scholarly journals Blame game or dialogue? Financial, professional and democratic accountabilities in a complex health care setting

2018 ◽  
Vol 31 (2) ◽  
pp. 626-650 ◽  
Author(s):  
Jukka Pellinen ◽  
Toni Mättö ◽  
Kari Sippola ◽  
Antti Rautiainen
Keyword(s):  
Health Care ◽  
Empirical Studies ◽  
Network Governance ◽  
Organizational Characteristics ◽  
Public Health Care ◽  
Care Organization ◽  
Democratic Accountability ◽  
Structured Interviews ◽  
Content Type ◽  
Stakeholder Groups

Purpose The purpose of this paper is to investigate how the complexity of the network governance setting affects accountability practices. The authors pay particular attention to the organizational characteristics that may enable a common understanding of multiple accountability relationships, or lead to problems in reconciling competing forms of accountability, thereby appearing as blame game-type behavior. Design/methodology/approach The authors conducted a case study with 31 semi-structured interviews in a Finnish health care organization (FHC) that offers basic public health care services. The organization represents a co-operative arrangement with the main city and three smaller municipalities. The FHC has faced difficulties in balancing budget constraints with the provision of statutory care to citizens. This case is analyzed with the help of theories relating to accountability, the blame game, and dialogue. Findings The authors found that in the FHC operating under austerity constraints, attempts to reconcile financial, professional, and democratic accountability were made but, instead of dialogue and consensus, the different stakeholder groups resorted to defensive tactics in order to protect their resources, position, or sense of professional obligation. The authors suggest that in a context of network governance, accompanied by an increasing emphasis on financial accountability, organizational practices are susceptible to conflicting accountabilities and behavior characterized in this paper as a blame game. Originality/value The study contributes to the empirical studies on accountability in the new public governance context by analyzing the complex accountability relations between stakeholder groups with different agendas. The authors suggest organizational characteristics that may exacerbate conflicts between different stakeholder groups and prevent constructive dialogue. Furthermore, the study analyzes the composition of democratic accountability within the studied organization.

Maslow’s theory for preventive healthcare in India – a content analysis approach

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Komal Chopra
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Role Model ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Public Health Care ◽  
Analysis Approach ◽  
Structured Interviews ◽  
Content Type ◽  
Peace Of Mind

Purpose The purpose of the study was to apply Maslow’s hierarchy of needs to understand consumer motivation for preventive health care in India using content analysis. Design/methodology/approach Content analysis approach which is a qualitative-based approach was adopted. The responses were collected through semi-structured interviews using purposeful sampling method, and the responses were analyzed using content analysis approach. Sub themes and main themes were derived from the data which related to concepts in Maslow’s theory. Findings The results indicate the following: healthy food, healthy diet and health supplements are the basic need; sustainability of health and fitness and health security relate to safety and security need; feeling of pride in being fit, being a role model of fitness for others and influence of electronic media relate to social and self-esteem need; freedom from disease and peace of mind fulfill the need for self-actualization. Research limitations/implications To strengthen the external validity, a mix of alternate research methodologies adopting qualitative and quantitative approach need to be adopted. Practical implications This study will help to better understand motivation for preventive health care. It will enable health-care companies to design health-care marketing programs based on Maslow’s theory to motivate individuals to purchase health products. The public health-care departments can issue guidelines based on Maslow’s theory to motivate citizens toward preventive health care. Originality/value Maslow’s theory was applied in the context of preventive health care.

Reconciling value-based objectives for security and identity management

2018 ◽  
Vol 26 (2) ◽  
pp. 194-212 ◽  
Author(s):  
Kane J. Smith ◽  
Gurpreet Dhillon ◽  
Karin Hedström
Keyword(s):  
Health Care ◽  
Identity Management ◽  
Health Care Organization ◽  
Strategic Decision ◽  
Management Approach ◽  
Care Organization ◽  
Content Type ◽  
Stakeholder Groups ◽  
Value Focused Thinking ◽  
Health Organization

Purpose In this paper, using values of individuals in a Swedish health-care organization, electronic identity management objectives related to security are defined. Design/methodology/approach By using value-focused thinking, eliciting values from interviews of three groups of health-care staff’s objective hierarchies for three stakeholder groups are identified and defined. Objective hierarchies allow comparison across multiple stakeholder groups such that strategic objectives for identity management can be compared and contrasted. Findings This qualitative investigation, which used value-focused thinking, revealed 94 subobjectives, grouped into 12 fundamental and 14 means objectives, which are essential for developing measures that address potential value conflicts in a health-care organization around electronic identity management. The objectives developed in this study are grounded socioorganizationally and provide a way forward in developing measures aimed to reducing potential conflicts at a policy level. Originality/value In a final synthesis, congruence (or lack thereof) in the electronic identity management approach for a Swedish health organization is suggested. This also creates a foundation to evaluate and weight different objectives for strategic decision management.

Dual leadership in a hospital practice

2017 ◽  
Vol 30 (1) ◽  
pp. 101-112 ◽  
Author(s):  
Bettina Ravnborg Thude ◽  
Svend Erik Thomsen ◽  
Egon Stenager ◽  
Erik Hollnagel
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Design Methodology ◽  
Leadership Teams ◽  
Decision Processes ◽  
Power Balance ◽  
Structured Interviews ◽  
Hospital Practice ◽  
Content Type ◽  
Danish Hospital

Purpose Despite the practice of dual leadership in many organizations, there is relatively little research on the topic. Dual leadership means two leaders share the leadership task and are held jointly accountable for the results of the unit. To better understand how dual leadership works, this study aims to analyse three different dual leadership pairs at a Danish hospital. Furthermore, this study develops a tool to characterize dual leadership teams from each other. Design/methodology/approach This is a qualitative study using semi-structured interviews. Six leaders were interviewed to clarify how dual leadership works in a hospital context. All interviews were transcribed and coded. During coding, focus was on the nine principles found in the literature and another principle was found by looking at the themes that were generic for all six interviews. Findings Results indicate that power balance, personal relations and decision processes are important factors for creating efficient dual leaderships. The study develops a categorizing tool to use for further research or for organizations, to describe and analyse dual leaderships. Originality/value The study describes dual leadership in the hospital context and develops a categorizing tool for being able to distinguish dual leadership teams from each other. It is important to reveal if there are any indicators that can be used for optimising dual leadership teams in the health-care sector and in other organisations.

First and foremost, physicians: the clinical versus leadership identities of physician leaders

2016 ◽  
Vol 30 (4) ◽  
pp. 711-728 ◽  
Author(s):  
Joann Farrell Quinn ◽  
Sheri Perelli
Keyword(s):  
Health Care ◽  
Skills Training ◽  
Leadership Role ◽  
Organizational Level ◽  
Care Organization ◽  
Full Time ◽  
Clinical Expertise ◽  
Physician Leadership ◽  
Content Type ◽  
Physician Leaders

Purpose – Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach – Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings – These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications – Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications – These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications – This work points to a broader and more fundamental need – a modified mindset about the nature and value of physician leadership. Originality/value – This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer and organizational level in the creation of their own leadership identity.

Value co-creation in the B2B context: a diagnosis of knowledge management based on multiple case studies

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrei Bonamigo ◽  
Camila Guimarães Frech ◽  
Ana Carolina Custódio Lopes
Keyword(s):  
Empirical Studies ◽  
Structured Interviews ◽  
Content Type ◽  
Knowledge Based ◽  
Multiple Case ◽  
Multiple Case Studies ◽  
Knowledge Asymmetry ◽  
Business To Business ◽  
Practical Implications

Purpose This study aims to empirically investigate how organizations delivering services in business-to-business relations deal with the boundary paradox and knowledge asymmetry in value co-creation. Design/methodology/approach This study adopted a qualitative multiple case study strategy. Datas were gathered through 13 semi-structured interviews that were then analyzed through the content analysis. Findings The authors identified three mechanisms that organizations use to deal with the boundary paradox and two strategies to handle the knowledge asymmetry. Research limitations/implications First, no opportunities were afforded to involve more participants. Second, owning to confidentiality reasons, not all organizations provided us documents to be analyzed. Practical implications The findings guide managers in balancing the use of contracts and trust in inter-firm collaborations and fostering the learning of customers. Also, insights to protect knowledge based on the paradox of openness in value co-creation. Originality/value This study’s findings address the gap in value co-creation literature concerning the lack of empirical studies.

Transforming the scope of the bank through fintechs: toward a modularized network governance

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Piotr Łasak ◽  
Marta Gancarczyk
Keyword(s):  
Organizational Design ◽  
Banking Sector ◽  
Transaction Cost Economics ◽  
Empirical Studies ◽  
Theoretical Framework ◽  
Network Governance ◽  
Content Type ◽  
Ict Adoption ◽  
Conceptual Foundations ◽  
Practical Implications

PurposeThe aim of this paper is to develop a theoretical framework of the transformation of the bank's scope driven by fintechs.Design/methodology/approachThe conceptual foundations for a comprehensive transformation of the bank governance through financial technologies (fintechs) are underexplored. In order to develop such foundations, the authors adopt transaction cost economics (TCE), the concepts of external enablers and a modular organizational design, as well as a systematic literature review.FindingsThe results point to three scenarios of the banks' scope, depending on the adopted technological mechanisms and related effects that change the characteristics of organizational activities, justifying new bank boundaries. The most advanced application of fintechs results in a modularized network scenario leading to the emergence of financial ecosystems.Research limitations/implicationsThe proposed micro-perspective of decisional rules in an individual organization is unique in the current literature that predominantly focuses on the banking sector at large. The identified scenarios are valuable for solid theoretical and empirical grounding and can be further exploited in decision simulations and empirical studies.Practical implicationsThe proposed theoretical framework points to the rationales and consequences of adopted technologies for the boundaries of a bank organization.Originality/valueThis paper provides three contributions to the literature on technology-driven transformations of organizations with a focus on banks. First, the authors elaborate a theoretical framework for establishing the bank's boundaries in response to the expansion of financial technologies. Second, the authors add to the knowledge accumulation in the area of organizational transformations based on the ICT adoption, in particular, to the literature on the modular organizational design. Third, the authors contribute to the decision-maker practice by proposing the alternative options of banks' scope transformed through fintechs.

A strategic and good governance perspective on handling patient complaints

2018 ◽  
Vol 31 (8) ◽  
pp. 923-934
Author(s):  
Sanna Pauliina Ryynänen ◽  
Risto Harisalo
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Good Governance ◽  
Care Organization ◽  
Content Type ◽  
Patient Complaints ◽  
Care Processes ◽  
Patient’S Rights ◽  
Strategic Goals

Purpose The patient complaint is one of the main procedures of exercising patient’s rights in the Finnish health care system. Such complaints typically concern the quality of care and/or patient safety. The purpose of this paper is to examine the types of patient complaints received by a specialized medical care organization and the kinds of responses given by the organization’s personnel. The organization’s strategy and good governance principles provide the framework for understanding the organization’s action. Design/methodology/approach This study’s data comprise patient complaints and the responses from personnel of a specialized medical care organization from the start of 2012 to the end of January 2014. The data were analyzed through qualitative data analysis. Findings The results show many unwanted grievances, but also reveal the procedures employed to improve health care processes. The results are related to patients’ care experiences, provision of information, personnel’s professional skills and the approach to patient complaints handling. The integrative result of the analysis was to find consensus between the patients’ expectations and personnel’s evaluation of patients’ needs. Originality/value Few prior studies have examined patient complaints related to both strategy and good governance. Patient complaints were found to have several confluences with an organization’s strategic goals, objectives and good governance principles. The study recommends further research on personnel procedures for patient complaints handling, with a view to influencing strategic planning and implementation of strategies of organizations.

The relationships between obesity-increasing risk factors for public health, environmental impacts, and health expenditures worldwide

2018 ◽  
Vol 29 (1) ◽  
pp. 131-147 ◽  
Author(s):  
Eduardo Botti Abbade
Keyword(s):  
Public Health ◽  
Health Care ◽  
Environmental Impact ◽  
Environmental Impacts ◽  
Health Care Cost ◽  
Health Care Systems ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Public Health Care ◽  
Content Type

Purpose The purpose of this paper is to investigate the associations between obesogenic severity, the public health situation, environmental impacts, and health care expenditures in populations worldwide. Design/methodology/approach This ecological study is based on official data available for approximately 140 countries worldwide. This study defines four main variables: obesogenic severity, environmental impact, public health implications (PHI), and health expenditures, all measured through specific indicators. Data were obtained mainly from the WHO, World Bank, and IDF. The indicators were reduced to the main variables through factorial reduction and multiple regression analyses were used to test the main hypotheses. Findings Obesogenic severity strongly and positively affects environmental impacts (β=0.6578; p<0.001), PHI-1 (cardiovascular risk factor) (β=0.3137; p<0.001) and PHI-2 (blood glucose and diabetes diagnoses) (β=0.3170; p<0.001). Additionally, environmental impacts strongly and positively affect PHI-1 (β=0.4978; p<0.001) but not PHI-2. Thus, results suggest that environmental impact, PHI-1, and PHI-2 strongly affect health expenditures (β=0.3154; p<0.001, β=0.5745; p<0.001, and β=−0.4843; p<0.001, respectively), with PHI-2 negatively affecting the health expenditures. Practical implications This study presents evidence that can aid in decision making regarding public and private efforts to better align budgets and resources as well as predict the needs and expenditures of public health care systems. Originality/value This investigation finds that the main variables addressed are strongly associated at the worldwide level. Thus, these analytical procedures can be used to predict public health and health care cost scenarios at the global level.

Big data and data analytics in auditing: in search of legitimacy

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Federica De Santis ◽  
Giuseppe D’Onza
Keyword(s):  
Big Data ◽  
Data Analytics ◽  
Audit Quality ◽  
Empirical Studies ◽  
Innovation Process ◽  
Structured Interviews ◽  
Senior Managers ◽  
Content Type ◽  
Audit Strategy ◽  
Audit Standards

Purpose This study aims to analyze the utilization of big data and data analytics (BDA) in financial auditing, focusing on the process of producing legitimacy around these techniques, the factors fostering or hindering such process and the action auditors take to legitimate BDA inside and outside the audit community. Design/methodology/approach The analysis bases on semi-structured interviews with partners and senior managers of Italian audit companies. Findings The BDA’s legitimation process is more advanced in the audit professional environment than outside the audit community. The Big Four lead the BDA-driven audit innovation process and BDA is used to complement traditional audit procedures. Outside the audit community, the digital maturity of audit clients, the lack of audit standards and the audit oversight authority’s negative view prevent the full legitimation of BDA. Practical implications This research highlights factors influencing the utilization of BDA to enhance audit quality. The results can, thus, be used to enhance the audit strategy and to innovate audit practices by using BDA as a source of adequate audit evidence. Audit regulators and standards setters can also use the results to revise the current auditing standards and guidance. Originality/value This study adds to the literature on digital transformation in auditing by analyzing the legitimation process of a new audit technique. The paper answers the call for more empirical studies on the utilization of BDA in financial auditing by analyzing the application of such techniques in an unexplored operational setting in which auditees are mainly medium-sized enterprises and family-run businesses.

Willingness to pay for traditional, complementary and alternative medicine (TCAM) among Malaysian adults

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
M.Z.Y. Koh ◽  
Yen-Nee Goh
Keyword(s):  
Health Care ◽  
Willingness To Pay ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Health Care Facilities ◽  
Partial Least Square ◽  
Least Square ◽  
Public Health Care ◽  
Content Type ◽  
Complementary And Alternative

Purpose Health plays a crucial role in the daily lives and supporting health is the important role of medicine. With the availability of traditional, complementary and alternative medicine (TCAM), the demands and willingness to pay among users are increasing. Hence, this study aims to determine the psychological factors influencing the willingness to pay for TCAM among Malaysian adults. Design/methodology/approach In total, 300 completed self-administered questionnaires were collected from Malaysian adults using a purposive sampling method through intercepts at public health-care facilities. A structural equation modelling approach using partial least square was used to test the hypotheses. Findings The findings show that attitude, subjective norms, perceived price and knowledge have a significant impact on willingness to pay for TCAM. Surprisingly, there was no relationship found between perceived behavioural control and health consciousness on willingness to pay for TCAM. Originality/value The findings of this study are expected to provide better insights into TCAM use among Malaysian adults. The results are also important to encourage health-care institutions and practitioners to educate the general public on the safety of TCAM to ensure more health benefits to the users.

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