Stakeholder expectations of performance in public healthcare services

2017 ◽  
Vol 25 (1) ◽  
pp. 136-157 ◽  
Author(s):  
Joseph Phiri
Keyword(s):  
Service Delivery ◽  
Healthcare Services ◽  
Macro Level ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Stakeholder Expectations ◽  
Content Type ◽  
Economic Context ◽  
Facility Level

Purpose The purpose of this paper is to explore stakeholder expectations of performance within public healthcare services from a less-developed economic context – Zambia in this case. The study emerges from extant literature indicating potential variations in stakeholder conceptions and expectations of performance within public services. Design/methodology/approach The paper draws on institutional and structuration theories to investigate cross-sectional stakeholder expectations of performance together with power relations embedded within public healthcare performance expectations. Empirical data are drawn from semi-structured interviews with 33 stakeholders including legislators, policymakers, regulators of health services, healthcare professionals and health facility managers. Findings The findings not only reiterate the constructed and multi-dimensional nature of performance but also highlight the hierarchical configuration of stakeholder expectations linking macro-level health outcomes with micro facility-level service delivery processes. Practical implications The study points towards the need of harmonising the national performance measurement (PM) framework to ensure that macro-level goals are suitably cascaded and translated into micro-level service delivery processes through bottom-up structuration linkages. Originality/value In addition to filling the gap of explicating public healthcare PM practices in a less-developed economic context, the paper integrates insights from institutional and structuration theories to depict stakeholder expectations of performance through a multi-level and hierarchical framework.

scholarly journals ICT Framework to Support a Patient-Centric approach in Public Healthcare

2020 ◽  
Vol 16 ◽  
pp. 45-76
Author(s):  
Richard Pankomera ◽  
Darelle Van Greunen
Keyword(s):  
Public Health ◽  
Information And Communication Technologies ◽  
Health Sector ◽  
Cost Effective ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Poor Countries ◽  
Patient Centric

Although Information and Communication Technologies (ICTs) in the healthcare sector are extensively deployed globally, they are not used effectively in developing countries. Many resource poor countries face numerous challenges in implementing the ICT interventions. For instance, many health applications that have been deployed are not user-centric. As a result, such ICT interventions do not benefit many health consumers. The lack of an ICT framework to support patient-centric healthcare services in Malawi renders the e-health and mhealth interventions less sustainable and less cost effective. The aim of the study was therefore to develop an ICT Framework that could support patient-centric healthcare services in the public health sector in Malawi. The comprehensive literature review and semi-structured interviews highlighted many challenges underlying ICT development in Malawi. An ICT framework for patient-centric healthcare services is therefore proposed to ensure that eHealth and mobile health interventions are more sustainable and cost effective. The framework was validated by five experts selected from different areas of expertise including mhealth application developers, ICT policy makers and public health practitioners. Results show that the framework is relevant, useful and applicable within the setting of Malawi. The framework can also be implemented in various countries with similar settings.

Building resilience in retail supply chains: Lessons learned from COVID-19 and future pathways

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Atif Saleem Butt
Keyword(s):  
Supply Chain ◽  
Supply Chains ◽  
United Arab Emirates ◽  
Cash Flows ◽  
Lessons Learned ◽  
Third Party ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Content Type ◽  
The Impact

PurposeThis study explores the countermeasures taken by retailers to mitigate the effects of COVID-19 on supply chain disruptions.Design/methodology/approachThis research uses a multiple case study approach and undertakes 36 semi-structured interviews with senior management of the four largest retailers of the United Arab Emirates. The respondents were designated at different positions such as Vice President, Director and Project Manager.FindingsResults reveal that retailers are employing six countermeasures to mitigate the effects of COVID-19 on supply chains. Particularly, retailers are securing required demand, preserving cash flows, redirecting inventory, adding capacity to their distribution centres, becoming more flexible with their direct or third-party logistics provider and finally widening delivery options for their suppliers to mitigate the impact of COVID-19.Research limitations/implicationsThis study has some limitations. First, the results of this study cannot be generalized to a broader population as it attempts to build an initial theory. Second, this study uses a cross-sectional approach to explore the countermeasures employed by retailing firms to mitigate the effects of COVID-19.Originality/valueA notable weakness in a supply chain disruption literature is an unfulfilled need for research examining the strategies employed by retailers to respond to/address the challenges posed by COVID-19. Our study fills this gap.

Managers do it their way: How managers act in a decentralised healthcare services provider organisation – a mixed methods study

2021 ◽  
pp. 095148482110654
Author(s):  
Mikael Ohrling ◽  
Sara Tolf ◽  
Karin Solberg-Carlsson ◽  
Mats Brommels
Keyword(s):  
Content Analysis ◽  
Service Delivery ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Management Model ◽  
Public Healthcare ◽  
Healthcare Organisation ◽  
Programme Theory ◽  
Local Conditions ◽  
Community Healthcare

Purpose: Decentralisation is considered a way to get managers more committed and more prone to respond to local needs. This study analyses how managers perceive a decentralised management model within a large public healthcare delivery organisation in Sweden. Design/methodology/approach: A programme theory evaluation was performed applying direct content analysis to in-depth interviews with healthcare managers. Balance score card data were used in a blinded comparative content analysis to explore relations between performance and how the delegated authority was perceived and used by the managers. Findings: Managers’ perceptions of the decentralised management model supported its intentions to enable the front-line to make decisions to better meet customer needs and flexibly adapt to local conditions. The managers appreciated and used their delegated authority. Central policies and control on human resources and investments were accepted as those are to the benefit of the whole organisation. Leadership development and organisation-wide improvement programmes were of support. Units showing high organisational performance had proactive managers, although differences in manager perceptions across units were small. Originality: This, one of the first of its kind, study of a decentralisation in service delivery organisation shows a congruence between the rationale of a management model, the managers’ perceptions of the authority and accountability as well as management practises. These observations stemming from a large public primary and community healthcare organisation has not, to our knowledge, been reported and provide research-informed guidance on decentralisation as one strategy for resolving challenges in healthcare service delivery organisations.

Mergers may enhance the legitimacy of community health organisations in neoliberal environments

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Veronique Roussy ◽  
Grant Russell ◽  
Charles Livingstone ◽  
Therese Riley
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Community Health ◽  
Social Model ◽  
Business Practices ◽  
Structured Interviews ◽  
Content Type ◽  
Comprehensive Primary Health Care ◽  
Health And Social Care ◽  
Cognitive Legitimacy

PurposeComprehensive primary health care (PHC) models are seldom implemented in high income countries, in part due to their contested legitimacy in neoliberal policy environments. This article explores how merging affected the perceived legitimacy of independent community health organisations in Victoria, Australia, in providing comprehensive PHC services.Design/methodology/approachA longitudinal follow-up study (2–3 years post-merger) of two amalgamations among independent community health organisations from the state of Victoria, Australia, was conducted. This article explores the perceived effects of merging on (1) the pragmatic, normative and cognitive legitimacy of studied organisations and (2) the collective legitimacy of these organisations in Victoria's health care system. Data were collected through 19 semi-structured interviews with key informants and subjected to template and thematic analyses.FindingsMerging enabled individual organisations to gain greater overall legitimacy as regional providers of comprehensive PHC services and thus retain some capacity to operationalise a social model of health. Normative legitimacy was most enhanced by merging, through acquisition of a large organisational size and adoption of business practices favoured by neoliberal norms. However, mergers may have destabilised the already contested cognitive legitimacy of community health services as a group of organisations and as a comprehensible state-wide platform of service delivery.Practical implicationsOver-reliance on individual organisational behaviour to maintain the legitimacy of comprehensive PHC as a model of organising health and social care could lead to inequities in access to such models across communities.Originality/valueThis study shows that organisations can manage their perceived legitimacy in order to ensure the survival of their preferred model of service delivery.

scholarly journals User-centric work environments in modular healthcare facilities

2019 ◽  
Vol 26 (6) ◽  
pp. 1047-1062
Author(s):  
Leena Aalto ◽  
Pia Sirola ◽  
Tiina Kalliomäki-Levanto ◽  
Marjaana Lahtinen ◽  
Virpi Ruohomäki ◽  
...  
Keyword(s):  
Work Environment ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Structured Interviews ◽  
Public And Private ◽  
Content Type ◽  
Healthcare Facilities ◽  
Safety Issues ◽  
User Centric ◽  
Traditional Construction

Purpose The challenges arising from the reform of the social and healthcare sector call for efficient, effective and novel processes in both public and private health and medical care. Facilities need to be designed to suit the new processes and to offer usable workspaces at different levels of healthcare services. Along with traditional construction, modular facility innovations could be one solution to these pressures. The paper aims to discuss these issues. Design/methodology/approach This case study analyzed the different usability characteristics of the work environment in modular and non-modular healthcare facilities (HCFs). The qualitative research method was based on semi-structured interviews of employees and observations of the case buildings. Findings According to the results, the usability characteristics were divided into four main categories: functionality, healthiness, safety/security and comfort. The main differences between the modular and non-modular facilities appeared to be room size, soundproofing, safety issues and the utilization of colors and artwork, which were all perceived as better realized in the non-modular facilities. The staff highlighted functionality as the most important characteristic in their work environment. They even considered functionality as a feature of a comfortable work environment. Originality/value This paper presents new knowledge and a detailed description of the opinions and experiences of healthcare professionals concerning a user-centric, usable environment in the context of modular and non-modular HCFs.

Deterrents to knowledge-sharing in the pharmaceutical industry: a case study

2015 ◽  
Vol 19 (2) ◽  
pp. 296-314 ◽  
Author(s):  
Athar Mahmood Ahmed Qureshi ◽  
Nina Evans
Keyword(s):  
Pharmaceutical Industry ◽  
Knowledge Sharing ◽  
Pharmaceutical Company ◽  
Manufacturing Industry ◽  
Current Knowledge ◽  
Pharmaceutical Manufacturing ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Content Type

Purpose – This study aims to explore deterrents to knowledge-sharing in pharmaceutical manufacturing. Effective knowledge-sharing is fundamental to stimulation of the process of knowledge absorption. The limited proximal communication between the employees in the pharmaceutical industry stifles their knowledge-sharing behaviour significantly. Design/methodology/approach – A cross-sectional case study, consisting of semi-structured interviews with managers and scientists, was conducted in a multinational pharmaceutical company in Australia. Respondents were asked to answer questions regarding their current knowledge-sharing practices and to identify organisational deterrents to knowledge-sharing. The data were condensed into themes according to the thematic analysis method. Findings – The pharmaceutical industry is extensively regulated and its excessive competitiveness is cultivating organisational reticence towards the development of a knowledge-sharing culture. Nine categories of deterrents to intra- (within) and inter-organisational (between organisations) knowledge-sharing have been identified. These categories include high cost of sharing knowledge, information technology limitations, knowledge-hiding, lack of socialisation, lack of trust culture, non-educational mindset, organisational politics, poor leadership and time pressure. Research limitations/implications – The population of this study consists of managers and practitioners working for a pharmaceutical company. Hence, the generalisability of the findings to other health-care settings is unknown. Practical implications – The findings have implications for leaders and managers who should be aware of these professional diversities, instigators as well as the ripple effects of limited knowledge-sharing to guide the organisation towards developing an optimal knowledge-sharing culture. Originality/value – A focussed investigation of knowledge-sharing behaviour within the pharmaceutical industry in Australia, considering the pressure applied to this industry over the past decade. This case study specifically focusses on the diversity of deterrents to knowledge-sharing in the pharmaceutical manufacturing industry.

Healthscape role towards customer satisfaction in private healthcare

2016 ◽  
Vol 29 (6) ◽  
pp. 600-613 ◽  
Author(s):  
Debajani Sahoo ◽  
Tathagata Ghosh
Keyword(s):  
Customer Satisfaction ◽  
Service Quality ◽  
Service Delivery ◽  
Healthcare Service ◽  
Reliability And Validity ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Valuable Insight ◽  
Content Type ◽  
Private Healthcare

Purpose – The purpose of this paper is to identify the motives that enforce consumers to find out the major determinants that frame healthscape in private healthcare service that leads to their satisfaction in a developing country like India. Design/methodology/approach – The generic motive dimensions are identified using an exploratory factor analysis. Next the reliability and validity of the factors are established followed by regression analysis using SPSS 20.0 s/w. Findings – This paper identifies six healthscape motives in the private healthcare sector named as service personnel conduct and cleanliness, service delivery and facilities, ambience, location and look, appealing decoration, and upgraded safety service, out of which only service delivery, ambience, location, and decorations contribute the most to build customer satisfaction as per their significance value. Research limitations/implications – The various dimensions of healthcare motives should be viewed as the levers of improving hospitals’ service quality in the minds of its present and future customers. This finding can offer valuable insight to the forthcoming as well as existing developer who are planning to have their healthcare service presence in India. Practical implications – This study suggests some important strategic guidelines for service positioning and market segmentation of healthcare services as per customer requirements. In the recent past, availing services from hospitals were purely utilitarian in nature. Customers were more inclined to get proper and timely services and cared more about the service quality of the healthcare service provider. Originality/value – This paper is among the few works done on understanding private healthcare service delivery process in India and customer satisfaction level from those Hospitals. This study addresses the gap by identifying a set of dimensions that are relevant to customers for a unique healthcare experience.

Nursing staff and patients’ length of stay

2019 ◽  
Vol 32 (6) ◽  
pp. 1004-1012
Author(s):  
Ioannis Moisoglou ◽  
Petros Galanis ◽  
Evangelia Meimeti ◽  
Angeliki Dreliozi ◽  
Petros Kolovos ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Nursing Staff ◽  
Work Experience ◽  
Nurse Staffing ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Nurse Education ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Content Type

Purpose The purpose of this paper is to investigate the effect of nurse staffing, nurse education and work experience on patients’ length of stay (LOS) in the Greek public hospitals. Design/methodology/approach A cross-sectional study, with retrospective administrative data, was implemented. From all seven Regional Health Authorities of Greece, 25 general surgical units in 17 public hospitals participated in the study. Findings All over the hospitals were studied, 32,287 patients ⩾17 years old and 203 nursing staff, who were working in the study units, were included in the analysis. According to the multivariate linear regression model, increased years of experience as a nurse (b= −0.04, 95% CI= −0.06 to −0.02, p=0.001) and increased percentage of registered nurse to the total nursing staff (b= −1.18, CI= −1.88 to −0.47, p=0.03) were associated with decreased patient LOS. Originality/value This was the first extended study in Greece, which explored the relationship between nurse staffing, nurse education, work experience and the LOS. The role that nurse staffing play together with its characteristics in the provision toward the quality healthcare services has already been recognized worldwide. The findings revealed the great shortage of nursing staff and the significant correlation between the work experience and educational level to patients’ LOS.

scholarly journals Attitude towards entrepreneurship: a study among Asnaf Millennials in Malaysia

2020 ◽  
Vol 14 (1) ◽  
pp. 2-14 ◽  
Author(s):  
Tengku Mohd Azizuddin Tuan Mahmood ◽  
Abdullah Al Mamun ◽  
Mohamed Dahlan Ibrahim
Keyword(s):  
Low Income ◽  
Cognitive Skills ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Content Type ◽  
Internal Locus Of Control ◽  
The Government ◽  
Entrepreneurial Activities

Purpose This study intended to determine the effect of selected entrepreneurial traits on the attitude of Asnaf Millennials in Malaysia towards entrepreneurship. Design/methodology/approach This is a cross-sectional study that collected the quantitative data via structured interviews from 310 randomly selected Asnaf Millennials from Kelantan, Malaysia. Findings The findings confirmed the positive and statistically significant effect of innovativeness, internal locus of control, need for achievement and proactive personality on the attitude of Asnaf Millennials on entrepreneurship. Originality/value This study focussed on the development of non-cognitive skills for individual characteristics regarding entrepreneurship for the benefit of development practitioners and policymakers. The government and development organisations should focus on developing entrepreneurial traits that are expected to improve the attitude towards entrepreneurship and increase the entrepreneurial activities in Malaysia. This initiative can improve the socio-economic condition of Asnaf Millennials with low income.

Nutritional status as a determinant of cognitive development among preschool children in South-Western Nigeria

2016 ◽  
Vol 118 (7) ◽  
pp. 1568-1578 ◽  
Author(s):  
Oyepeju Mary Onifade ◽  
Jesse Abiodun Otegbayo ◽  
Joshua Odunayo Akinyemi ◽  
Titus Ayodeji Oyedele ◽  
Ademola Richard Akinlade
Keyword(s):  
Preschool Children ◽  
Cognitive Function ◽  
Cognitive Development ◽  
Nutritional Status ◽  
Cognitive Performance ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Content Type ◽  
Nutritional Status Of Children

Purpose – Improving the health of children under the age of five is one of the main objectives of primary healthcare services in most developing countries. The purpose of this paper is to identify the nutritional status of children under the age of five and its impact on cognitive function. Design/methodology/approach – The cross-sectional study was carried out in a semi-urban community in south-western Nigeria. The sample consisted of 220 school children under the age of five. Anthropometric measurements including weight, height and mid arm circumference were carried out to determine the nutritional status of the children. Cognitive function of the children was assessed using a developmental checklist developed by the American Academy of Pediatrics and their performance was graded as good, fair and poor. Findings – The overall prevalence of malnutrition in this study was low with stunting, underweight and wasting recording 8.2, 6.8 and 1.8 percent, respectively thereby making stunting the most common malnutrition indicator in this study. A large proportion of the children (88.6 percent) had good cognitive performance while 11.4 and 5.5 percent had fair and poor cognitive performance, respectively. Among the various malnutrition indicators measured in this study, stunting was found to have a statistically significant association with cognitive development (p=0.005).Stunted children have multiple functional disadvantages that persist throughout childhood and poor nutrition almost certainly plays a role. This paper calls for a need for the Nigerian Government to intervene by ensuring that policies are implemented that will ensure that health and nutritional needs of preschool children are guaranteed right from conception. Originality/value – In view of the importance of nutrition for cognition in children, this research has shown that the cognitive function of preschool children can be affected by stunting and it has contributed to global data on nutrition and cognition particularly in South-Western Nigeria.

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