Governance and coordination in health care: organic processes and structural capacity

2019 ◽  
Vol 33 (7/8) ◽  
pp. 757-763
Author(s):  
Peter Nugus ◽  
Jean-Louis Denis ◽  
Denis Chênevert
Keyword(s):  
Health Care ◽  
Organizational Behavior ◽  
Health Care Delivery ◽  
Research Policy ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Human Action ◽  
Future Research ◽  
Content Type ◽  
Local Agency

Purpose The purpose of this paper is to articulate cutting-edge conceptions of the relationship between local processes in the here-and-now, and the broader influences on those processes, that are both organic and overtly designed, and to discern the implications of this relationship for future research, policy and practice. Design/methodology/approach A focused and structured approach was taken to give effect to this purpose by reviewing the chosen articles in this collection, which from the 2018 Organizational Behavior in Health Care conference papers. Findings Research in coordination within and across health care boundaries increasingly recognizes: the multilevel influences on human action and interaction in health care delivery; the challenge of balancing individual or local agency with overt interventions; the everchanging the local circumstances of healthcare delivery; and the need to foster reflexivity, that is, self-improvement capacity, in healthcare organizations. Research limitations/implications Interventions to improve care coordination must be grounded in the reality of changing local circumstances and incentives for action from the broader environment. Originality/value This paper articulates the implied tension in health care delivery between individual and local agency, and imposed structures that may contradict, but are at the same time necessary, to foster such agency.

Creating a compassion system to achieve efficiency and quality in health care delivery

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Timothy J. Vogus ◽  
Laura E. McClelland ◽  
Yuna S.H. Lee ◽  
Kathleen L. McFadden ◽  
Xinyu Hu
Keyword(s):  
Health Care ◽  
Organizational Behavior ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Quality Care ◽  
Well Being ◽  
Care Providers ◽  
Leader Behaviors ◽  
Conceptual Approach ◽  
Content Type

PurposeHealth care delivery is experiencing a multi-faceted epidemic of suffering among patients and care providers. Compassion is defined as noticing, feeling and responding to suffering. However, compassion is typically seen as an individual rather than a more systemic response to suffering and cannot match the scale of the problem as a result. The authors develop a model of a compassion system and details its antecedents (leader behaviors and a compassionate human resource (HR) bundle), its climate or the extent that the organization values, supports and rewards expression of compassion and the behaviors and practices through which it is enacted (standardization and customization) and its effects on efficiently reducing suffering and delivering high quality care.Design/methodology/approachThis paper uses a conceptual approach that synthesizes the literature in health services, HR management, organizational behavior and service operations to develop a new conceptual model.FindingsThe paper makes three key contributions. First, the authors theorize the central importance of compassion and a collective commitment to compassion (compassion system) to reducing pervasive patient and care provider suffering in health care. Second, the authors develop a model of an organizational compassion system that details its antecedents of leader behaviors and values as well as a compassionate HR bundle. Third, the authors theorize how compassion climate enhances collective employee well-being and increases standardization and customization behaviors that reduce suffering through more efficient and higher quality care, respectively.Originality/valueThis paper develops a novel model of how health care organizations can simultaneously achieve efficiency and quality through a compassion system. Specific leader behaviors and practices that enable compassion climate and the processes through which it achieves efficiency and quality are detailed. Future directions for how other service organizations can replicate a compassion system are discussed.

scholarly journals Incorporating digital self-services into integrated mental health care: a physician’s perspective

2018 ◽  
Vol 52 (11) ◽  
pp. 2234-2250 ◽  
Author(s):  
Heini Sisko Maarit Taiminen ◽  
Saila Saraniemi ◽  
Joy Parkinson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Delivery ◽  
Value Creation ◽  
Care Delivery ◽  
Service Marketing ◽  
Content Type ◽  
Integrated Mental Health ◽  
Physician’S Perspective

Purpose This paper aims to enhance the current understanding of digital self-services (computerized cognitive behavioral therapy [cCBT]) and how they could be better incorporated into integrated mental health care from the physician’s perspective. Service marketing and information systems literature are combined in the context of mental health-care delivery. Design/methodology/approach An online survey of 412 Finnish physicians was undertaken to understand physicians’ acceptance of cCBT. The study applies thematic analysis and structural equation modeling to answer its research questions. Findings Adopting a service marketing perspective helps understand how digital self-services can be incorporated in health-care delivery. The findings suggest that value creation within this context should be seen as an intertwined process where value co-creation and self-creation should occur seamlessly at different stages. Furthermore, the usefulness of having a value self-creation supervisor was identified. These value creation logic changes should be understood and enabled to incorporate digital self-services into integrated mental health-care delivery. Research limitations/implications Because health-care systems vary across countries, strengthening understanding through exploring different contexts is crucial. Practical implications Assistance should be provided to physicians to enable better understanding of the application and suitability of digital self-service as a treatment option (such as cCBT) within their profession. Additionally, supportive facilitating conditions should be created to incorporate them as part of integrated care chain. Social implications Digital self-services have the potential to serve goals beyond routine activities in a health-care setting. Originality/value This study demonstrates the relevance of service theories within the health-care context and improves understanding of value creation in digital self-services. It also offers a profound depiction of the barriers to acceptance.

scholarly journals A COMPARATIVE STUDY OF THE PERCEPTIONS OF RURAL DWELLERS TOWARDS HEALTH CARE DELIVERY

2021 ◽  
Vol 9 (04) ◽  
pp. 451-454
Author(s):  
Felix a ◽  
◽  
J. Ugwu ◽  
Clara Okenyi ◽  
◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Significant Relationship ◽  
Survey Design ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Test Analysis ◽  
Rural Dwellers

The present study aimed to comparatively analyze healthcare delivery perception among rural dwellers based on education (formal/informal) and gender. The study adopted a cross-sectional survey design. A total of two hundred rural dwellers comprising males and females participated in the study. Perception towards health care delivery was measured with a self-developed instrument with demographic information. An independent t-test analysis found no statistically significant relationship between education and perception towards health care delivery. However, the result revealed a significant relationship between gender and perception towards health care delivery. Females were found to show a more positive attitude towards health care delivery than their male counterparts. The findings and conclusions are discussed.

Managed care Medicaid

2017 ◽  
Vol 11 (2) ◽  
pp. 198-210 ◽  
Author(s):  
William Trombetta
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Care Quality ◽  
Market Segment ◽  
Economic Aspects ◽  
Content Type ◽  
The Poor

Purpose Providing health care to the poor is evolving in the new US marketplace. The Affordable Care Act has set goals enhancing access to health care, lowering costs and improving patient outcomes. A key segment in this evolution is the most vulnerable health-care population of all: Medicaid. This paper aims to provide a general review of how providing health care to Medicaid patients is changing including how socio-economic aspects of this vulnerable population affects the quality of the health care provided. Design/methodology/approach The paper is entirely secondary research; no primary research has been conducted. Findings Managed care Medicaid provides a risk-based model to treating a vulnerable health-care market segment. The jury is still out on whether managed care Medicaid (MCM) is improving health-care quality and saving cost, but the provision of health care to the Medicaid segment is definitely shifting from a fee-for-service model to value based payment. Very recent developments of new health-care delivery approaches present a positive outlook for improving quality and containing costs going forward. Research limitations/implications At this stage, whether or not MCM saves money or provides better health-care quality to this vulnerable population is a work in progress. Health-care marketing can impact socio-economic aspects of health care for the poor. There is a need to follow up on the positive results being documented in demonstration health-care delivery models. Practical implications At this point, there has been no long-term study of whether managed care Medicaid offers better quality of health care and cost savings. The research to date suggest that the quality of health-care delivery to the poor is improving at a lower cost to payers. Social implications Medicaid patients are an underserved market segment. Managed care Medicaid offers a new model that has the potential to provide quality care at acceptable cost. Critical to this vulnerable market segment is the need to integrate socio-economic aspects of the population with the delivery of health care. Originality/value There has been very little discussion of Medicaid overall in the marketing literature, much less any discussion of managed care Medicaid.

Five focus strategies to organize health care delivery

2016 ◽  
Vol 29 (2) ◽  
pp. 177-191 ◽  
Author(s):  
Antti Peltokorpi ◽  
Miika Linna ◽  
Tomi Malmström ◽  
Paulus Torkki ◽  
Paul Martin Lillrank
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Management Practices ◽  
Care Delivery ◽  
System Level ◽  
Content Type ◽  
Requisite Variety ◽  
Care Outcomes ◽  
Definition Of ◽  
Focus Strategies

Purpose – The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. The purpose of this paper is to discuss strategic options to focus health care operations. Design/methodology/approach – First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies. Findings – The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: population; urgency and severity; illnesses and symptoms; care practices and processes; and care outcomes. Research limitations/implications – Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination. Practical implications – Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization’s strategy and key performance indicators. Originality/value – Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care.

Social enterprises, health-care provision and ethical capital

2014 ◽  
Vol 10 (2) ◽  
pp. 105-120 ◽  
Author(s):  
Lucy Frith
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Services ◽  
Care Delivery ◽  
Social Enterprises ◽  
Ethical Perspective ◽  
Content Type ◽  
Care Services ◽  
The Relationship

Purpose – The aim of this paper is to advance a conceptual understanding of the role of social enterprises in health care by developing the concept of ethical capital. Social enterprises have been an important part of both the coalition and the previous government’s vision for improving health-care delivery. One of the central arguments for increasing the role of social enterprises in health care is they can provide the benefits of a public service ethos with the efficiencies and innovatory strategies of a business. Social enterprises are well placed to promote the type of values that should underpin health care delivery. Design/methodology/approach – This paper explores the conceptual issues raised by using social enterprises to provide health-care services that were previously provided by the National Health Service (NHS) from an ethical perspective. Findings – It will be argued that conceptualising social enterprises as organisations that can and should produce ethical capital could be a useful way of developing the debate over social enterprises in health care. Practical implications – The paper provides suggestions on how ethical capital might be produced and monitored in social enterprises. Originality/value – This paper advances the debate over the use of the concept of ethical capital in social enterprises and explores the relationship between ethical and social capital – both under researched areas. It also contributes to the emerging discussions of social enterprises in current health policy and their role in the radically reformed English NHS.

Physicians’ Perceptions Toward Use of Telemedicine During COVID-19 Pandemic in Riyadh, Saudi Arabia (Preprint)

2021 ◽  
Author(s):  
sarah idriss ◽  
walaa alasaadi ◽  
abdullah Aldhuhayyan ◽  
Ahmed alenzi ◽  
Reem alharbi ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Well Being ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Face To Face

BACKGROUND The use of communication technologies to deliver health care remotely is known as telemedicine. The coronavirus disease 2019 (COVID-19) pandemic had a variety of consequences for health-care delivery in 2020. As a result, it was necessary to adapt and deliver high-quality care to patients while limiting possible viral exposure for both patients and health-care workers. During the pandemic, physicians employed video visits, phone visits, and electronic written visits (e-consultations), all of which have the ability to provide a comparable quality of care while removing social barriers. OBJECTIVE The study’s aim is to assess physicians’ perspectives and attitudes concerning the usage of telemedicine in Riyadh hospitals during the COVID-19 pandemic. The main domains of the assessment are physicians’ overall experience with telemedicine use before and during COVID-19, future adaptability to using telemedicine, perceptions about patients’ experience, and the influence of telemedicine on burnout. METHODS Methods: An anonymous 28-question cross-sectional survey was developed using SurveyMonkey and distributed to all physicians from all specialty disciplines across Riyadh city hospitals. RESULTS A total of 362 doctors were included in the study. Among them, 28.7% were consultants, 30.4% were specialists, and 40.9% were residents. Male doctors formed the majority (56.1%). When asked about the frequency of using telemedicine, 41.4% answered “frequently,” 26% responded “occasionally,” and 32.6% said “never.” Thirty one percent of doctors agreed and somewhat agreed that the “quality of care during telemedicine is comparable with face-to-face visits.” About 55% doctors believed that telemedicine consultation is a cost-effective way, compared to face-to-face visits. Most of the doctors were skilled (70%) at telemedicine, and they were also able to solve technology issues during telemedicine visits (54%). Overall, the physicians felt that their patients liked telemedicine: 68% said they felt comfortable using telemedicine and 76% said theyfound that it saved time. As per the burnout question, 4.1% of doctors felt burnout every day, 7.5% felt burnout a few times a week, and 27.3% felt burnout a few times per month. CONCLUSIONS Physicians had a generally favorable attitude toward telemedicine, believing that the quality of health-care delivery using it was comparable to that of in-person care. Future research is needed to investigate how physicians’ attitudes toward telemedicine have changed since the pandemic, as well as how this virtual technology might be used to improve their professional and personal well-being.

Barriers to healthcare delivery in Iranian prisons: a qualitative study

2020 ◽  
Vol 16 (4) ◽  
pp. 373-388
Author(s):  
Ahmad Hajebrahimi ◽  
Khalil Alimohammadzadeh ◽  
Seyed Mojtaba Hosseini ◽  
Ali Maher ◽  
Mohammadkarim Bahadori
Keyword(s):  
Health Care ◽  
Human Resources ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Process Data ◽  
Health Care Managers ◽  
Barriers To Health Care ◽  
Content Type ◽  
Care Managers ◽  
Barriers To Health

Purpose High quality health-care delivery is not only the governments’ responsibility but also every prisoner’s right. Health care in prison and, particularly, of Iranian prisoners is increasingly important topic because of the rising number of the prison population. This paper aims to explore health-care managers’ perspectives and experiences of prisons and the barriers to health-care delivery in Iranian prisons. Design/methodology/approach A qualitative research design was conducted in Iran from October 2018 to August 2019. The participants consisted of 51 health-care managers (50 men and one woman) from Iranian prisons. A combination of face-to-face (N = 42) and telephonic (N = 9) semi-structured interviews were used because of the geographical distribution of the respondents. The first part of the interview guide consisted of demographic characteristics, and the second part consisted of three main open ended-questions. Interviews were recorded and transcribed, and thematic descriptive analysis was used to interpret the data. Findings The barriers to health-care delivery in Iranian prisons were categorized into four main topics: human resources, financing, facilities and barriers related to the health-care delivery process. Data synthesis identified the following themes for barriers to human resources: barriers to human resources planning (with eight sub-themes); barriers to education (with three sub-themes); and motivational barriers (with seven sub-themes). Moreover, barriers to financing consisted of five sub-themes. The barriers to facilities consisted of barriers related to physical infrastructures (with two sub-themes) and barriers related to equipment (with six sub-themes). Finally, barriers to the health-care delivery process included the following themes: communication barriers (with six sub-themes); legal barriers (with five sub-themes); and environmental-demographic factors (with seven sub-themes). Originality/value Identifying the barriers to health-care delivery in Iranian prisons plays a critical role in the improvement of planning, decision-making and the health-care delivery process.

Patient organizations supporting health care and co-creating value: insights from a simulation model

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Francesca Costanza
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Resource Planning ◽  
Positive Contribution ◽  
Care Providers ◽  
Holistic View ◽  
Content Type ◽  
Patient Organizations

Purpose Patient organizations (POs) belong to the non-profit world and carry on several activities alongside health care. However, literature devotes scarce attention to POs’ management specificities in the interaction with health-care delivery. This paper aims to describe the contribution of POs to health care from an operational point of view; investigate the effect of POs’ managerial choices on health-care performance; and provide useful insights for patient organizations and health-care management. Design/methodology/approach The paper combines qualitative case study research and system dynamics (SD). After a literature review about patient organizations’ role, modeling steps are described. In first place, the analyses of institutional documents, interviews and observations are condensed in a stock-and-flow diagram. The latter is translated into a set of differential equations to simulate the effect of alternative resource allocations. Findings The case study emphasizes PO’s educational and administrative role in supporting health-care delivery. Simulated policy scenarios, while confirming the positive contribution of patient co-created health, disclose potential divergencies in public and private/third sector decision-making, to be read considering key feedback mechanisms within the system. Originality/value This study proposes a holistic view of patient organizations’ engagement in health care. The findings highlight synergies and trade-offs of alternative managerial decisions involving POs and health-care providers, disclosing the benefits of joint resource planning.

Heart Failure Management: Optimal Health Care Delivery Programs

2000 ◽  
Vol 18 (1) ◽  
pp. 91-126 ◽  
Author(s):  
DEBRA K. MOSER
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Disease Management ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Health Care Expenditure ◽  
The United States ◽  
Future Research ◽  
Disease Management Programs ◽  
Heart Failure Disease Management

Heart failure is the single most costly health care expenditure in the United States, The major proportion of these costs is attributable to rehospitalizations, and by many estimates the majority of rehospitalizations might be preventable with better health care delivery. The past 5 years have seen an explosion in the number of heart failure disease management programs put in place across the country to try to decrease the economic burden of heart failure and improve patient outcomes. Yet few of these are based on programs tested by researchers, let alone tested in randomized, controlled trials. This chapter summarizes findings from studies of heart failure disease management programs from 1980 to the present, critiques those studies, and offers suggestions for future research in this area.

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