scholarly journals La quinta disciplina e le organizzazioni che apprendono nel Management sanitario

2013 ◽  
Vol 62 (6) ◽  
Author(s):  
Claudio Pensieri ◽  
Maddalena Pennacchini

Cultura del presente, della fretta, unitamente al fatto che le aziende, comprese le aziende sanitarie, si sono trasformate da complicate in complesse rende difficile gestire le conseguenze impreviste e dare significato a una nuova situazione economico-organizzativa. La Quinta Disciplina della Sloan School of Management del MIT è una strada percorsa da anni nel mondo del business ma inesplorata nel mondo della Sanità Italiana. In questo articolo vogliamo esporre le basi teoriche del funzionamento della “Quinta Disciplina” con particolare attenzione a: “Le sette incapacità di apprendere”, riservandoci l’opportunità di approfondire l’argomento de: “Le cinque leggi” e de: “I sei archetipi sistemici” in altre occasioni. ---------- Culture of “now”, of “hurry”, with the fact that companies, including healthcare organizations, turned from complicated to complex, makes it difficult to manage the unintended consequences and to give meaning to a new situation and economic organization. The Fifth Discipline of the MIT Sloan School of Management is a road traveled for years in the business world but it is unexplored in the Italian Healthcare System. In this article we explain the theoretical basis of the functioning of the “Fifth Discipline” with particular attention to: “The seven inability to learn”, reserving the opportunity to deepen the topic of: “The Five Laws” and the “Six systemic archetypes” in other papers.

2020 ◽  
Vol 17 (4, Special Issue) ◽  
pp. 369-376
Author(s):  
Raffaela Casciello ◽  
Fiorenza Meucci

The aim of the paper is to investigate COVID-19-related issues currently affecting the Italian Healthcare System and offer causes for reflection on how to deal efficiently with risk management criticalities. Through the lenses of the Quality in Extreme Adversity (QEA) action framework, such reflections benefit from a greater depth of holistic analysis on risk management opportunities and threats towards both renewing and protecting the welfare services of the Italian Healthcare System. The complexity and urgency to overcome the multitude of risks require healthcare organizations to intervene immediately with integrated top-down enterprise-wide approaches of risk management. In such conditions, the adoption of ad hoc shaped ERM models could be the right solution for facing adequately the inefficiencies in pandemic management.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ginevra Gravili ◽  
Francesco Manta ◽  
Concetta Lucia Cristofaro ◽  
Rocco Reina ◽  
Pierluigi Toma

PurposeThe aim of this paper is to analyze and measure the effects of intellectual capital (IC), i.e. human capital (HC), relational capital (RC) and structural capital (SC), on healthcare industry organizational performance and understanding the role of data analytics and big data (BD) in healthcare value creation (Wang et al., 2018). Through the assessment of determined variables specific for each component of IC, the paper identifies the guidelines and suggests propositions for a more efficient response in terms of services provided to citizens and, specifically, patients, as well as predicting effective strategies to improve the care management efficiency in terms of cost reduction.Design/methodology/approachThe study has a twofold approach: in the first part, the authors operated a systematic review of the academic literature aiming to enquire the relationship between IC, big data analytics (BDA) and healthcare system, which were also the descriptors employed. In the second part, the authors built an econometric model analyzed through panel data analysis, studying the relationship between IC, namely human, relational and structural capital indicators, and the performance of healthcare system in terms of performance. The study has been conducted on a sample of 28 European countries, notwithstanding the belonging to specific international or supranational bodies, between 2011 and 2016.FindingsThe paper proposes a data-driven model that presents new approach to IC assessment, extendable to other economic sectors beyond healthcare. It shows the existence of a positive impact (turning into a mathematical inverse relationship) of the human, relational and structural capital on the performance indicator, while the physical assets (i.e. the available beds in hospitals on total population) positively mediates the relationship, turning into a negative impact of non-IC related inputs on healthcare performance. The result is relevant in terms of managerial implications, enhancing the opportunity to highlight the crucial role of IC in the healthcare sector.Research limitations/implicationsThe relationship between IC indicators and performance could be employed in other sectors, disseminating new approaches in academic research. Through the establishment of a relationship between IC factors and performance, the authors implemented an approach in which healthcare organizations are active participants in their economic and social value creation. This challenges the views of knowledge sharing deeply held inside organizations by creating “new value” developed through a more collaborative and permeated approach in terms of knowledge spillovers. A limitation is given by a fragmented policymaking process which carries out different results in each country.Practical implicationsThe analysis provides interesting implications on multiple perspectives. The novelty of the study provides interesting implications for managers, practitioners and governmental bodies. A more efficient healthcare system could provide better results in terms of cost minimization and reduction of hospitalization period. Moreover, dissemination of new scientific knowledge and drivers of specialization enhances best practices sharing in the healthcare sector. On the other hand, an improvement in preventive medicine practices could help in reducing the overload of demand for curative treatments, on the perspective of sharply decreasing the avoidable deaths rate and improving societal standards.Originality/valueThe authors provide a new holistic framework on the relationship between IC, BDA and organizational performance in healthcare organizations through a systematic review approach and an empirical panel analysis at a multinational level, which is quite a novelty regarding the healthcare. There is little research focussed on healthcare industries' organizational performance, and, specifically, most of the research on IC in healthcare delivered results in terms of theoretical contribution and qualitative analyzes. The authors even contributed to analyze the healthcare industry in the light of the possible existence of synergies and networks among countries.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S592-S592
Author(s):  
Kelley M Boston ◽  
Luis Ostrosky-Zeichner ◽  
Misti G Ellsworth ◽  
Tawanna A McInnis-Cole

Abstract Background Measles is a highly infectious illness that is causing increased numbers of outbreaks in the United States. Patients involved in a healthcare measles exposure and who have been discharged before identification of exposure are at risk of becoming infectious in the community, and may seek healthcare within their infectious window, creating a secondary exposure risk for healthcare systems. A measles exposure in an integrated healthcare system occurred, resulting in patient exposures in multiple locations at three campuses, including two community-based emergency departments and three inpatient units. There were 159 patients who were included in the exposure group; 123 were exposed in an ED, and 36 were exposed in an inpatient setting. Ninety-four percent (149/159) of the patients had been discharged at the time of measles case identification and were in the pre-infectious phase of illness. Of those, 36 percent (54/149) presented back to the healthcare system within the potentially infectious window; these 54 patients had 97 individual healthcare contacts in the potentially infectious period following the exposure event. Sixty-one of the 97 return visits (63%) were within the window in which the exposed patients were potentially infectious. Return locations included the three exposure facilities and inpatient and outpatient locations at 10 other system campuses. Methods An alert system was developed within the electronic medical record that identified patients that were involved in the exposure, and guided clinicians to mask and place in airborne isolation until measles immunity was verified. Results The alert activated 13 days after the exposure was identified, and identified 100% of returns to healthcare at all sites within the system, representing 48% of all potential secondary exposure events (29 /61). No secondary exposures or transmission occurred. Conclusion Measles exposures are an enormous burden on healthcare organizations and public health systems. When exposures occur, healthcare organizations need systems to rapidly identify discharged patients who may return within the potentially infectious window. Rapid development of electronic readmission alerts can help standardize identification and reduce the risk of subsequent exposure. Disclosures All authors: No reported disclosures.


2020 ◽  
Vol 27 (6) ◽  
pp. 957-962 ◽  
Author(s):  
Jedrek Wosik ◽  
Marat Fudim ◽  
Blake Cameron ◽  
Ziad F Gellad ◽  
Alex Cho ◽  
...  

Abstract The novel coronavirus disease-19 (COVID-19) pandemic has altered our economy, society, and healthcare system. While this crisis has presented the U.S. healthcare delivery system with unprecedented challenges, the pandemic has catalyzed rapid adoption of telehealth, or the entire spectrum of activities used to deliver care at a distance. Using examples reported by U.S. healthcare organizations, including ours, we describe the role that telehealth has played in transforming healthcare delivery during the 3 phases of the U.S. COVID-19 pandemic: (1) stay-at-home outpatient care, (2) initial COVID-19 hospital surge, and (3) postpandemic recovery. Within each of these 3 phases, we examine how people, process, and technology work together to support a successful telehealth transformation. Whether healthcare enterprises are ready or not, the new reality is that virtual care has arrived.


2018 ◽  
Vol 10 (10) ◽  
pp. 123 ◽  
Author(s):  
Melkamu D. Kassa ◽  
Jeanne Grace

Introduction: Physical exercise is recognized as one component of non-communicable disease prevention, but little attention has been devoted to integrating physical exercise into the Ethiopian healthcare system, with the barriers to its inclusion being unclear. Objectives: The present study explores the bottlenecks to integrate physical exercise into the Ethiopian healthcare system to treat non-communicable disease. Design: A mixed method sequential explanatory design. Setting: Public referral hospitals in Ethiopia. Methodology: Data was collected in two phases among 312 (195 males and 117 females) healthcare professionals. The participants were selected proportionately and randomly from 13 public referral hospitals. Results: Lack of: national coordination to promote physical exercise (t (311) = 69.20, p < .0005), trained physical exercise professionals (t (311) = 14.42, p < .0005); physical exercise guidelines (t (311) = 33.25, p < .0005); training how to prescribe physical exercise by healthcare providers (t (311) = 62.94, p < .0005); information on the health benefits of physical exercise to give to their patients (t (311) = 65.62, p < .0005); and built environment that encourages physical exercise participation (t (311) = 59.64, p < .0005) were identified as barriers. Additionally, built environment, policy, healthcare professionals' lifestyle, demography of healthcare professionals, health information coverage of physical exercise and the hospital physical building were also identified as barriers. Conclusions: Physical exercise appears marginalized from the Ethiopian healthcare system. Healthcare organizations and policy makers could take the cited barriers into consideration to plan, design and integrate physical exercise into the healthcare system to prevent NCDs in Ethiopia.


2021 ◽  
Vol 9 (4) ◽  
pp. p8
Author(s):  
Joumana A. Younis ◽  
Hussin Jose Hejase ◽  
Hala Rashid Dalal ◽  
Nabila Abbas Ibrahim ◽  
Ale J. Hejase

Nurse turnover has become a continuous and increasing challenging problem in the healthcare system worldwide; and this became a priority that needs to be adequately managed. As a matter of fact, nurses are care givers and represent the frontline services that hospitals deliver to their patients, so it is an indispensable necessity to retain this workforce through both job satisfaction and job motivation. Providing the nurse workforce an appropriate treatment will surely lead to retention of talent that is critical to the continuity of the healthcare organizations. This research aims to assess the impact of Human Resource Management (HRM) practices mainly in relation to job satisfaction on nurses’ turnover intention, especially that Lebanon is one of the countries where the healthcare system is suffering from nurses’ shortage. This study uses a descriptive correlational study based on a structured questionnaire administered to 100 nurses within North Lebanon Hospitals. The collected data statistical analysis is carried out via the Statistical Product and Service Solutions SPSS-version 25. Results revealed that the absence of efficient HR practices forces nurses toward turnover decision. Thus, the creation of supported and motivated environment will positively affect the nurses’ decision to stay, and thus minimize the turnover rate.


2020 ◽  
Author(s):  
Emily L. DeWit ◽  
Emily M. Meissen-Sebelius ◽  
Robin P. Shook ◽  
Kimberly Ann Pina ◽  
Evelyn Donis De Miranda ◽  
...  

Abstract Background Children in food-insecure families face increased barriers to meeting recommendations for fruit and vegetable consumption. Hospitals and pediatric healthcare institutions have attempted to alleviate food-insecurity through various internal programs like food prescriptions, yet little evidence for these programs exist. Consistent with a patient-centered perspective, we sought to develop a comprehensive understanding of barriers to fruit and vegetable consumption and a parent-driven agenda for healthcare system action. Methods We conducted six qualitative focus group discussions (four in English, two in Spanish) with 29 parents and caregivers of patients who had screened positive for food-insecurity during visits to a large pediatric healthcare system in a midwestern U.S. city. Out iterative analysis process consisted of audio-recording, transcribing and coding discussions, aiming to produce a) a conceptual framework of barriers to fruit and vegetable consumption and b) a synthesis of participant programmatic suggestions for their healthcare system. Results Participants were 90% female, 41% Black/African American and 41% Hispanic/Latino. Barriers to fruit and vegetable consumption in their families fell into three intersecting themes: affordability, accessibility and desirability. Participant-generated intervention recommendations were multilevel, suggesting healthcare systems focus not only on clinic and community-based action, but also advocacy for broader policies that alleviate barriers to acquiring healthy foods. Conclusion Parents envision an expanded role for healthcare systems in ensuring their children benefit from a healthy diet. Finding offers critical insight on why clinic-driven programs aimed to address healthy eating may have failed and healthcare organizations may more effectively intervene by adopting a multilevel strategy.


2020 ◽  
Author(s):  
Emily L. DeWit ◽  
Emily M. Meissen-Sebelius ◽  
Robin P. Shook ◽  
Kimberly Ann Pina ◽  
Evelyn Donis De Miranda ◽  
...  

Abstract Background: Children in food-insecure families face increased barriers to meeting recommendations for fruit and vegetable consumption. Hospitals and pediatric healthcare institutions have attempted to alleviate food-insecurity through various internal programs like food prescriptions, yet little evidence for these programs exist. Consistent with a patient-centered perspective, we sought to develop a comprehensive understanding of barriers to fruit and vegetable consumption and a parent-driven agenda for healthcare system action. Methods: We conducted six qualitative focus group discussions (four in English, two in Spanish) with 29 parents and caregivers of patients who had screened positive for food-insecurity during visits to a large pediatric healthcare system in a midwestern U.S. city. Our iterative analysis process consisted of audio-recording, transcribing and coding discussions, aiming to produce a) a conceptual framework of barriers to fruit and vegetable consumption and b) a synthesis of participant programmatic suggestions for their healthcare system.Results: Participants were 90% female, 38% Black/African American and 41% Hispanic/Latino. Barriers to fruit and vegetable consumption in their families fell into three intersecting themes: affordability, accessibility and desirability. Participant-generated intervention recommendations were multilevel, suggesting healthcare systems focus not only on clinic and community-based action, but also advocacy for broader policies that alleviate barriers to acquiring healthy foods. Conclusion: Parents envision an expanded role for healthcare systems in ensuring their children benefit from a healthy diet. Findings offer critical insight on why clinic-driven programs aimed to address healthy eating may have failed and healthcare organizations may more effectively intervene by adopting a multilevel strategy.


2020 ◽  
Vol 47 (3) ◽  
pp. 267-279
Author(s):  
Ariel C. Avgar ◽  
Adrienne E. Eaton ◽  
Rebecca Kolins Givan ◽  
Adam Seth Litwin

Even before the word pandemic reentered the lexicon, pressures stemming from institutional and technological change challenged policymakers and provider organizations to rethink core features of the manner in which we deliver healthcare. This essay introduces a special issue devoted to the consequences of change on the healthcare sector’s varied stakeholders. It does so in the context of our eventual, post-coronavirus reemergence and a renewed interest in remaking the healthcare system in light of its obvious deficiencies. Towards that end, we introduce the five papers composing this special issue, each of which informs the ways that change actually transpires in healthcare organizations and systems.


2022 ◽  
pp. 349-365
Author(s):  
Sema Üstgörül

In a globalized and complicated international economy, executives believe that management culture will be given new direction by management teams comprised of both men and women, and that these mixed teams will contribute to the diversity of ideas and perspectives in management. Despite the fact that there are as many female graduates as male graduates today, women continue to be significantly underrepresented in executive roles in the business world, particularly in top management (executive board, supervisory board). The most important factor preventing women from being managers is work-family balance. While women indeed tend to climb the ladder step by step, men make several jumps in their careers, and they meet with success. It makes no difference whether a candidate for a position as a board member, director, or divisional manager is male or female. The goal of this study is to try to demonstrate that female managers may be more effective in management because of their personalities and areas of competence in the healthcare sector.


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