Purpose: This study aims to build a typology of patient-driven health services innovation (PDHSI) and propose their relationships with healthcare quality.
Design/methodology/approach: Guided by value co-creation theory (VCC), this study adopted in-depth interviews and focus groups to collect qualitative data in Taiwan's health services sector. The collected data were analyzed using manual thematic analysis, following the standard procedures for transcribing, encoding and identifying themes. This approach allowed for a comprehensive identification of unique types of PDHSI.
Findings: This study found four types of PDHSI. They are Human-Computer Interaction Mode (HCIM), Online Social Network Mode (OSNM), Co-created Decision-Making Mode (CDM) and Channel Complementarity Mode (CCM). This study defines these typologies and explains their fundamental properties, key outcomes and important determinants. Finally, through qualitative analysis, four propositions on the relationship between health services innovation and health service quality are put forward.
Practical implications: By constructing a patient-driven typology of health services innovation, this study helps medical institutions understand the strategic behavior of the doctor-patient relationship, to improve the quality of medical service and contribute to patient education and consulting practice.
Originality/value: This study contributes to the theoretical understanding of PDHSI by identifying and categorizing the types of such innovations. It provides a comprehensive typology that is useful for both academic research and practical application in healthcare management. This typology offers new insights into the roles of patients in co-creating healthcare services, addressing a gap in the existing literature regarding PDHSI and supporting the development of patient-centered approaches to healthcare.
Purpose: This systematic literature review aims to provide a comprehensive and structured synthesis of the existing knowledge about chatbots in healthcare from both a theoretical and methodological perspective.
Design/methodology/approach: To this end, a systematic literature review was conducted with 89 articles selected through a SPAR-4-SLR systematic procedure. The document for this systematic review was collected from Scopus database. The VoSviewer software facilitates the analysis of keyword co-occurrence to form the fundamental structure of the subject field.
Findings: In addition, this study proposes a future research agenda revolving around three main themes such as (1) telemedicine, (2) mental health and (3) medical information.
Originality/value: This study underscores the significance, implications and predictors of chatbot usage in healthcare services. It is concluded that adopting the proposed future direction and further research on chatbots in healthcare will help to refine chatbot systems to better meet the needs of patients.
Purpose: The need to match highly variable demand for healthcare services with existing capacity has been a significant health system challenge experienced by the COVID-19 pandemic. Despite mounting research on various COVID-19 responses in the recent literature, there has not been a structured review examining key determinants of health system volume flexibility. The focus of the present research is to review recent literature based on a conceptual framework developed based on the volume flexibility literature on COVID-19. The review also provides a meaningful way to guide practice and future research in the area.
Design/methodology/approach: A literature review was performed guided by the theoretical frameworks developed in the previous volume of flexibility literature. Selected research papers were reviewed and analyzed to identify key determinants of health system volume flexibility.
Findings: Seven determinants of health system volume flexibility under three domains (demand management, capacity management, and performance) included demand management strategies, integration, capacity management strategies, workforce management, technology, quality of disease outcomes, and health system knowledge.
Originality/value: The research provides both health systems researchers as well as practitioners with a foundational conceptual framework and knowledge related to health system volume flexibility. In addition, this research identifies future research areas to expand knowledge relevant to health system volume flexibility.
Purpose: The purpose of this study is to investigate how mentors can convince young, certified, inexperienced employees to remain in a healthcare organisation, and how mentors address "stay or quit" when mentees' lived experiences reveal feelings of insufficiency as crisis in their daily work. We explore how turnover is affected by the mentors' and mentees' discussions within the manager's domain.
Design/methodology/approach: Within the framework of crisis management, the study employs qualitative content analysis of 21 interview responses from mentors, mentees and managers. The analysis includes mentees' answers, which are analysed in terms of "weak signals" based on lived experiences and mentors' and managers' answers in terms of different capabilities to increase mentees' wish to remain in the organisation.
Findings: The results show that the deep relationship between the mentee and the mentor is crucial. It is possible for the mentor to detect weak signals from the mentee's thoughts, doubts and lived experiences. The study extends the understanding of a more subtle mechanism the mentor uses in the close relation to the mentee, alongside the manager. The findings confirm those of previous research concerning improved job satisfaction and self-improvement in the profession.
Practical implications: The findings explain why mentors, as necessary organisational resources, can contribute more successfully than managers to keeping young employees.
Originality/value: The study links the crucial relational mentorship to increased willingness to remain in an organisation among young mentees without career support.
Purpose: This paper explores the significance of work-based learning in the context of leadership development, organizational growth and the promising economic success in Tennessee organizations. It aims to investigate the practical implications of work-based learning, focusing on its role in enhancing leadership capabilities, fostering innovation and contributing to a prosperous economic future.
Design/methodology/approach: The research employs a systematic literature review to examine existing studies on work-based learning, leadership development, organizational growth and economic success in Tennessee. It also involves data collection from various sources, including government agencies, colleges and organizations in the state. The collected data are rigorously verified and cross-referenced to ensure reliability and relevance.
Findings: The findings emphasize the transformative potential of work-based learning initiatives in Tennessee. They reveal that work-based learning programs are vital in developing influential leaders, fostering a culture of learning and innovation and contributing to economic competitiveness. The research also highlights the interconnectedness of leadership development, organizational growth and economic success, emphasizing the critical role of work-based learning in driving positive outcomes in all these dimensions.
Originality/value: This research contributes to the existing body of knowledge by emphasizing the practical applicability of work-based learning findings. It provides insights into the unique context of Tennessee organizations and their motivations, challenges and opportunities related to work-based learning. The research also outlines recommendations and future research directions to bridge the gap between theory and practice, enhancing the impact of work-based learning initiatives in Tennessee and beyond. The insights gained can assist other states and industries in developing effective work-based learning programs tailored to their specific economic needs and industry demands, fostering broader economic prosperity.
Purpose: This study aims to understand the experiences of Brazilian nurse auditors in the practice of their profession, exploring the importance, challenges, rewards and strategies related to the occupation.
Design/methodology/approach: This is a qualitative descriptive study conducted with 44 nurse auditors. An online, open-ended questionnaire was used. Thematic content analysis was performed.
Findings: Five themes were identified: (1) functions of a nurse auditor; (2) skills required for a nurse auditor; (3) learning to be a nurse auditor; (4) advantages of being a nurse auditor and (5) challenges faced by a nurse auditor. Also, a total of 16 subthemes were presented.
Research limitations/implications: The study critically examined essential aspects of auditing through the lens of nurse auditors, addressing a relevant topic. However, limitations must be acknowledged, including the use of self-report questionnaires, regional representation disparities, the scarcity of international articles on the topic and potential researcher bias.
Practical implications: The study underscores the importance of increasingly integrating nurse auditors into the workforce while emphasizing the need to enhance the capacitation of these professionals through theoretical and practical education. It highlights the significance of educating other multidisciplinary team members about the nurse auditor's crucial role in fostering teamwork and ensuring the quality of healthcare services.
Originality/value: To the best of the author's knowledge, this is the first study conducted with Brazilian nurse auditors, exploring crucial aspects of auditing from the perspective of these professionals. Understanding the critical role of nurse auditors in maintaining and improving healthcare quality can enhance public trust in healthcare systems.
Purpose: Medical institutions face management challenges from intense competition and an unclear link between patient-centredness and profitability. This study examined the association between efficiency and patient-centredness in general hospitals and identified management strategies to optimise both.
Design/methodology/approach: Data from the 2021 patient experience evaluation by the Health Insurance Review and Assessment Service and financial statements from the Korea Health Industry Development Institute for general hospitals in South Korea were used. Efficiency scores and patient-centredness were determined for 256 general hospitals using data envelopment analysis (DEA), and their relationships were analysed through matrix analysis. The Kruskal-Wallis and Mann-Whitney tests assessed group differences identified through matrix analysis.
Findings: Efficiency and patient-centredness can be improved concurrently. Hospitals in the highest efficiency group reported significantly higher average inpatient revenue per 100 beds (179.67) and net profit (158.84) than those in lower-performing groups (p < 0.001). Optimal management of hospital beds and specialised diagnostic equipment per 100 beds was associated with higher efficiency scores, while a greater number of doctors and nurses positively influenced patient-centredness metrics. Therefore, general hospitals should invest in personnel and resources to enhance efficiency and patient-centredness, achieving optimal financial and operational outcomes.
Originality/value: This study combines DEA and matrix analysis to explore the link between hospital efficiency and patient-centredness, using recent data on patient experience and financials from South Korean hospitals. It identifies strategies to enhance both dimensions.
Purpose: The study tests the relationships between continuous improvement (CI) and clinical practices (CP) with perceived operational performance in Australian and New Zealand (NZ) emergency departments.
Design/methodology/approach: A survey instrument was designed to collect data from Australian and NZ Emergency Department physicians to test a model developed from the literature, the continuous improvement and clinical practice (CICP) model. Hypotheses were developed and tested using bivariate correlation analysis and multiple regression analysis.
Findings: ED operational performance is positively impacted by CI culture, reinforced by an established CI governance structure built on employee education of CI tools and methods. The lack of nonclinical time allocation for CI activities has remained a major impediment for the implementation of a sustainable CI culture. The study found physicians experience tension between continuous improvement and clinical practice.
Practical implications: Developing a CI mindset across all levels of emergency departments would encourage staff to embrace change to support the implementation of CI and to improve clinical practices. The study highlights potential implications for national bodies, academics, policymakers and ED physicians. Study insights suggest that continuous improvement and effective clinical practices are crucial for enhancing ED performance results in their day-to-day responsibilities.
Originality/value: The paper is original by applying methodological rigour to identify the best predictors of performance in EDs and how a theoretical causal model can be tested to identify the best predictors of operational performance in EDs.
Purpose: This paper uses data from an ethnographic study of a group of NHS community nurses in England, to analyse their work using labour process theory. A theory influenced by Marxist thinking, which is concerned with the examination of the labour process. This study of the nurses' work provides insights into their labour process, as well as proposing theoretical development relating to labour process theory.
Design/methodology/approach: The paper has been developed using data from an ethnographically oriented study of a group of community nurses. Data was produced from 140 h of field observations and also semi-structured interviews with six, community nurses. The data produced from field observations and interview transcripts were analysed thematically and theory building was developed inductively.
Findings: The analysis within this paper highlights two areas of the nurses' work and both illustrate the theoretical difficulties raised, when using labour process as a tool for analysis, as well as its usefulness. These two areas of work are aspects of invisible work and feelings of joy and sorrow; analysis of both these areas supports a theorising of a distinct relationship between nurse and patient. That is, a relationship between worker and human product, which the paper argues should be accommodated within labour process theory.
Research limitations/implications: More research is required to understand the nature of the proposed social relation in production, particularly with reference to other types of worker, in other caregiving settings. As the demands on healthcare workers and other public sector workers are likely to remain consistently high, improved analytical tools to support research into the nature of caregiving work seem both prudent and timely.
Originality/value: Labour process theory is a useful (but often under-used and rather unfashionable) tool in the analysis of service-based, public sector work. This paper proposes a theoretical development within labour process theory, which would recognise a social relation in production between a worker and their human product, based on empirical data from a study of community nurses. This theoretical development has the potential to improve the usefulness of labour process theory in the analysis of caregiving labour.
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