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1 – 10 of 190Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide…
Abstract
Purpose
Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.
Design/methodology/approach
Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).
Findings
The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.
Originality/value
Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.
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Health systems worldwide are hampered by disconnects between governance, management, and operations, which negatively impact on their ability to deliver efficient, effective, and…
Abstract
Purpose
Health systems worldwide are hampered by disconnects between governance, management, and operations, which negatively impact on their ability to deliver efficient, effective, and safe healthcare services. This paper shows how insights from the Viable System Model (VSM) can help us to conceptualise health system disconnects impacting specialist clinical services and develop solutions to address organisational fragmentation.
Design/methodology/approach
A case study of a specialist clinical service was undertaken, where the VSM was used to guide semi-structured interviews and workshops with clinicians and managers and analysis of findings.
Findings
The VSM provides a coherent way to conceptualise the disconnects and identify their structural underpinnings. Three novel organisational pathologies emerged from the study.
Research limitations/implications
This New Zealand-based study was undertaken during the COVID-19 pandemic and a period of major health system reform, introducing uncertainty into service provision that may have impacted stakeholders’ views.
Practical implications
The three novel pathologies affect how health systems define their services, their understanding of the management function, and the importance of coordination. The resulting clarity of functioning could improve service quality, staff and patient satisfaction, and the effectiveness and efficiency of healthcare service delivery.
Originality/value
This study contributes to the VSM literature on organisational pathologies by providing three novel pathologies for a perspective that may be useful beyond healthcare and invites consideration of health system disconnects as a coherent field of study.
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This viewpoint introduces a “Readiness Self-Assessment Guide” that can be used as a diagnostic tool to help health service governors and managers, particularly in Low-Middle…
Abstract
Purpose
This viewpoint introduces a “Readiness Self-Assessment Guide” that can be used as a diagnostic tool to help health service governors and managers, particularly in Low-Middle Income Countries, or those in the early stages of developing their governance program.
Design/methodology/approach
The approach uses the conceptual framework for governance developed by Barbazza and Tello (2014).
Findings
The Guide is based on five foundational elements or components of governance that frame the actual governance activities. The self-assessment process uses a sequence of real-world examples to help users of the Guide assess their organization’s “readiness” or current capacity to strengthen quality. A simple scoring process allows users to rate their organization’s progress through potential evolutionary steps. The resulting analysis is intended to be the starting point of a structured discussion among team members about priorities, enabling factors and constraints.
Practical implications
Assessment of the institutional context is a fundamental step that will enable quality teams to select the appropriate tools for their priority concerns. This Readiness Self-Assessment Guide can be used as part of that diagnostic assessment.
Originality/value
This paper is empirically derived from the author’s experience as a consultant helping health service organizations and governing authorities to develop health governance programs in several countries.
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Daryl Mahon and Michael John Norton
Supervision is an essential component of the helping professions. It provides a gatekeeping role into the quality and effectiveness of care, while also having a safeguarding and…
Abstract
Supervision is an essential component of the helping professions. It provides a gatekeeping role into the quality and effectiveness of care, while also having a safeguarding and reporting function. Moreover, practitioners' use of effective supervision is associated with various personal and organisational outcomes. Supervision is generally provided by a more senior member of the same or very similar profession. However, peer support is still a developing profession and does not, generally speaking, have peer supervisors. Although other professions can and do supervise peer workers effectively, there are various concerns that for many, the peer role gets diluted when those without lived experience are supervising peers.
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Anna Prenestini, Stefano Calciolari and Arianna Rota
During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the…
Abstract
Purpose
During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.
Design/methodology/approach
We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.
Findings
We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.
Originality/value
The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.
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Vidya Lawton, Verity Pacey, Taryn M. Jones and Catherine M. Dean
Work readiness is an important aspect of the transition from higher education to professional practice. The purpose of this study was to explore the perceptions of work readiness…
Abstract
Purpose
Work readiness is an important aspect of the transition from higher education to professional practice. The purpose of this study was to explore the perceptions of work readiness of individuals transitioning into physiotherapy practice in Australia and identify any association with personal, education and work factors.
Design/methodology/approach
Purpose-built surveys were distributed to final-year students and graduates of physiotherapy programmes nationally. Work readiness was measured using the recently validated Work Readiness Scale for Allied Health Professionals 32 (WRS-AH32), which captures the following four domains: Practical Wisdom, Interpersonal Capabilities, Personal Attributes and Organisational Acumen. The surveys also included personal, education and work data. Work readiness was expressed as percentages for total work readiness and within each domain. Independent t-tests were used to examine the influence of personal, education and work factors on work readiness.
Findings
176 participant responses were analysed (84 students and 92 graduates). Total work readiness was 80% [standard deviation (SD)8], with Practical Wisdom the highest scoring domain (91%, SD8) and Personal Attributes the lowest scoring domain (65%, SD14). Considering overall work readiness, individuals reporting some psychological symptoms scored lower than asymptomatic individuals [mean difference 7% (95% confidence interval (CI) 4 to 9)] and final-year students scored less than graduates [mean difference 3% (95%CI 0 to 5)].
Practical implications
All stakeholders, including individuals, universities and employers, need to consider further strategies to develop aspects of work readiness, particularly within the domain of Personal Attributes and those with psychological symptoms.
Originality/value
This study demonstrates that physiotherapy students and graduates perceive themselves to be well prepared to transition to the workforce.
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Ngatindriatun Ngatindriatun, Muhammad Alfarizi and Tika Widiastuti
This study aims to analyze the influence of the dimensions of Sharia hospital service standards, religiosity commitment and trust of Muslim patients on attitudes and satisfaction…
Abstract
Purpose
This study aims to analyze the influence of the dimensions of Sharia hospital service standards, religiosity commitment and trust of Muslim patients on attitudes and satisfaction, as well as the implications of loyalty.
Design/methodology/approach
This study was carried out by analyzing data obtained from a survey with purposive sampling techniques with 425 patients in an Indonesian-certified Sharia hospital and analyzing it using partial least squares structural equation modeling software to test the path modeling and the relationship between the instruments.
Findings
This study shows that hospital amenities, doctor’s services, nurses’ services, health-care technicalities and hospital environmental and administrative behavior affect patient satisfaction. In addition, religiosity and trust in encouraging patient attitudes determine patient satisfaction. High satisfaction points will increase loyalty to Sharia hospitals.
Research limitations/implications
This study encourages managers to maximize the quality of humanist Islamic medical services and the infrastructure of comfortable facilities. In addition, hospitals need to improve their holistic atmosphere, technical services and administrative behavior so that they can become essential value for hospital marketing – the development of competence and ethical behavior of health workers through various training programs internally and externally.
Originality/value
This study presents the determination of Sharia hospital service standards accompanied by a commitment to religiosity and trust as a psychological perspective of Muslim patients on attitudes and satisfaction and its implications on the brand loyalty of Indonesian Sharia hospitals that have been officially certified.
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Karthik Padamata and Rama Devi Vangapandu
The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between…
Abstract
Purpose
The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between both the groups.
Design/methodology/approach
Authors have referred to the Victorian patient satisfaction monitoring (VPSM) scale and studied the responses of 327 patients and 327 employees collected from six private Indian tertiary care hospitals. SPSS v26 software was used to conduct the data reliability test, descriptive analysis and Mann–Whitney U test.
Findings
Authors have found significant differences in perceptions of quality of care between the patients and employees in the Indian hospitals. Employees have high positive perceptions towards the provided medical care whereas the patients have less favourable perceptions for many quality indicators.
Practical implications
This study findings help the healthcare managers, practitioners and healthcare workers of the Indian hospitals to understand the perceptions of both the employees and the patients towards healthcare quality elements and help to reduce the existing perceptual gap in the process of providing quality healthcare services.
Originality/value
To the best of authors knowledge, this is one of the pioneering studies conducted in Indian healthcare industry to capture and compare the perceptions of both the employees' and the patients' perceptions of various quality of care elements. This study highlighted the existing perceptual gap between the employees and the patients on various healthcare quality elements and indicated the critical areas for improvement to provide high quality healthcare services.
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Dona Budi Kharisma and Alvalerie Diakanza
This paper aims to identify the reasons why cases of leakage of patient personal data often occur in the health sector. This paper also analyzes personal data protection…
Abstract
Purpose
This paper aims to identify the reasons why cases of leakage of patient personal data often occur in the health sector. This paper also analyzes personal data protection regulations in the health sector from a comparative legal perspective between Indonesia, Singapore and the European Union (EU).
Design/methodology/approach
This type of research is legal research. The research approach used is the statute approach and conceptual approach. The focus of this study in this research is Indonesia with a comparative study in Singapore and the EU.
Findings
Cases of leakage of patient personal data in Indonesia often occur. In 2021, the data for 230,000 COVID-19 patients was leaked and sold on the Rapid Forums dark web forum. A patient’s personal data is a human right that must be protected. Compared to Singapore and the EU, Indonesia is a country that does not yet have a law on the protection of personal data. This condition causes cases of leakage of patients’ personal data to occur frequently.
Research limitations/implications
This study analyzes the regulation and protection of patients’ personal data in Indonesia, Singapore and the EU to construct a regulatory design for the protection of patients’ personal data.
Practical implications
The results of this study are useful for constructing regulations governing the protection of patients’ personal data. The regulation is to protect the patient’s personal data like a patient’s human right.
Social implications
The ideal regulatory design can prevent data breaches. Based on the results of comparative studies, in Singapore and the EU, cases of personal data leakage are rare because they have a regulatory framework regarding the protection of patients’ personal data.
Originality/value
Legal strategies that can be taken to prevent and overcome patient data breaches include the establishment of an Act on Personal Data Protection; the Personal Data Protection Commission; and management of patients’ personal data.
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Oti Amankwah, Weng-Wai Choong and Naana Amakie Boakye-Agyeman
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always…
Abstract
Purpose
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always managed and maintained with the attention required. This is due mainly to the complexity of health-care infrastructure and equipment and shortage of maintenance budget. This study aims to determine if patient’s satisfaction of core health-care business is mediated by the quality of health-care infrastructure and equipment.
Design/methodology/approach
This cross-sectional study comprises 622 adult patients at the Physician OPD and Polyclinic of Komfo Anokye Teaching hospital, Tamale Teaching hospital and Cape Coast Teaching hospital in Ghana. Structural equation model Smart PLS was used to analyse the data.
Findings
The study results showed that the quality of health-care infrastructure and equipment has a positive significant influence (mediation) on the relationship between health-care delivery and patient’s satisfaction as well as the relationship between adequacy of health-care resources and patient’s satisfaction. However, it was shown not to have a positive significant influence (mediation) on the relationship between quality of health-care personnel and patients’ satisfaction as well as health-care administrative process and patient’s satisfaction.
Research limitations/implications
First, the study findings are centred on cross-sectional data, which capture the opinion of the patients at a specific time period instead of over a period of time. Consequently, in future, though difficult to achieve, a longitudinal study can be piloted to provide more insight. Second, the data was collected from only one country (Ghana); thus, the ability to generalise the results may be a challenge.
Practical implications
The implication of this study is that there is the need to prudently maintain hospital infrastructure and equipment in good working condition as it has a positive effect on patients’ satisfaction of their overall health-care experience.
Originality/value
Most studies have concentrated on patient’s health-care experience. This study extends the knowledge of patient’s health-care experience by determining the mediating role of quality of health-care infrastructure and equipment on the relationship between patient’s satisfaction and core health-care business. There are limited studies of such nature in Ghana. Therefore, this study will provide invaluable empirical data for the health-care sector of a developing African country.
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