Journal of Health Organization and Management最新文献

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: 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.

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.