims to empirically investigate the effects of organizational learning culture (OLC), strategic reconfiguration (SREC) and digital transformation (DT), altogether, on Egyptian private hospitals' strategic renewal in the face of the COVID-19 pandemic.

This study adopted a cross-sectional design to collect the data used to carry out mediation analysis. A self-administered questionnaire was used to collect data from a sample consisted of 264 Egyptian private hospitals. The smart partial least square structural equation modeling technique (PLS-SEM) was adopted to test the hypotheses.

The results demonstrate that OLC directly and positively affects SR. Besides, SREC and DT partially and serially mediate the OLC-SR relationship.

The sample size was small, covering only Egyptian private hospitals. The results may be different in the manufacturing sector and in other countries. The study was cross-sectional which is limited to trace long-term effects of OLC, SREC and DT on SR. Accordingly, a longitudinal study may be undertaken.

Private hospitals' managers must actively explore and dig out valuable resources in order to discover potential information and trends endeavor to redesign internal structures, and reconfigure their current resources, structures and strategies to achieve strategic renewal. The findings also provide new insights to mangers of private sectors' institutions and direct their attention toward adopting the strategic renewal option to survive amidst crises instead of retrenchment, persevering, or quitting business.

The study's results imply that health care providers have sought to improve the capacities of their health care systems to address the patient-level social needs through continuous learning, internal reconfigurations and the transformation toward digitalization to renew their services.

This study therefore contributes to SR literature by being the first empirical study to introduce an integrative model for the antecedents of SR amidst the pandemic.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

Since the outbreak of the COVID-19 pandemic, most organizations have experienced a sudden and unprecedented drop in revenue and productivity. However, the pandemic did not exclusively negatively impact organizations; rather, it resulted in both negative and positive effects. To delve into the multi-level process through which organizational outcomes change from negative to positive indicators, this study focuses on organizational resilience as a theoretical concept to overcome pandemic-related turmoil.

The authors conducted a multi-level analysis based on grounded theory with a sample of 30 healthcare employees who worked in hospitals and were simultaneously enrolled in a part-time master of business administration (MBA) program at a university in the Midwest. Of the 30 participants, 21 were from a single university hospital (UH), and the remaining 9 participants were from other hospitals (non-UH).

The authors analyzed the data and incorporated three existing perspectives of organizational resilience (attribute, process and multi-level views) into an integrated model. The authors identified 25 first-order concepts and 8 second-order themes and categorized them into 4 aggregate dimensions at different unit levels: organizational field, leadership, operation and individual units.

A resilient hospital operates as a cohesive system, with entities at various levels – from individuals and teams to the broader organization – collaborating seamlessly to foster resilience. Top management team (TMT) should persistently communicate with employees to provide information about the current crisis and clear strategic directions to reduce employees' fear and prevent anomie stemming from future uncertainty. Managers should not only be concerned about employees' physical safety from infection and psychological safety from isolation but also encourage employees to elicit meaningfulness from their work. Furthermore, TMT and human resource (HR) teams should adapt human resource management (HRM) practices to allow for flexibility and optimism in employee roles.

In this study, the authors utilized a qualitative methodology with grounded theory in order to develop a comprehensive model that holds theoretical, methodological and practical significance. Theoretically, the authors' novelty lies in the synthesis of three distinct perspectives: attribute, process and multi-level. The authors merged these approaches into a unified model, identifying precursors of resilience at different levels. Methodologically, the authors focused on hospitals as target samples, which were the foremost and representative organizations severely confronting the crisis and turmoil brought by the pandemic. The authors documented organizations' experiences amidst the crisis as they unfolded in real time rather than in hindsight. This approach highlights the immediacy and significance of the authors' research in the realm of crisis management. Practically, the authors' findings illuminate that organizational resilience can be developed through a collaborative effort. It emerges from coordinated interactions across various organizational actors, from employees and middle managers to the TMT.

The purpose of this paper is to establish a relationship between pay satisfaction and leader–member relationship and examine pay satisfaction as a moderator of the relationship between toxic leadership and LMX among public sector nurses in Ghana.

Using a cross-sectional survey approach, the authors used questionnaires to collect data from 225 nurses working in public hospitals in Ghana. The hypotheses were tested using covariance-based structural equation modelling.

The results of this study revealed that pay satisfaction levels of nurses had an influence on leader–member exchange (LMX). The results further showed that pay satisfaction as a moderator of the relationship between toxic leadership and LMX was not statistically significant.

Cross-sectional surveys are often criticised for causality issue. The causality issue here is that the link between toxic leadership, pay satisfaction and LMX was explored at a given point in time and ignores changes through time.

Hospitals must encourage their leaders to demonstrate more supportive and positive behaviours to foster positive leader–member relationships. Maladjusted, malcontent and malevolent leadership behaviours are dangerous for nurses and hospitals and can be addressed through leadership training and development.

Toxic leadership has considerable organisational costs of low productivity and negative work relationship at the workplace. The indirect effects of toxic leadership at the workplace on employees’ families and friends are often silent in organisations.

Nurses have been ignored in toxic leadership research in emerging economies. LMX is extended to examine toxic leadership and pay satisfaction in public hospitals in an emerging economy.

This study aims to increase the understanding of the starting points and presuppositions of organizational learning (OL) processes in a hospital’s surgical department based on the existing theory of OL and to make visible the practical possibilities of the theory in this context.

The study was conducted as a case study. The data were collected from personnel of the hospital’s surgical department and consisted of 26 thematic interviews. The data were analyzed using qualitative theory-driven content analysis.

This study found different starting points for both employee-oriented and organization-oriented learning processes that could potentially progress to different levels of the organization: from individuals to a wider group or from a large group to an individual. The starting point of employee-oriented learning processes was depicted as everyday life problems or situations or was based on the person’s interest. The starting points of organization-oriented learning processes were described as achieving or maintaining the organization’s expected skill levels, pursuing continuous development or pursuing the organization’s specific development needs. Different kinds of presuppositions were also located within the OL processes.

This study produced new practice-based knowledge about the starting points of OL processes and their presuppositions. In health-care organizations, learning is especially important due to intensive and complex changes, and this study provides empirical evidence on how to enhance learning.

The research problem in this study is how a client (as a project owner) should organise early stakeholder involvement and integration in the front-end phase of a project. This study aims to create normative managerial statements as propositions from the client's perspective and to combine them into a set of activities enabling efficient organisation in the front-end phase of a hospital construction project.

Action design research (ADR) was carried out in a large hospital construction project where the first author acted as an “involved researcher” and the other authors acted as “outside researchers”.

The authors created seven normative managerial propositions that were verified by the case project stakeholders and developed a managerial framework describing the client's essential stakeholder involvement and integration activities in the front-end phase of a hospital construction project based on these propositions. The authors have also depicted the subphases of the front-end phase: value definition phase in the client permanent organisation, value proposition phase in the client Programme Management Office (PMO) and finally development phase in the alliance organisation ending on the final investment decision.

The collaborative contract delivery model enables the early involvement and integration of stakeholders. It has been somewhat surprising to note the extent to which collaborative contracts change the client role in the project front-end. The results offer practical activities for how clients can manage front-end activities in collaborative contracts.

The case project offered a platform to analyse how the collaborative contract delivery model changes the emphasis of activities in the front-end of a project. One of the key benefits of collaborative contracts is that development, design and delivery occur partially in parallel, thereby enabling contributions from production to be included in the design and development. The benefit of having a real-life case under study provides the possibility to triangulate and analyse rich data, however limited by the qualitative case method.

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.

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.

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.

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.

This chapter contributes to a better knowledge of the role played by the collective entrepreneurship of networks of scientists and doctors in the transfer and adaptation of ideas on hospital organization and management for modern hospitals with new technology, from Western Europe and above all the United States. Literature about new medical technology has demonstrated how medical innovations required changes in human capital and organization in hospitals, to benefit patients in the private and the public hospitals after World War II. The chapter provides an analysis about the origins of the modern North American ideas about professionalization and hospital accreditation, in the consolidation of a modern hospital management and organization. In particular, the focus is in demonstrating how networks of scientists’ entrepreneurs were fundamental drivers in the process of knowledge transfer and the dissemination of these ideas to the large Western European hospitals. More specifically, the chapter studies the diffusion of the new ideas about the large hospital organization and management from the United States to the Western Europe, applied to the Spanish context. Informal networks of doctors applied new ideas developed in the United States to new clinics and hospitals in Spain. Some of them occupied official positions in the key public health administrations and were crucial to introducing the hospital accreditation systems and the US ideas in Spain.

Lean Six Sigma (LSS) implementation follows a structured approach called define-measure-analyze-improve-control (DMAIC). Earlier research about its application in emergency healthcare services shows that it requires organizational transformation, which many healthcare setups find difficult. The Kotter change management model facilitates organizational transformation but has not been attempted in LSS settings till now. This study aims to integrate the LSS framework with the Kotter change management model to come up with an integrated framework that will facilitate LSS deployment in emergency health services.

Two-stage Delphi method was conducted by using a literature review. First, the success factors and barriers of LSS are investigated, especially from an emergency healthcare point of view. The features and benefits of Kotter's change management models are then reviewed. Subsequently, they are integrated to form a framework specific to LSS deployment in an emergency healthcare set-up. The elements of this framework are analyzed using expert opinion ratings. A new framework for LSS deployment in emergency healthcare has been developed, which can prevent failures due to challenges faced by organizations in overcoming resistance to changes.

The eight steps of the Kotter model such as establishing a sense of urgency, forming a powerful guiding coalition, creating a vision, communicating the vision, empowering others to act on the vision, planning for and creating short-term wins, consolidating improvements and producing still more change, institutionalizing new approaches are derived from the eight common errors that managers make while implementing change in the institution. The study integrated LSS principles and Kotter’s change management model to apply in emergency care units in order to reduce waste and raise the level of service quality provided by healthcare companies.

The present study could contribute knowledge to the literature by providing a framework to integrate lean management and Kotter's change management model for the emergency care unit of the healthcare organization. This framework guides decision-makers and organizations as proper strategies are required for applying lean management practices in any system.

The proposed framework is unique and no other study has prescribed any integrated framework for LSS implementation in emergency healthcare that overcomes resistance to change.