scholarly journals Supporting integrated care in practice

2019 ◽  
Vol 28 (1) ◽  
pp. 27-40 ◽  
Author(s):  
Jenny Billings ◽  
Rasa Mikelyte ◽  
Anna Coleman ◽  
Julie MacInnes ◽  
Pauline Allen ◽  
...  
Keyword(s):  
Integrated Care ◽  
Performance Monitoring ◽  
Expert Knowledge ◽  
National Level ◽  
Data Availability ◽  
Content Type ◽  
Support Programme ◽  
Additional Funding ◽  
Care Models ◽  
And Performance

Purpose The purpose of this paper is to investigate the perceptions of key informants on a national support programme for the development of new care models (NCM) in England (2015/2016–2017/2018). It focuses on the perceived facilitators and barriers affecting the development and implementation of the NCM programme and offers some insight into the role of national level support in enabling local integration initiatives. Design/methodology/approach A set of 29 interviews were carried out with a variety of respondents at the national level (including current and past programme leads, strategic account managers, advisors to the programme and external regulators) between October 2017 and March 2018, and analysed thematically. Findings A set of facilitative elements of the programme were identified: the development of relationships and alliances, strong local and national leadership, the availability of expert knowledge and skills, and additional funding. Challenges to success included perceived expectations from the national Vanguard programme, oversight and performance monitoring, engagement with regulators, data availability and quality, as well as timetables and timescales. Crucially, the facilitators and challenges were found to interact in dynamic and complex ways, which resulted in significant tensions and ambiguities within the support programme. Research limitations/implications While the sample was drawn from a range of different senior players and the authors ensured a diverse sample associated with the NCM support programme, it inevitably cannot be complete and there may have been valuable perspectives absent. Originality/value The paper demonstrates that the analysis of facilitators and challenges with respect to the national support of implementation of integrated care initiatives should move beyond the focus on separate influencing factors and address the tensions that the complex interplay among these factors create.

Health workforce planning under conditions of uncertainty: identifying supportive integrated care policies using scenario analysis

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gareth H. Rees ◽  
Peter Crampton ◽  
Robin Gauld ◽  
Stephen MacDonell
Keyword(s):  
Integrated Care ◽  
Scenario Analysis ◽  
Health Workforce ◽  
Interprofessional Education ◽  
Health Sector ◽  
Workforce Planning ◽  
Content Type ◽  
Health Workforce Planning ◽  
Workforce Policy ◽  
Care Models

PurposeIntegrated care presents health workforce planners with significant uncertainty. This results from: (1) these workforces are likely in the future to be different from the present, (2) integrated care's variable definitions and (3) workforce policy and planning is not familiar with addressing such challenges. One means to deal with uncertainty is scenario analysis. In this study we reveal some integration-supportive workforce governance and planning policies that were derived from the application of scenario analysis.Design/methodology/approachThrough a mixed methods design that applies content analysis, scenario construction and the policy Delphi method, we analysed a set of New Zealand's older persons health sector workforce scenarios. Developed from data gathered from workforce documents and studies, the scenarios were evaluated by a suitably qualified panel, and derived policy statements were assessed for desirability and feasibility.FindingsOne scenario was found to be most favourable, based on its broad focus, inclusion of prevention and references to patient dignity, although funding changes were indicated as necessary for its realisation. The integration-supportive policies are based on promoting network-based care models, patient-centric funding that promotes collaboration and the enhancement of interprofessional education and educator involvement.Originality/valueScenario analysis for policy production is rare in health workforce planning. We show how it is possible to identify policies to address an integrated care workforce's development using this method. The article provides value for planners and decision-makers by identifying the pros and cons of future situations and offers guidance on how to reduce uncertainty through policy rehearsal and reflection.

Entrepreneurial orientation and performance of SMEs in the services industry

2015 ◽  
Vol 28 (2) ◽  
pp. 194-212 ◽  
Author(s):  
María José Rodríguez-Gutiérrez ◽  
Pilar Moreno ◽  
Pilar Tejada
Keyword(s):  
Entrepreneurial Orientation ◽  
National Level ◽  
Business Environment ◽  
Data Set ◽  
Unit Of Analysis ◽  
Content Type ◽  
Competitive Success ◽  
Resources And Capabilities ◽  
Services Industry ◽  
And Performance

Purpose – The purpose of this paper is to examine both the sources of competitiveness of small and medium- sized enterprises (SMEs) in the services industry measured by their capability to grow, and the relative importance of each of these sources. More specifically, the resources and capabilities of Spanish SMEs in the services industry that may become sources of competitive advantage are analysed. Design/methodology/approach – In order to achieve this objective, this paper is organized as follows. First, a concise overview of prior research on determinants of performance of SMES is provided, outlining the role of factors regarding resources and capabilities. Second, a set of lineal regression models are performed to test the hypothesis research. In line with several previous studies, competitive success and performance of the company are approached through the recent evolution of firms in terms of employment, turnover and productive investment. The data set comes from a survey on Spanish SMEs operating in the services industry that was carried out between the end of 2010 and the beginning of 2011. Findings – The findings reveal that entrepreneur characteristics, firm features and managerial attributes have significant effect on the business performance. The results from the empirical analysis indicate that competitive success of the Spanish SMEs in the service industry is conditioned by macroeconomic and social factors related to the general business environment and especially by business factors concerning the entrepreneurial orientation of the firm, these findings are consistent with those of earlier research conducted at both an international level a national level. Originality/value – The fundamental contribution of SMEs to the overall performance of the economy constitutes a crucial motive for researchers to investigate and examine the key success factors behind these enterprises. This issue has been analysed exhaustively for the manufactured goods industry, but has scarcely been addressed for the services industry. Thus, further research is needed to clarify the variables explaining survival and success for services SMEs. Furthermore, since this research is focused on the microeconomic level, by considering the firm as the unit of analysis, it contributes towards complementing previous research on this topic that has been conducted from a macroeconomic approach. Thus it attempts to provide certain empirical evidences for support the traditional academic debate between economic and administrative disciplines concerning the appropriate unit of analysis for the understanding and explanation of businesses competitiveness.

Public-sector reforms and balanced scorecard adoption: an Ethiopian case study

2017 ◽  
Vol 30 (6) ◽  
pp. 1230-1256 ◽  
Author(s):  
Belete Jember Bobe ◽  
Dessalegn Getie Mihret ◽  
Degefe Duressa Obo
Keyword(s):  
Public Sector ◽  
Balanced Scorecard ◽  
Political Ideology ◽  
Performance Monitoring ◽  
Management Practices ◽  
Actor Network Theory ◽  
Content Type ◽  
Public Sector Reforms ◽  
And Performance

Purpose The purpose of this paper is to examine adoption of the balanced scorecard (BSC) by a large public-sector health organisation in an African country, Ethiopia as part of a programme to implement a unified sector-wide strategic planning and performance monitoring system. The study explains how this trans-organisational role of the BSC is constituted, and explores how it operates in practice at the sector-and organisation-levels. Design/methodology/approach The study employs the case-study method. Semi-structured interview data and documentary evidence are analysed by drawing on the concept of translation from actor-network theory. Findings The case-study organisation adopted the BSC as a part of broader public-sector reforms driven by political ideology. Through a centralised government decision, the BSC was framed as a sector-wide system aimed at: aligning the health sector’s strategic policy goals with strategic priorities and operational objectives of organisations in the sector; and unifying performance-monitoring of the sector’s organisations by enabling aggregation of performance information to a sector level in a timely manner to facilitate health sector policy implementation. While the political ideology facilitated BSC adoption for trans-organisational use, it provided little organisational discretion to integrate financial administration and human resource management practices to the BSC framework. Further, inadequate piloting of information system use for the anticipated BSC model, originating from the top-down approach followed in the BSC implementation, inhibited implementation of the BSC with a balanced emphasis between the planning and performance monitoring roles of the BSC. As a result, the BSC underwent a pragmatic shift in emphasis and was reconceptualised as a system of enhancing strategic alignment through integrated planning, compared to the balanced emphasis between the planning and performance monitoring roles initially anticipated. Originality/value The study provides a theory-based explanation of how politico-ideological contexts might facilitate the framing of novel roles for the BSC and how the roles translate into practice.

Competitive productivity in South African public–private partnerships

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daniella Fjellstrom ◽  
Paul Frick
Keyword(s):  
South African ◽  
Government Policy ◽  
Research Question ◽  
Qualitative Interviews ◽  
National Level ◽  
Secondary Data ◽  
Content Type ◽  
Moderating Factors ◽  
And Performance

PurposeThis study aims to develop the concept of competitive productivity focussing on the interplay between national competitive productivity (NCP) and firm competitive productivity (FCP) based on the following research question: how does the competitive productivity framework explain the influence that government has on public–private procurement programmes?Design/methodology/approachA case study is conducted on the South African Renewable Energy Independent Power Producer Procurement Programme. Data were collected using an exploratory, mixed methods design, starting with national level secondary data on five bid windows between 2011 and 2014, followed by eight in-depth qualitative interviews with industry experts.FindingsThe findings indicate that non-financial factors, such as trust (through consistent and transparent government policy) as well as a pragmatic attitude on the part of government, increased competition and ultimately resulted in a productive procurement process.Social implicationsBy understanding what moderating factors influence competitiveness in African procurement programmes, using competitive productivity (CP) as a framework, the research contributes to development of government policy and procurement programmes. Incidentally, there is little doubt that improving infrastructure and in turn a greater percentage of access to electricity leads to increased competitiveness of the nation, firms and individuals, thus enabling companies to grow and operate with more stability.Originality/valueOriginality is demonstrated through the interplay of NCP and FCP, where the constructs of culture, benchmarking and performance were found to have the strongest influence of the six constructs of the CP model.

Transparency and performance in Islamic banking

2014 ◽  
Vol 7 (1) ◽  
pp. 61-88 ◽  
Author(s):  
Nada Lahrech ◽  
Abdelmounaim Lahrech ◽  
Youssef Boulaksil
Keyword(s):  
Generalized Least Squares ◽  
Profit Sharing ◽  
Study Data ◽  
Data Availability ◽  
Islamic Banking ◽  
Islamic Banks ◽  
Content Type ◽  
Management Incentives ◽  
And Performance ◽  
Banking Development

Purpose – The purpose of this paper is to assess whether Islamic banks are transparent regarding profit (and loss) sharing to investment account holders. Another objective is to appraise whether Islamic banks' performance affects management incentives to distribute profit (and loss) to investment account holders. Design/methodology/approach – To investigate the research issue, the authors conducted an empirical study. Data of 25 global operating Islamic banks have been collected and analyzed for the period 2006-2010. The authors also developed a mathematical model based on the generalized least-squares principle. Findings – The research results showed that enhancing transparency will prevent Islamic banks from shadowing their profit allocation practices and place investment account holders in a better position to manage their invested funds. The study also showed that bettering Islamic banks’performance will induce them to manager profit-sharing investment account holders’ funds under bonafides. Research limitations/implications – The main limitation is data availability. The maximum number of Islamic banks that disclose financial data covering the period of 2006-2010 limited the scope of the study to 25 banks. Practical implications – The findings are very valuable for designing policies and standards as well as for the enforcement of these standards to improve transparency in Islamic banking. Originality/value – The study outcome is vital to many parties involved in the Islamic banking field and can be taken as a strong foundation to make appropriate actions that would help grow and sustain Islamic banking development globally.

scholarly journals Comparative performance-related fund flows for Malaysian Islamic and conventional equity funds

2015 ◽  
Vol 8 (3) ◽  
pp. 380-394 ◽  
Author(s):  
Ainulashikin Marzuki ◽  
Andrew Worthington
Keyword(s):  
Empirical Studies ◽  
Search Costs ◽  
Data Availability ◽  
Fund Flows ◽  
Market Returns ◽  
Comparative Performance ◽  
Content Type ◽  
Fund Flow ◽  
Equity Funds ◽  
And Performance

Purpose – The purpose of this paper is to compare the fund flow – performance relationship for Islamic and conventional equity funds in Malaysia. Design/methodology/approach – The authors use panel regression models to estimate the relationship between fund flows and performance for Islamic and conventional equity funds in Malaysia from 2001 to 2009. The data for each fund include fund flows, assets under management, management expenses, fund age, portfolio turnover, fund risk and return and the number of funds in the fund’s family. The authors also include market returns and year effects. The sample consists of 127 Malaysian equity funds with at least 65 per cent domestic equity holdings comprising 35 Islamic and 92 conventional equity funds. Findings – Islamic fund investors respond to performance in much the same way as conventional fund investors, increasing fund flows to better performing funds and decreasing fund flows to poorer performing funds. However, there is also evidence that Islamic fund investors are relatively less responsive toward poorly performing Islamic funds, suggesting an asymmetry in the expected positive fund flow – performance relationship, but only for Islamic fund investors. When choosing funds based on other fund attributes, Islamic fund investors again exhibit similar behaviour, and like conventional fund investors direct larger percentage fund flows into smaller funds as well as funds with larger past fund flows and higher expense ratios. Research limitations/implications – The authors were only able to access data on annual net fund flows not quarterly or monthly fund inflows and outflows as usual in developed markets and this may obscure some important aspects of investor decision-making. There is also insufficient data for matched-sample techniques, which may better control for fund-specific characteristics. Practical implications – Islamic funds like conventional funds will experience increased fund flows with better performance and vice versa. However, Islamic fund investors appear somewhat less likely to remove monies from poorly performing funds. The authors believe this is because investors either place a premium on the non-return attributes of Shariah-compliant funds and/or wish to avoid search costs in finding another suitable Islamic fund. Apart from this, Islamic and conventional fund investors behave in a similar manner, and the authors believe that this is possible in Malaysia given the size and diversity of its Islamic fund sector. Originality/value – This paper is one of the very few empirical studies concerning the behaviour of Islamic investors, particularly in Malaysia, primarily because of limitations in data availability.

Understanding the diversity of alliance governance in OECD healthcare settings

2019 ◽  
Vol 28 (2) ◽  
pp. 183-195 ◽  
Author(s):  
Kimberly Cousins ◽  
Robin Gauld ◽  
Richard Greatbanks
Keyword(s):  
Performance Measurement ◽  
Integrated Care ◽  
Service Providers ◽  
Oecd Countries ◽  
Narrative Review ◽  
Content Type ◽  
Healthcare Settings ◽  
Measurement Framework ◽  
Care Models ◽  
Governance Arrangements

Purpose Healthcare alliances are a mechanism for developing collaborative and integrated care governance and service delivery arrangements. Yet is not known how widespread alliance arrangements are in Organisation for Economic Co-operation and Development (OECD) countries, how alliances function or how effective they are. The purpose of this paper is to provide an overview of alliances in OECD countries, including key areas covered and how performance is measured. Design/methodology/approach A structured narrative review of literature published between 2010 and 2018 was undertaken, focussed on OECD countries. The literature included peer-reviewed articles as well as publications from key policy analysis organisations. Findings Many OECD countries have implemented integrated care models but only a small number had explicitly adopted health alliances that link primary and secondary providers under joint governance arrangements. Most alliances are pilot initiatives and not broadly adopted. Most had not adopted a unified performance measurement framework. Practical implications Policy makers and service providers interested in joint governance arrangements that support integration must consider the range of potential options overviewed in this paper, as well as how to create supportive performance measurement frameworks. Originality/value This is the first narrative review of alliance arrangements in OECD countries. It provides an overview of arrangements, while illustrating that there is considerable scope for further alliance development.

Integrated ambulatory care in the New Zealand health system: a scoping review

2020 ◽  
Vol 28 (3) ◽  
pp. 253-280
Author(s):  
Gagan Gurung ◽  
Carol Atmore ◽  
Robin Gauld ◽  
Tim Stokes
Keyword(s):  
New Zealand ◽  
Leadership Development ◽  
Ambulatory Care ◽  
Integrated Care ◽  
Scoping Review ◽  
Grey Literature ◽  
Models Of Care ◽  
Content Type ◽  
Workforce Skills ◽  
Care Models

PurposeThe purpose of this paper is to identify and describe the international and New Zealand (NZ) evidence for models of integrated ambulatory care and describe key implementation issues and lessons learnt.Design/methodology/approachA scoping review was conducted for published and grey literature on integrated care. Publications from 2000 to February 2019 that described integrated ambulatory care were included.FindingsA total of 34 articles were included. Internationally and in NZ, the most common models of integrated care found were: transfer, relocation and joint working. The international literature showed that transferring care from hospitals to community and other integrated models of care between the primary–specialist interface increased access and convenience for patients. However, there was insufficient evidence of clinical and economic outcomes. Very few NZ-based studies reported on effectiveness of models of care. Key implementation issues were: no viable and sustainable funding, lack of infrastructure, lack of confidence, trust and communication between providers, increased workload and time and knowledge and skills gap to perform new roles. The NZ literature highlighted the need for an appropriate location for services, committed leadership, development of a governance group representing different provider groups, strong communication mechanisms, new workforce skills and overall change management.Originality/valueThe review provides an overview of key components of integrated care models in ambulatory settings and identifies some common elements across the models of care. The findings can inform the design and implementation of integrated ambulatory care in health systems.

scholarly journals Big Data and what it means for evaluating integrated care programmes

2019 ◽  
Vol 27 (3) ◽  
pp. 249-258 ◽  
Author(s):  
Axel Kaehne
Keyword(s):  
Big Data ◽  
Integrated Care ◽  
Evaluation Studies ◽  
Model Development ◽  
Dynamic Modelling ◽  
Data Availability ◽  
Data Generation ◽  
Content Type ◽  
Care Integration ◽  
The Way

Purpose Big Data is likely to have significant implications for the way in which services are planned, organised or delivered as well as the way in which we evaluate them. The increase in data availability creates particular challenges for evaluators in the field of integrated care and the purpose of this paper is to set out how we may usefully reframe these challenges in the longer term. Design/methodology/approach Using the characteristics of Big Data as defined in the literature, the paper develops a narrative around the data and research design challenges and how they influence evaluation studies in the field of care integration. Findings Big Data will have significant implications for how we conduct integrated care evaluations. In particular, dynamic modelling and study designs capable of accommodating new epistemic foundations for the phenomena of social organisations, such as emergence and feedback loops, are likely to be most helpful. Big Data also generates opportunities for exploratory data analysis approaches, as opposed to static model development and testing. Evaluators may find research designs useful that champion realist approaches or single-n designs. Originality/value This paper reflects on the emerging literature and changing practice of data generation and data use in health care. It draws on organisational theory and outlines implications of Big Data for evaluating care integration initiatives.

An ICT-based framework to improve global supply chain integration for final assembly SMES

2018 ◽  
Vol 31 (5) ◽  
pp. 634-657 ◽  
Author(s):  
Tony Cragg ◽  
Tom McNamara
Keyword(s):  
Supply Chain ◽  
Supply Chains ◽  
Performance Monitoring ◽  
Supply Chain Integration ◽  
Manufacturing Companies ◽  
Content Type ◽  
Final Assembly ◽  
Information And Communication ◽  
Frame Work ◽  
And Performance

Purpose To access new markets and improve sourcing practices small to medium sized manufacturing companies (SMEs) increasingly seek suppliers and customers in distant countries. Yet these new relationships with global partners often pose problems of an agency nature. The purpose of this paper is to directly address these challenges through the proposal of an information and communication technology (ICT)-based framework. Design/methodology/approach There has been very little research into how lead SMEs manage their global supply chains and the challenges they face. This paper uses a case study investigation to analyze how four French SMEs – final assemblers of machinery in the farming and agri-business sector – manage their international supply chains. Findings It was observed that the relationships and interactions between the SMEs and their immediate upstream and downstream partners were dominated by the agency problem and fell into six distinct categories (termed “barriers” to effective supply integration), namely; asymmetries, contractual design, supplier dependence, product specifications, supply chain complexity and performance monitoring. Originality/value The contribution of this paper is that a conceptual frame work was developed in which ICT solutions are offered to help address the barriers to supply chain integration, thus reducing the overall risk exposure due to externalities and problems of agency.

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