Dealing With Pluralism: Managerial Work of CEOs in Italian Public Healthcare Organizations

Abstract Background: Healthcare organizations are extremely complex, and the work of their CEOs is particularly demanding, especially in the public sector. However, we know little about how healthcare executives’ managerial work unfolds. Drawing from scholarship on pluralistic organizations and managerial work, we answer the questions: what is the content of managerial work of executives in public healthcare? How do CEOs deal with pressures from internal and external stakeholders while maintaining a strategic agenda?Methods: We adopted a mixed method with a survey to measure CEO behaviors, coding CEOs time for four weeks; a questionnaire to understand the strategic dimensions of interactions; interviews of senior CEOs.Results: CEOs in Italian public healthcare devote most of their time to interactions, by and large responding to pressures by internal stakeholders. Although half of this time is perceived as occupied in answering operational requests, this is necessary to nurture relations, create networks and develop alliances and consensus, which are functional in achieving CEOs’ strategic agenda.Conclusions: CEOs in public healthcare must deal with enormous contextual pressures and cannot manage the complexity but are called to manage within the complexity, fostering involvement in decision making, building networks, and establishing alliances. Amidst ambiguity and fragmentation, executives need to find solutions to perform their managerial work without being entrapped by stakeholders’ pressures, thanks to effective stakeholder management as well as delegation.Trial registration: The article does not report the results of a health care intervention on human participants, and material used in the research did not need ethical approval according to Italian law.

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Anticipating on a post covid-19 world and the pivotal role of science and technology

Coronaviruses ◽

10.2174/2666796701999201116121451 ◽

2020 ◽

Vol 01 ◽

Author(s):

Saeed Khan ◽

Tusha Sharma ◽

Basu Dev Banerjee ◽

Scotty Branch ◽

Shea Harrelson

Keyword(s):

Public Health ◽

Pivotal Role ◽

Public Healthcare ◽

Healthcare Organizations ◽

Health Crisis ◽

Outbreak Management ◽

The Public ◽

Public Health Crisis ◽

Future Outbreak

: Currently, Coronavirus disease 2019 (COVID-19) has transformed into a severe public health crisis and wreaking havoc worldwide. The ongoing pandemic has exposed the public healthcare system's weaknesses and highlighted the urgent need for investments in scientific programs and policies. A comprehensive program utilizing the science and technologydriven strategies combined with well-resourced healthcare organizations appears to be essential for current and future outbreak management.

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The Outpatient Use of Ascorbic Acid in a Public Healthcare Organization in Riyadh Region

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59a34335 ◽

2021 ◽

pp. 831-835

Author(s):

Nehad J. Ahmed ◽

Mohammad Javed Ansari

Keyword(s):

Emergency Department ◽

Ascorbic Acid ◽

Retrospective Study ◽

Public Hospital ◽

Healthcare Organization ◽

Public Healthcare ◽

Healthcare Organizations ◽

The Public ◽

Electronic Prescriptions

Aim: The present study aimed to describe the outpatient use of ascorbic acid in a public healthcare organization in Riyadh Region. Methodology: This is a retrospective study included reviewing the outpatient electronic prescriptions that contained ascorbic acid in a public healthcare organization in Riyadh Region. Results: More than 51% of the patients who received ascorbic acid in the hospital during 2018 were females and the age of 57.14 % of them was less than 30 years. Most of the prescriptions were regular prescriptions (88.57%) and only 5.71% of the prescriptions were urgent prescriptions. More than 42% of the patients received ascorbic acid for 1 week and 37.14% of them received it for 1 month. Most of the prescriptions were prescribed by residents (85.71%) and most of these prescriptions were prescribed by emergency department (80.00%). Conclusion: The prescribing of ascorbic acid was uncommon in the public hospital. More studies are needed to know the frequency and the pattern of using ascorbic acid in the public hospital and in other healthcare organizations in Riyadh Region.

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Optimizing Emergency Medical Service Structures Using a Rule-Based Discrete Event Simulation—A Practitioner’s Point of View

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052649 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2649

Author(s):

Christoph Strauss ◽

Günter Bildstein ◽

Jana Efe ◽

Theo Flacher ◽

Karen Hofmann ◽

...

Keyword(s):

Discrete Event Simulation ◽

Emergency Services ◽

Prehospital Care ◽

Discrete Event ◽

Point Of View ◽

Public Healthcare ◽

Healthcare Organizations ◽

Rule Based ◽

Event Simulation ◽

Emergency Medical

Many studies in research deal with optimizing emergency medical services (EMS) on both the operational and the strategic level. It is the purpose of this method-oriented article to explain the major features of “rule-based discrete event simulation” (rule-based DES), which we developed independently in Germany and Switzerland. Our rule-based DES addresses questions concerning the location and relocation of ambulances, dispatching and routing policies, and EMS interplay with other players in prehospital care. We highlight three typical use cases from a practitioner’s perspective and go into different countries’ peculiarities. We show how research results are applied to EMS and healthcare organizations to simulate and optimize specific regions in Germany and Switzerland with their strong federal structures. The rule-based DES serves as basis for decision support to improve regional emergency services’ efficiency without increasing cost. Finally, all simulation-based methods suggest normative solutions and optimize EMS’ performance within given healthcare system structures. We argue that interactions between EMS, emergency departments, and public healthcare agencies are crucial to further improving effectiveness, efficiency, and quality.

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Earnings management in public healthcare organizations: the case of the English NHS hospitals

Public Money & Management ◽

10.1080/09540962.2020.1866854 ◽

2021 ◽

pp. 1-10

Author(s):

Seraina C. Anagnostopoulou ◽

Charitini Stavropoulou

Keyword(s):

Earnings Management ◽

Public Healthcare ◽

Healthcare Organizations

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How healthcare structures and communication delivery influence trust: a parallel-group randomized controlled trial

Journal of Public Health ◽

10.1007/s10389-021-01620-z ◽

2021 ◽

Author(s):

Stephen Cantarutti ◽

Emmanuel M. Pothos

Keyword(s):

Controlled Trial ◽

Random Order ◽

Healthcare Sector ◽

Public Healthcare ◽

The Public ◽

Private Healthcare ◽

Public Healthcare Sector ◽

Parallel Group ◽

Therapy Compliance ◽

Study Offer

Abstract Background According to recent polling, public trust in the healthcare sector remains low relative to other industries globally. The implications of low healthcare trust permeate throughout the industry in a number of ways, most visibly by discouraging therapy compliance. Methods This study investigated four putative determinants of trust in healthcare-related scenarios: individuals vs. collective groups as communicators of healthcare advice; expert vs. laypeople as providers of healthcare communication; public vs. private healthcare sector; and positive vs. negative information. Two hundred seventy-four participants were recruited via Prolific Academic and were presented with four statements in random order, related to a positive reflection of the public healthcare sector, a negative reflection of the public healthcare sector, a positive reflection of the private healthcare sector and a negative reflection of the private healthcare sector. According to these reflection, participants were repeatedly asked to rate the system on its trustworthiness. Trust outcomes were constructed using a four-dimension framework, consisting of benevolence, reliability, competence and predictability. Results Claims relating to the public sector had a significantly stronger impact on benevolence and reliability than claims relating to the private sector; claims from individuals had a significantly stronger impact on all trust variables than claims from collectives; and claims from laypeople had a significantly greater impact on reliability and competence ratings than claims from experts. Conclusions The findings in this study offer insight into the patterns with which trust decisions are made in healthcare contexts. More importantly, this research offers a novel perspective of how different factors interact to affect the various facets of trust. These results provide a foundation for future study in this evolving area, and offer insights into designing effective communication strategies that cultivate greater levels of individual trust in the healthcare sector.

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The Problems and Needs of Patients Diagnosed with Cancer and Their Caregivers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010087 ◽

2020 ◽

Vol 18 (1) ◽

pp. 87

Author(s):

Anna Lewandowska ◽

Grzegorz Rudzki ◽

Tomasz Lewandowski ◽

Sławomir Rudzki

Keyword(s):

Cancer Patients ◽

Medical Information ◽

Unmet Needs ◽

Public Healthcare ◽

Literature Analysis ◽

The Public ◽

The Mean ◽

High Level ◽

Patients Experience

(1) Background: As the literature analysis shows, cancer patients experience a variety of different needs. Each patient reacts differently to the hardships of the illness. Assessment of needs allows providing more effective support, relevant to every person’s individual experience, and is necessary for setting priorities for resource allocation, for planning and conducting holistic care, i.e., care designed to improve a patient’s quality of life in a significant way. (2) Patients and Methods: A population survey was conducted between 2018 and 2020. Cancer patients, as well as their caregivers, received an invitation to take part in the research, so their problems and needs could be assessed. (3) Results: The study involved 800 patients, 78% women and 22% men. 66% of the subjects were village residents, while 34%—city residents. The mean age of patients was 62 years, SD = 11.8. The patients received proper treatment within the public healthcare. The surveyed group of caregivers was 88% women and 12% men, 36% village residents and 64% city residents. Subjects were averagely 57 years old, SD 7.8. At the time of diagnosis, the subjects most often felt anxiety, despair, depression, feelings of helplessness (46%, 95% CI: 40–48). During illness and treatment, the subjects most often felt fatigued (79%, 95% CI: 70–80). Analysis of needs showed that 93% (95% CI: 89–97) of patients experienced a certain level of need for help in one or more aspects. (4) Conclusions: Patients diagnosed with cancer have a high level of unmet needs, especially in terms of psychological support and medical information. Their caregivers also experience needs and concerns regarding the disease. Caregivers should be made aware of the health consequences of cancer and consider appropriate supportive care for their loved ones.

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Public and private sectors collective response to combat COVID-19 in Malaysia

Journal of Pharmaceutical Policy and Practice ◽

10.1186/s40545-021-00322-x ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Ching Siang Tan ◽

Saim Lokman ◽

Yao Rao ◽

Szu Hua Kok ◽

Long Chiau Ming

Keyword(s):

Insurance Coverage ◽

Healthcare Providers ◽

Screening Tests ◽

Public Healthcare ◽

Private Hospitals ◽

Public And Private ◽

The Public ◽

Private Healthcare ◽

Care Services ◽

Challenges And Opportunities

AbstractOver the last year, the dangerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world. Malaysia has not been excluded from this COVID-19 pandemic. The resurgence of COVID-19 cases has overwhelmed the public healthcare system and overloaded the healthcare resources. Ministry of Health (MOH) Malaysia has adopted an Emergency Ordinance (EO) to instruct private hospitals to receive both COVID-19 and non-COVID-19 patients to reduce the strain on public facilities. The treatment of COVID-19 patients at private hospitals could help to boost the bed and critical care occupancy. However, with the absence of insurance coverage because COVID-19 is categorised as pandemic-related diseases, there are some challenges and opportunities posed by the treatment fees management. Another major issue in the collaboration between public and private hospitals is the willingness of private medical consultants to participate in the management of COVID-19 patients, because medical consultants in private hospitals in Malaysia are not hospital employees, but what are termed “private contractors” who provide patient care services to the hospitals. Other collaborative measures with private healthcare providers, e.g. tele-conferencing by private medical clinics to monitor COVID-19 patients and the rollout of national vaccination programme. The public and private healthcare partnership must be enhanced, and continue to find effective ways to collaborate further to combat the pandemic. The MOH, private healthcare sectors and insurance providers need to have a synergistic COVID-19 treatment plans to ensure public as well as insurance policy holders have equal opportunities for COVID-19 screening tests, vaccinations and treatment.

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Child ombudsmen as collaborators of child psychiatry ?

European Psychiatry ◽

10.1016/s0924-9338(11)72062-4 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 353-353

Author(s):

I. Škodáček

Keyword(s):

Healthcare Professionals ◽

Public Healthcare ◽

Child Psychiatrist ◽

Young Generation ◽

Public Defender ◽

European Network ◽

The Public ◽

Developmental Problems ◽

Mental Problems ◽

Abuse And Neglect

Legislation regulates rights also of individuals with mental disorders. Observance of these regulations is monitored by so-called Ombudsperson,or the Public Defender of the Rights. Since 2002, special attention has been paid to young generation in Slovakia. Developmental problems and issues of rights of ordinary and mentally handicapped children have also been dealt with, applying the paradigm that childhood is entitled to special care and assistance. And this is the ground for collaborators of the Public Defender of Rights, i.e. for school. They are helpful to parents of the minor, to teachers, healthcare professionals and to other adults working with minors. Thus the children ombudspersons become assistants of pedopsychiatry. From the viewpoint of a child psychiatrist, it was important to solve cases of Child Abuse and Neglect syndrome of various scope. Since December 2008, a project for creating the network of children collaborators of the Public Defender of Rights is in operation in Slovakia. Children from a school or other institution selected from their ranks a “children ombudsperson” who is willing to defend the rights of each member also with mental problems and disorders. For this reason is the necessity of development of international cooperation of ombudspersons for children which takes place in 22 European countries within the ENOC (The European Network of Ombudspersons for Children) which was commenced in a greater scale in April 2010. The children ombudspersons should be taken into account in the public healthcare system and they should become a part of the standard care for minor patients.

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