A practical framework for achieving value creation and capture in healthcare through process improvement

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jane Evans ◽  
Sandra Leggat ◽  
Danny Samson
Keyword(s):  
Conceptual Framework ◽  
Process Improvement ◽  
Single Case ◽  
Hospital Setting ◽  
Current Approach ◽  
Single Case Study ◽  
Hospital System ◽  
Content Type ◽  
Financial Benefits

PurposeThe purpose of this study was to examine the concept of value in healthcare through a practical appraisal of the applicability of a conceptual framework, which is aimed at supporting the measurement and realisation of financial benefits from process improvement (PI) activities in a hospital setting.Design/methodology/approachA single case study of a hospital system in Melbourne, Victoria, Australia, was used to assess the applicability of the framework. The study sought to verify the framework's intention, that PI methods could be used to address known wastes that contribute to the cost of providing healthcare. The case study examines the current approach taken by the hospital to measure and realise financial benefits from PI activities and compares these to the components of the Strategy to Balance Cost and Quality in Health Care framework to assess its applicability in practice.FindingsThe case study revealed that the steps described in the framework were fundamentally in place albeit with some variation. Importantly, the case study identified an additional step that could be added into the framework to support hospitals to better define their portfolio of initiatives to deliver value. The case study also clarified three types of contributory elements that should be in place for the application of the framework to be successful.Practical implicationsThe Framework to Achieve Value in Healthcare is offered to hospitals as a model by which they can look to reduce expenditure through the removal of non-value adding activities. The modification to the conceptual framework has arisen from a single case study and would benefit from further testing by other hospitals in other policy settings (i.e. other countries).Originality/valueThis is the first paper to examine and enhance an existing framework to assist hospitals balance cost and quality through PI.

“Speaking truth to power”: analysing shadow reporting as a form of shadow accounting

2017 ◽  
Vol 30 (3) ◽  
pp. 510-533 ◽  
Author(s):  
Helen Tregidga
Keyword(s):  
Power Relations ◽  
Design Methodology ◽  
Empirical Investigation ◽  
Single Case ◽  
Senior Management ◽  
Single Case Study ◽  
Content Type ◽  
Transformative Potential ◽  
Perceived Impacts

Purpose The purpose of this paper is to empirically investigate the act of shadow reporting by a social movement organisation as a form of shadow accounting within a sustained campaign against a target corporation. Situated within a consideration of power relations, the rationales underlying the production of the shadow report, and the shadow reports perceived value and limits as a shadow accounting mechanism, are investigated. Design/methodology/approach A Foucauldian approach to power/knowledge and truth is drawn upon in the analysis of a single case study. Alongside a consideration of the shadow report itself, interviews with both the preparers of the report and senior management of the corporation targeted comprise the main data. Findings The paper provides an empirical investigation into shadow reporting as a form of shadow accounting. While a range of insights are garnered into the preparation, dissemination and impact of the shadow report, key findings relate to a consideration of power relations. The perceived “truth” status of corporate accounts compared to accounts prepared by shadow accountants is problematised through a consideration of technologies of power and power/knowledge formations. Power relations are subsequently recognised as fundamental to the emancipatory potential of shadow reporting. Research limitations/implications Results from a single case study are presented. Furthermore, given the production of the shadow report occurred several years prior to the collection of data, participants were asked to reflect on past events. Findings are therefore based on those reflections. Originality/value While previous studies have considered the preparation of shadow reports and their transformative potential, this study is, the author believes, the first to empirically analyse the preparation, dissemination and perceived impacts of shadow reporting from the perspectives of both the shadow report producers and the target corporation.

scholarly journals Exploring collaboration within social housing retrofit practice for an ageing population: a single case study in the West of Scotland

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dayna Rodger ◽  
Nicola Callaghan ◽  
Craig Thomson
Keyword(s):  
Social Housing ◽  
Single Case ◽  
Well Being ◽  
Unintended Consequences ◽  
Ageing Population ◽  
Single Case Study ◽  
Content Type ◽  
Data Infrastructure ◽  
The Social

Purpose Sustainably addressing the social and economic demands from an ageing population is a major global challenge, with significant implications for policy and practice. This is resultant of the increasing demand for housing adaptations to prevent increased pressure upon acute health services. Through the lens of institutional theory, this paper aims to explore the levels of joined-up retrofit practice within a Scottish social housing provider, under a constructivist approach. Design/methodology/approach An exploratory single case study of a Scottish local authority was undertaken. Within this, nine key stakeholders were interviewed, taking a hierarchical approach, from director to repair and maintenance staff. Results were analysed by using Braun and Clarke’s six stages of thematic analysis. Findings There is a need for greater levels of integration within retrofit practice to not only improve the health and well-being of the older population but also increase efficiency and economic savings within public services. Currently, there are key issues surrounding silo-based decision-making, poor data infrastructure, power struggles and a dereliction of built environment knowledge and expertise, preventing both internal and external collaboration. However, housing, energy and health have interlinking agendas which are integral to achieving ageing in place. Therefore, there must be system-wide recognition of the potential benefits of improved cross-sector collaboration, preventing unintended consequences whilst providing socioeconomic outcomes. Originality/value This research provides a new perspective surrounding retrofit practice within the context of an ageing population. It highlights the requirement for improved cross sector collaboration and the social and economic cost of poor quality practice.

Street-level collaboration: perception, power, and politics on the frontlines of collaboration

2020 ◽  
Vol 33 (4) ◽  
pp. 461-476
Author(s):  
Harish P. Jagannath
Keyword(s):  
Single Case ◽  
Sufficient Conditions ◽  
Collaborative Governance ◽  
Bureaucratic Politics ◽  
Causal Mechanism ◽  
Single Case Study ◽  
Content Type ◽  
Street Level ◽  
Collaborative Initiative

PurposeTo examine the implementation processes and outcomes of collaborative governance initiatives through the lens of bureaucratic politics.Design/methodology/approachAn in-depth single case study research design with 28 embedded cases to study the implementation of a collaborative governance initiative. This paper uses the analytical technique of process tracing to explicate necessary and sufficient conditions to uncover causal mechanisms and confirm descriptive and causal inferences.FindingsThis study finds that when street-level bureaucrats perceived the collaborative initiative as a health intervention (and not as a collaborative initiative), it resulted in low levels of stakeholder participation and made the collaborative initiative unsuccessful. This paper finds that bureaucratic politics is the causal mechanism that further legitimized this perception resulting in each stakeholder group avoiding participation and sticking to their departmental siloes.Research limitations/implicationsThis is a single case study about a revelatory case of collaborative governance implementation in India, and findings are analytically generalizable to similar administrative contexts. Further research is needed through a multiple case study design in a comparative context to examine bureaucratic politics in implementing collaborative initiatives.Practical implicationsPolicymakers and managers need to carefully consider the implications of engaging organizations with competing institutional histories when formulating and implementing collaborative governance initiatives.Originality/valueThis study's uniqueness is that it examines implementation of collaborative governance through a bureaucratic politics lens. Specifically, the study applies Western-centric scholarship on collaborative governance and street-level bureaucracy to a non-Western developing country context to push the theoretical and empirical boundaries of key concepts in public administration.

scholarly journals Purchasing’s tasks at the interface between internal and external networks

2020 ◽  
Vol 35 (1) ◽  
pp. 159-171
Author(s):  
Steffen Muxoll Bastholm ◽  
Kristin B. Munksgaard
Keyword(s):  
User Interface ◽  
Design Methodology ◽  
Single Case ◽  
Relationship Management ◽  
Single Case Study ◽  
Design Data ◽  
Content Type ◽  
Case Study Design ◽  
Practical Implications

Purpose The strategic importance of the purchasing function increases, as its task become more dynamic in various interfaces with different suppliers. Changes in these customer–supplier interfaces pose specific challenges. The purpose of this study is to investigate how the purchasing function handles the interplay of interface changes. Design/methodology/approach This study applies a qualitative single case study design. Data are collected through observations and interviews conducted before, during and after a concrete change of interface taking place between a buying firm and its suppliers and customers. Findings Three main findings are identified to redefine the tasks of the purchasing function. The first concerns the new ways of defining the purchasing tasks. The main issue is to balance tasks with the simultaneous changes influencing other interfaces and relationships. The second is the division and alignment of tasks in intra- and inter-organizational networks with regards to who decides and coordinates what. Third, the inter-connected performance relates to how other actors perform their tasks. For the purchasing function, managing supplier interfaces influences and is influenced by how the firm simultaneously manages its user interface. Practical implications For management, a new way to evaluate the performance of the purchasing function is needed by including relationship management and interactive capabilities. Originality/value This study contributes with new insights into how managing the dynamics of changing interfaces requires interactively defined purchasing tasks, division and alignment of tasks and inter-connected performance vis-à-vis others in the wider network setting.

Leveraging resource ecologies for sustainability transitions – a waste management case

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rumy Narayan ◽  
Annika Tidström
Keyword(s):  
Waste Management ◽  
Social Intelligence ◽  
Single Case ◽  
Continuous Process ◽  
Case Study Research ◽  
Management Program ◽  
Single Case Study ◽  
Diverse Range ◽  
Content Type

Purpose Addressing fundamental sustainability challenges has now become strategic for multi-national corporations. However, such challenges by their very nature are complex and require resources that are frequently beyond those that are traditionally accepted as relevant and crucial to a firm’s core business operations. The purpose of this paper is to illustrate how firms identify and integrate diverse groups of actors using social intelligence to build an ecology of resources to tackle these complex challenges. Design/methodology/approach The empirical part is based on qualitative single case study research of a packaging company and its waste management program. Findings Organizing for sustainability requires business activities to be conceptualized as a continuous process of project building, involving actors in diverse settings and responsibilities divided thematically and spatially forming nets within a network to solve problems, collectively. There is a fundamental analytical problem of integrating a diversity of value spheres, and society has a set of rational methods for planning and action where decisions are made to privilege one aspect to the exclusion of others. Artificial separation of activities that are interdependent and failure to allow these activities to evolve through interactions in time and space could threaten sustainability. Research limitations/implications This is a single case study within a certain context, therefore ways for orchestrating resource ecologies need further investigation. Practical implications For managers, it is very important to recognize and appreciate the interconnectedness of resource ecologies but also that interactions resulting in joint actions can often have different rewards and benefits for the diverse range of actors implicated in such networks. This kind of social intelligence offers managers options to experiment with transitional pathways that match the objectives of diverse network actors and provide unique resource combinations for building competitive advantage. There is only so much that is under the control of managers or even firms, which means both must embrace uncertainty and the phenomenon of emergence. Social implications From a societal perspective, the findings of the study show how the open and transparent activities for the sustainability of one firm spread through different layers of the society through connecting, sharing and developing resources. Therefore, it is important for societies to enable and support the open sharing of resources for sustainability. Investments in large programs for transitions to sustainability tend to spread from a focal company into various projects for sustainability involving several layers of actors within society. This ensures that awareness, behaviors and attitudes related with sustainability become rooted in society and give rise to valuable innovations. Originality/value This study illustrates how resources are created and shaped through nets during transitions toward sustainability using social intelligence.

Lean Six Sigma in policing services

2018 ◽  
Vol 67 (5) ◽  
pp. 935-940 ◽  
Author(s):  
Jiju Antony ◽  
Bryan Rodgers ◽  
Inness Coull ◽  
Vijaya Sunder M.
Keyword(s):  
Six Sigma ◽  
Design Methodology ◽  
Single Case ◽  
Lean Six Sigma ◽  
Single Case Study ◽  
Content Type ◽  
The Public ◽  
Study Approach ◽  
Learning Points

Purpose This paper is based on a single case study carried out as part of a change programme but is used as a reflective tool to draw on some of the wider organisational learning which can be considered when implementing, reviewing or re-energise a Lean Six Sigma (LSS) Programme. The paper aims to discuss this issue. Design/methodology/approach A case study approach has been used and referenced throughout the paper with references to literature to support the wider learning points drawn which are then applied to any continuous improvement (CI) programmes. Findings The paper presents a range of learning points which are drawn from a successful deployment of LSS within a change project carried out as part of an overall programme in Scottish policing services. Research limitations/implications The points are drawn from a single case study which was deployed within a wider change programme and is supported by wider literature but is used as a vehicle for informing strategic considerations within an organisation. Originality/value This case study is drawn from policing services in the public sector which alone is an area that has not been significantly studied. It is used to explore wider implications in terms of strategic alignment, organisational performance and project management and presents the argument that the design of a CI programme is much wider than the implementation of LSS itself.

Analyzing the formation of a paradoxical organizational identity

2020 ◽  
Vol 28 (6) ◽  
pp. 1227-1241 ◽  
Author(s):  
Bruno Felix
Keyword(s):  
Organizational Identity ◽  
Design Methodology ◽  
Single Case ◽  
Single Case Study ◽  
Construction Process ◽  
Content Type ◽  
The Core ◽  
Optimal Distinctiveness ◽  
Depth Interviews

Purpose This study aims to understand the construction process of an organizational identity in a hybrid organization. Design/methodology/approach The author developed a single case study based on in-depth interviews, non-participant observations and document analysis in a credit cooperative. Findings After periods of changes in organizational identity (from idealism to pragmatism), the formation of a paradoxical organizational identity was observed in which the core value became a central polarity between idealism and pragmatism; after periods when members engaged in actions that promoted resistance or change, they framed past events in a story of stable dynamics between idealism and pragmatism; and pro-distinctiveness and -similarity forces in relation to other organizations were reconciled in a quest for optimal distinctiveness that simultaneously enabled the development of uniqueness and adequacy. Originality/value This is the first study to adopt a paradox perspective to analyze the identity of a cooperative.

scholarly journals Living in a care home during COVID-19: a case study of one person living with dementia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ian Davies-Abbott ◽  
Catrin Hedd Jones ◽  
Gill Windle
Keyword(s):  
Study Design ◽  
Single Case ◽  
Care Home ◽  
Care Homes ◽  
Single Case Study ◽  
Content Type ◽  
Case Study Design ◽  
People With Dementia ◽  
The Impact

Purpose This paper aims to understand the lived experience of a person living with dementia in a care home during the COVID-19 pandemic. It responds to the absence in research of the voices of people with dementia living in care homes during the pandemic. Design/methodology/approach The paper adopts a single case study design applied thematic analysis to semi-structured interview data to discover the experiences of one person living with dementia in a care home during a period of lockdown. Findings Five themes reveal how the participant responded to the practical and emotional challenges of the pandemic: autonomy; fears; keeping connected; keeping safe and other people living with dementia. These themes highlight the participant’s ability to adapt, accept and dispute lockdown restrictions, revealing considerable insight into their situation. Research limitations/implications The pandemic has restricted access to care homes, which informed the single case study design. This approach to the research may restrict the generalisability of the findings. Other researchers are encouraged to include the voices of people with dementia living in care homes in further studies. Practical implications Implications for practice, presented in this paper, promote quality psychosocial approaches when health-care workers engage with people living with dementia during periods of restricted activity. Originality/value Unlike other studies about the impact of the pandemic on care homes, this paper explores the experience of the pandemic in care homes from the perspective of a person living with dementia.

Developing dynamic capabilities for learning and internationalization

2016 ◽  
Vol 11 (3) ◽  
pp. 328-347 ◽  
Author(s):  
Margaret Tallott ◽  
Rachel Hilliard
Keyword(s):  
Conceptual Model ◽  
Dynamic Capabilities ◽  
Single Case ◽  
Empirical Work ◽  
Strategic Decision ◽  
Dynamic Capability ◽  
Single Case Study ◽  
Capability Development ◽  
Content Type

Purpose – The purpose of this paper is to examine the development process of dynamic capabilities. Design/methodology/approach – The paper adopts a qualitative, longitudinal participant-observation research design. A single case study firm was observed over a ten-year period of active researcher engagement allowing for the collection of rich data on the development and deployment of dynamic capabilities as they evolved. Findings – Dynamic capabilities can be identified as sensing, seizing and transforming. They are capable of intentional development by managers through strategic decision making and deliberative learning, within a path-dependent evolution. Research limitations/implications – A longitudinal single case study allowed for a close look at the development of dynamic capabilities, exploring the context and conditions that facilitated change and tracing the evolution of the organization’s processes. However, this study remains subject to the limits of a single case approach. Future cross-sectional research would be able to test the conceptual model and allow for generalization of the findings to other populations of firms. Practical implications – The dynamic capability concept has been criticized for being of little practical use to managers. This research shows the process of intentional dynamic capability development, offering insights to practicing managers. Originality/value – This research adds to the relatively scant base of empirical work on dynamic capabilities and offers a conceptual model of dynamic capability development. The paper contributes to the neglected area of dynamic capabilities in SME’s, showing that the dynamic capability concept is relevant to this sector. The paper provides insight for practitioners by showing that intentional dynamic capability development is achievable.

scholarly journals The prioritization and categorization method (PCM) process evaluation at Ericsson: a case study

2017 ◽  
Vol 23 (2) ◽  
pp. 377-398 ◽  
Author(s):  
Jens Ohlsson ◽  
Shengnan Han ◽  
Harry Bouwman
Keyword(s):  
Decision Making ◽  
Process Improvement ◽  
Process Management ◽  
Single Case ◽  
Management Decision ◽  
Organizational Setting ◽  
Content Type ◽  
Business Context ◽  
Management Decision Making

Purpose The purpose of this paper is to demonstrate and evaluate the prioritization and categorization method (PCM), which facilitates the active participation of process stakeholders (managers, owners, customers) in process assessments. Stakeholders evaluate processes in terms of effectiveness, efficiency and relevance against certain contextual business and industry factors. This collective evaluation serves as a foundation for the management decision-making process regarding process improvement and redesign. Design/methodology/approach The PCM is examined based on a case study at Ericsson. In total, 55 stakeholders, representing different organizational levels and functions, assessed eight core processes. Follow-up interviews and feedback after the evaluation sessions were collected for triangulation purpose. Findings The PCM helps Ericsson evaluate its processes within business context and industry environments. The results show that, to realize seamless end-to-end processes in the eight assessed processes, Ericsson has to make a greater effort to improve its process structures, governance and culture for fulfilling the needs of future business. Ericsson Steering Group is satisfied with the insights provided and has decided to train more stakeholders to use PCM. Research limitations/implications This research is based on a single case within a specific organizational setting. The results may not be necessary generalizable to other business and industry settings. Organizations need to configure PCM in consideration of their own processes and business contingencies to explore and fulfil their process improvement purposes. Originality/value This paper presents a new context-aware, easy-to-use and holistic method for business process management (BPM), the PCM. The method requires the active engagement of stakeholders, it focusses on developing dynamic BPM capabilities and fully embeds organizational contingencies and contextual factors in the decision-making regarding BPM. This paper contributes a novel method to explorative BPM.

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