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1 – 10 of 64Armando 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.
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Annika Eklund and Maria Skyvell Nilsson
While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in…
Abstract
Purpose
While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators’ perspectives on implementing a transition program for newly graduated nurses.
Design/methodology/approach
An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.
Findings
The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.
Originality/value
This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.
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Siva Shaangari Seathu Raman, Anthony McDonnell and Matthias Beck
Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing…
Abstract
Purpose
Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.
Design/methodology/approach
Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.
Findings
We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.
Research limitations/implications
Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.
Practical implications
Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.
Social implications
Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.
Originality/value
The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.
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Eeva Vuorivirta-Vuoti, Suvi Kuha and Outi Kanste
Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study…
Abstract
Purpose
Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study aims to describe nurse leaders’ perceptions of what future leadership in hospital settings in the post-pandemic era needs to be like.
Design/methodology/approach
A qualitative descriptive study was used. A total of 20 nurse leaders from the Finnish central hospital were interviewed from June to October 2021. The data were analysed using inductive content analysis.
Findings
The analysis revealed five main categories describing nurse leaders’ perceptions of future leadership in hospital settings in the post-pandemic era: digitalisation and hybrid working culture, development of sustainable working conditions, moving smoothly to the post-pandemic era, dissolution of traditional regimes of organisation and flexibility in leadership.
Practical implications
In the post-pandemic era, the constantly changing demands and challenges currently facing healthcare systems have significantly increased the complexity of hospital organisations. This requires critical evaluation and change to traditional leadership. Enhancing flexibility and authenticity in leadership, strengthening competencies, implementing a wide range of digital resources and increasing the appeal of the nursing profession to build the next generation of nurses – all of these are needed to provide sustainability in future healthcare.
Originality/value
The results identify the critical points of leadership that need to be developed for future challenges and for maintaining a sufficient supply of qualified professionals. Acting on this information will enhance flexibility in organisations and lead to acceleration of changes and the development of new kinds of leadership in the future
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Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe
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…
Abstract
Purpose
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.
Design/methodology/approach
Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.
Findings
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.
Originality/value
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.
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As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing…
Abstract
Purpose
As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work.
Design/methodology/approach
This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level.
Findings
The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions.
Practical implications
The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions.
Originality/value
This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities’ perspective and the organizational perspective to understand the manager’s role in handling the contingency of decisions and managing paradoxes in the decision-making process.
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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.
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Anna Prenestini, Stefano Calciolari and Arianna Rota
During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the…
Abstract
Purpose
During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.
Design/methodology/approach
We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.
Findings
We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.
Originality/value
The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.
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Rania Ahmed Aly El Garem, Amira Fouad and Hassan Mohamed
This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating…
Abstract
Purpose
This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating role of the sociodemographic factors.
Design/methodology/approach
The data were gathered from 462 patients via a structured questionnaire, while structural equation modeling was utilized for the analysis.
Findings
Results indicated that trust, perceived value and patient satisfaction have important roles in shaping the patient loyalty, while patient satisfaction was found to fully mediate the patient’s perceived service quality. Loyalty relationship was also found to partially mediate the trust–loyalty relationship. Nonetheless, the patient’s satisfaction–loyalty relationship was found to be only moderated by the age factor.
Practical implications
Implications are provided to the Egyptian private hospitals in order for them to formulate improvement plans as well as set higher standards of conduct.
Originality/value
This original research is the first one, up to the researcher knowledge, that explores the drivers of patient satisfaction in the private hospitals in Egypt.
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The purpose of the paper is to showcase the significant achievements of Egypt's scientists in the 20th century across various fields of study such as medicine, physics, chemistry…
Abstract
Purpose
The purpose of the paper is to showcase the significant achievements of Egypt's scientists in the 20th century across various fields of study such as medicine, physics, chemistry, biology, math, geology, astronomy and engineering. The paper highlights the struggles and successes of these scientists, as well as the cultural, social and political factors that influenced their lives and work. The aim is to inspire young people to pursue careers in science and make their own contributions to society by presenting these scientists as role models for hard work and dedication. Ultimately, the paper seeks to promote the importance of science and its impact on society.
Design/methodology/approach
The purpose of this review is to present the scientific biographies of Egypt's most distinguished scientists, primarily in the field of Natural Sciences, in a balanced and comprehensive manner. The work is objective, honest and abstract, avoiding any bias or exaggeration. The author provides a clear and concise methodology, including a brief introduction to the scientist and their field of study, an explanation of their major contributions, the impact of their work on society, any challenges or obstacles faced during their career and their lasting legacy. The aim is to showcase the important achievements of these scientists, their impact on their respective fields and to inspire future generations to pursue scientific careers.
Findings
The group of outstanding scientists in 20th century Egypt were shaped by various factors, including familial upbringing, education, society, political and cultural atmosphere and state support for scientific research. These scientists made significant contributions to various academic disciplines, including medicine, physics, chemistry, biology, mathematics and engineering. Their impact on their communities and cultures has received international acclaim, making them role models for future generations of scientists and researchers. The history of these scientists highlights the importance of educational investments and supporting scientific research to foster innovation and social progress. The encyclopedia serves as a useful tool for students, instructors and education professionals, preserving Egypt's scientific heritage and honouring the scientists' outstanding accomplishments.
Research limitations/implications
The encyclopedia preserves Egypt's scientific heritage, which has been overlooked for political or other reasons. It is a useful tool for a variety of readers, including students, instructors and education professionals, and it offers insights into universally relevant scientific success factors as well as scientific research methodologies. The encyclopedia honours the outstanding scientific accomplishments of Egyptian researchers and their contributions to the world's scientific community.
Practical implications
The practical implications of this paper are several. First, it highlights the importance of education, family upbringing and societal support for scientific research in fostering innovation and social progress. Second, it underscores the need for continued funding and support for scientific research to maintain and build upon the accomplishments of past generations of scientists. Third, it encourages young people to pursue scientific careers and make their own contributions to society. Fourth, it preserves the scientific heritage of Egypt and honors the contributions of its outstanding scientists. Finally, it serves as a useful tool for students, instructors and education professionals seeking to understand the factors underlying scientific success and research methodologies.
Social implications
The social implications of the paper include promoting national pride and cultural identity, raising awareness of the importance of education and scientific research in driving social progress, inspiring future generations of scientists and researchers, reducing socioeconomic disparities and emphasizing the role of society, politics and culture in shaping scientific researchers' personalities and interests.
Originality/value
The paper's originality/value lies in its comprehensive documentation of the scientific biographies of Egypt's most prominent scientists in the 20th century, providing unique insights into the factors that contributed to their development and their impact across various academic disciplines. It preserves Egypt's scientific heritage and inspires future generations of scientists and researchers through the promotion of educational investments and scientific research. The encyclopedia serves as a useful tool for education professionals seeking to understand scientific success factors and research methodologies, emphasizing the importance of supportive and inclusive environments for scientific development.
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