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Article
Publication date: 17 May 2024

Neda Rasooli, Fariborz Jolai, Mohammad Mehdi Sepehri and Afsaneh Tehranian

The childbirth process is a complex and vital event that requires careful analysis and improvement. This experience can shape a woman's perspective on motherhood and even affect…

Abstract

Purpose

The childbirth process is a complex and vital event that requires careful analysis and improvement. This experience can shape a woman's perspective on motherhood and even affect her mental health. Healthcare providers must prioritize improving the birth experience for women. In this interdisciplinary research, a combination of business process modeling (BPM) and medicine have been used with the aim of realizing an improved delivery experience and increased maternal satisfaction.

Design/methodology/approach

The data collection of this study was done by observing 518 childbirth processes and interviewing the chief of labor, chief residents, and midwives in the obstetrics and gynecology department of a hospital in Tehran from October 2022 to February 2023.

Findings

The research has been done in four main stages. The first phase is to model the primary process and sub-processes of normal vaginal delivery (NVD). The second phase is validation using expert confirmation and process mining (PM). The third phase is the analysis of the causes of maternal dissatisfaction in labor. The fourth phase of the heuristics redesigning and improving the process, in which for the first time three new categories have been presented including hospital-based, patient-based, and medical technique-based results show BPM intervention effect can be far-reaching in improving patient care and optimizing operational efficiency.

Originality/value

This study is one of only a few to adopt a process-oriented perspective to show how BPM can be used in clinical processes and has specifically examined an essential clinical process, i.e. childbirth.

Highlights

  1. Developing business process management (BMP) applications in a medical special process related to childbirth as interdisciplinary research.

  2. A combination of qualitative and quantitative techniques contains engineering software and management approaches for a Case study, Implementation of BPM lifecycle in the women's hospital in Iran, Tehran, for a clinical process, which is called, normal vaginal delivery (NVD) process for fetal expulsion normally.

  3. Modeling NVD clinical process and sub-process for the first time by BPMN2.0 notations in visual paradigm (VP) software and Validation of the made model with process mining (PM), by Disco process mining software. This was done through event log collection from HIS at the hospital.

  4. Improving the childbirth process by redesigning heuristics and Introducing two new categories special for clinical process improvement for the first time.

  5. Clinical process improvement heuristics obtained in this research are not consistent with the previous seven categories presented in previous studies such as Marlon Dumas' book. Therefore, we have introduced two new heuristics to redesign clinical processes compatible with medical centers, including hospital-based, patient-based, and medical technique-based.

  6. Providing a framework for clinical process modeling and improvement containing steps and tools.

Developing business process management (BMP) applications in a medical special process related to childbirth as interdisciplinary research.

A combination of qualitative and quantitative techniques contains engineering software and management approaches for a Case study, Implementation of BPM lifecycle in the women's hospital in Iran, Tehran, for a clinical process, which is called, normal vaginal delivery (NVD) process for fetal expulsion normally.

Modeling NVD clinical process and sub-process for the first time by BPMN2.0 notations in visual paradigm (VP) software and Validation of the made model with process mining (PM), by Disco process mining software. This was done through event log collection from HIS at the hospital.

Improving the childbirth process by redesigning heuristics and Introducing two new categories special for clinical process improvement for the first time.

Clinical process improvement heuristics obtained in this research are not consistent with the previous seven categories presented in previous studies such as Marlon Dumas' book. Therefore, we have introduced two new heuristics to redesign clinical processes compatible with medical centers, including hospital-based, patient-based, and medical technique-based.

Providing a framework for clinical process modeling and improvement containing steps and tools.

Details

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

Keywords

Article
Publication date: 13 November 2017

Mahdi Salehi, Afsaneh Lotfi and Shayan Farhangdoust

The purpose of this paper is to examine the effect of financial distress costs, corporate growth rate, and flexibility on the interaction between ownership structure and corporate…

1283

Abstract

Purpose

The purpose of this paper is to examine the effect of financial distress costs, corporate growth rate, and flexibility on the interaction between ownership structure and corporate debt policy.

Design/methodology/approach

The authors test the hypotheses by employing simultaneous equations system methodology with two-stage least squares regression and panel data technics on a sample of 786 listed companies on the Tehran Stock Exchange during 2010-2015.

Findings

The results indicate that there is a positive and significant relationship between corporate debt level and managerial ownership in the Iranian listed companies. The authors also find no convincing evidence that either the firm’s growth or financial health could influence or moderate this interrelationship.

Research limitations/implications

The implications drawn from this study are constrained by two primary limitations. First, the present study is conducted in an Iranian setting; therefore, the data utilized for the study only contain companies listed on the Tehran Stock Exchange. The utilization of listed companies on the Tehran Stock exchange is likely to affect the generalizability of the study in a national context. Second, the authors were unable to extend the sample time period due to some major deficiencies in the Tehran Stock Exchange library and its supplementary software.

Social implications

Since the fundamental institutional assumptions underpinning the western and even East Asia capital structure models are not valid in the institutional environment of Iran, the findings could provide substantial implications for our understanding of capital structures as well as debt policy literature.

Originality/value

This is an innovative research in terms of the mutual relationship between debt and ownership structure and the use of equations system to measure the interaction between them.

Details

Journal of Management Development, vol. 36 no. 10
Type: Research Article
ISSN: 0262-1711

Keywords

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