Search results

1 – 10 of over 18000
To view the access options for this content please click here
Article
Publication date: 8 October 2018

Saligrama Agnihothri and Raghav Agnihothri

The purpose of this paper is to develop a framework for the application of evidence-based management to chronic disease healthcare.

Abstract

Purpose

The purpose of this paper is to develop a framework for the application of evidence-based management to chronic disease healthcare.

Design/methodology/approach

Chronic healthcare is specially characterized by recursive patient-physician interactions in which evidence-based medicine (EBM) is applied. However, implementing evidence-based solutions to improve healthcare quality requires managers to effect changes in many different areas: organizational structure, procedures, technology and in physician/provider behaviors. To complicate matters further, they must achieve these changes using the tools of resource allocation or incentives. The literature contains many systematic reviews evaluating the question of physician and patient behavior under various types and structures of incentives. Similarly, systematic reviews have also been done regarding specific changes to the healthcare process and their effectiveness in improving patient outcomes. Yet, these reviews uniformly lament a lack of appropriate data from well-organized studies on the question of “Why?” solutions may work in one instance while not in another. The authors present a new theoretical framework that aids in answering this question.

Findings

This paper presents a new theoretical framework (Influence Model of Chronic Healthcare) that identifies: the critical areas in which managers can effect changes that improve patient outcomes; the influence these areas can have on each other, as well as on patient and physician behavior; and the mechanisms by which these influences are exerted. For each, the authors draw upon, and present the evidence in the literature. Ultimately, the authors recognize that this is a complex question that has not yet been fully researched. The contribution of this model is twofold: first, the authors hope to focus future research efforts, and second, provide a useful heuristic to managers who must make decisions with only the lesser-quality evidence the literature contains today.

Originality/value

This model can be used by managers as a heuristic either ex ante or ex post to determine the effectiveness of their decisions and strategies in improving healthcare quality. In addition, it can be used to analyze why actions or decisions taken achieved a given outcome, and how best to proceed to effect further improvements on patient outcomes. Last, the model serves to focus attention on specific questions for further research.

To view the access options for this content please click here
Article
Publication date: 2 May 2017

Patrik Nordin, Anna-Aurora Kork and Inka Koskela

The purpose of this paper is to shed light on the potential of organizational learning for developing effectiveness of care. Value-based healthcare measurement recognizes…

Abstract

Purpose

The purpose of this paper is to shed light on the potential of organizational learning for developing effectiveness of care. Value-based healthcare measurement recognizes patient value as a driver for improving health outcomes at the societal and individual levels. By using the action learning method, this paper examines the phases of organizational learning in a private healthcare organization that has developed a novel Big Data screening tool for the treatment of patients with type 2 diabetes mellitus (DM2).

Design/methodology/approach

Relying on triple-loop learning as a conceptual framework and by applying the action learning method to case study design, this paper illustrates the phases of organizational learning and efforts to utilize value-based measurement in healthcare.

Findings

The case organization was able to identify patients at risk and to improve their care balance. Although the results for the measurement of patient outcomes led to questioning of previous care processes and practices in the organization, increasing value for all stakeholders by incorporating social needs to business opportunities remains under process.

Originality/value

With the focus on organizational learning and organizational value creation processes, this paper demonstrates incorporation of measuring patient outcomes in re-structuring care processes, enhancing organizational performance and improving effectiveness as well as quality of care.

Details

Leadership in Health Services, vol. 30 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

To view the access options for this content please click here
Book part
Publication date: 24 July 2020

Soo-Hoon Lee, Thomas W. Lee and Phillip H. Phan

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on…

Abstract

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

Details

Research in Personnel and Human Resources Management
Type: Book
ISBN: 978-1-80043-076-1

Keywords

To view the access options for this content please click here
Article
Publication date: 6 October 2014

Stanley J. Smits, Dawn Bowden, Judith A. Falconer and Dale C. Strasser

– This paper aims to present a two-decade effort to improve team functioning and patient outcomes in inpatient stroke rehabilitation settings.

Abstract

Purpose

This paper aims to present a two-decade effort to improve team functioning and patient outcomes in inpatient stroke rehabilitation settings.

Design/methodology/approach

The principal improvement effort was conducted over a nine-year period in 50 Veterans Administration Hospitals in the USA. A comprehensive team-based model was developed and tested in a series of empirical studies. A leadership development intervention was used to improve team functioning, and a follow-up cluster-randomized trial documented patient outcome improvements associated with the leadership training.

Findings

Iterative team and leadership improvements are presented in summary form, and a set of practice-proven development observations are derived from the results. Details are also provided on the leadership training intervention that improved teamwork processes and resulted in improvements in patient outcomes that could be linked to the intervention itself.

Research limitations/implications

The practice-proven development observations are connected to leadership development theory and applied in the form of suggestions to improve leadership development and teamwork in a broad array of medical treatment settings.

Practical implications

This paper includes suggestions for leadership improvement in medical treatment settings using interdisciplinary teams to meet the customized needs of the patient populations they serve.

Originality/value

The success of the team effectiveness model and the team-functioning domains provides a framework and best practice for other health care organizations seeking to improve teamwork effectiveness.

Details

Leadership in Health Services, vol. 27 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

To view the access options for this content please click here
Article
Publication date: 19 November 2020

Isaac S. Obeng and Ikedinachi K. Ogamba

This study identifies and synthesizes existing literature on the integration of diabetic and dental services and explores a service integration model for optimising…

Abstract

Purpose

This study identifies and synthesizes existing literature on the integration of diabetic and dental services and explores a service integration model for optimising diabetic patient health outcomes and improving healthcare systems in low and middle-income countries.

Design/methodology/approach

Peer-reviewed literature that analysed the integration of health services regarding dental and medical services were reviewed. The articles were identified using the Academic Search Complete, Business Source Complete, CINAHL Complete, Google Scholar and MEDLINE databases and screened using the PRISMA guidelines.

Findings

A total of 40 full-text articles were examined for eligibility out of which 26 were selected for analysis. Diabetes was shown to contribute significantly to the global disease burden and this is also reflected in most low and middle-income countries. It is found that the integration of medical and dental services could help alleviate this burden. Hence, locally adapted Rainbow-Modified Integrated Care model is proposed to fill this integration gap.

Originality

The integration of dental and medical services has been proven to be useful in improving diabetic patient outcomes. Hence, the need to facilitate cross-professional collaboration between dentists and physicians cannot be overemphasised and this can be extended and locally adapted by different health systems across the world.

Practice Implications

The integration of dental and diabetic services using models such as the Rainbow Model of Integrated Care is recommended to optimise health outcomes of diabetic patients and enhancing service delivery, especially in resource-poor healthcare systems.

Details

Journal of Integrated Care, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1476-9018

Keywords

To view the access options for this content please click here
Book part
Publication date: 26 October 2020

Lorens A. Helmchen

Public reports of provider-specific patient outcomes aim to help consumers select suppliers of medical services. Yet, in an environment of rapidly changing medical…

Abstract

Public reports of provider-specific patient outcomes aim to help consumers select suppliers of medical services. Yet, in an environment of rapidly changing medical technology and increasingly heterogeneous patient populations, and because they necessarily reflect the experience of other patients who received care in the past, such reports may be of limited value in helping patients forecast the probability of an adverse outcome for each provider they are considering. I propose that providers underwrite insurance policies that promptly pay patients a predetermined sum after an adverse outcome. Patients can use such outcome warranties to infer quality differences among providers easily and reliably. In addition, outcome warranties efficiently reward both providers and patients for reducing the risk of adverse outcomes and thereby improve the safety and affordability of health care. As such, outcome warranties help advance four important goals of health care management: reduction of financial risk, recruitment and retention of physicians, remediation of adverse outcomes, and raising the provider's reputation.

To view the access options for this content please click here
Book part
Publication date: 23 February 2015

Bita A. Kash, Kayla M. Cline, Stephen Timmons, Rahil Roopani and Thomas R. Miller

Health care institutions in many Western countries have developed preoperative testing and assessment guidelines to improve surgical outcomes and reduce cost of surgical…

Abstract

Purpose

Health care institutions in many Western countries have developed preoperative testing and assessment guidelines to improve surgical outcomes and reduce cost of surgical care. The aims of this chapter are to (1) summarize the literature on the effect of preoperative testing on clinical outcomes, efficiency, and cost; and (2) to compare preoperative testing guidelines developed in the United States, the United Kingdom, and Canada.

Design/methodology/approach

We reviewed the literature from 1975 to 2014 for studies and preoperative testing guidelines.

Findings

We identified 29 empirical studies and 8 country-specific guidelines for review. Most studies indicate that preoperative testing is overused and comes at a high cost. Guidelines are tied to payment only in one country studied. This is the most recent review of the literature on preoperative testing and assessment with a focus on quality of care, efficiency, and cost outcomes. In addition, this chapter provides an international comparison of preoperative guidelines.

Details

International Best Practices in Health Care Management
Type: Book
ISBN: 978-1-78441-278-4

Keywords

To view the access options for this content please click here
Book part
Publication date: 31 July 2013

Marc Verschueren, Johan Kips and Martin Euwema

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient

Abstract

Purpose

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care.

Design/methodology/approach

We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit.

Findings

We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level.

Value/originality

This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

Details

Leading in Health Care Organizations: Improving Safety, Satisfaction and Financial Performance
Type: Book
ISBN: 978-1-78190-633-0

Keywords

To view the access options for this content please click here
Article
Publication date: 8 July 2014

Gangaraju Vanteddu and Charles D. McAllister

The purpose of this paper is to propose an integrated framework to simultaneously identify and improve healthcare processes that are important from the healthcare…

Abstract

Purpose

The purpose of this paper is to propose an integrated framework to simultaneously identify and improve healthcare processes that are important from the healthcare provider's and patient's perspectives.

Design/methodology/approach

A modified quality function deployment (QFD) chart is introduced to the field of healthcare quality assurance. A healthcare service example is used to demonstrate the utility of the proposed chart.

Findings

The proposed framework is versatile and can be used in a wide variety of healthcare quality improvement contexts, wherein, two different perspectives are needed to be considered for identifying and improving critical healthcare processes.

Practical implications

The modified QFD chart used in conjunction with the stacked Pareto chart will facilitate the identification of key performance metrics from the patient's and the hospital's perspectives. Subsequently, the chief contributory factors at different levels are identified in a very efficient manner.

Originality/value

Healthcare quality improvement professionals will be able to use the proposed modified QFD chart in association with stacked Pareto chart for effective quality assurance.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Book part
Publication date: 28 September 2020

Maureen Walsh Koricke and Teresa L. Scheid

PurposePatient safety and adverse events continue to present significant challenges to the US health care delivery system. Mandated reporting of adverse events can be a…

Abstract

PurposePatient safety and adverse events continue to present significant challenges to the US health care delivery system. Mandated reporting of adverse events can be a mechanism to “coerce” hospitals to identify, evaluate, and ultimately improve the quality and safety of patient care. The objective of this study is to determine if the coercion of mandated reporting impacts hospital patient safety scores.

Methods – We utilize the US News and World Report 2012–2013 Best Hospital Rankings which includes patient safety data from US teaching hospitals. The dependent variable is a composite measure of six indicators of patient safety during and after surgery. The independent variable is state mandated reporting of hospital adverse events. Three control variables are included: Magnet accreditation status, surgical volume, and the percentage of surgical admissions.

Findings – Using ordered logistic regression (n = 670 hospitals) we find a positive, but not significant, relationship between state mandated reporting and better patient safety scores.

Implications – This finding suggests that regulatory policy may not actually prompt performance improvement, and our data point to the need for further study of both formal and informal processes to manage patient safety within the hospital.

Originality – While increased reporting of adverse events has been linked to hospitals providing safer care, no research to date has examined whether or not state-level mandates actually lead to improvements in patient safety.

Details

Race, Ethnicity, Gender and Other Social Characteristics as Factors in Health and Health Care Disparities
Type: Book
ISBN: 978-1-83982-798-3

Keywords

1 – 10 of over 18000