Management accountants’ role and coercive regulations: evidence from the Italian health-care sector

2020 ◽  
Vol 17 (3) ◽  
pp. 405-433
Author(s):  
Chiara Oppi ◽  
Emidia Vagnoni
Keyword(s):  
Health Care ◽  
Role Conflict ◽  
Information Needs ◽  
Health Care Organizations ◽  
Secondary Data ◽  
University Hospital ◽  
Content Type ◽  
Conflicting Information ◽  
Management Accountants ◽  
Emilia Romagna Region

Purpose This paper aims to investigate the consequences of the coercive regulations for performance measurement and comparability that strengthened regional health authority’s control over organizations’ activities on management accountants’ relationship with clinician managers, who are the recipients of accounting information for decisional processes in health-care organizations. To achieve this aim, the research focuses on management accountants’ perception of their role and whether they perceive role conflict and role ambiguity. Design/methodology/approach A case study was undertaken in a public university hospital in the Emilia-Romagna region, Italy; 9 management accountants and 11 clinician managers were interviewed and secondary data analyzed. Findings Management accountants show low capabilities to support clinician managers’ decisional processes. Following the enactment of regulations, management accountants perform their role with a primary focus on functional responsibility. The focus on the provision of information to address regulations influenced management accountants’ capability to act as business partners in the organization. Because of the conflicting information needs from regulations and clinician managers, management accountants experience role conflict and ambiguity. Research limitations/implications The paper has implications for policymakers, underlining the consequences of strict regulations on management accountants’ role. It also emphasizes the importance of revising accounting techniques to satisfy both regional requirements and clinician managers’ needs for decision-making. Originality/value The article contributes to knowledge related to the role of management accountants in health care. It explores, in particular, the consequences of coercive regulations in health-care organizations, adding knowledge to a field that remains quite unexplored.

Social media as a platform for information and support for coronavirus: analysis ofCOVID-19 Facebook groups

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Maryam Shekofteh ◽  
Maryam Andalib-Kondori
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Design Methodology ◽  
Information Needs ◽  
Descriptive Statistics ◽  
Public Knowledge ◽  
Care Providers ◽  
Analysis Method ◽  
Content Type ◽  
Content Analysis Method

Purpose This study aims to investigate the characteristics, as well as the purpose and posts of the COVID-19 Facebook groups. Design/methodology/approach A systematic search for COVID-19 Facebook groups was conducted on June 1, 2020. Characteristics of the groups were examined using descriptive statistics. Mann-Whitney test was used to study the differences between groups. The study of the most popular groups’ posts was also carried out using the content analysis method. Findings The groups had a combined membership of 2,729,061 users. A total of 147,885 posts were received. There were about approximately 60% public groups. A high percentage of the groups (86.5%) had descriptions. The results showed a significant relationship between the groups’ description status and the number of members (p-value = 0.016). The majority of COVID-19 Facebook groups (56%) were created to meet their members’ information needs. The highest number of studied posts were related to vaccination (35.2%), followed by curfew rules (19.6%) and symptoms (10.6%). Originality/value Translating these insights into policies and practices will put policymakers and health-care providers in a stronger position to make better use of Facebook groups to support and enhance public knowledge about COVID-19.

Imprecise DEA framework for evaluating health-care performance of districts

Kybernetes ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 706-727 ◽  
Author(s):  
E. Ertugrul Karsak ◽  
Melis Almula Karadayi
Keyword(s):  
Health Care ◽  
Performance Evaluation ◽  
Health Care Organizations ◽  
Health Sector ◽  
Evaluation Methodology ◽  
Policy Makers ◽  
Content Type ◽  
Relative Evaluation ◽  
Health Care Performance ◽  
Care Performance

Purpose This paper aims to address performance measurement in the health-care sector, which gains increasing importance for most countries because growing health expenditures and increased quality and competition in the health sector require hospitals to use their resources efficiently. Health policy-makers and health-care managers stress the need for developing a robust performance evaluation methodology for health-care organizations. Design/methodology/approach This paper presents an imprecise data envelopment analysis (DEA) framework for evaluating the health-care performance of 26 districts in Istanbul, a metropolis with nearly 15 million inhabitants. The proposed methodology takes into account both quantitative and qualitative data represented as linguistic variables for performance evaluation. Moreover, this study reckons that weight flexibility in DEA assessments can lead to unrealistic weighting schemes for some inputs and outputs, which are likely to result in overstated efficiency scores for a number of decision-making units (in here, districts). To overcome this problem, a weight restricted imprecise DEA model that constrains weight flexibility in DEA is proposed. Findings The proposed imprecise DEA approach sets forth a more realistic decision methodology for evaluating the relative health-care performance and also enables to determine the best district in terms of health-care performance in Istanbul. Originality/value This paper includes the quality dimension, which has been overlooked in previous studies, into the health-care performance evaluation of districts. Moreover, it circumvents unrealistic weight flexibility which may distort the relative evaluation of health-care performance.

Strategic leadership and management factors driving sustainability in health-care organizations in Thailand

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Suparak Suriyankietkaew ◽  
Pavinee Kungwanpongpun
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Performance Outcomes ◽  
Equation Modeling ◽  
Strategic Leadership ◽  
Sustainable Leadership ◽  
Leadership And Management ◽  
Content Type ◽  
Positive Effects ◽  
Management Factors

Purpose This empirical study aims to identify the essential strategic leadership and management factors underlying sustainability in healthcare. It also examines which factors drive sustainability performance outcomes (SPO) in health-care organizations, an analysis lacking to date. It provides a strategic leadership and management perspective toward sustainable healthcare, responding to the United Nations Sustainable Development Goals.Design/methodology/approachThe investigation adopted Sustainable Leadership as its research framework. Using a cross-sectional survey, 543 employees working in health-care and pharmaceutical companies in Thailand voluntarily provided responses. Factor analyses and structural equation modeling were employed.Findings The results revealed an emergent research model and identified 20 unidimensional strategic leadership and management factors toward sustainability in healthcare. The findings indicate significant positive effects on SPO in health-care organizations. Significant factors include human resource management/development, ethics, quality, environment and social responsibility, and stakeholder considerations.Research limitations/implicationsThe study was conducted in one country. Future studies should examine these relationships in diverse contexts. In practice, health-care firms should foster significant strategic leadership and management practices to improve performance outcomes for sustainability in healthcare.Originality/value This paper is the first empirical, multidisciplinary study with a focus on strategic leadership, health-care management and organizational sustainability. It identifies a proxy for measuring the effects of essential strategic leadership and managerial factors for sustainability in pharmaceutical health-care companies. It advances our currently limited knowledge and provides managerial implications for improving performance outcomes toward sustainable healthcare.

Measuring change attitudes in health care organizations

2019 ◽  
Vol 33 (3) ◽  
pp. 266-285
Author(s):  
Kira Isabel Hower ◽  
Holger Pfaff ◽  
Christoph Kowalski ◽  
Michel Wensing ◽  
Lena Ansmann
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Healthcare Providers ◽  
Attitude Scale ◽  
Equation Modeling ◽  
Cancer Center ◽  
Successful Implementation ◽  
Content Type ◽  
Attitudes Toward Change ◽  
Change Attitude

Purpose Measuring attitudes of healthcare providers and managers toward change in health care organizations (HCOs) has been of widespread interest. The purpose of this paper is to evaluate the psychometric characteristics and usability of an abbreviated German version of the Change Attitude Scale. Design/methodology/approach The Change Attitude Scale was used in a survey of healthcare providers and managers in German hospitals after the implementation of a breast cancer center concept. Reliability analysis, confirmatory factor analysis, structural equation modeling and bivariate analysis were conducted. Findings Data from 191 key persons in 82 hospitals were analyzed. The item-scale structure produced an acceptable model fit. Convergent validity was shown by significant correlations with measures of individuals’ general opinions of the breast center concept. A non-significant correlation with a scale measuring the hospital’s hierarchical structure of leadership verified discriminant validity. The interaction of key persons’ change attitude and hospitals’ change performance through change culture as a mediator supported the predictive validity. Research limitations/implications The study found general support for the validity and usability of a short version of the German Change Attitude Scale. Practical implications Since attitudes toward change influence successful implementation, the survey may be used to tailor the design of implementation programs and to create a sustainable culture of high readiness for change. Originality/value This is the first study finding that a short instrument can be used to measure attitudes toward change among healthcare providers and managers in HCOs.

Can complexity science inform physician leadership development?

2016 ◽  
Vol 29 (3) ◽  
pp. 251-263 ◽  
Author(s):  
Colleen Marie Grady
Keyword(s):  
Complex System ◽  
Health Care ◽  
Leadership Development ◽  
Patient Outcomes ◽  
Health Care Organizations ◽  
Complexity Science ◽  
Primary Role ◽  
Physician Leadership ◽  
Content Type ◽  
Physician Leaders

Purpose The purpose of this paper is to describe research that examined physician leadership development using complexity science principles. Design/methodology/approach Intensive interviewing of 21 participants and document review provided data regarding physician leadership development in health-care organizations using five principles of complexity science (connectivity, interdependence, feedback, exploration-of-the-space-of-possibilities and co-evolution), which were grouped in three areas of inquiry (relationships between agents, patterns of behaviour and enabling functions). Findings Physician leaders are viewed as critical in the transformation of healthcare and in improving patient outcomes, and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system, such as health care. Physician leadership development remains a low priority for most health-care organizations, although physicians admit to being limited in their capacity to lead. This research was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can provide data regarding leadership development for physicians. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician’s relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership and medical education that provides minimal opportunity for leadership skill development. Practical Implications This research provides practical applications for physician leadership development and emphasizes that it is incumbent upon physicians and organizations to focus attention on this to achieve improved patient and organizational outcomes. Originality/value This study pairing complexity science and physician leadership represents a unique way to view the development of physician leaders within the context of the complex system that is health care.

Country-of-origin and brand positioning for health care services

2019 ◽  
Vol 13 (2) ◽  
pp. 183-199 ◽  
Author(s):  
Katherine A. Meese ◽  
Thomas L. Powers ◽  
Andrew N. Garman ◽  
Seongwon Choi ◽  
S. Robert Hernandez
Keyword(s):  
Health Care ◽  
Consumer Culture ◽  
Health Care Organizations ◽  
Country Of Origin ◽  
Eastern Health ◽  
Unique Contribution ◽  
Brand Positioning ◽  
High Involvement ◽  
Content Type ◽  
Chi Square Analysis

PurposeThe purpose of this paper is to examine the relationship between country-of-origin (COO) and brand positioning in the context of the high-involvement service of health care. This paper compares and analyzes different positioning strategies used in Europe, North America and the Middle East.Design/methodology/approachThis paper uses content analysis of promotional materials for a sample of 168 health-care organizations located in 14 countries to identify brand positioning strategies used, such as foreign, local and global consumer culture positioning. A chi-square analysis and post hoc testing is used to examine how positioning strategies differ among regions.FindingsThe findings indicate that European and Middle Eastern health-care organizations most frequently use foreign consumer culture positioning, while North American institutions tend to use global consumer culture positioning. The findings indicate that health-care organizations in countries with a better reputation for care use different positioning strategies than in countries with a lesser reputation for quality care.Practical implicationsThe findings are of value to international advertising and marketing professionals and hospitals seeking to attract patients globally in a competitive marketplace. Hospitals must consider their positioning relative to both domestic and international competitors and the COO of their target audience.Originality/valueCOO is important in high-involvement service industries because consumers lack the information needed to evaluate service quality. Consumers may rely on COO and brand positioning signals more heavily relative to goods or low-involvement services. However, little prior research exists examining COO effects and brand positioning for high involvement services and for health care specifically. This paper makes a unique contribution by filling this gap.

Managing gender diversity in healthcare: getting it right

2017 ◽  
Vol 30 (1) ◽  
pp. 92-100 ◽  
Author(s):  
Paul Vanderbroeck ◽  
Jean-Blaise Wasserfallen
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Gender Diversity ◽  
Negative Influence ◽  
Organizational Level ◽  
Team Leaders ◽  
Content Type ◽  
Maximum Benefit ◽  
Team Productivity ◽  
Published Research

Purpose Diversity, notably gender diversity, is growing in health care, both at the level of teams and the level of organizations. This paper aims to describe the challenges for team leaders and leaders of organizations to manage this diversity. The authors believe that more could be done to help leaders master these challenges in a way that makes diverse teams and organizations more productive. Design/methodology/approach Drawing on previously published research, using gender diversity as an example, the paper first describes how diversity can both have a positive and a negative influence on team productivity. Next, it describes the challenge of gender diversity at an organizational level, using Switzerland as an example. Findings The first part of the paper espouses the causes of gender diversity, undoes some of the myths surrounding diversity and presents a model for effective management of diversity in teams. The second part looks at gender diversity at an organizational level. Drawing from sources inside and outside healthcare, the effects of the “leaking pipeline”, “glass wall” and “glass ceiling” that prevent health-care organizations from leveraging the potential of female talent are discussed. Practical implications The authors propose a model developed for intercultural teamwork as a framework for leveraging gender diversity for better team productivity. Proposals are offered to health-care organizations on how they can tip the gender balance at senior levels into their favor, so as to get the maximum benefit from the available talent. Originality/value Applying the “how to” ideas and recommendations from this general review will help leaders of health-care organizations gain a better return on investment from their talent development as well as to increase the productivity of their workforce by a better use of diverse talent.

Patient safety culture: finding meaning in patient experiences

2015 ◽  
Vol 28 (6) ◽  
pp. 595-610 ◽  
Author(s):  
Andrea C. Bishop ◽  
Brianna R. Cregan
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Safety Culture ◽  
Health Care Organizations ◽  
Patient Safety Culture ◽  
Patient Experiences ◽  
Qualitative Inquiry ◽  
Data Set ◽  
Content Type ◽  
Family Stories

Purpose – The purpose of this paper is to determine what patient and family stories can tell us about patient safety culture within health care organizations and how patients experience patient safety culture. Design/methodology/approach – A total of 11 patient and family stories of adverse event experiences were examined in September 2013 using publicly available videos on the Canadian Patient Safety Insitute web site. Videos were transcribed verbatim and collated as one complete data set. Thematic analysis was used to perform qualitative inquiry. All qualitative analysis was done using NVivo 10 software. Findings – A total of three themes were identified: first, Being Passed Around; second, Not Having the Conversation; and third, the Person Behind the Patient. Results from this research also suggest that while health care organizations and providers might expect patients to play a larger role in managing their health, there may be underlying reasons as to why patients are not doing so. Practical implications – The findings indicate that patient experiences and narratives are useful sources of information to better understand organizational safety culture and patient experiences of safety while hospitalized. Greater inclusion and analysis of patient safety narratives is important in understanding the needs of patients and how patient safety culture interventions can be improved to ensure translation of patient safety strategies at the frontlines of care. Originality/value – Greater acknowledgement of the patient and family experience provides organizations with an integral perspective to assist in defining and addressing deficiencies within their patient safety culture and to identify opportunities for improvement.

Not for the faint of heart

2014 ◽  
Vol 9 (1) ◽  
pp. 47-65 ◽  
Author(s):  
Ann-Marie Urban ◽  
Elizabeth Quinlan
Keyword(s):  
Health Care ◽  
Data Collection ◽  
Health Care Organizations ◽  
Institutional Ethnography ◽  
Health Care Environment ◽  
Care Environment ◽  
Collection Method ◽  
Content Type ◽  
Data Collection Method ◽  
Health Care Context

Purpose – The purpose of this paper is to share two researcher's experience about the challenges associated with shadowing within the health care context. Design/methodology/approach – Institutional ethnography and shadowing. Findings – Shadowing is increasingly being used as a data collection method, however, before proceeding to use this approach in today's health care environment, the researcher must give thoughtful consideration to the context. Originality/value – This paper provides a reflexive elaboration of the differences between the insider and outsider perspective when using the shadowing data collection method within health care organizations.

The performance of primary health care organizations depends on interdependences with the local environment

2016 ◽  
Vol 30 (6) ◽  
pp. 836-854 ◽  
Author(s):  
Paul Lamarche ◽  
Lara Maillet
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Organizational Climate ◽  
Design Methodology ◽  
Health Care Organizations ◽  
Local Environment ◽  
Content Type ◽  
Primary Health ◽  
Optimal Execution ◽  
Do So

Purpose Improving the performance of health care organizations is now perceived as essential in order to better address the needs of the populations and respect their ability to pay for the services. There is no consensus on what is performance. It is increasingly considered as the optimal execution of four functions that every organization must achieve in order to survive and develop: reach goals; adapt to its environment; produce goods or services and maintain values; and a satisfying organizational climate. There is also no consensus on strategies to improve this performance. The paper aims to discuss these issues. Design/methodology/approach This paper intends to analyze the performance of primary health care organizations from the perspective of Kauffman’s model. It mainly aims to understand the often contradictory, paradoxical and unexpected results that emerge from studies on this topic. Findings To do so, the first section briefly presents Kauffman’s model and lays forward its principal components. The second section presents three studies on the performance of primary organizations and brings out the contradictory, paradoxical and unexpected results they obtained. The third section explains these results in the light of Kauffman’s model. Originality/value Kauffman’s model helps give meaning to the results of researches on performance of primary health care organizations that were qualified as paradoxical or unexpected. The performance of primary health care organizations then cannot be understood by only taking into account the characteristics of these organizations. The complexity of the environments in which they operate must simultaneously be taken into account. This paper brings original development of an integrated view of the performance of organizations, their own characteristics and those of the local environment in which they operated.

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