Five focus strategies to organize health care delivery

2016 ◽  
Vol 29 (2) ◽  
pp. 177-191 ◽  
Author(s):  
Antti Peltokorpi ◽  
Miika Linna ◽  
Tomi Malmström ◽  
Paulus Torkki ◽  
Paul Martin Lillrank
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Management Practices ◽  
Care Delivery ◽  
System Level ◽  
Content Type ◽  
Requisite Variety ◽  
Care Outcomes ◽  
Definition Of ◽  
Focus Strategies

Purpose – The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. The purpose of this paper is to discuss strategic options to focus health care operations. Design/methodology/approach – First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies. Findings – The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: population; urgency and severity; illnesses and symptoms; care practices and processes; and care outcomes. Research limitations/implications – Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination. Practical implications – Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization’s strategy and key performance indicators. Originality/value – Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care.

scholarly journals Incorporating digital self-services into integrated mental health care: a physician’s perspective

2018 ◽  
Vol 52 (11) ◽  
pp. 2234-2250 ◽  
Author(s):  
Heini Sisko Maarit Taiminen ◽  
Saila Saraniemi ◽  
Joy Parkinson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Delivery ◽  
Value Creation ◽  
Care Delivery ◽  
Service Marketing ◽  
Content Type ◽  
Integrated Mental Health ◽  
Physician’S Perspective

Purpose This paper aims to enhance the current understanding of digital self-services (computerized cognitive behavioral therapy [cCBT]) and how they could be better incorporated into integrated mental health care from the physician’s perspective. Service marketing and information systems literature are combined in the context of mental health-care delivery. Design/methodology/approach An online survey of 412 Finnish physicians was undertaken to understand physicians’ acceptance of cCBT. The study applies thematic analysis and structural equation modeling to answer its research questions. Findings Adopting a service marketing perspective helps understand how digital self-services can be incorporated in health-care delivery. The findings suggest that value creation within this context should be seen as an intertwined process where value co-creation and self-creation should occur seamlessly at different stages. Furthermore, the usefulness of having a value self-creation supervisor was identified. These value creation logic changes should be understood and enabled to incorporate digital self-services into integrated mental health-care delivery. Research limitations/implications Because health-care systems vary across countries, strengthening understanding through exploring different contexts is crucial. Practical implications Assistance should be provided to physicians to enable better understanding of the application and suitability of digital self-service as a treatment option (such as cCBT) within their profession. Additionally, supportive facilitating conditions should be created to incorporate them as part of integrated care chain. Social implications Digital self-services have the potential to serve goals beyond routine activities in a health-care setting. Originality/value This study demonstrates the relevance of service theories within the health-care context and improves understanding of value creation in digital self-services. It also offers a profound depiction of the barriers to acceptance.

Managed care Medicaid

2017 ◽  
Vol 11 (2) ◽  
pp. 198-210 ◽  
Author(s):  
William Trombetta
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Care Quality ◽  
Market Segment ◽  
Economic Aspects ◽  
Content Type ◽  
The Poor

Purpose Providing health care to the poor is evolving in the new US marketplace. The Affordable Care Act has set goals enhancing access to health care, lowering costs and improving patient outcomes. A key segment in this evolution is the most vulnerable health-care population of all: Medicaid. This paper aims to provide a general review of how providing health care to Medicaid patients is changing including how socio-economic aspects of this vulnerable population affects the quality of the health care provided. Design/methodology/approach The paper is entirely secondary research; no primary research has been conducted. Findings Managed care Medicaid provides a risk-based model to treating a vulnerable health-care market segment. The jury is still out on whether managed care Medicaid (MCM) is improving health-care quality and saving cost, but the provision of health care to the Medicaid segment is definitely shifting from a fee-for-service model to value based payment. Very recent developments of new health-care delivery approaches present a positive outlook for improving quality and containing costs going forward. Research limitations/implications At this stage, whether or not MCM saves money or provides better health-care quality to this vulnerable population is a work in progress. Health-care marketing can impact socio-economic aspects of health care for the poor. There is a need to follow up on the positive results being documented in demonstration health-care delivery models. Practical implications At this point, there has been no long-term study of whether managed care Medicaid offers better quality of health care and cost savings. The research to date suggest that the quality of health-care delivery to the poor is improving at a lower cost to payers. Social implications Medicaid patients are an underserved market segment. Managed care Medicaid offers a new model that has the potential to provide quality care at acceptable cost. Critical to this vulnerable market segment is the need to integrate socio-economic aspects of the population with the delivery of health care. Originality/value There has been very little discussion of Medicaid overall in the marketing literature, much less any discussion of managed care Medicaid.

Empirical exploration of brilliance in health care: perceptions of health professionals

2017 ◽  
Vol 41 (3) ◽  
pp. 336 ◽  
Author(s):  
Leila Karimi ◽  
Ann Dadich ◽  
Liz Fulop ◽  
Sandra G. Leggat ◽  
Jiri Rada ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Management Practices ◽  
Health Management ◽  
Care Delivery ◽  
Lessons Learned ◽  
Lexical Analysis ◽  
Professional Perspective

Objective The aim of the present study was to develop a positive organisational scholarship in health care approach to health management, informed by health managers and health professionals’ experiences of brilliance in health care delivery. Methods A sample of postgraduate students with professional and/or management experience within a health service was invited to share their experiences of brilliant health services via online discussions and a survey running on the SurveyMonkey platform. A lexical analysis of student contributions was conducted using the individual as the unit of analysis. Results Using lexical analysis, the examination of themes in the concept map, the relationships between themes and the relationships between concepts identified ‘care’ as the most important concept in recognising brilliance in health care, followed by the concepts of ‘staff’ and ‘patient’. Conclusions The research presents empirical material to support the emergence of an evidence-based health professional perspective of brilliance in health management. The findings support other studies that have drawn on both quantitative and qualitative materials to explore brilliance in health care. Pockets of brilliance have been previously identified as catalysts for changing health care systems. Both quality, seen as driven from the outside, and excellence, driven from within individuals, are necessary to produce brilliance. What is known about the topic? The quest for brilliance in health care is not easy but essential to reinvigorating and energising health professionals to pursue the highest possible standards of health care delivery. What does this paper add? Using an innovative methodology, the present study identified the key drivers that health care professionals believe are vital to moving in the direction of identifying brilliant performance. What are the implications for practitioners? This work presents evidence on the perceptions of leadership and management practices associated with brilliant health management. Lessons learned from exceptionally well-delivered services contain different templates for change than those dealing with failures, errors, misconduct and the resulting negativity.

Social enterprises, health-care provision and ethical capital

2014 ◽  
Vol 10 (2) ◽  
pp. 105-120 ◽  
Author(s):  
Lucy Frith
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Services ◽  
Care Delivery ◽  
Social Enterprises ◽  
Ethical Perspective ◽  
Content Type ◽  
Care Services ◽  
The Relationship

Purpose – The aim of this paper is to advance a conceptual understanding of the role of social enterprises in health care by developing the concept of ethical capital. Social enterprises have been an important part of both the coalition and the previous government’s vision for improving health-care delivery. One of the central arguments for increasing the role of social enterprises in health care is they can provide the benefits of a public service ethos with the efficiencies and innovatory strategies of a business. Social enterprises are well placed to promote the type of values that should underpin health care delivery. Design/methodology/approach – This paper explores the conceptual issues raised by using social enterprises to provide health-care services that were previously provided by the National Health Service (NHS) from an ethical perspective. Findings – It will be argued that conceptualising social enterprises as organisations that can and should produce ethical capital could be a useful way of developing the debate over social enterprises in health care. Practical implications – The paper provides suggestions on how ethical capital might be produced and monitored in social enterprises. Originality/value – This paper advances the debate over the use of the concept of ethical capital in social enterprises and explores the relationship between ethical and social capital – both under researched areas. It also contributes to the emerging discussions of social enterprises in current health policy and their role in the radically reformed English NHS.

scholarly journals Telemedicine During the COVID-19 Pandemic: Experiences From Western China (Preprint)

2020 ◽  
Author(s):  
Zhen Hong ◽  
Nian Li ◽  
Dajiang Li ◽  
Junhua Li ◽  
Bing Li ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Western China ◽  
Smartphone App ◽  
Telemedicine System ◽  
Health Care Resources ◽  
Health Care Outcomes ◽  
The World ◽  
Care Outcomes

UNSTRUCTURED Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.

Barriers to healthcare delivery in Iranian prisons: a qualitative study

2020 ◽  
Vol 16 (4) ◽  
pp. 373-388
Author(s):  
Ahmad Hajebrahimi ◽  
Khalil Alimohammadzadeh ◽  
Seyed Mojtaba Hosseini ◽  
Ali Maher ◽  
Mohammadkarim Bahadori
Keyword(s):  
Health Care ◽  
Human Resources ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Process Data ◽  
Health Care Managers ◽  
Barriers To Health Care ◽  
Content Type ◽  
Care Managers ◽  
Barriers To Health

Purpose High quality health-care delivery is not only the governments’ responsibility but also every prisoner’s right. Health care in prison and, particularly, of Iranian prisoners is increasingly important topic because of the rising number of the prison population. This paper aims to explore health-care managers’ perspectives and experiences of prisons and the barriers to health-care delivery in Iranian prisons. Design/methodology/approach A qualitative research design was conducted in Iran from October 2018 to August 2019. The participants consisted of 51 health-care managers (50 men and one woman) from Iranian prisons. A combination of face-to-face (N = 42) and telephonic (N = 9) semi-structured interviews were used because of the geographical distribution of the respondents. The first part of the interview guide consisted of demographic characteristics, and the second part consisted of three main open ended-questions. Interviews were recorded and transcribed, and thematic descriptive analysis was used to interpret the data. Findings The barriers to health-care delivery in Iranian prisons were categorized into four main topics: human resources, financing, facilities and barriers related to the health-care delivery process. Data synthesis identified the following themes for barriers to human resources: barriers to human resources planning (with eight sub-themes); barriers to education (with three sub-themes); and motivational barriers (with seven sub-themes). Moreover, barriers to financing consisted of five sub-themes. The barriers to facilities consisted of barriers related to physical infrastructures (with two sub-themes) and barriers related to equipment (with six sub-themes). Finally, barriers to the health-care delivery process included the following themes: communication barriers (with six sub-themes); legal barriers (with five sub-themes); and environmental-demographic factors (with seven sub-themes). Originality/value Identifying the barriers to health-care delivery in Iranian prisons plays a critical role in the improvement of planning, decision-making and the health-care delivery process.

scholarly journals Telemedicine During the COVID-19 Pandemic: Experiences From Western China

10.2196/19577 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e19577 ◽  
Author(s):  
Zhen Hong ◽  
Nian Li ◽  
Dajiang Li ◽  
Junhua Li ◽  
Bing Li ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Western China ◽  
Smartphone App ◽  
Telemedicine System ◽  
Health Care Resources ◽  
Health Care Outcomes ◽  
The World ◽  
Care Outcomes

Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.

Patient organizations supporting health care and co-creating value: insights from a simulation model

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Francesca Costanza
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Resource Planning ◽  
Positive Contribution ◽  
Care Providers ◽  
Holistic View ◽  
Content Type ◽  
Patient Organizations

Purpose Patient organizations (POs) belong to the non-profit world and carry on several activities alongside health care. However, literature devotes scarce attention to POs’ management specificities in the interaction with health-care delivery. This paper aims to describe the contribution of POs to health care from an operational point of view; investigate the effect of POs’ managerial choices on health-care performance; and provide useful insights for patient organizations and health-care management. Design/methodology/approach The paper combines qualitative case study research and system dynamics (SD). After a literature review about patient organizations’ role, modeling steps are described. In first place, the analyses of institutional documents, interviews and observations are condensed in a stock-and-flow diagram. The latter is translated into a set of differential equations to simulate the effect of alternative resource allocations. Findings The case study emphasizes PO’s educational and administrative role in supporting health-care delivery. Simulated policy scenarios, while confirming the positive contribution of patient co-created health, disclose potential divergencies in public and private/third sector decision-making, to be read considering key feedback mechanisms within the system. Originality/value This study proposes a holistic view of patient organizations’ engagement in health care. The findings highlight synergies and trade-offs of alternative managerial decisions involving POs and health-care providers, disclosing the benefits of joint resource planning.

Distinguishing competencies of effective physician leaders

2015 ◽  
Vol 34 (5) ◽  
pp. 566-584 ◽  
Author(s):  
Margaret M. Hopkins ◽  
Deborah A. O'Neil ◽  
James K Stoller
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Thematic Analysis ◽  
Critical Incident ◽  
Care Delivery ◽  
Cleveland Clinic ◽  
Self Awareness ◽  
Emerging Leaders ◽  
Content Type ◽  
Physician Leaders

Purpose – The purpose of this paper is to determine the particular competencies demonstrated by effective physician leaders. Changing organizational and environmental dynamics present unique challenges to leaders in the field of healthcare. An accelerated emphasis on increasing the quality of health care delivery, containing costs, and restructuring the delivery of health care itself are redefining the very nature of healthcare and the roles of physicians as leaders. Given this context, the authors propose to identify the essential competencies for twenty-first century physician leadership. Design/methodology/approach – In all, 53 critical incident interviews from 28 physicians identified as emerging leaders at the Cleveland Clinic, a top-rated US academic healthcare institution, were examined in two ways: an existing leadership competency model was applied to each critical incident and inductively derived themes were identified through thematic analysis of the incidents. Findings – The predominant distinguishing leadership competencies demonstrated by the physician leaders included: Empathy, Initiative, Emotional Self-Awareness and Organizational Awareness. Communicating deliberately, getting buy-in from colleagues, focussing on the mission of the organization and showing respect for others were also discovered through thematic analysis to be essential practices of these effective physician leaders. Over 90 percent of the critical incident stories dealt with colleague-to-colleague interactions. Research limitations/implications – The research was conducted in one academic healthcare organization, thus limiting the generalizability of the results. Additional research testing these results in a variety of healthcare institutions is warranted. Originality/value – This study identified specific competencies that distinguish effective physician leaders. These leaders actively sought to work with colleagues to obtain their input and consensus in order to enact organizational change and improve health care delivery in their institution. Importantly, their intentions were neither self-focussed nor self-promoting but strongly mission driven. The identification of physician leader competencies will assist incumbent and emerging physician leaders in their ability to be effective leaders, as well as inform the design of training and development programs for physicians.

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