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Article
Publication date: 1 May 2023

Elizabeth A. Cudney, Clair Reynolds Kueny and Susan L. Murray

As healthcare continues to become more expensive and complex, considering the voice of the patient in the design and operation of healthcare practices is important. Wound care and…

Abstract

Purpose

As healthcare continues to become more expensive and complex, considering the voice of the patient in the design and operation of healthcare practices is important. Wound care and rural healthcare scenarios pose additional complexities for providers and patients. This study sought to identify key determinants of patient service quality in wound care.

Design/methodology/approach

Patients at the wound care/ostomy clinic (WOC) in a rural hospital were surveyed using the Kano model. The Kano model enables the categorization of quality attributes based on the attributes' contribution to the subject's overall satisfaction (and dissatisfaction). Chi-square goodness-of-fit testing, multinomial analysis and power analysis were then used to determine the Kano categories for each satisfaction-related attribute.

Findings

The analyses resulted in 14 one-dimensional attributes and 3 indeterminable attributes. For the one-dimensional attributes, customer satisfaction is directly proportional to the level of performance for that attribute. The one-dimensional attributes included providing correct care on the first, provision of necessary supplies for care, appropriately qualified medical staff and confidence in care provided by medical staff, among others. Understanding the attributes important to the patient drive patient-centered care, which improves positive patient outcomes and recovery. These attributes can then be used by healthcare professionals to design patient-centric processes and services. This research provides a framework for incorporating the voice of the patient into healthcare services.

Research limitations/implications

While the research methodology can be used in other healthcare settings, the findings are not generalizable to other wound care clinics. This research was conducted in one small, rural hospital. In addition, the sample size was small due to the size of the wound clinic; therefore, an analysis of the differences between demographics could not be performed.

Practical implications

Considering the perspectives of rural wound care patients is important, as the patients are an under-served population with unique challenges related to patient care. The research findings detail rural patients' expectations during wound care treatments, which enable the clinic to focus on improving patient satisfaction. This research contributes to understanding the factors that are important to patient satisfaction in wound care. Further, the methodology presented can be applied to other healthcare settings.

Originality/value

While studies exist using the Kano model in healthcare and the literature is sparse in rural healthcare, this is the first case study using the Kano model in wound care to understand patient preferences.

Details

The TQM Journal, vol. 36 no. 4
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 9 February 2024

Armando Calabrese, Antonio D'Uffizi, Nathan Levialdi Ghiron, Luca Berloco, Elaheh Pourabbas and Nathan Proudlove

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

Abstract

Purpose

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

Design/methodology/approach

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

Findings

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

Originality/value

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

Details

European Journal of Innovation Management, vol. 27 no. 9
Type: Research Article
ISSN: 1460-1060

Keywords

Open Access
Article
Publication date: 13 February 2024

Felipa de Mello-Sampayo

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these…

Abstract

Purpose

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

Design/methodology/approach

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Findings

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

Practical implications

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Social implications

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

Originality/value

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

Details

Journal of Economic Studies, vol. 51 no. 9
Type: Research Article
ISSN: 0144-3585

Keywords

Article
Publication date: 9 May 2024

Claudio Rocco, Gianvito Mitrano, Angelo Corallo, Pierpaolo Pontrandolfo and Davide Guerri

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes…

Abstract

Purpose

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

Design/methodology/approach

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

Findings

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

Originality/value

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

Details

Business Process Management Journal, vol. 30 no. 3
Type: Research Article
ISSN: 1463-7154

Keywords

Article
Publication date: 10 May 2024

Jacopo Frassini

This article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU…

Abstract

Purpose

This article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU. While both systems are driven by the same goal of providing high-quality healthcare services and achieving optimal patient outcomes, they operate under different national approaches and resources.

Design/methodology/approach

Two recent crises are presented as examples that highlight the necessity of cooperation between civilian and military medical systems. The Covid-19 Pandemic and the Ukrainian Conflict are described based on the experience gathered by the author as a member of the NATO Centre of Excellence for Military Medicine and form the base to shape a broader perspective on the future of civil-military interaction in healthcare at the European Union level.

Findings

The ability to deliver coordinated responses during crises depend on the level of interoperability, preparation and mutual understanding. To improve synergies, a structured partnership should be established, prioritizing common standards of care and shared best practices. Integrating military and civilian healthcare pathways can be especially beneficial in situations where patients are moved from the point of injury or sickness across different military and civilian structures to receive the most appropriate treatment and rehabilitation for their conditions.

Originality/value

The relationship between military and civilian healthcare systems is often discussed at multinational level, but a clear focus is lacking concerning their shared mission, distinct functions and potential for cross-border collaboration.

Details

Journal of Integrated Care, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 14 July 2023

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.

Details

Benchmarking: An International Journal, vol. 31 no. 5
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 5 December 2023

Abdulkareem Salameh Awwad, Abdel Latef Anouze and Elizabeth A. Cudney

This study aims to investigate and test the impact of competitive priorities, in terms of quality, speed, dependability, flexibility, cost and patient engagement, on patient…

Abstract

Purpose

This study aims to investigate and test the impact of competitive priorities, in terms of quality, speed, dependability, flexibility, cost and patient engagement, on patient satisfaction with healthcare services. It considers patients’ rather than managers’ points of view to collect responses about competitive priorities.

Design/methodology/approach

This research employed a cross-sectional survey design to analyze a sample of customers through an empirical study of 488 patients in Qatar’s healthcare service context.

Findings

The confirmatory factor analysis results show that competitive priorities and engagement positively and significantly impact patient satisfaction.

Research limitations/implications

Researchers can use this methodology to explore the role of competitive priorities in different service contexts and sectors. The researchers conducted the study in Qatar; therefore, the results are not generalizable to all healthcare sectors. However, regardless of geographic location, the research approach can be used in healthcare.

Practical implications

Managers can employ the developed scales to diagnose competitive priorities and improve customer service experiences.

Originality/value

The paper is original as it suggests using competitive priorities as a measurement tool for predicting patient satisfaction compared to prior research that mostly measured competitive priorities based on internal perspectives (managers’ perspectives). Further, this paper is original because it depends on the external perspective (customers’ perspective) for the competitive priorities for measuring patient satisfaction.

Details

International Journal of Quality & Reliability Management, vol. 41 no. 5
Type: Research Article
ISSN: 0265-671X

Keywords

Open Access
Article
Publication date: 21 February 2024

Tina Bedenik, Claudine Kearney and Éidín Ní Shé

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and…

Abstract

Purpose

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

Design/methodology/approach

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

Findings

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

Originality/value

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 5 December 2023

Yushi Jiang, Sobia Jamil, Syed Imran Zaman and Syeda Anum Fatima

This paper investigates the interactional relationships between sustainable human resource management (SHRM) and organizational performance (OP). Sustainable HRM is an approach…

Abstract

Purpose

This paper investigates the interactional relationships between sustainable human resource management (SHRM) and organizational performance (OP). Sustainable HRM is an approach that links HRM and sustainability. These studies focused on integrating HR with sustainable developments, such as economic and social aspects, in favour of focusing on the environmental aspect. Organizational change is an ongoing process that has to be managed effectively to keep the change in place for a long time.

Design/methodology/approach

A framework was offered to estimate the cause-and-effect relation of the SHRM and OP factors. Data is gathered from professionals from various pharmaceutical industries. This study applied two methods, Fuzzy AHP and DEMATEL Type II. These techniques are used to understand the cause-and-effect factors and their interactions.

Findings

It was observed from the findings that the factor of SHRM, such as Social Justice (F2), Green Job Design (F5), Green Training (F6) and Implementation of Green Policy (F8), was the most critical for the pharmaceutical sector that effects Financial performance (F13), Customer Satisfaction (F15) and Market performance (F14). Pharmaceutical firms ought to coordinate public health advocacy efforts, engage in healthcare initiatives and provide financial support for environmentally friendly efforts that improve social and economic conditions.

Practical implications

For this sustainability, managers concentrate on creating an environment that is healthy and acceptable, and they work hard to mitigate the impact of natural factors and repair damage done to the environment; it is essential to move towards sustainable development to resolve environmental problems. Improving HR efficiency is among essential HRM responsibilities, as they expand the knowledge base of the workforce, enhance human capital, and eventually create valuable intangible assets and promote and encourage sustainable pharmaceutical products for some years.

Originality/value

This research paper has presented exclusive worth to the SHRM and organizational performance literature as it employs fuzzy FAHP and DEMATEL type 2. There is less research on SHRM in the pharmaceutical sector with these factors. In addition, FAHP and TYPE 2 DEMATEL are used in very few researches on SHRM approaches.

Details

Journal of Organizational Effectiveness: People and Performance, vol. 11 no. 2
Type: Research Article
ISSN: 2051-6614

Keywords

Article
Publication date: 21 May 2024

Jing Han Beh, Ming Kun Yew, Kok Hong Tan and John Patrick Rayner

Therapeutic landscapes can be beneficial for patients recovering from cognitive and behavioural impairments. The therapeutic garden in the Royal Talbot rehabilitation centre…

Abstract

Purpose

Therapeutic landscapes can be beneficial for patients recovering from cognitive and behavioural impairments. The therapeutic garden in the Royal Talbot rehabilitation centre (RTRC) located in Kew, Melbourne is a precedent for its nature design outdoor spaces and horticultural therapy (HT) program for patients with cognitive impairments due to brain and spinal cord injuries. There have been no studies into the physical design of the RTRC therapeutic garden.

Design/methodology/approach

This case study unveils the critical design themes, and dominant physical elements of the RTRC therapeutic garden through site observation and analysis over the course of two months, a semi-structured interview with a key staff, and graphical representations using integrated photography and collaborative digital tools of AutoCAD and Adobe Photoshop.

Findings

Seven critical design themes are identified for the RTRC garden: (1) space layout and organization, (2) physical and visual access, (3) pathway and facility, (4) multisensory vegetation, (5) amenity, wayfinding and seasonal interest, (6) cognitive stimulation, (7) utility and HT. Qualitative and quantitative data analysed in visual and descriptive format reveal multisensory vegetation, amenity, wayfinding and seasonal interest, and utility and HT are the top three most pivotal critical design themes in the RTRC therapeutic garden.

Research limitations/implications

The findings of this case study can be used to impart knowledge about the design of therapeutic landscape settings for cognitive impairments to design professionals and the public.

Originality/value

There is no case study has been conducted for this precedent of therapeutic garden in the Royal Talbot rehabilitation centre that targets for cognitive impairment patients. With the increasing awareness in medical and healthcare environments, this case study would help to inject mutual understanding, generate knowledge and design awareness among design professionals and public, and to cultivate more good quality healthcare settings.

Details

Archnet-IJAR: International Journal of Architectural Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2631-6862

Keywords

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