scholarly journals The role of organizational factors in how efficiency-thoroughness trade-offs potentially affect clinical quality dimensions – a review of the literature

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Malin Knutsen Glette ◽  
Siri Wiig
Keyword(s):  
Health Personnel ◽  
Organizational Factors ◽  
Healthcare Services ◽  
Patient Centeredness ◽  
Clinical Quality ◽  
Content Type ◽  
Daily Work ◽  
Trade Offs ◽  
Quality Dimensions ◽  
Balancing Efficiency

PurposeThe purpose of this paper is to increase knowledge of the role organizational factors have in how health personnel make efficiency-thoroughness trade-offs, and how these trade-offs potentially affect clinical quality dimensions.Design/methodology/approachThe paper is a thematic synthesis of the literature concerning health personnel working in clinical, somatic healthcare services, organizational factors and clinical quality.FindingsIdentified organizational factors imposing trade-offs were high workload, time limits, inappropriate staffing and limited resources. The trade-offs done by health personnel were often trade-offs weighing thoroughness (e.g. providing extra handovers or working additional hours) in an environment weighing efficiency (e.g. ward routines of having one single handover and work-hour regulations limiting physicians' work hours). In this context, the health personnel functioned as regulators, balancing efficiency and thoroughness and ensuring patient safety and patient centeredness. However, sometimes organizational factors limited health personnel's flexibility in weighing these aspects, leading to breached medication rules, skipped opportunities for safety debriefings and patients being excluded from medication reviews.Originality/valueBalancing resources and healthcare demands while maintaining healthcare quality is a large part of health personnel's daily work, and organizational factors are suspected to affect this balancing act. Yet, there is limited research on this subject. With the expected aging of the population and the subsequent pressure on healthcare services' resources, the balancing between efficiency and thoroughness will become crucial in handling increased healthcare demands, while maintaining high-quality care.

Building a learning health system using clinical registers: a non-technical introduction

2016 ◽  
Vol 30 (7) ◽  
pp. 1105-1118 ◽  
Author(s):  
John Ovretveit ◽  
Eugene Nelson ◽  
Brent James
Keyword(s):  
Health Systems ◽  
Computer Literacy ◽  
Patient Empowerment ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Digital Data ◽  
Content Type ◽  
Daily Work ◽  
Effective Use ◽  
Unpublished Research

Purpose The purpose of this paper is to describe how clinical registers were designed and used to serve multiple purposes in three health systems, in order to contribute practical experience for building learning healthcare systems. Design/methodology/approach Case description and comparison of the development and use of clinical registries, drawing on participants’ experience and published and unpublished research. Findings Clinical registers and new software systems enable fact-based decisions by patients, clinicians, and managers about better care, as well as new and more economical research. Designing systems to present the data for users’ daily work appears to be the key to effective use of the potential afforded by digital data. Research limitations/implications The case descriptions draw on the experience of the authors who were involved in the development of the registers, as well as on published and unpublished research. There is limited data about outcomes for patients or cost-effectiveness. Practical implications The cases show the significant investments which are needed to make effective use of clinical register data. There are limited skills to design and apply the digital systems to make the best use of the systems and to reduce their disadvantages. More use can be made of digital data for quality improvement, patient empowerment and support, and for research. Social implications Patients can use their data combined with other data to self-manage their chronic conditions. There are challenges in designing and using systems so that those with lower health and computer literacy and incomes also benefit from these systems, otherwise the digital revolution may increase health inequalities. Originality/value The paper shows three real examples of clinical registers which have been developed as part of their host health systems’ strategies to develop learning healthcare systems. The paper gives a simple non-technical introduction and overview for clinicians, managers, policy-advisors and improvers of what is possible and the challenges, and highlights the need to shape the design and implementation of digital infrastructures in healthcare services to serve users.

e-Healthcare service quality: consumer satisfaction and its association with demographic characteristics

2020 ◽  
Vol 33 (6) ◽  
pp. 413-428 ◽  
Author(s):  
Prachi Verma ◽  
Satinder Kumar ◽  
Sanjeev K. Sharma
Keyword(s):  
Consumer Satisfaction ◽  
Strong Association ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Demographic Characteristics ◽  
Content Type ◽  
Interaction Quality ◽  
Quality Dimensions

PurposeUse of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of services with consumer satisfaction. With e-Healthcare services, consumer satisfaction is influenced by the quality of healthcare services provided and the demographic characteristics. The purpose of the present case study is to recognize the important predictors of quality, which are significant for consumer satisfaction with e-Healthcare services by using Zineldin's 5Qs model. It also aims to find the strength of association among the predictors of consumer satisfaction and the demographic characteristics of the respondents.Design/methodology/approachA questionnaire-based study was conducted at a public (PGIMER, Chandigarh) and a private hospital (Fortis Hospital, Mohali) of Punjab, India, from February 2018 to March 2019. The structured, closed-ended questionnaire, to be marked on a 1–5 point Likert scale, was adapted from Zineldin's 5Qs model and was distributed to the respondents sitting in the waiting halls of the selected hospitals. The respondents comprised of both the patients and their attendants who were aware of e-Healthcare services and were using them.FindingsThe analysis identified quality of interaction, quality of hospital atmosphere and quality of object to be the key predictors of consumer satisfaction with e-Healthcare services. The results reveal a strong association between different demographic characteristics and overall consumer satisfaction with e-Healthcare services.Practical implicationsThe results suggest that improvements in the quality of interaction, quality of hospital atmosphere and quality of object may result in higher consumer satisfaction with e-Healthcare services. Working on the identified dimensions of quality will help the e-Healthcare providers in identifying functional problems of e-Healthcare services and developing improvement strategies, which will also result in better health and quality outcomes. The results of this study will help the e-Healthcare providers in better segmentation of e-Healthcare consumers based on their demographic characteristics and in developing better marketing strategies.Originality/valueThis paper focuses on the quality of e-Healthcare services only and attempts to identify the quality dimensions, which leads to the satisfaction of e-Healthcare consumers. The identified quality dimensions will help in designing better e-Healthcare services and framing policies. It also highlights the association of demographic characteristics with important quality dimensions.

Patient experience: determinants and manifestations

2019 ◽  
Vol 24 (2) ◽  
pp. 143-154
Author(s):  
Moutasem Zakkar
Keyword(s):  
Patient Satisfaction ◽  
Patient Experience ◽  
Concept Map ◽  
Healthcare Quality ◽  
Healthcare Services ◽  
Patient Centeredness ◽  
Holistic View ◽  
Content Type ◽  
Experience Of Illness ◽  
The Impact

Purpose Patient experience is a complex multidimensional phenomenon that has been linked to constructs that are also complex to conceptualize, such as patient-centeredness, patient expectations and patient satisfaction. The purpose of this paper is to shed light on the different dimensions of patient experience, including those that receive inadequate attention from policymakers such as the patient’s lived experience of illness and the impact of healthcare politics. The paper proposes a simple classification for these dimensions, which differentiates between two types of dimensions: the determinants and the manifestations of patient experience. Design/methodology/approach This paper uses a narrative review of the literature to explore select constructs and initiatives developed for theorizing or operationalizing patient experience. Literature topics reviewed include healthcare quality, medical anthropology, health policy, healthcare system and public health. Findings The paper identifies five determinants for patient experience: the experience of illness, patient’s subjective influences, quality of healthcare services, health system responsiveness and the politics of healthcare. The paper identifies two manifestations of patient experience: patient satisfaction and patient engagement. Originality/value The paper proposes a classification scheme of the dimensions of patient experience and a concept map that links together heterogeneous constructs related to patient experience. The proposed classification and the concept map provide a holistic view of patient experience and help healthcare providers, quality managers and policymakers organize and focus their healthcare quality improvement endeavors on specific dimensions of patient experience while taking into consideration the other dimensions.

Trust building in a Norwegian municipal acute ward

2020 ◽  
Vol 34 (6) ◽  
pp. 673-685
Author(s):  
Brita Gjerstad ◽  
Svein Ingve Nødland ◽  
Inger Lise Teig
Keyword(s):  
Health Care ◽  
Healthcare Workers ◽  
Care Service ◽  
Health Care Service ◽  
Healthcare Services ◽  
Trust Building ◽  
Content Type ◽  
Daily Work ◽  
Systemic Factors

PurposeTrust plays an important role in the organisation of healthcare services. In Norway, the establishment of mandatory municipal acute wards with 24 h inpatient services introduces a new unit into the healthcare system. This article discusses how this new health care service succeeds in building trust with patients and among healthcare workers.Design/methodology/approachThe article is an in-depth case study of a single, exemplary inter-municipal acute ward. The study draws on interviews with COPD patients, the leader and doctors at the ward. The study also includes observations of daily work at the municipal acute ward. Moreover, administrators and healthcare workers at related healthcare institutions have been interviewed. Data were analysed using a qualitative method.FindingsThe study reveals that trust is built in complex relations and that it has both individual and systemic factors. The practices employed in the daily treatment and care of patients and in encounters between health care personnel and patients are important trust-building processes; however, these processes depend on structures and routines that promote efficient and adequate inter-organisational communication and patient-oriented procedures.Practical implicationsThe study provides insight into how trust dynamics work on multiple organisational levels and how they depend on both individual and systemic factors. Additionally, the study may provide a picture of the importance of trust in organising healthcare services in the future.Originality/valueLessons regarding trust building inspired by data from a case-study care institution can be applied in different care settings and countries.

Empower me or not? Influence of societal culture

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jasenko Ljubica ◽  
Romie Frederick Littrell ◽  
Gillian Warner-Søderholm ◽  
Inga Minelgaite
Keyword(s):  
Cultural Models ◽  
Empirical Work ◽  
Cultural Influences ◽  
Organizational Factors ◽  
Employee Empowerment ◽  
Future Research ◽  
Content Type ◽  
Societal Culture ◽  
Employee Preferences ◽  
Trade Offs

PurposeThe purpose of this paper is to empirically investigate the relationships between societal culture value dimensions and employee preferences for empowerment behaviors by managerial leaders across societal cultures. To do this, the authors synthesize the extant literature to underpin this study and to set the research agenda for future empirical work.Design/methodology/approachUsing field survey research method, the authors obtain and analyze data from ten samples in eight geographically and culturally diverse societies from a global longitudinal study of preferred managerial leader behavior.FindingsCultural value dimension predictor variables affect employee preferences for leader empowerment behaviors in the societies studied. Some significant effects of gender and organizational factors on these relationships were found.Research limitations/implicationsFuture research should expand upon variations in the meaning of employee empowerment across cultures, consider other cultural models and theories, and a more extensive set of personal, organizational and relational factors.Practical implicationsEmployee preferences for leader empowerment behaviors are more likely the result of the interplay, exchange and trade-offs between cultural, personal and organizational values. The effectiveness of employee empowerment is contingent upon well-designed training programs aligning management and worker values, goals and tasks.Originality/valueThe authors offer more realistic, objective and evidence-based insights into the cultural influences on the effectiveness of empowerment and employee cognitions towards it than the extant, conceptually and methodologically compromised, strategic cross-cultural studies.

Service quality and acculturation: advancing immigrant healthcare utilization

2017 ◽  
Vol 31 (4/5) ◽  
pp. 362-372 ◽  
Author(s):  
Kathryn Simons Davis ◽  
Mayoor Mohan ◽  
Steven W. Rayburn
Keyword(s):  
Service Quality ◽  
Service Providers ◽  
Service Design ◽  
Target Population ◽  
Healthcare Services ◽  
Content Type ◽  
Immigrant Populations ◽  
Key Variables ◽  
Quality Dimensions ◽  
Vulnerable Consumer

Purpose This paper aims to develop an understanding of key variables for designing and marketing healthcare services for immigrant consumers – widely considered a vulnerable consumer group. Design/methodology/approach Data collected from 277 participants was analyzed using ANOVA models and mean score comparisons. Findings Differences based on immigrant status and acculturation level are identified. Differences between immigrant acculturation levels based on service quality dimensions are also revealed. Research implications This research indicates that acculturation-based studies are insightful and finds that immigrants’ service responses do not mirror those of native respondents in healthcare services. Practical and social implications This research highlights key nuances within immigrant populations that hold significant implications for service providers. Culturally appropriate service design and marketing can enhance service utilization by the target population. Originality/value This study focuses on the healthcare service experiences of immigrant populations and application of this information to service design.

An exploratory study of teacher buoyancy

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Angel Kit Yi Wong ◽  
Sylvia Yee Fan Tang ◽  
Dora Dong Yu Li ◽  
May May Hung Cheng
Keyword(s):  
Professional Growth ◽  
Pearson Correlation ◽  
Well Being ◽  
Initial Teacher Education ◽  
Enabling Factors ◽  
Content Type ◽  
Daily Work ◽  
Component Framework ◽  
Personal Strengths ◽  
New Instrument

PurposeThe purpose of this paper is threefold. Firstly, a new concept, teacher buoyancy, is introduced. Based on the significance to study how teachers bounce back from minor and frequent setbacks (vs. major adversities emphasized in resilience) in their daily work and the research on buoyancy by Martin and Marsh, a dual-component framework to conceptualize this new concept is introduced. Secondly, the development of a new instrument, the Teacher Buoyancy Scale (TBS), to measure it is presented. Thirdly, results of a study using the TBS are reported, which provide insights into how teacher buoyancy can be fostered.Design/methodology/approachThe study employed a quantitative design. A total of 258 teachers taking a part-time initial teacher education (ITE) program completed the TBS. Their responses were analyzed by exploratory factor analysis (EFA). In addition to descriptive statistics and reliability coefficients, Pearson correlation coefficients were calculated to examine the relationship among the factors.FindingsThe data analysis indicated five factors, namely, Coping with difficulties, Bouncing back cognitively and emotionally, Working hard and appraising difficulties positively, Caring for one's well-being and Striving for professional growth. These factors can be readily interpreted by the dual-component framework. Correlations among the factors further revealed that enabling factors can be subdivided into more proximal personal strengths relating to direct coping, and more distal personal assets pertaining to personal well-being. It is the latter that correlates most highly with perceived teacher buoyancy.Originality/valueThe most original contribution of this paper is the proposal of the new concept of teacher buoyancy which is teachers' capacity to deal with the everyday challenges that most teachers face in their teaching. The delineation between buoyancy and resilience sharpens the focus of the problem domain that is most relevant to teachers. The development of the TBS provides a useful and reliable instrument to examine teacher buoyancy in future studies.

scholarly journals Interventions to reduce sickness absence among healthcare workers: a systematic review

2019 ◽  
Vol 8 (2) ◽  
pp. 147-162
Author(s):  
Laura Simmons ◽  
Arwel W. Jones ◽  
Niro Siriwardena ◽  
Christopher Bridle
Keyword(s):  
Systematic Review ◽  
Influenza Vaccination ◽  
Sickness Absence ◽  
Healthcare Workers ◽  
Healthcare Services ◽  
Primary Outcome Measure ◽  
Healthcare Sector ◽  
Intervention Programme ◽  
Content Type ◽  
Multicomponent Intervention

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.

Performance management in public universities: overcoming bureaucracy

2018 ◽  
Vol 67 (4) ◽  
pp. 736-753 ◽  
Author(s):  
Nunzio Angiola ◽  
Piervito Bianchi ◽  
Letizia Damato
Keyword(s):  
Performance Management ◽  
Public Universities ◽  
Organizational Factors ◽  
Public University ◽  
Management Systems ◽  
Management Tools ◽  
Performance Levels ◽  
Content Type ◽  
Performance Management Systems ◽  
Adoption And Implementation

Purpose Considering a micro performance perspective, the purpose of this paper is to analyze whether and to what extent the adoption of better performance management systems could improve the performance levels of a public university. Design/methodology/approach With reference to a period of four years (2011-2014), the quality of performance management systems of 29 Italian universities (response rate: 48 percent) was examined and the possible effects on performance levels of these institutions were analyzed by means of statistical methodologies (multiple regression analysis). Outcome indicators were considered. Findings The findings indicate the need to go further “measurement,” and to take care of performance “management,” especially in complex organizations as universities, where academicians identify themselves more with their professions than with the organization and where technicians and administrative employees might look at the performance-based reform with “bureaucratic eyes.” A fruitful cooperation between the professional soul and the bureaucratic one is paramount. Originality/value Studies which analyze organizational factors that could affect the adoption and implementation of performance management systems are rare, and use in prevalence qualitative methods or refer to machine bureaucracies, not many to professional ones as public universities. Moreover, the performance management literature in a public university context deepens the topic of the selection of KPIs and the focus is mainly on macro performance or on management tools for gathering and analyzing performance measures.

scholarly journals Identifying integrated options for agricultural climate change mitigation

2014 ◽  
Vol 6 (2) ◽  
pp. 192-211 ◽  
Author(s):  
John Tzilivakis ◽  
Kathleen Lewis ◽  
Andrew Green ◽  
Douglas Warner
Keyword(s):  
Climate Change ◽  
Climate Change Mitigation ◽  
Effective Means ◽  
Integrated Approach ◽  
Management Options ◽  
Content Type ◽  
Mitigation Options ◽  
Trade Offs ◽  
Environmental Objectives ◽  
Change Mitigation

Purpose – In order to achieve reductions in greenhouse gas (GHG) emissions, it is essential that all industry sectors have the appropriate knowledge and tools to contribute. This includes agriculture, which is considered to contribute about a third of emissions globally. This paper reports on one such tool: IMPACCT: Integrated Management oPtions for Agricultural Climate Change miTigation. The paper aims to discuss these issues. Design/methodology/approach – IMPACCT focuses on GHGs, carbon sequestration and associated mitigation options. However, it also attempts to include information on economic and other environmental impacts in order to provide a more holistic perspective. The model identifies mitigation options, likely economic impacts and any synergies and trade-offs with other environmental objectives. The model has been applied on 22 case study farms in seven Member States. Findings – The tool presents some useful concepts for developing carbon calculators in the future. It has highlighted that calculators need to evolve from simply calculating emissions to identifying cost-effective and integrated emissions reduction options. Practical implications – IMPACCT has potential to become an effective means of provided targeted guidance, as part of a broader knowledge transfer programme based on an integrated suite of guidance, tools and advice delivered via different media. Originality/value – IMPACCT is a new model that demonstrates how to take a more integrated approach to mitigating GHGs on farms across Europe. It is a holistic carbon calculator that presents mitigation options in the context other environmental and economic objectives in the search for more sustainable methods of food production.

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