Journal of Health Organization and Management最新文献

Purpose: The COVID-19 pandemic exposed critical vulnerabilities in healthcare systems, particularly in hospital procurement and preparedness for supply chain disruptions. This study aims to investigate how healthcare procurement professionals can develop sustainable preparedness plans for future supply disruptions.

Design/methodology/approach: A case study approach was adopted in this research. Data collection was performed through 15 semi-structured interviews with purchasing experts in 11 German hospitals.

Findings: The findings of this research led to the development of a roadmap to support preparedness planning, based on the best practices identified by hospital purchasing professionals during the COVID-19 pandemic. The study also identified six types of barriers affecting physical preparedness, intangible preparedness activities and both simultaneously. The best practices were categorised under six domains: storage, human resources, knowledge management, operations and process management, financial resources and community collaboration. The findings suggest that combining different types of preparedness activities is essential for developing preparedness plans.

Practical implications: This research provides practical guidelines for hospital purchasing professionals to better prepare for future disruptions, such as a roadmap to improve preparedness.

Originality/value: A healthcare procurement lens is applied in our study, exploring preparedness at the organisational level, a perspective that has been underexplored in literature. This study raises awareness of the lack of preparedness plans in hospitals from a procurement perspective. This research provides a roadmap based on best practices to strengthen hospitals' preparedness plans for possible future disruptions.

Purpose: This study explored factors influencing nurses' participation in the health policy development processes in the newly established Bono East Region of Ghana.

Design/methodology/approach: Utilising a qualitative research approach, an explorative case study design and purposive sampling were employed to recruit 24 nurses from three health facilities in the Techiman Municipality. In-depth interviews were conducted, recorded, transcribed, coded and analysed using a thematic content analysis. Emerging themes were used for the analysis and explained within the theoretical perspective of the social-ecological model.

Findings: The findings revealed that individual factors, such as personal motivations and commitment to improving patient outcomes, significantly impacted nurses' engagement in health policy development. Interpersonal dynamics, including effective collaboration and communication among healthcare professionals, emerged as crucial factors in creating a supportive environment. Organisational support, policies, resource availability and management encouragement are key organisational determinants shaping nurses' capacity to contribute to policy development. Societal factors, such as prevailing attitudes and political considerations, could influence nurses' participation.

Originality/value: This study provides a comprehensive insight into the diverse factors influencing nurses' participation in health policy development in the recently created Bono East Region. The findings offer a foundation for targeted interventions to enhance their active involvement in shaping healthcare policies.

Purpose: In 2023, a major structural reform reorganised both the administrative and financial structures of the public health and social service system in Finland. Governance is one of the key health system functions, and this study aims to describe the changes in governance structures following the reform.

Design/methodology/approach: Data were collected through semi-structured interviews conducted at two time points in 2023-2024. Participants included directors of the newly established wellbeing services counties (WBSCs) (n = 38) and representatives from the key ministries (n = 8). The data were analysed using inductive thematic analysis.

Findings: Transferring the responsibility for organising health and social services from municipalities to WBSCs and centralising funding at the state level represents a large change in the overall governance of the system. Following the reform, power balances and roles between and within different governance levels changed. Competition between national policy goals also emerged, especially in relation to financial and health and social policy goals. The new WBSCs additionally have limited ability to exercise self-governance, which challenges their role as self-governing entities.

Originality/value: Finland's health and social service reform is a multidimensional entity, which can be studied from different perspectives, and many lessons can be shared with other countries. For instance, Finnish experiences provide valuable insights to reform the governance structures of health systems, emphasising the importance of governance as a key function to consider when health systems are restructured. The findings highlight the need for clarity and transparency in responsibilities and mandates when roles are redistributed in the system.

Purpose: The post-COVID-19 era in Pakistan is marked by economic turbulence and political instability. These circumstances have significantly disrupted the supply chains of numerous industries, including healthcare. The aim of this study is to explore the supply chain risk factors faced by hospitals in the post-COVID-19 era.

Design/methodology/approach: A Qualitative inductive approach was adopted for this study. Semi-structured interviews were conducted with 12 supply chain professionals working at various Pakistani hospitals. Thematic analysis was carried out, generating six main themes that impact the supply chain of the hospitals: (1) organizational risks, (2) political and regulatory risks, (3) external risks, (4) financial risks, (5) supplier risks and (6) demand risks.

Findings: Organizational risks, including employees' resistance to change and staff turnover, highlight the critical need for robust human resource strategies. Hospitals are particularly vulnerable to uncertain governance and economic policies, which are reflected in political and regulatory disruptions that are made worse by import bans, delays in customs clearance, strikes and communication blackouts. External risks such as counterfeit medicines, compromise patient safety and treatment outcomes. Financial risks, such as dollar rate fluctuations and tax revisions and Supplier-related risks, such as single-source supplier monopoly, further enhance the vulnerability of the supply chain.

Originality/value: The article fills the gap in the literature by adopting a qualitative approach, offering an in-depth understanding of risk factors impacting the supply chain of Pakistani hospitals. The study highlights that with the changing economic and political scenario, new risks have emerged, including political, regulatory and financial challenges, which have been largely overlooked in the previous studies. This study enriches our understanding by exploring these factors in the post-pandemic era, particularly in the context of a developing country like Pakistan.

Purpose: Co-leadership between physicians and senior managers is being explored as an avenue to improve decision processes and ensure support of orientations. Reaching those objectives depends partly on the role played by physician co-leaders, a role crafted through ongoing negotiation between actors attempting to expand or constrict the role. The study aims to contribute insight into how physicians entering senior co-leadership roles, and those around them, craft their roles.

Design/methodology/approach: A qualitative, inductive study of new senior co-leadership roles for physicians in four healthcare centers in Quebec, Canada, was conducted over 21 months, involving interviews, observations and document analysis.

Findings: A total of 16 practices mobilized by actors to expand and/or constrict the new roles are identified, revealing that role crafting can occur by creating emptiness in one's role or adjacent roles, by shaping other actors' agency and by influencing processes.

Practical implications: During the early phases of implementation of co-leadership, attention should be paid to agency and processes, since much role crafting can be done through others or by refraining from exerting influence. A balanced level of cultural sensitivity is more important than a unified culture, and a positioning exercise should be conducted to contemplate the new role relative to its wider organizational leadership context, beyond the dyad.

Originality/value: The study suggests that the shared role of co-leaders, during the early phases of implementation of co-leadership, is much more vulnerable than portrayed in previous work, overlapping with other constellations and subject to significant intervention from outside the dyad itself.

Purpose: This study aims to investigate the impact of key contextual factors, specifically those related to governance structures and resource availability, on the operational and financial performance of hospitals.

Design/methodology/approach: Adopting a quantitative research design, the analysis applies a multivariate regression model to assess the relationship between governance structure and the allocation of material, financial and human resources with hospital performance outcomes. Empirical data were collected from the official websites of 40 hospitals within the Portugue National Health Service (NHS) and the Ministry of Health's benchmarking platform.

Findings: Findings indicate a significant and positive association between governance quality and the availability of financial and human resources, with both operational efficiency (measured through production outputs) and financial performance. In contrast, the presence of an external auditor, while essential for regulatory oversight, shows a negative correlation with financial resources, reflecting its role in financial scrutiny and constraint. A reduction in financial resources impacts, indirectly, on the hospital productivity.

Originality/value: This study contributes to the health management literature by integrating multiple contextual variables, governance and organisational resources to evaluate their combined impact on hospital performance, a dimension still underexplored in empirical research. Furthermore, it introduces a novel methodological contribution by employing structural equation modelling (SEM) within the context of healthcare management. Although based on data from Portugal, the methodological and analytical framework is applicable to comparative studies and may be replicated in other national healthcare systems.

Purpose: Healthcare workers are facing unprecedented levels of stress, leading to increased burnout and intentions to leave the profession. Through a qualitative study of behavioral healthcare workers in an urban community hospital, we identify specific behaviors and cognitive beliefs to cope with workplace stressors.

Design/methodology/approach: Semi-structured interviews of key personnel of a behavioral healthcare facility (n = 25) were conducted over a three-month period. Participants were asked to describe the current environment and procedures of the department. Data were analyzed through thematic coding following the Gioia methodology.

Findings: We found workers identify threats in terms of a dangerous environment, financial security and unexpected conditions without sources of assistance from external resources, internal resources and effective management. Workers coped with this stress through problem-based coping strategies including deviant workplace behavior and justification of the system. Workers engaged in emotion-based strategies of meaningful work, behavioral justification and disengagement.

Originality/value: Based on our findings, we offer a model identifying specific coping behaviors and beliefs in response to workplace stress. We set forth a future research agenda in which the relationships in the model may be investigated through quantitative research methods.

Purpose: To pursue sustainability in healthcare, leadership must evolve to meet the industry's ever-changing emotional and operational demands. Drawing on the social exchange theory and the conservation of resources theory, this study examines the interplay between emotional intelligence (EI), empowering leadership (EL), work engagement (WE), and risk-taking behavior (RTB) among healthcare professionals.

Design/methodology/approach: Leveraging structural equation modeling (SEM) on data from 314 healthcare workers, the research uncovers the significant influence of emotionally intelligent leadership on fostering a resilient and engaged workforce. EI emerges as a powerful driver, boosting WE by fueling dedication and focus, and encouraging innovative RTB - a key component for adapting to complex healthcare challenges.

Findings: Surprisingly, the findings suggest that EL alone fails to promote risk-taking without the supporting effect of EI, underscoring the necessity of emotionally attuned leaders in environments requiring creativity and calculated risks.

Originality/value: This research underscores the importance of healthcare organizations prioritizing EI in leadership development to foster sustainable innovation and cultivate a deeply committed workforce.

Purpose: Despite empirical studies detailing the vulnerabilities of blockchain, minimal attention is directed to assessing blockchain performance during its adoption cycle. We examine potential competencies and requirements that impact blockchain performance in healthcare over three time periods, focusing on organizational readiness (ex ante), technical capabilities (in situ) and supportive institutions (ex post).

Design/methodology/approach: An extensive literature review encompasses three phases of data collection: an appraisal of publications from 2017 to mid-2021, totaling 111 publications; from mid-2021 to June 2024, totaling 52 publications, and a comprehensive update focused on selected features of healthcare blockchain, bringing the total review to 37 publications.

Findings: Using an assessment framework, findings prioritize conceptual and prescriptive papers (ex ante), blockchain technical requirements (in situ) and supportive institutions (ex post). It evaluates recent applications on patient health records privacy, security, scalability and interoperability.

Originality/value: This paper fills the gap in the literature that has minimal coverage of blockchain performance. It provides a comprehensive assessment framework to evaluate blockchain performance in healthcare over time and presents implications for research and guidance to practitioners on managing blockchain applications, with insights on societal impact.

Purpose: The aim of the study was to determine the predictive power of two relational factors, procedural justice and legitimacy, against the well-being of patients receiving medical care.

Design/methodology/approach: The study sample consisted of 590 patients in treatment for somatic conditions in hospital outpatient clinics. The study was conducted in a correlational scheme. Subjects evaluated their relationship with their chosen doctor. In order to verify the hypotheses, SEM was carried out.

Findings: The relationship effect was noted. Procedural justice was a significant and positive predictor of psychological well-being, while distributive justice, i.e. time and money invested by the patient in their treatment, was not. The perceived legitimacy of the doctor was not a significant predictor of the psychological well-being of their patient. The relationship between the experience of procedural justice and psychological well-being was serially mediated by patients' perceived physician legitimacy and perceived life satisfaction.

Originality/value: Relational factors shape treatment outcomes operationalized by patients' subjective sense of well-being. Fair patient handling is a predictor of positive treatment outcomes.