scholarly journals The Importance of Leadership and Organizational Capacity in Shaping Health Workers’ Motivational Reactions to Performance-Based Financing: A Multiple Case Study in Burkina Faso

2019 ◽  
Vol 8 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Amandine Fillol ◽  
Julia Lohmann ◽  
Anne-Marie Turcotte-Tremblay ◽  
Paul-André Somé ◽  
Valéry Ridde
Keyword(s):  
Organizational Context ◽  
Health Workers ◽  
Multiple Case Study ◽  
Health Facilities ◽  
Health System Strengthening ◽  
Effect Change ◽  
Performance Levels ◽  
Performance Based Financing ◽  
Multiple Case

Background: Performance-based financing (PBF) is currently tested in many low- and middle-income countries as a health system strengthening strategy. One of the main mechanisms through which PBF is assumed to effect change is by motivating health workers to improve their service delivery performance. This article aims at a better understanding of such motivational effects of PBF. In particular, the study focused on organizational context factors and health workers’ perceptions thereof as moderators of the motivational effects of PBF, which to date has been little explored. Methods: We conducted a multiple case study in 2 district hospitals and 16 primary health facilities across three districts. Health facilities were purposely sampled according to pre-PBF performance levels. Within sampled facilities, 82 clinical skilled healthcare workers were in-depth interviewed one year after the start of the PBF intervention. Data were analyzed using a blended deductive and inductive process, using self-determination theory (SDT) as an analytical framework. Results: Results show that the extent to which PBF contributed to positive, sustainable forms of motivation depended on the "ground upon which PBF fell," beyond health workers’ individual personalities and disposition. In particular, health workers described three aspects of the organizational context in which PBF was implemented: the extent to which existing hierarchies fostered as opposed to hindered participation and transparency; managers’ handling of the increased performance feedback inherent in PBF; and facility’s pre-PBF levels in regards to infrastructure, equipment, and human resources. Conclusion: Our results underline the importance of leadership styles and pre-implementation performance levels in shaping health workers’ motivational reactions to PBF. Ancillary interventions aimed at fostering participatory as opposed to directional leadership or start-up support to low-performing health facilities will likely boost PBF effects in regards to the development of valuable motivational capacities.

scholarly journals In Education and in Work: The Globalized Community College

2002 ◽  
Vol 32 (2) ◽  
pp. 47-77
Author(s):  
John S. Levin
Keyword(s):  
Community College ◽  
Community Colleges ◽  
Organizational Context ◽  
Multiple Case Study ◽  
The United States ◽  
Work Behaviors ◽  
Educational Programming ◽  
Field Methods ◽  
Multiple Case

This is a multiple case study of seven colleges using field methods research to examine institutional life and organizational context. This study determines that community colleges in both Canada and the United States exhibited educational and work behaviors in the 1990s consistent with the globalization process. Education was oriented to the marketplace, and the needs of business and industry received high priority in educational programming. Work within these institutions was valued for and carried out with economic ends: to realize productivity and efficiency.

scholarly journals System-wide lean implementation in health care: A multiple case study

2018 ◽  
Vol 31 (2) ◽  
pp. 60-73 ◽  
Author(s):  
Federica Centauri ◽  
Pamela Mazzocato ◽  
Stefano Villa ◽  
Marta Marsilio
Keyword(s):  
Health Care ◽  
Organizational Context ◽  
Multiple Case Study ◽  
Hospital System ◽  
Lean Implementation ◽  
Organizational Conditions ◽  
Effective System ◽  
Efficiency Performance ◽  
Multiple Case

Background Lean practices have been widely used by health care organizations to meet efficiency, performance and quality improvement needs. The lean health care literature shows that the effective implementation of lean requires a holistic system-wide approach. However, there is still limited evidence on what drives effective system-wide lean implementation in health care. The existing literature suggests that a deeper understanding of how lean interventions interact with the organizational context is necessary to identify the critical variables to successfully sustain system-wide lean strategies. Purpose and methodology: A multiple case study of three Italian hospitals is conducted with the aim to explore the organizational conditions that are relevant for an effective system-wide lean implementation. A conceptual framework, built on socio-technical system schemas, is used to guide data collection and analysis. Findings: The analysis points out the importance to support lean implementation with an integrated and coordinated strategy involving the social, technical, and external components of the overall hospital system.

What are the factors associated with the implementation of a peer-led health promotion program? Insights from a multiple-case study

2019 ◽  
Vol 34 (6) ◽  
pp. 578-591
Author(s):  
A Lorthios-Guilledroit ◽  
J Filiatrault ◽  
L Richard
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Conceptual Framework ◽  
Program Implementation ◽  
Organizational Context ◽  
Multiple Case Study ◽  
Health Promotion Program ◽  
Structured Interviews ◽  
Multiple Case

Abstract Peer education is widely used as a health promotion strategy. However, few efforts have been undertaken to understand the implementation of peer-led health promotion programs (HPPs). This multiple-case study identifies factors facilitating the implementation of a peer-led HPP for older adults presenting with fear of falling (Vivre en �quilibre) and their mechanisms of action. It used a conceptual framework postulating factors that may influence peer-led HPPs implementation and mechanisms through which such factors may generate implementation outcomes. Six independent-living residences for older adults in Quebec (Canada) implemented Vivre en �quilibre as part of a quasi-experimental study. Implementation factors and outcomes were documented through observation diaries, attendance sheets, peers’ logbooks, questionnaires administered to participants and semi-structured interviews conducted among peers, activity coordinators of residences and a subgroup of participants. The analysis revealed three categories of factors facilitating program implementation, related to individuals, to the program and to the organizational context. Three action mechanisms identified in the framework (interaction, self-organization and adaptation) were facilitated by some of these factors. These findings support the application of the peer-led program implementation conceptual framework used in this study and provide insights for practitioners and researchers interested in implementing peer-led HPPs.

Die Problematik der Implementierung von Kinästhetik in Einrichtungen der stationären Langzeitpflege – Eine Multiple Case-Study

Pflege ◽  
2020 ◽  
pp. 1-9
Author(s):  
Carola Maurer ◽  
Heidrun Gattinger ◽  
Hanna Mayer
Keyword(s):  
Multiple Case Study ◽  
Multiple Case

Zusammenfassung. Hintergrund: Einrichtungen der stationären Langzeitpflege investieren seit Jahren Ressourcen in die Entwicklung der Kinästhetikkompetenz der Pflegenden. Aus aktuellen Studien geht hervor, dass die Implementierung, bzw. die nachhaltige Förderung der Kinästhetikkompetenz problematisch ist, vertiefte Erkenntnisse zu den Ursachen fehlen jedoch. Fragestellung: Welche Hemmnisse verhindern eine nachhaltige Implementierung von Kinästhetik in Einrichtungen der stationären Langzeitpflege? Methode: Es wurde eine Multiple Case-Study in drei Einrichtungen der deutschsprachigen Schweiz durchgeführt. Aus leitfadengestützten Interviews und (fallbezogener) Literatur zum externen Kontext wurden in den Within-Case-Analysen die Daten induktiv verdichtet und diese Ergebnisse in der Cross-Case-Synthese miteinander verglichen und abstrahierend zusammengeführt. Ergebnisse: Die Synthese zeigt, dass die Implementierung von Kinästhetik innerhalb der Einrichtung auf drei verschiedenen Ebenen – der Leitungs-, Pflegeteam- und Pflegeperson-Ebene – als auch durch externe Faktoren negativ beeinflusst werden kann. Schlussfolgerungen: In der Pflegepraxis und -wissenschaft sowie im Gesundheitswesen benötigt es ein grundlegendes Verständnis von Kinästhetik und wie dieses im Kontext des professionellen Pflegehandelns einzuordnen ist. Insbesondere Leitungs- und implementierungsverantwortliche Personen müssen mögliche Hemmnisse kennen, um entsprechende Strategien entwickeln zu können.

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