Primary health care facility performance assessment in Armenia

2010 ◽  
Vol 23 (2) ◽  
pp. 141-155
Author(s):  
Tsovinar Harutyunyan ◽  
Anahit Demirchyan ◽  
Michael Thompson ◽  
Varduhi Petrosyan

PurposeThe purpose of this study is to focus on the performance of select facilities in Lori and Shirak provinces in Armenia in Spring 2008. This is in response to the deterioration of the primary healthcare sector in Armenia.Design/methodology/approachThe performance assessment focused on the status of several performance indicators, both current and as recalled for 2006. The interviewer‐administered questionnaire addressed access to care, provider relations with community and clients, environment, management, and primary and secondary prevention at the facilities. For each domain, a summative score that ranged from 0 to 3 was computed and a mean score for each facility derived.FindingsThe project has had significant positive impact on facilities' performance. Access to care scores increased from 2.0 in 2006 to 2.5 in 2008; provider relations with community improved from 1.1 to 1.4; environment scores improved from 1.3 to 1.9, facility management improved from 1.4 to 1.7; and prevention efforts increased from 1.3 to 1.9. The overall mean facility score increased from 1.4 to 1.8. Although the scores for small rural clinics increased, their scores were lower than the scores for other facility types.Originality/valueIn the chronic absence of administrative surveillance data, this paper provides valuable information on the status of primary healthcare services in Armenian provinces. It demonstrates the value of interviewer‐administered performance assessments in obtaining data across project sites when internal monitoring of progress is unavailable.

2019 ◽  
Vol 8 (2) ◽  
pp. 147-162
Author(s):  
Laura Simmons ◽  
Arwel W. Jones ◽  
Niro Siriwardena ◽  
Christopher Bridle

Purpose Sickness absence is a major concern for healthcare services and their employees with healthcare workers having higher sickness absence rates compared to the general population. The purpose of this paper is to systematically review randomised control trials (RCTs) that aimed to reduce sickness absence among healthcare workers. Design/methodology/approach A systematic review was conducted that aimed to include RCTs with study participants who were employed in any part of the healthcare sector. This review included any type of intervention with the primary outcome measure being sickness absence. Findings Seven studies were included in the review and consisted of one exercise-only intervention, three multicomponent intervention programmes, two influenza vaccination interventions and one process consultation. Three studies (exercise-only, one multicomponent intervention programme and one influenza vaccination intervention) were able to demonstrate a reduction in sickness absence compared to control. Research limitations/implications Due to the lack of high-quality evidence, this review identified that there are currently no interventions that healthcare organisations are able to use to effectively reduce sickness absence among their employees. This review also highlights the importance of a standardised measure of sickness absence for healthcare staff, such as shifts. Originality/value To the authors’ knowledge, this is the first systematic review to synthesise such evidence among healthcare workers.


2019 ◽  
Vol 35 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Rosanna Spanò ◽  
Mariavittoria Cicellin ◽  
Adriana Scuotto

Purpose In the last few decades, the effectiveness of the evaluation of human resources and their performances has become a crucial theme in the debates of the public sector. The purpose of this paper is to analyze key design characteristics of performance management system (PMS) that may be effectively adopted and deployed by management to enable the assessment for a health system improvement. Design/methodology/approach This paper falls under the field of studies that focuses on the design and implementation of PMS in the healthcare sector. This research adopted a qualitative approach across the case study method to understand the role of different contextual factors and their impact upon the design of PMS. Mainly drawing on previous studies on the Italian regional health systems, a target region has been selected for these purposes. Findings As a result, the new PMS was effectively working and was structured with a balanced focus on the region and the single healthcare organizations. The need for improving the information systems within the healthcare organizations was strongly emphasized. The crucial element of the new PMS was the transparency about the assessment procedures. Originality/value This paper contributes to the debate on factors that can influence the design of PMS in healthcare. Relying on a contingent approach, the authors put forward the need of a more comprehensive and integrated frameworks encompassing organic conception of PMSs, as well as of the interdependencies among their components.


2016 ◽  
Vol 29 (6) ◽  
pp. 973-993 ◽  
Author(s):  
Jan Hassink ◽  
John Grin ◽  
Willem Hulsink

Purpose Care farming is an underexplored example of agricultural diversification. In their process of diversification, care farmers are newcomers to the healthcare sector, facing high entry barriers and lacking the skills required to build a solid and legitimate presence in this new domain. Changes in the care regime have provided opportunities for new players, like regional organizations of care farmers, to gain access to care budgets. The purpose of this paper is to describe and analyze how strategies designed to establish regional organizations of care farms with similar access to institutional resources unfold and are translated into entrepreneurial behavior, organizational identity and legitimacy, and help provide access to care budgets. Design/methodology/approach Using entrepreneurship, identity formation and legitimacy building as guiding concepts, the authors interviewed stakeholders and analyzed activities and documents to gain a broad perspective with regard to the organizations, skills and activities. Findings The authors identified two types of regional care farm organizations: a cooperative and a corporate type. While the corporate type clearly exhibited entrepreneurial behavior, leading to a trustful and appealing organizational identity, substantial fund-raising and an early manifestation of institutional and innovative legitimacy in the care sector, the cooperative type initially lacked entrepreneurial agency, which in turn led to a lack of legitimacy and a slow development toward a more professional market-oriented organization. Manifesting entrepreneurial behavior and strategically aligning the healthcare and agricultural sectors, and building up both institutional and innovative legitimacy in the care sector proved to be crucial to the successful development of regional organizations of care farms. This study contributes to existing literature by exploring relationships between entrepreneurial and institutional strategies, legitimacy, organizational identity and logics. Originality/value This study contributes to the literature by exploring how in times with changes in institutional logics, strategies to establish new organizations unfold. The authors have shown how differences in strategy to establish new organizations with similar access to institutional resources unfold and are translated into diverging organizational identities and degrees of legitimacy. Entrepreneurial behavior is the key to create a trustful and appealing identity and innovative and institutional legitimacy which is important for providing access to an institutionalized sector.


2014 ◽  
Vol 32 (4) ◽  
pp. 315-330 ◽  
Author(s):  
Michelle C. Brennan ◽  
Alison J. Cotgrave

Purpose – Despite the surge of interest in construction sustainability and the many Government initiatives encouraging reform in the UK construction industry (CI), the prevalence of sustainable development (SD) in the industry is still largely lagging behind that of other industries. Given the amount of focus and activity identified nationally in this area, the purpose of this paper is to investigate the reasons why this is not being translated into action and to seek counsel from industry professionals as to how they believe change can be achieved with a particular focus on how they believe higher education institutions (HEIs) can contribute. Design/methodology/approach – An explorative, qualitative study using three focus groups was of construction professionals. Findings – Despite a lack of action, many in industry support sustainability and actively attempt to engage in sustainable practices but a number of barriers preclude successful implementation. Government initiatives are having a positive impact, with participants believing that both Government and HEIs are imperative in driving the sustainability agenda forward. Research limitations/implications – Whilst limited in scale, this paper highlights the current state of the CI in relation to SD and evidences that progress is being made albeit slowly. The findings may help both Government and HEIs alongside industry in achieving how this can be overcome. Originality/value – Previous research in this area has generally adopted a quantitative approach. Adopting a qualitative approach provides a more in depth view as to why the status quo remains with regards to SD in the CI.


2019 ◽  
Vol 26 (6) ◽  
pp. 1047-1062
Author(s):  
Leena Aalto ◽  
Pia Sirola ◽  
Tiina Kalliomäki-Levanto ◽  
Marjaana Lahtinen ◽  
Virpi Ruohomäki ◽  
...  

Purpose The challenges arising from the reform of the social and healthcare sector call for efficient, effective and novel processes in both public and private health and medical care. Facilities need to be designed to suit the new processes and to offer usable workspaces at different levels of healthcare services. Along with traditional construction, modular facility innovations could be one solution to these pressures. The paper aims to discuss these issues. Design/methodology/approach This case study analyzed the different usability characteristics of the work environment in modular and non-modular healthcare facilities (HCFs). The qualitative research method was based on semi-structured interviews of employees and observations of the case buildings. Findings According to the results, the usability characteristics were divided into four main categories: functionality, healthiness, safety/security and comfort. The main differences between the modular and non-modular facilities appeared to be room size, soundproofing, safety issues and the utilization of colors and artwork, which were all perceived as better realized in the non-modular facilities. The staff highlighted functionality as the most important characteristic in their work environment. They even considered functionality as a feature of a comfortable work environment. Originality/value This paper presents new knowledge and a detailed description of the opinions and experiences of healthcare professionals concerning a user-centric, usable environment in the context of modular and non-modular HCFs.


2019 ◽  
Vol 32 (4) ◽  
pp. 1065-1084 ◽  
Author(s):  
Jia Li ◽  
Jie Tang ◽  
David C. Yen ◽  
Xuan Liu

PurposeThe purpose of this paper is to investigate the moderating effect of disease risk in terms of the major signals (i.e. status, reputation and self-representation) on the e-consultation platforms.Design/methodology/approachIn this study, the proposed research hypotheses are tested using the transaction data collected from xywy.com (in Need of Therapy). In fact, xywy.com is one the leading e-consultation service websites in China that provides a platform for the interactions between the physicians and patients (Yu et al., 2016; Peng et al., 2015). Generally speaking, it has all the needed design elements and in other words, a standard e-consultation website should have such items/components as physician homepage, physician review, free consultation, paid consultation and recommendation systems.FindingsThe obtained results reveal that all attributes including status, reputation and self-representation have a positive impact on physician’s online order volume. Moreover, there is a positive moderating effect of disease risk onto the online reputation, indicating a higher effect exists for the diseases with high risk. However, the effect of offline status and online self-representation is not moderated by the disease risk, indicating market signals (online reputation) may have a stronger predictive power than seller signals (offline status and online self- representation), and therefore market signals are more effective when/if the disease risk is high.Originality/valueE-consultation has gradually become a significant trend to provide the healthcare services, in the emerging economy such as China because of shortage of medical resources but having an adequate access in internet usage. The impacts of signals on the health care market have been validated by previous studies. However, the research focusing on the moderating effect of signaling environment in the health care industry is still lacking. As a result, the value of this research helps to bridge the aforementioned research gap.


2019 ◽  
Vol 34 (3) ◽  
pp. 255-272 ◽  
Author(s):  
Martha L.P. MacLeod ◽  
Neil Hanlon ◽  
Trish Reay ◽  
David Snadden ◽  
Cathy Ulrich

Purpose Despite many calls to strengthen connections between health systems and communities as a way to improve primary healthcare, little is known about how new collaborations can effectively alter service provision. The purpose of this paper is to explore how a health authority, municipal leaders and physicians worked together in the process of transforming primary healthcare. Design/methodology/approach A longitudinal qualitative case study was conducted to explore the processes of change at the regional level and within seven communities across Northern British Columbia (BC), Canada. Over three years, 239 interviews were conducted with physicians, municipal leaders, health authority clinicians and leaders and other health and social service providers. Interviews and contextual documents were analyzed and interpreted to articulate how ongoing transformation has occurred. Findings Four overall strategies with nine approaches were apparent. The strategies were partnering for innovation, keeping the focus on people in communities, taking advantage of opportunities for change and encouraging experimentation while managing risk. The strategies have bumped the existing system out of the status quo and are achieving transformation. Key components have been a commitment to a clear end-in-view, a focus on patients, families, and communities, and acting together over time. Originality/value This study illuminates how partnering for primary healthcare transformation is messy and complicated but can create a foundation for whole system change.


2016 ◽  
Vol 29 (6) ◽  
pp. 600-613 ◽  
Author(s):  
Debajani Sahoo ◽  
Tathagata Ghosh

Purpose – The purpose of this paper is to identify the motives that enforce consumers to find out the major determinants that frame healthscape in private healthcare service that leads to their satisfaction in a developing country like India. Design/methodology/approach – The generic motive dimensions are identified using an exploratory factor analysis. Next the reliability and validity of the factors are established followed by regression analysis using SPSS 20.0 s/w. Findings – This paper identifies six healthscape motives in the private healthcare sector named as service personnel conduct and cleanliness, service delivery and facilities, ambience, location and look, appealing decoration, and upgraded safety service, out of which only service delivery, ambience, location, and decorations contribute the most to build customer satisfaction as per their significance value. Research limitations/implications – The various dimensions of healthcare motives should be viewed as the levers of improving hospitals’ service quality in the minds of its present and future customers. This finding can offer valuable insight to the forthcoming as well as existing developer who are planning to have their healthcare service presence in India. Practical implications – This study suggests some important strategic guidelines for service positioning and market segmentation of healthcare services as per customer requirements. In the recent past, availing services from hospitals were purely utilitarian in nature. Customers were more inclined to get proper and timely services and cared more about the service quality of the healthcare service provider. Originality/value – This paper is among the few works done on understanding private healthcare service delivery process in India and customer satisfaction level from those Hospitals. This study addresses the gap by identifying a set of dimensions that are relevant to customers for a unique healthcare experience.


2019 ◽  
Author(s):  
Crystal Jongen ◽  
Janya McCalman ◽  
Sandy Campbell ◽  
Ruth Fagan

Abstract Background: The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce. Methods: Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce. Results: Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together. A range of enabling factors at the macro, community, organisational and individual levels were also identified. Conclusion: Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts.


2019 ◽  
Vol 16 (1) ◽  
pp. 34-50
Author(s):  
Matthew J. Mazzei ◽  
John A. Galdo

Theoretical basis This case builds on elements of project management (PM) – specifically project initiation – including the development of a project charter and stakeholder analysis. Research methodology The case was developed from secondary sources as well as first-hand knowledge of the project by one of the authors. This author was on faculty at a private university in the southeastern USA, teaching numerous courses in the pharmacy curriculum while also serving as the Community Practice Residency Director for community pharmacies around the state. While connecting with these organizations, additional revenue requirements and complementary services were frequent topics of attention, leading to a grant to assist pharmacies in building out such services. Through this grant, the author engaged in consultations with community pharmacies around the state, including the pharmacy highlighted via this case. Pseudonyms have been used for the business, and all individuals associated with it, to maintain anonymity. Secondary sources used for additional research include industry reports and related websites. Case overview/synopsis Richard has owned and operated a community pharmacy, Our Family Farmacy (OFF), for years. A changing industry climate has forced Richard to diversify the products and services he provides. In addition to the distribution of medicine and front-end sales of consumer goods, Richard is seeking to expand into a larger spectrum of healthcare services. After researching several different types of services, and after dealing with related personal family circumstances, Richard decided that OFF should begin their expansion by offering depression screening services. He turned initiation of the project over to his pharmacy intern, Caitlin. Complexity academic level This compact case is geared toward undergraduate- and graduate-level students taking courses in general management and, more specifically, PM. This case might also be used by students with a career focus in the healthcare sector, and could of particular interest for students in a pharmacy program. Classroom application should encompass discussions on the project initiation process group, particularly with the processes regarding the project charter deliverable and the identification and assessment of project stakeholders.


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