Analysis of public hospital governance reforms: a case from a developing country

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrew Munthopa Lipunga ◽  
Betchani M.H. Tchereni ◽  
Rhoda Cythia Bakuwa
Keyword(s):  
Design Methodology ◽  
Public Hospital ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Content Type ◽  
Structural Characterisation ◽  
Hospital Governance ◽  
Conceptual Innovation ◽  
District Hospitals ◽  
Governance Reforms

PurposeThe purpose of this paper is to explore the nature of governance reforms also called conceptual innovation for public hospitals in Malawi.Design/methodology/approachIt focuses on the reforms for central and district hospitals. It uses semi-structured interviews to collect data and thematic approach to analyse it.FindingsThe results show that the reforms for central hospitals are structurally well characterised as aimed at corporatisation though they are termed as automatisation. The terminological seems not to pose any harm on the direction of the reforms due to the thorough structural characterisation. On the other hand, reforms for district hospitals are vague as such implementation is retrogressive, in that, instead of progressively moving the hospitals towards greater autonomy the opposite is happening.Originality/valueThe paper highlights the significance of characterisation of the intended outcome on the direction of the reforms and proposes a framework to guide conceptual innovation for public hospitals in a devolution-mediated environment.

Exploring organisational governance awareness among public hospitals' governance actors in Malawi: a qualitative study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrew Munthopa Lipunga ◽  
Betchani Henry M. Tchereni ◽  
Rhoda Cynthia Bakuwa
Keyword(s):  
Professional Identity ◽  
Design Methodology ◽  
Educational Background ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Broad Perspective ◽  
Content Type ◽  
Effective Governance ◽  
Hospital Board ◽  
Governance Reforms

PurposeSound organisational governance does not occur naturally; it is a product of effective awareness. This study aims to examine the level of governance awareness among public hospitals' governance actors in Malawi.Design/methodology/approachThe study uses semi-structured interviews to collect data that are analysed thematically.FindingsThe study found that governance awareness among the actors was low. Although the majority of the actors displayed a broad perspective, they, however, failed to clearly affirm the nexus of the governing organs – hospital board (or its equivalent) and hospital management. Furthermore, most were not aware of the existence of the country's self-regulatory framework for organisational governance. A possible compounding factor to the low level of awareness is their educational background that hardly recognises organisational governance as an essential component of their professional identity.Originality/valueThis is the first study to explore in-depth governance awareness in the context of public hospitals in developing countries. It highlights the need to develop strategies for creating effective governance awareness amongst the actors, which is often overlooked when carrying governance reforms.

Emerging structural models for governance of public hospitals

2019 ◽  
Vol 24 (2) ◽  
pp. 98-116 ◽  
Author(s):  
Andrew Munthopa Lipunga ◽  
Betchani M.H. Tchereni ◽  
Rhoda Cythia Bakuwa
Keyword(s):  
Health System ◽  
Public Hospital ◽  
Best Practice ◽  
Structural Models ◽  
Public Hospitals ◽  
Content Type ◽  
Policy Model ◽  
Hospital Governance ◽  
Critical Knowledge ◽  
Health System Governance

Purpose The purpose of this paper is to present the contemporary understanding and emerging structural models of organisational governance of public hospitals in order to provide evidence-based guidance to countries that are reforming their public hospital governance structures in line with best practice. Design/methodology/approach The paper uses the structural dimension of Cooper, Fusarelli and Randall’s policy model and institutional theory to review the legislative frameworks of four model countries supported by extant literature. Findings The paper conceptually distinguishes health system governance and organisational governance in the health system. It further visualises the emerging alternative legislative models of organisational governance and a hierarchy of governors applicable to public hospitals. Originality/value The paper provides critical knowledge for understanding organisational governance within health system governance framework and develops tools that can be used in reforming institutional mechanism of organisational governance of public hospitals.

scholarly journals Teaching innovations in Asian higher education: perspectives of educators

2018 ◽  
Vol 13 (2) ◽  
pp. 179-190 ◽  
Author(s):  
T.M. Wong
Keyword(s):  
Higher Education ◽  
Design Methodology ◽  
Higher Education Institutions ◽  
The Other ◽  
Asian Countries ◽  
Structured Interviews ◽  
Content Type ◽  
Advanced Technologies ◽  
The Many

Purpose The purpose of this paper is to identify the teaching innovations that have been implemented in higher education institutions in Asia and the perspectives of educators on them. Design/methodology/approach Semi-structured interviews were conducted with 28 educators who were affiliated with 23 higher education institutions in ten Asian countries/regions. The interviews covered information about the teaching innovations of the participants’ institutions, the characteristics of the innovative practices and the participants’ views on them. The relationships between the characteristics of institutions and their teaching innovations were also examined. Findings The results showed that the teaching innovations included two main categories, namely, those which involved the use of advanced technologies and those which did not. The innovations that involved the use of advanced technologies were mainly from larger institutions, while the other category was mainly from smaller ones and had been practised for less than 1.5 years. Differences were also identified between the two categories in terms of the aims and importance of innovations, innovative features, the evaluation of innovations and improvements needed for them. Originality/value The results highlighted that technology is only one of the many aspects of teaching innovations, which is different from the view prevailing in the literature. They also suggested that differences in the scale of institutions (in terms of number of students) possibly influences the kind of teaching innovations adopted.

scholarly journals Exploring producers' motivations and challenges within a farmers' market

2020 ◽  
Vol 122 (7) ◽  
pp. 2089-2103
Author(s):  
Rosario Michel-Villarreal ◽  
Eliseo Luis Vilalta-Perdomo ◽  
Martin Hingley
Keyword(s):  
Design Methodology ◽  
Farmers Markets ◽  
Full Time ◽  
Structured Interviews ◽  
Farmers Market ◽  
Content Type ◽  
Food Supply Chains ◽  
Part Time ◽  
Short Food Supply Chains

PurposeThe purpose of this study is to explore food producers' motivations and challenges whilst participating in short food supply chains (SFSCs). This paper compares findings with previous literature and investigates the topic in the context of producers' motivations.Design/methodology/approachThe paper includes a literature review concerning producers' motivations to engage in SFSCs. A case study was designed to investigate motivations underlying producers' engagement in SFSCs, as well as the challenges that they face. Semi-structured interviews were conducted in a farmers' market located in Mexico. Thematic analysis is used to identify the principal issues for producers'. Propositions based on findings are presented.FindingsFindings suggest that small, large, part-time and full-time producers are willing to engage with farmers' markets for diverse primary economic and non-economic motivations. Individual and collective challenges were also identified.Originality/valueThis research helps to explain producers' motivations and challenges within SFSCs in an under-researched context, namely a focus on producers' and in the Global South.

Has Lean improved organizational decision making?

2016 ◽  
Vol 29 (5) ◽  
pp. 536-549 ◽  
Author(s):  
Pascale Simons ◽  
Jos Benders ◽  
Jochen Bergs ◽  
Wim Marneffe ◽  
Dominique Vandijck
Keyword(s):  
Decision Making ◽  
Design Methodology ◽  
Lean Management ◽  
Structured Interviews ◽  
Organizational Decision Making ◽  
Content Type ◽  
Organizational Contexts ◽  
Sustainable Improvement ◽  
Care Processes ◽  
Practical Implications

Purpose – Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization’s decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization’s decision-making context, making it more amenable for QI initiatives. Design/methodology/approach – In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings – Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications – Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value – Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI’s sustainability.

Emotion display and suppression among Arab and Jewish assistant principals in Israel

2018 ◽  
Vol 3 (3) ◽  
pp. 173-191 ◽  
Author(s):  
Khalid Arar ◽  
Izhar Oplatka
Keyword(s):  
Emotion Regulation ◽  
Emotional Expression ◽  
Assistant Principals ◽  
Design Methodology ◽  
Practical Knowledge ◽  
Educational Leaders ◽  
Structured Interviews ◽  
Content Type ◽  
Personal Needs ◽  
Teachers And Parents

Purpose It is widely accepted that educational leaders and teachers need to manage and regulate their emotions continually, mainly because schooling and teaching processes expose many emotions. Thus, the purpose of this paper is to trace the ways Israeli assistant principals, both Arab and Jewish, manage their emotions at work. Design/methodology/approach Based on semi-structured interviews with 15 assistant principals, it was found that they are required to manage their emotions in accordance with entrenched emotion rules in the culture and society. Findings Most of the Jewish female APs tend to display warmth and empathy toward teachers in order to better understand their personal needs and professional performances. In contrast, Arab APs suppressed or fabricated emotional expression in their discourse with teachers and parents, in order to maintain a professional façade and retain the internal cohesion of the school. Both groups of APs believed their emotion regulation results in higher level of harmony in the school. Empirical and practical suggestions are put forward. Originality/value The paper is original and contributes to the theoretical and practical knowledge.

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.

scholarly journals Student engagement with sustainability: understanding the value–action gap

2014 ◽  
Vol 15 (4) ◽  
pp. 404-417 ◽  
Author(s):  
Gareth Chaplin ◽  
Paul Wyton
Keyword(s):  
Design Methodology ◽  
Strong Association ◽  
Structured Interviews ◽  
Online Questionnaire ◽  
Sustainable Living ◽  
Content Type ◽  
Lack Of Information ◽  
Significant Barrier ◽  
The Uk ◽  
Insight Into

Purpose – The purpose of this paper is to present the findings of research that aimed to determine what university students living in Unite accommodation in the UK understand about the concept of sustainable living. It considers what barriers they perceive to be standing in the way of following sustainable living practices. In particular, the research aimed to explore any value–action gap for the student population with a view to informing future actions to help close any gap. Design/methodology/approach – The study was completed through an online questionnaire survey of students living in halls of residence operated by provider The Unite Group Plc. The survey informed semi-structured interviews and focus groups that explored the issues raised in greater detail. Findings – It was found that students living in Unite properties believed sustainable living to be important, yet levels of understanding were very low and there appeared to be a wide value–action gap. Reasons for this are varied; however, an unexpected theme emerged around the association of effort and importance. There was a very strong association between sustainable living and recycling, which, therefore, saw the lack of adequate recycling facilities as a significant barrier to sustainable living. There were also issues around a lack of information, cost and respondents’ flatmates as further barriers. However, the most significant barrier was the displacement of responsibility for sustainable living to other people or organisations. Originality/value – Gaining an insight into the complexity of attitude and behaviour of students with the sustainability agenda will enable understanding that can be applied to activities that promote sustainability.

scholarly journals Adaptations in traditional courtyard houses in Baghdad, Iraq

2017 ◽  
Vol 35 (4) ◽  
pp. 348-363 ◽  
Author(s):  
Rand H.M. Agha ◽  
John M. Kamara
Keyword(s):  
Design Methodology ◽  
Full Range ◽  
Physical Structure ◽  
Structured Interviews ◽  
Content Type ◽  
Case Study Analysis ◽  
Physical Spaces ◽  
Adaptation Model

Purpose The purpose of this paper is to investigate the adaptations that have been made to traditional courtyard houses (TCHs) in Baghdad, Iraq. The aim is to develop an understanding of various factors in the adaptation of these buildings to suit contemporary lifestyles, which will contribute to the wider field of building adaptability. Design/methodology/approach Empirical evidence was collected through case studies of 12 TCHs in the Al-Kadhimiya area of Baghdad, which involved a physical survey of buildings and semi-structured interviews with 24 occupants. Findings Case study analysis show that building adaptability involves both a change to physical spaces and also to lifestyles; with the latter being more likely when there are limitations in how much change can be made to the physical structure. Research limitations/implications The focus of this research is mainly on users’ adaptation of spaces and therefore does not consider the full range of stakeholders involved in the adaptation process. The findings also only apply to the cases considered and may not be applicable to other house types or locations. Originality/value Studies on building adaptability mostly focus on the ease of change to the building fabric, although the role of users is acknowledged. This study provides insights into the complexity and variety of changes that users can make, which are influenced by lifestyles and driven by the need for comfort. These insights are represented in an adaptation model, which can serve as a basis for further research.

Re-conceptualising call-centres as sites of control: the insider perspective

2014 ◽  
Vol 48 (1/2) ◽  
pp. 25-46 ◽  
Author(s):  
Edward Kasabov ◽  
Anna C.C.C. da Cunha
Keyword(s):  
Design Methodology ◽  
Customer Orientation ◽  
Practical Importance ◽  
Call Centre ◽  
Structured Interviews ◽  
Content Type ◽  
Call Centres ◽  
Customer Dissatisfaction ◽  
Customer Centricity

Purpose – The role of call-centres during service recovery has attracted much attention in research. However, marketers know less about controlling customers during recovery interactions and consequences of such control. In order to address this gap and empirically ascertain whether service interactions are marked by customer centricity or by employees exerting control over customers, the aim of the authors was to organise an empirical research in two Brazilian call-centres. Design/methodology/approach – The research consisted of direct, open observation and 33 semi-structured interviews with insiders (call-centre managers, supervisors and operatives). Findings – Four key findings emerged during interviews with insiders. First, control over customers may be more widely practiced than assumed in certain sections of marketing academe. Second, such control is viewed positively by call-centre insiders and is sanctioned by management. Third, control does not disempower and demoralise call-centre staff but protects operatives. Finally, control does not seem to unavoidably generate lasting customer dissatisfaction. These findings are incorporated in a framework of call-centre management which incorporates control through scripting. Research limitations/implications – The discussion calls for the revisit of certain marketing concepts and philosophies, including customer orientation, by demonstrating that control over customers is practised and should not be viewed negatively or avoided altogether in practice and as a topic of analysis. A re-conceptualisation of call-centres as sites of control over customers is proposed. Originality/value – Control and power are rarely analysed in services marketing. This is one of a few studies that makes sense of providers' (insiders') viewpoints and argues that control may play a constructive role and should be seen as a legitimate topic of services and call-centre analysis. As such it addresses a question of intellectual and practical importance which is rarely discussed and may be viewed as incongruous with an age when customers are assumed to have rights.

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