Journal of Health Organization and Management最新文献

Purpose: Despite robust quality improvement efforts in healthcare, learning from patient safety incidents remains difficult. Our study explores counter-vailing powers shaping learning processes and possibilities in healthcare organizations, with a focus on social, political and organizational dynamics of learning.

Design/methodology/approach: Deploying concepts of situated curriculum, boundary work and interconnected knowledge practices, we interviewed staff and physicians (n = 15) in a large Academic Health Science Centre in Canada about their experiences of incident investigations and resultant information sharing. Our analytical strategy was abductive, drawing connections to sociology of the professions and learning sciences literature.

Findings: Incident investigation and follow-up processes are relatively robust for learning about incidents in the organization. However, learning from incidents remains difficult, complicated by the professional politics of incident classification, counter-vailing policies related to privacy, the organization of improvement work towards reporting, and an organizational focus on incidents with severe outcomes.

Practical implications: Participants advocated for a broader view of incidents, moving beyond classification and investigation based on severity of outcome to also include incidents that are "learning rich". To that end, we argue for more research on the role of Patient Safety Specialists in organizational learning and more collaborations with learning sciences.

Originality/value: This paper illuminates ways in which robust information dissemination structures are an important but insufficient condition for learning from incidents. The argument goes beyond a prescriptive approach to learning from incidents to instead explore the competing visions and values implicated with improvement practices.

Purpose: The healthcare ecosystem continues to evolve with new technological developments with the support of its stakeholders. The technology-driven and patient-centric Healthcare 5.0 (H5.0) ecosystem is undergoing a transformation promising enormous benefits. However, the need to identify and understand the inherent challenges and barriers faced in the journey of H5.0 implementation and the relevant countermeasures for accelerated implementation has become critical.

Design/methodology/approach: The current research paper has utilised the Delphi approach for the collection of information and applied a well-proven quality function deployment (QFD) methodology for analysis.

Findings: The house of quality (HOQ) tool from the QFD has highlighted the critical H5.0 challenges which contribute to, approximately, 60% of the total weight. The identified top five process descriptors from the developed HOQ also contribute, approximately 60% among overall countermeasures. A useful H5.0 implementation progress (HIP) index has been recommended for tracking the progress made in the H5.0 implementation journey.

Originality/value: This research is among the first that has provided the application of the HOQ approach in the QFD methodology in the domain of H5.0. It has provided useful insights to the stakeholders. Furthermore, the development of a simple and practical HIP index is another useful value addition.

Purpose: Using conservation of resources (COR) theory as our theoretical basis, we investigate how nurses' perceived overqualification influences their service behavior. In doing so, we highlight nurses' silence toward patient safety and praise from patients as a mediator and moderator, respectively.

Design/methodology/approach: Data were collected from 201 nurses employed in a Greek public hospital. To examine the present hypotheses, we used the PROCESS macro.

Findings: We found that nurses' perceived overqualification affects their silence toward patient safety, which in turn leads to reduced levels of service behavior. Furthermore, praise from patients attenuated the relationship of perceived overqualification with nurses' silence toward patient safety, such that this association was significant only when praise from patients was low. Similarly, the indirect linkage of perceived overqualification with service behavior through nurses' silence toward patient safety was significant only for nurses who had low levels of praise from patients.

Originality/value: This is one of the few studies that examine the phenomenon of perceived overqualification in nursing. Specifically, the potential effect of nurses' perceived overqualification on their service behavior has been neglected. In addition, less is known about how nurse-patient interaction mitigates or boosts nurses' experience of overqualification. By investigating the mediating and moderating mechanisms, this study extends the existing literature regarding why and how perceived overqualification affects nurses' service behavior. Based on our findings, we discuss implications for theory and practice.

Purpose: Health technologies are an issue that directly affects the sustainability and quality of health services. Due to budget constraints, it is not financially possible for businesses to apply comprehensive improvement strategies to all these criteria. In this case, it is possible for businesses to implement more priority strategies. Accordingly, the main purpose of this study is to evaluate the important performance indicators of health technology investments.

Design/methodology/approach: Firstly, with the help of the artificial intelligence system, a decision matrix is established. Secondly, spherical fuzzy total order of preference decision-making trial and evaluation laboratory methodology is taken into consideration for weighting the criteria. Thirdly, emerging seven countries are ranked by using spherical fuzzy MultiAtributive Ideal-Real Comparative Analysis (MAIRCA).

Findings: The findings demonstrate that the criteria of health policies and research and development are defined as the most significant factor in this regard. China and Turkey are also found to be the most successful emerging countries with respect to the performance of health technology investments.

Originality/value: The main contribution of this study is that a novel decision-making model is generated by integrating artificial methodology into the spherical fuzzy sets.

Purpose: This study aims to investigate possible factors, such as trust in management and shared vision, that influence value congruence and its mediating effect on work engagement. It also explores how resilience, functioning as a moderator, could change the nature of the links between value congruence and its determinants.

Design/methodology/approach: Data were collected through an online survey from 301 healthcare employees in Thailand. Hypotheses were tested and analyzed using confirmatory factor analysis, structural equation modeling and bootstrapping procedures.

Findings: The results reveal that value congruence mediates the positive impacts of trust in management and shared vision on work engagement. Trust in management and shared vision translate into higher levels of value congruence, more so when employees are highly resilient.

Practical implications: The findings suggest that healthcare administrators should design interventions to cultivate trustworthy leadership behaviors in daily operations while improving communication of the organization's overarching vision and objectives to help employees internalize and seamlessly integrate its core values into their own professional identities.

Originality/value: Despite the extensive research on value congruence and its outcomes, little is known about its development. This study makes a valuable contribution by addressing these missing links, particularly in hospital settings. It also highlights how resource management explains the ways in which resilience in practice influences employees' value congruence at work.

Purpose: The COVID-19 pandemic has reignited the debate on effective leadership during a crisis. The study examined healthcare leaders' experiences, challenges and responses amid the COVID-19 crisis in India and the USA.

Design/methodology/approach: Thematic analysis culminated in developing a thematic framework that encapsulates the behavior of operational healthcare leaders in India and the USA to illustrate how they responded to the global pandemic. Twelve hospital leadership experiences were collected through in-depth Interviews.

Findings: The study highlighted comparable experiences and leadership responses from the USA and India. Thematic framework induced from three themes and eight sub-themes to illustrate how leaders handled unknown challenges of the pandemic, which they countered with increased accountability as a leader, extended need-based networking with inevitable experience of self-role distance, leading to their pragmatic approach and reinforcement of self-belief.

Research limitations/implications: The study findings provide a way forward for revisiting existing crisis management frameworks and cross-cultural leadership theories in terms of behavioral aspects integration with the technical or operational aspects of crisis management.

Practical implications: Healthcare leaders aiming to rebuild hospital systems would benefit from the study by incorporating identified skills such as coping with emotional labor, self-role distance, perseverance, pragmatic approach, networking with extended stakeholders, and extra-role behaviors into training and mentoring programs.

Originality/value: Using a thematic analysis approach, the study's two-country research design identified a homogeneous leadership response despite a distinct countrywide context.

Purpose: Co-production improves the quality of healthcare services by prioritizing patient-centred care and ensuring optimal implementation. Current patient participation research have primarily concentrated on the co-production stages, despite patient participation being the central emphasis of its implementation. A study conducted analysed four specific attributes of patient participation, with patient engagement specifically emphasizing the interactions between patients and healthcare workers. Several studies have concluded that the interaction between the two actors is inefficient. This article examines current study trends concerning patient participation and identifies knowledge gaps from these studies.

Design/methodology/approach: This study used bibliometric analysis. This study used VOSviewer software for bibliometric analysis. The Scopus database contained 398 publications about patient participation in co-production in healthcare, which served as the basis for the analysis.

Findings: The study on patient engagement in a co-production context for healthcare had grown fast in recent years. Patient-centred approach and patient-centred care were two important things in patient engagement. Several factors influenced the implementation of patient engagement: attitude, ability, awareness, responsibility and knowledge. It is still uncommon to do research on the measurement of output and results from patient engagement implementation. Studies on instruments for measuring these two factors, particularly in a quantitative manner, are still few.

Research limitations/implications: Various recommendations have been put forward for additional investigation. Firstly, further examination of outcome measurement in patient engagement is necessary, given the lack of decisive instruments available. Secondly, examining the most influential factors on patient engagement in co-production in healthcare. Thirdly, a more thorough analysis is needed regarding the dimensions of co-production, considering that some dimensions overlap, such as the activation and empowerment dimensions, which are really carried out during engagement. The researcher acknowledges the inherent limitations of bibliometric studies, including the dependence on the Scopus databases for extracting data and the choice of search phrases. Furthermore, conducting a systematic literature review may be necessary to thoroughly examine and delineate the research topics, methodologies and outcomes of this study.

Originality/value: This study updates us on patient engagement study trends and establishes a framework for implementing patient engagement in healthcare services.

Purpose: The first aim of this study is to determine the effect of lean leadership on the workload and job satisfaction of healthcare workers, and the second aim is to reveal the moderating role of workload and employee gender in this relationship.

Design/methodology/approach: In this study, we created a comprehensive model to determine the effect of lean leadership on the workload and job satisfaction of healthcare employees and to reveal the moderating role of workload and employee gender in this relationship. We collected 1,207 valid questionnaires among Turkish health workers.

Findings: The results indicate that: (1) Lean leadership reduces perceived workload, (2) Lean leadership increases job satisfaction, (3) Workload moderates the effect of lean leadership on job satisfaction and (4) Employee gender moderates the effect of lean leadership on job satisfaction and workload. These findings have provided theoretical and practical suggestions for reducing the workload and increasing the job satisfaction of healthcare employees. Finally, we will make some suggestions for the future.

Research limitations/implications: As with other studies, there are some limitations in this study. The data used in this study were collected in Turkey. Turkish culture has a more collectivist culture than Western countries (Koksal 2011). In addition, the research was carried out with the participation of health employees. Due to Turkish cultural characteristics and the characteristics of health services, the generalization of research results may be limited. Therefore, it is recommended that the research be repeated across different cultures and different sectors to determine whether our results are culture-specific, sector-specific or generalized.

Practical implications: Healthcare managers can reduce the perception of employees' workload by showing lean leadership behavior. Healthcare managers can increase their job satisfaction by valuing employees, inviting them to participate in business processes and providing them with the resources they need.

Social implications: In order to maintain and increase health workers' job satisfaction, we recommend that health managers should ensure fair job sharing. In addition, health managers should take into account that female employees are more sensitive about the workload.

Originality/value: This research is the first study to examine the effect of lean leadership behavior on healthcare professionals' workload perception and job satisfaction. Therefore, it offers important theoretical and practical implications.

Purpose: Based on the well-known risks associated with deviating from established routines in primary healthcare and the positive consequences of upholding them, the purpose of this study is to increase the understanding of the role of meaningfulness in the enactment of organizational routines.

Design/methodology/approach: The study is based on 24 semi-structured interviews with three different professional categories in primary healthcare in Sweden. The data were analyzed using thematic analysis on a latent level, combined with a two-factor model as sensitizing concepts.

Findings: Differences are identified between factors that reduce meaninglessness (called "sufficiency factors") and those that enable meaningfulness (called "meaningfulness factors"). Nine sufficiency factors and six meaningfulness factors explain what makes organizational routines perceived as meaningful by the different professional groups. A two-factor matrix is developed that highlights the intricate challenges associated with routine enactment based on these factors.

Originality/value: The study is unique in that it is the first to integrate research on organizational routines and meaningfulness. However, understanding meaningful organizational routines is not only essential because it is an overlooked area in both of these two streams of research but also because of its clear, practical relevance in the primary healthcare setting.