Organising health services through modularity

2015 ◽  
Vol 35 (6) ◽  
pp. 925-945 ◽  
Author(s):  
Mervi Vähätalo ◽  
Tomi Juhani Kallio
Keyword(s):  
Health Service ◽  
Health Services ◽  
Elderly Care ◽  
Public And Private ◽  
Health Service Provision ◽  
Content Type ◽  
Modular Systems ◽  
Wide Range ◽  
Service Managers ◽  
Better Than

Purpose – The purpose of this paper is to analyse the way in which the factors influencing a transformation towards or away from modularity, according to general modular systems theory, appear in the context of health services, and the extent to which the special characteristics of health services might support or prevent its application. Design/methodology/approach – The arguments constructed in the study are based on the theme of modularity, reflected against the special characteristics of health services identified in the context of health economics. Findings – The results include 11 proposition pairs that direct health services both towards and away from modularity. Research limitations/implications – Health services are highly heterogeneous in nature and the authors illustrate this with a wide range of examples from elderly care as the authors discuss the application of modularity in this context. Nevertheless, the authors recognise that modularity might suit some health services better than others. The findings provide potentially important information to health service managers and providers, enabling them to understand how modularity would benefit health service provision and where contradictions are to be expected. Originality/value – This study contributes to the discourse on service modularity in general, and complements the literature on modularity with reference to both public and private health services.

scholarly journals Technology push without a patient pull

2019 ◽  
Vol 53 (9) ◽  
pp. 1701-1732 ◽  
Author(s):  
Debbie Isobel Keeling ◽  
Ko de Ruyter ◽  
Sahar Mousavi ◽  
Angus Laing
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Survey Methodology ◽  
Social Issues ◽  
Building Blocks ◽  
Online Services ◽  
Health Service Provision ◽  
Content Type ◽  
Services Delivery

PurposePolicymakers push online health services delivery, relying on consumers to independently engage with online services. Yet, a growing cluster of vulnerable patients do not engage with or disengage from these innovative services. There is a need to understand how to resolve the tension between the push of online health service provision and unengagement by a contingent of health-care consumers. Thus, this study aims to explore the issue of digital unengagement (DU) (i.e. the active or passive choice to engage or disengage) with online health services to better inform service design aligned to actual consumer need.Design/methodology/approachAdopting a survey methodology, a group of 486 health services consumers with a self-declared (acute or chronic) condition were identified. Of this group, 110 consumers were classified as digitally unengaged and invited to write open-ended narratives about their unengagement with online health services. As a robustness check, these drivers were contrasted with the drivers identified by a group of digitally engaged consumers with a self-declared condition (n= 376).FindingsDU is conceptualized, and four levels of DU drivers are identified. These levels represent families of interrelated drivers that in combination shape DU: subjective incompatibility (misalignment of online services with need, lifestyle and alternative services); enactment vulnerability (personal vulnerabilities around control, comprehension and emotional management of online services); sharing essentiality (centrality of face-to-face co-creation opportunities plus conflicting social dependencies); and strategic scepticism (scepticism of the strategic value of online services). Identified challenges at each level are the mechanisms through which drivers impact on DU. These DU drivers are distinct from those of the digitally engaged group.Research limitations/implicationsAdding to a nascent but growing literature on consumer unengagement, and complementing the engagement literature, the authors conceptualize DU, positioning it as distinct from, not simply a lack of, consumer engagement. The authors explore the drivers of DU to provide insight into how DU occurs. Encapsulating the dynamic nature of DU, these drivers map the building blocks that could help to address the issue of aligning the push of online service provision with the pull from consumers.Practical implicationsThis paper offers insights on how to encourage consumers to engage with online health services by uncovering the drivers of DU that, typically, are hidden from service designers and providers impacting provision and uptake.Social implicationsThere is a concern that there will be an unintentional disenfranchisement of vulnerable segments of society with a generic policy emphasis on pushing online services. The paper sheds light on the unforeseen personal and social issues that lead to disenfranchisement by giving voice to digitally unengaged consumers with online health services.Originality/valueOffering a novel view from a hard-to-reach digitally unengaged group, the conceptualization of DU, identified drivers and challenges inform policymakers and practitioners on how to facilitate online health service (re)engagement and prevent marginalization of segments of society.

scholarly journals Health service provision for disease control among prisoners: a conceptual note

2020 ◽  
Vol 34 (4) ◽  
pp. 353-358
Author(s):  
Behnam Farhoudi ◽  
SeyedAhmad SeyedAlinaghi ◽  
Omid Dadras ◽  
Mehrzad Tashakoriyan ◽  
Mohammad Nazari Pouya ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Healthcare Providers ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Noncommunicable Diseases ◽  
Health Service Provision ◽  
Chronic Health ◽  
Content Type

PurposeThe aim of present study was to integrate vital noncommunicable diseases (coronary artery disease, hypertension, diabetes mellitus and mental health disorders) into Prison-Based Active Health Services Provision (PAHSP).Design/methodology/approachOn Jan 1, 2018, there were 230,000 prisoners in Iran. Timely and systematic detection and diagnosis of chronic health conditions among this population are imperative. The collaboration between healthcare providers in prison and members of the multidisciplinary team of the healthcare community outside prison initiated an active health service provision approach for HIV and tuberculosis (TB). Guidelines for the control of HIV and TB in prison were piloted, and the finalized version was named “Prison-based Active Health Services Provision” (PAHSP), which has been scaled up in 16 of 260 Iranian prisons.FindingThe PAHSP approach emphasizes the importance of early identification of key symptoms and risk factors. This approach provides an opportunity for improved prevention and treatment, enabling prisoners identified at risk or those who have been diagnosed with a target disease to be followed up and receive the appropriate health care.Originality/valueInitiatives such as screening for chronic health conditions coupled with treatment will reduce the burden of chronic illness among prisoners and the broader community, thereby saving on healthcare costs and lives.

School Settings

2018 ◽  
Author(s):  
Melissa K. Holt ◽  
Jennifer Greif Green ◽  
Javier Guzman
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Community Mental Health Service ◽  
Health Service Provision ◽  
School Settings ◽  
Mental Health Service Provision

Schools are a primary setting for mental health service provision to youth and are also main sources of referral to community mental health service providers. This chapter examines the school context and its key role in the child and adolescent mental health services system. The chapter first provides information about the association of emotional and behavioral disorders with school experiences, including academic performance. Next, the chapter presents a framework for mental health service provision and assessment in schools, including describing methods for identifying students who might need mental health services and tracking their progress. Further, several evidence-based interventions are highlighted as examples of effective practices in schools. The chapter concludes with recommendations for clinical practice in school settings.

scholarly journals Experiences of men with psychosis participating in a community-based football programme

2017 ◽  
Vol 45 (2) ◽  
pp. 100-111 ◽  
Author(s):  
Laura Moloney ◽  
Daniela Rohde
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Mental Health Services ◽  
Health Services ◽  
Occupational Therapy ◽  
Positive Impact ◽  
Physical And Mental Health ◽  
Community Based ◽  
Health Service Provision ◽  
Content Type

Purpose Physical activity is associated with both physical and mental health benefits for people with psychosis. However, mental health services have been criticised for failing to adequately promote physical activities. Occupational Therapy, with its focus on meaningful everyday occupations, is well placed to incorporate physical activity interventions. The purpose of this study was to explore the experiences of men with psychosis participating in an Irish community-based football programme. Design/methodology/approach Six men with psychosis participated in qualitative interviews. The interviews were audio-recorded and transcribed verbatim. Interview data were analysed thematically. Findings Participants identified many benefits of engaging in the programme. Football became a valued part of weekly routines and fostered re-engagement with previously valued roles. Participants identified improvements in social confidence and motor and process skills, as well as a positive impact on their mental and physical health. Originality/value This study highlights the value and meaning of participation in football for men with psychosis, as well as demonstrating the longer-term feasibility of football as a therapeutic medium in Occupational Therapy mental health service provision. Findings could help to promote the routine use of sports interventions to mental health services.

scholarly journals The impact of a night confinement policy on patients in a UK high secure inpatient mental health service

2015 ◽  
Vol 17 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Simon Chu ◽  
Kimberley McNeill ◽  
Karen M. Wright ◽  
Anthony Hague ◽  
Tracy Wilkins
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Negative Impact ◽  
Sleep Hygiene ◽  
Content Type ◽  
Inpatient Mental Health ◽  
The Impact

Purpose – From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service efficiency and reduce costs. The purpose of this paper is to assess the views of staff and patients concerning the policy and examine the specific impact of the policy on patients. Design/methodology/approach – Measures of patients’ sleep hygiene, patients’ behaviour, ward atmosphere, engagement with therapy and adverse incidents were taken both before and after the night confinement (NC) policy was implemented. Both patients and staff also expressed their views of the impact of the NC policy. Findings – Results provide converging evidence that the impact of the NC policy on patients is negligible. There were no consistent negative effects of confining patients overnight. Rather, patients and staff were broadly positive about the impact that the practice had on patients. Practical implications – Confining patients to locked bedrooms overnight does not exert any consistent influence, positive or negative, on patients’ sleep hygiene, behaviour or engagement with therapy, and patients expressed a broadly positive view of the practice of NC. Thus, a NC policy may have a contribution to make to the provision an effective high-secure mental health service. Originality/value – The study provides convincing evidence that secure inpatient mental health services that are considering the adoption of a NC policy may do so without fear of a negative impact on patients.

Conceptual foundations of organizational structure: re-structuring of women's health services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Peter Nugus ◽  
Joanne Travaglia ◽  
Maureen MacGinley ◽  
Deborah Colliver ◽  
Maud Mazaniello-Chezol ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Women’S Health ◽  
Women's Health ◽  
Health Needs ◽  
Structured Interviews ◽  
Content Type ◽  
Stakeholder Views ◽  
Women’S Health Services ◽  
Feminist Discourse

PurposeResearchers often debate health service structure. Understanding of the practical implications of this debate is often limited by researchers' neglect to integrate participants' views on structural options with discourses those views represent. As a case study, this paper aims to discern the extent to which and how conceptual underpinnings of stakeholder views on women's health contextualize different positions in the debate over the ideal structure of health services.Design/methodology/approachThe researchers chose a self-standing, comprehensive women's health service facing the prospect of being dispersed into “mainstream” health services. The researchers gathered perspectives of 53 professional and consumer stakeholders in ten focus groups and seven semi-structured interviews, analyzed through inductive thematic analysis.Findings“Women's marginalization” was the core theme of the debate over structure. The authors found clear patterns between views on the function of women's health services, women's health needs, ideal client group, ideal health service structure and particular feminist discourses. The desire to re-organize services into separate mainstream units reflected a liberal feminist discourse, conceiving marginalization as explicit demonstration of its effects, such as domestic abuse. The desire to maintain a comprehensive women's health service variously reflected post-structural feminism's emphasis on plurality of identities, and a radical feminist discourse, holding that womanhood itself constituted a category of marginalization – that is, merely being at risk of unmet health needs.Originality/valueAs a contribution to health organizational theory, the paper shows that the discernment of discursive underpinnings of particular stakeholder views can clarify options for the structure of health services.

Predictors of users’ preferences for online health services

2020 ◽  
Vol 37 (2) ◽  
pp. 215-225
Author(s):  
Shahidul Islam ◽  
Md Rakibul Hoque ◽  
Md Abdullah Al Jamil
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Quality ◽  
Rational Choice Theory ◽  
Service Providers ◽  
Well Being ◽  
Ease Of Use ◽  
Future Research ◽  
Content Type ◽  
Health Service Quality

Purpose The purpose of this study is to explain predictors that discriminate users’ preferences for online health services, focusing on a downtown area in a developing country. Design/methodology/approach Drawing on rational choice theory (RCT), the authors test a model that links the frequency of online health service usage to access-activators and access-inhibitors. Multivariate analysis of variance (MANOVA) and the discriminant analysis model were used to analyze data from a sample of 215 internet users. Findings Results confirm the significance of responsiveness, user’s attitude, accessibility and perceived ease of use, indicating their discriminating role in the usage of online health services. Research limitations/implications The study demonstrates the relevance of RCT in measuring perceived online health service quality in an emerging context. Future research should consider the influence of electronic health (eHealth) literacy, norms and trustworthiness to increase the generalizability of the findings. Practical implications The findings of this study can help enhance the eHealth service quality by encouraging service providers to improve the interactivity and ease of use of their platforms, thus delivering value to both consumers and firms and improving the well-being of the society at large. Originality/value Few existing studies draw attention to access-activators and access-inhibitors to predict users’ preferences for online health services. This study shows the applicability of RCT in preparing the instrumental dimensions of online health service quality.

A health management competency framework for Australia

2020 ◽  
Vol 44 (6) ◽  
pp. 958
Author(s):  
Zhanming Liang ◽  
Felicity Blackstock ◽  
Peter Howard ◽  
Geoffrey Leggat ◽  
Alison Hughes ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Middle Level ◽  
Competency Framework ◽  
Competency Assessment ◽  
Australian Health ◽  
Assessment Program ◽  
Service Managers ◽  
And Training ◽  
Management Competency

ObjectiveThis study examined whether the management competency framework for health service managers developed in the Victorian healthcare context is applicable to managers in other Australian states. MethodsAn online questionnaire survey of senior and middle-level health service managers in both community health services and hospitals was conducted in New South Wales and Queensland. ResultsThe study confirmed that the essential tasks for senior and middle-level managers are consistent across health and social care sectors, as well as states. Core competencies for health services managers identified in the Victorian healthcare context are relevant to other Australian states. In addition, two additional competencies were incorporated into the framework. ConclusionThe Management Competency Assessment Program competency framework summarises six competencies and associated behaviours that may be useful for guiding performance management and the education and training development of health service managers in Australia. What is known about the topic?The evidence suggests that competency-based approaches can enhance performance and talent management, and inform education and training needs, yet there has been no validated competency framework for Australian health service managers. What does the paper add?This paper explains the process of the finalisation of the first management competency framework for guiding the identification of the training and development needs of Australian health service managers and the management of their performance. What are the implications for practice?The Management Competency Assessment Program competency framework can guide the development of the health service management workforce in three Australian states, and may be applicable to other jurisdictions. Further studies are required in the remaining jurisdictions to improve the external validity of the framework.

Differentiating between average and high-performing public healthcare managers: implications for public sector talent management

2020 ◽  
Vol 44 (3) ◽  
pp. 434
Author(s):  
Sandra G. Leggat ◽  
Zhanming Liang ◽  
Peter F. Howard
Keyword(s):  
Public Sector ◽  
Health Service ◽  
Health Services ◽  
Talent Management ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
High Performing ◽  
The Public ◽  
Public Healthcare Sector ◽  
Service Managers

ObjectiveEnsuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual and organisational performance, there have been few studies exploring these concepts in the public healthcare sector. This study addresses this gap by exploring the perceived differences in demonstration of core competencies between average and higher-performing managers in public sector healthcare organisations. MethodsMixed methods were used to define and measure a set of competencies for health service managers. In addition, supervisors of managers were asked to identify the differences in competence between the average and high-performing managers reporting to them. ResultsSupervisors could clearly distinguish between average and higher-performing managers and identified related competencies. ConclusionsThe consistent pattern of competence among community health and hospital public sector managers demonstrated by this study could be used to develop a strategic approach to talent management for the public healthcare sector in Australia. What is known about this topic?Although there are validated competency frameworks for health service managers, they are rarely used in practice in Australia. What does this paper add?This paper illustrates the perceived differences in competencies between top and average health services managers using a validated framework. What are the implications for practitioners?The public health sector could work together to provide a more effective and efficient approach to talent management for public hospitals and community health services.

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