Buildings’ impact on effective hospital services

2014 ◽  
Vol 28 (3) ◽  
pp. 386-404 ◽  
Author(s):  
Marit Støre-Valen ◽  
Anne Kathrine Larssen ◽  
Svein Bjørberg

Purpose – The purpose of this paper is to assess the status of the physical assets of Norwegian hospital facilities in terms of technical condition, building performance, usability and adaptability, thereby comprehending the main challenges for property management as part of facilities management (FM) within hospitals of the Norwegian Specialist Health-Care Services and permitting a discussion on a more strategic property management role. Design/methodology/approach – The research is based on an action research approach using data collection from surveys, schemes and questionnaires, literature studies, documentation analysis and workshops with an active research team involvement with stakeholders. In-depth interviews were undertaken with owner representatives, property management representatives and health-care deliverers, and a GAP analysis allowed a study of the quality of property management (as part of the FM). Findings – A severe technical backlog was documented together with a strong demand for structural upgrading, which was roughly estimated to be approximately 30-35 billion NOK in 2012 (3.75-4.4 billion euros). Improvements are necessary in all areas of FM delivery within limited economic frameworks, even though several examples of good property management (as part of FM delivery) were found. A gap exists between the general strategy concerning hospital assets and the property management role, particularly with regard to the translation of change in user needs into changed facilities. A need for an increasing professionalization of the role is pressing, turning attention from operational costs and control to potential added value. This requires a shift of focus from the property manager in order to implement visions and goals for the health-care sector, which involves several actions such as an improved communication between stakeholders and technically improved skills, thus ensuring the recruitment and capability of property management staff and improved measurement processes. Practical implications – This paper give two major recommendations: first, a stronger integration of the property management role as part of the FM delivery with the executive management of the Health Authorities and Regional and Local Health Trusts; and second, a nationally coordinated strategy for the development of property management in the Specialist Health-Care Services (called Strategic FM). The authors believe that developing a pool of competencies at the national level is necessary to develop the tools, methods and standardized measurements to enable a change in the use of the terms of added value and sustainability. Ultimately, this will enhance the assets of the health sector, and this paper suggests a model that allows for this development. Originality/value – This paper shows a model for property management as a strategic role in a holistic process involving all stakeholders from both the bottom up and the top down. The authors believe this process will engage the stakeholders in agreeing upon a clear vision and set of goals for the health-care service assets.

2020 ◽  
Vol 14 (28) ◽  
pp. 486-492
Author(s):  
Francisco José Arias-Aragonés ◽  
Alexander Mauricio Caraballo-Payares ◽  
Javier Enrique Jiménez-Osorio

The article characterizes the medical tourism subsector in Bogota and Cartagena to detect potential service offers to foreign patients. We performed a comparative analysis between these two cities to identify the weaknesses, opportunities, strengths, and threats they have. The study has a quantitative research approach using primary sources of information to characterize the subsector in these cities. In Bogota, the quality of health care services, specialized infrastructure, the accreditation of some health care institutions, and the formation of the health care cluster stand out as competitive elements. Meanwhile, Cartagena shows attractive prices but has scarce health care infrastructure and health professionals, low levels of bilingual proficiency, and increased local health service needs. We conclude that there is a need to strengthen the subsector’s competitiveness in both cities, as the trend points to the growth of this type of tourism in the coming years.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ibraheem Khaled Abu Siam ◽  
María Rubio Gómez

Purpose Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan. Design/methodology/approach This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact. Findings The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake. Originality/value Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Eunju Suh ◽  
Mahdi Alhaery

PurposeWhile United States is among countries with the world’s highest coronavirus infections, its approaches and policies to reopen the economy vary by state. A lack of objective criteria and monitoring toward satisfying the criteria can lead to another COVID-19 outbreak and business closures. Considering the pressing need to return to normalcy without a rebound of COVID-19 infections and deaths, an index that provides a data-driven and objective insight is urgently needed. Hence, a method was devised to assess the severity of the COVID-19 pandemic and determine the degree of progress any state has made in containing the spread of COVID-19.Design/methodology/approachUsing measures such as the weekly averages of daily new deaths, ICU bed occupancy rates, positive cases and test positivity rates, two indexes were developed: COVID-19 reopening readiness and severity.FindingsA clear difference in the pandemic severity trends can be observed between states, which is possibly due to the disparity in the state’s response to coronavirus. A sharp upward trend in index values requires caution prior to moving to the next phase of reopening.Originality/valueThe composite indexes advanced in this study will provide a universal, standardized and unbiased view of each state’s readiness to reopen and allow comparisons between states. This in turn can help governments and health-care agencies take counter measures if needed as to the anticipated demand for future health-care services and minimize adverse consequences of opening.


2017 ◽  
Vol 13 (2) ◽  
Author(s):  
Torill Aarskog Skorpen ◽  
Marit Kvangarsnes ◽  
Torstein Hole

Health services in Norway have been described as fragmented with weak coordination between different care levels with respect to patient pathways. The Coordination Reform’s aim was to improve patient pathways and strengthen user participation. The aim of this study was to investigate health personnel ́s experiences with patient pathways in municipalities in Western Norway. A qualitative design was chosen. Six focus group interviews with health personnel working in municipalities in Western Norway were conducted in 2013 and 2014. The interviews revealed that health personnel experienced that local health services gave cohesive patient pathways and strengthened user participation. Cohesive patient pathways and locally adapted pathways were considered important. Coordination and electronic communication between primary and specialist health care services were seen as inadequate. Trust, teamwork, competence and necessary resources were considered vital. Health personnel ́s experiences indicated that the intended aim of cohesive patient pathways near the patient was met. 


2018 ◽  
Vol 31 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Susanna Hihnala ◽  
Lilja Kettunen ◽  
Marjo Suhonen ◽  
Hanna Tiirinki

Purpose The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers’ work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers (n = 7) and medical managers (n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers’ experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.


2018 ◽  
Vol 40 (2) ◽  
pp. 362-380
Author(s):  
Riitta Forsten-Astikainen ◽  
Pia Heilmann

Purpose This study examines in detail how a new occupational group in a field creates and defines its professional competences. The background of the study refers to a new way of organizing social and health care services that requires new type of expertise. The authors examine the professionals of this new sector – service agents and the competences – they need in a multi-professional networking organization. The goal of this organizational pilot project is to gather both experience and practical knowledge of how the “gatekeeper” model can work between the customer and the service provider. The purpose of this paper is to learn the service agents’ perspective on their own work, namely, how they create their work, what their visions of the future are, and what can be learned from the new organizing model. Design/methodology/approach Qualitative data collection and small-scale exploratory study of a new profession: eight service agents and their two supervisors were interviewed to raise awareness of what professional competences these new job contents require, how service agents can influence the content of their work, and what competence needs will emerge in the future. Findings The key findings indicate that service agents lack the courage to modify their own mission. When a new profession is created, they are uncertain about how to create self-content on their own terms. They assume they need a certain degree and to know something more than they already know. They do not dare define their own new professional territory, but rather wait for that definition to come from their organization or society. However, the results also show that some service agents have a hidden willingness to be creative even when there is a lack of courage. There is a need to take more initiative and for agents to think freely outside the box in this new situation. Research limitations/implications The number of interviewees is small and the context specific. However, the study gives an indication of the factors that need to be taken into account when the dissemination of the model starts. Originality/value The paper describes the results of the pilot project of a new profession and a customer-oriented model in the social and health care sector.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rimantas Stašys ◽  
Gintautas Virketis ◽  
Daiva Labanauskaitė

Purpose The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient transfers. Scientific research and statistical data show the increased number of interhospital transportation services; therefore, timely and qualified patient transportation between different health-care institutions must be considered, the activity that directly and significantly impacts the patient’s health status and overall quality of the health-care services. The successful patient transportation from the smaller hospitals to the health-care institutions with advanced intensive care or urgent care units can be enhanced through the partnership between private and public health-care institutions. Design/methodology/approach The methodology included quantitative method, statistical data analysis and theoretical data generalization. Both primary and secondary data were collected and analyzed during the research. Expert quantification was performed using the survey research method. The survey was conducted in Lithuania. The respondents were selected to be the general managers of the health-care and urgent care institutions, the chief doctors of the reanimation and intensive care department also the chief doctors of the emergency department. Findings Because of the centralization and regionalization of health-care services, the number of patients transferred between hospitals by the emergency medical services (EMS) and personal health-care institutions has increased. University hospitals are not sufficiently prepared to accept an increasing flow of patients in accordance with the Ministry of Health orders. Not all regional or district hospitals have the right to provide such assistance, which increases transportation time and costs as well as requires additional human resources. The five EMS categories could be used to improve the patient transfer between different levels of health-care institutions. To increase partnership between private and public health-care organizations, incentives should be provided for the development of private health-care organizations, as well as encouraging actions should be taken to increase the demand for private health-care services by Lithuanian patients. Practical implications Five EMS categories identified in this paper could be used to ensure a smooth mechanism for the patient transfer between different levels of the personal health-care institutions. The proposed categories should also be used in the pre-stationary emergency phase (for reducing the interhospital patient transportation amount). Social implications Properly organized secondary and tertiary interhospital patient transfers influence the availability and quality of the EMS and reduce inequalities in the provided services and social exclusion. Originality/value This paper presents the classification of the interhospital transfer issues, determines the main reasons for the patient interhospital transfer, creates the model for the EMS patient process flows and defines five EMS categories for the assessment of patient conditions. Therefore, the research conducted and the results obtained have both theoretical and social-practical value.


2019 ◽  
Vol 33 (2) ◽  
pp. 241-262 ◽  
Author(s):  
Terry J. Boyle ◽  
Kieran Mervyn

Purpose Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools. Design/methodology/approach This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development. Findings This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages. Research limitations/implications The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community. Practical implications The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles. Originality/value This paper demonstrates how health care leadership can be developed and sustained.


Author(s):  
Diya Guha Roy ◽  
Sujoy Bhattacharya

Purpose Collectively knowledge is mentioned to surpass the traditional assets such as workers, property and financial investment. The research studies on how the existing knowledge can be merged with new knowledge for further development of organizational progress is moving from nascent to active state. In this context, the applications of online data pose a research gap in the domain of hospital review ratings. The purpose of this study is to explore how this raw tacit knowledge can be transformed to explicit keywords associated with individual review ratings of the hospital. Design/methodology/approach The authors have attempted to decrypt the tacit knowledge extracted from Facebook page of nine Indian hospitals (sources for the nine hospitals) using NVivo 12.3 to explain the resources associated with the poor or good review ratings. Findings Distinct patterns emerged with review ratings and associated words, which can be used to improve the facets of health-care services. Research limitations/implications The data used are only from India catering to national and international patients. Originality/value The sentiment analysis and word cloud associated with individual review rating can be further used for devising finer branding scales, as well as be practically used for real-time branding efforts by health-care industry.


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