scholarly journals Governance tensions in the healthcare sector: a contrasting case study in France

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Laurent Mériade ◽  
Corinne Rochette
Keyword(s):  
Public Management ◽  
Health Sector ◽  
Healthcare Sector ◽  
Healthcare Organisation ◽  
Structured Interviews ◽  
Business World ◽  
For Profit ◽  
Not For Profit ◽  
Four Levels

Abstract Background Political and managerial reforms affect the health sector by translating into governance tensions. As identified in the public management literature, these tensions come from the diffusion of management principles and practices from the business world. These tensions manifest at four levels: institutional, organisational, managerial and instrumental. The aim of this research is to understand how these tensions are expressed in healthcare organisations of different status. Methods We conduct a contrasting case study exploring the cases of two French healthcare organisations, one private for-profit (clinic) and one public not-for-profit (cancer treatment centre). Our analyses are mainly based on the content analysis of 32 semi-structured interviews conducted with staff (nurses, doctors, management and administrative staff) of these two organisations. Results Our results show that these tensions can be distinguished into three categories (tensions on professional values, standards and practices) which are expressed differently depending on the type of healthcare organisation and its main management characteristics. Conclusions Unexpectedly, in the for-profit organisation, the most intense tensions concern professional standards, whereas they concern professional practices in the not-for-profit organisation. These analyses can help guide policy makers and healthcare managers to better integrate these tensions into their political and managerial decisions.

scholarly journals Governance Tensions in the Healthcare Sector: A Contrasting Case Study in France

2021 ◽  
Author(s):  
Laurent Mériade ◽  
Corinne Rochette
Keyword(s):  
Public Management ◽  
Health Sector ◽  
Healthcare Sector ◽  
Structured Interviews ◽  
Business World ◽  
For Profit ◽  
Not For Profit ◽  
Treatment Centre ◽  
Four Levels

Abstract Background: Political and managerial reforms affect the health sector by translating into governance tensions. As identified in the public management literature, they come from the diffusion of management principles and practices from the business world. They manifest at four levels: institutional, organisational, managerial and instrumental. The objective of this research is to understand how these tensions express healthcare institutions with different status. Methods: We conduct a contrasting case study exploring the cases of two French healthcare institutions, one private for-profit (clinic) and one public not-for-profit (cancer treatment centre). Our analyses are mainly based on the content analysis of 32 semi-structured interviews conducted with staff (nurses, doctors, management and administrative staff) of these two institutions.Results: Our results show that these tensions can be distinguished into three categories (tensions on professional values, standards and practices) which are expressed differently depending on the type of healthcare institution and its main management characteristics.Conclusions: Unexpectedly, in the for-profit institution, the most intense tensions concern professional standards, whereas they concern professional practices in the not-for-profit institution. These analyses can help guide policy makers and health care managers to better integrate these tensions into their political and managerial decisions.

scholarly journals Barriers to knowledge sharing in third sector social care: a case study

2016 ◽  
Vol 20 (1) ◽  
pp. 125-145 ◽  
Author(s):  
Lyndsay Bloice ◽  
Simon Burnett
Keyword(s):  
Knowledge Sharing ◽  
Social Service ◽  
Social Care ◽  
Third Sector ◽  
Structured Interviews ◽  
Case Study Methodology ◽  
Content Type ◽  
For Profit ◽  
Not For Profit

Purpose – This paper aims to build on existing theory of knowledge sharing barriers (KSBs) by exploring the concept in the relatively under-researched context of social service not-for-profit organisations. Design/methodology/approach – In this study, case study methodology was used. Practitioner staff members took part in online questionnaires, followed by semi-structured interviews with line management and middle management staff. Secondary sources from the case study organisation were also used in the analysis. The analysis of questionnaire responses alongside responses from semi-structured interviews is compared with extant research into KSBs. Findings – The findings of this study highlight the need to re-examine the KSBs identified in the literature to reflect contexts beyond the private sector. Common barriers were identified, but some found in the case study organisation did not neatly fit into the existing definitions of KSBs. An updated list of KSBs to reflect this social service not-for-profit context is presented. Research limitations/implications – Case studies are often not generalisable; however, the KSB list developed here could be further explored and tested in other third sector organisations. Practical implications – The research raises the question of applicability of current knowledge management (KM) theory and lexicon in the third sector and social care environment. Originality/value – This study provides an insight into KM applicability in a third sector context, which is a relatively under-developed research area.

Building capacity in the healthcare sector: A strengths-based approach for increasing employees' well-being and organisational resilience

2019 ◽  
Vol 26 (3) ◽  
pp. 309-323 ◽  
Author(s):  
Yvonne Brunetto ◽  
Tom Dick ◽  
Matthew Xerri ◽  
Ashley Cully
Keyword(s):  
Training Program ◽  
Appreciative Inquiry ◽  
Positive Emotions ◽  
Well Being ◽  
Theoretical Framework ◽  
Healthcare Sector ◽  
Healthcare Organisation ◽  
Building Capacity ◽  
For Profit ◽  
Not For Profit

AbstractThis study uses Appreciative Inquiry (AI) as a lens for informing the process for building on employees' existing wellbeing within one Australian organisation, using the ‘discovery, dreaming, designing, and achieving destiny’ process. Using POSH as a theoretical framework, we worked with a large Not-For-Profit healthcare organisation as part of the ‘discovery’ phase to identify elements of what was positive, flourishing, and life-giving in the practices of their employees. During the ‘dreaming’ process, employees' wellbeing was identified as a strength. During the ‘designing’ phase, a training program was co-designed to build on employees' existing levels of wellbeing. This paper reports outcomes as part of the ‘achieving destiny component’ of the AI process. In particular, the outcomes show that employees' knowledge of, and ability to use positive emotions increased, which is a positive first step for increasing employees' wellbeing and organisational resilience.

scholarly journals How performance measurement influences stakeholders in not-for-profit organizations

2017 ◽  
Vol 37 (9) ◽  
pp. 1164-1184 ◽  
Author(s):  
Haley Allison Beer ◽  
Pietro Micheli
Keyword(s):  
Performance Measurement ◽  
Single Case ◽  
Institutional Logics ◽  
Performance Goals ◽  
Content Type ◽  
For Profit ◽  
Not For Profit ◽  
And Performance ◽  
The Uk

Purpose The purpose of this paper is to examine the influences of performance measurement (PM) on not-for-profit (NFP) organizations’ stakeholders by studying how PM practices interact with understandings of legitimate performance goals. This study invokes institutional logics theory to explain interactions between PM and stakeholders. Design/methodology/approach An in-depth case study is conducted in a large NFP organization in the UK. Managers, employees, and external partners are interviewed and observed, and performance-related documents analyzed. Findings Both stakeholders and PM practices are found to have dominant institutional logics that portray certain goals as legitimate. PM practices can reinforce, reconcile, or inhibit stakeholders’ understandings and propensity to act toward goals, depending on the extent to which practices share the dominant logic of the stakeholders they interact with. Research limitations/implications A theoretical framework is proposed for how PM practices first interact with stakeholders at a cognitive level and second influence action. This research is based on a single case study, which limits generalizability of findings; however, results may be transferable to other environments where PM is aimed at balancing competing stakeholder objectives and organizational priorities. Practical implications PM affects the experience of stakeholders by interacting with their understanding of legitimate performance goals. PM systems should be designed and implemented on the basis of both their formal ability to represent organizational aims and objectives, and their influence on stakeholders. Originality/value Findings advance PM theory by offering an explanation for how PM influences attention and actions at an individual micro level.

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.

scholarly journals Enhancing GDPR compliance through data sensitivity and data hiding tools

2021 ◽  
Vol 27 (7) ◽  
pp. 650-666
Author(s):  
Xabier Larrucea ◽  
Micha Moffie ◽  
Dan Mor
Keyword(s):  
Health Services ◽  
Data Hiding ◽  
Industry 4.0 ◽  
Health Sector ◽  
Healthcare Sector ◽  
Sensitive Information ◽  
Sensitive Data ◽  
Architectural Model ◽  
Data Sensitivity

Since the emergence of GDPR, several industries and sectors are setting informatics solutions for fulfilling these rules. The Health sector is considered a critical sector within the Industry 4.0 because it manages sensitive data, and National Health Services are responsible for managing patients’ data. European NHS are converging to a connected system allowing the exchange of sensitive information cross different countries. This paper defines and implements a set of tools for extending the reference architectural model industry 4.0 for the healthcare sector, which are used for enhancing GDPR compliance. These tools are dealing with data sensitivity and data hiding tools A case study illustrates the use of these tools and how they are integrated with the reference architectural model.

Nurse perspectives on the psychosocial care of patients with urinary incontinence in home hospice: A qualitative study

2021 ◽  
pp. 026921632110433
Author(s):  
David Russell ◽  
Michelina D Stoddard ◽  
Natalie Morgan ◽  
Margaret V McDonald ◽  
Ritchell Dignam ◽  
...  
Keyword(s):  
New York ◽  
Urinary Incontinence ◽  
Disease Process ◽  
Psychosocial Care ◽  
Psychosocial Issues ◽  
Structured Interviews ◽  
For Profit ◽  
Not For Profit ◽  
Qualitative Descriptive ◽  
Psychosocial Benefits

Background: Urinary incontinence is prevalent among patients receiving home hospice and presents multiple care management challenges for nurses and family caregivers. Aim: This study sought to understand how urinary incontinence influences the psychosocial care of patients receiving home hospice and the strategies that nurses employ to maximize patient and family comfort. Design: Qualitative descriptive study using semi-structured interviews. Setting/participants: Nurses employed at a large not-for-profit hospice agency in New York City. Results: Analyses of 32 interviews revealed three primary themes. First, nurses considered urinary incontinence to be associated with multiple psychosocial issues including embarrassment for patients and caregiver burden. Second, nurses described urinary incontinence as a threat to patient dignity and took steps to preserve their continence function. Third, nurses assisted patients and their families to cope with urinary incontinence through normalization, reframing incontinence as part of the disease process, mobilizing caregiving assistance, and encouraging use of continence supplies such as diapers and liners. Conclusion: Urinary incontinence influences the psychosocial care of patients receiving home hospice and nurses employ strategies to maximize patient and family comfort. Additional research is needed to examine the psychosocial benefits of facilitated discussions with patients and family members about incontinence, provision of caregiving support, and distribution of comprehensive incontinence supplies to patients with fewer resources.

E-Government's Role in Shifting the Paradigm of Performance in the Public Sector

2020 ◽  
pp. 497-514
Author(s):  
Lidia Noto
Keyword(s):  
Dynamic Simulation ◽  
Public Management ◽  
Structured Interviews ◽  
The Public ◽  
Government Services ◽  
The World ◽  
Critical Issues ◽  
Government Project ◽  
Feedback Structure

The emergence of e-government changed the world of the Public Administration (PA) and the discipline of Public Management dramatically. Through the presentation of a case- study of the municipality of Palermo, this article attempts to discuss the renewed need for assessing performance of e-government services in a local government and to disclose the main critical issues in accomplishing this evaluation. Palermo is experiencing the implementation of a second- generation e-government project that is embodied in the realization of a web portal. The conceptualization of a framework to assess the performance of the digital services appears to be crucial in order to improve the system and to avoid the errors of the first project. This work relies on a survey to the citizens and semi-structured interviews to managers in charge of the development of the project. System Dynamics, a particular kind of dynamic simulation, is used to provide the necessary feedback structure for identifying the determinants of the success of the portal.

E-Government's Role in Shifting the Paradigm of Performance in the Public Sector

2015 ◽  
Vol 2 (4) ◽  
pp. 29-45 ◽  
Author(s):  
Lidia Noto
Keyword(s):  
Public Administration ◽  
Public Management ◽  
Structured Interviews ◽  
The Public ◽  
Digital Services ◽  
The World ◽  
Critical Issues ◽  
Government Project ◽  
Feedback Structure

The emergence of e-government changed the world of the Public Administration (PA) and the discipline of Public Management dramatically. Through the presentation of a case- study of the municipality of Palermo, this article attempts to discuss the renewed need for assessing performance of e-government services in a local government and to disclose the main critical issues in accomplishing this evaluation. Palermo is experiencing the implementation of a second- generation e-government project that is embodied in the realization of a web portal. The conceptualization of a framework to assess the performance of the digital services appears to be crucial in order to improve the system and to avoid the errors of the first project. This work relies on a survey to the citizens and semi-structured interviews to managers in charge of the development of the project. System Dynamics, a particular kind of dynamic simulation, is used to provide the necessary feedback structure for identifying the determinants of the success of the portal.

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