Journal of Health Organization and Management最新文献

Purpose: The study aims to investigate the status of patient safety culture in a tertiary hospital in Jordan during the COVID-19 pandemic.

Design/methodology/approach: This descriptive cross-sectional study used the validated Safety Attitude Questionnaire distributed to the staff working in a tertiary hospital in Jordan.

Findings: The highest scores of patient safety culture dimensions were reported for both "Stress recognition" (60.56%) and "safety climate" (58.75%) dimensions. However, the lowest scores were reported for "perception of management" (53.85%) and "working conditions" (55%).

Originality/value: This study highlighted serious concerns about the safety culture in hospitals during COVID-19. This study provides a baseline finding yielding a clearer vision of the areas of safety culture that need to be improved to safeguard patient safety during disasters.

Purpose: This article investigates healthcare utilization differences for Traditional Medicare (TM) and Medicare Advantage (MA) patients under the care of primary care physicians (PCPs) who receive reimbursement from risk-bearing capitation contracts.

Design/methodology/approach: We compare counts of medical services between Medicare patients for a single coverage year for inpatient, outpatient, carrier, home health, skilled nursing, and emergency department facilities. We utilized differences of means t-tests and Poisson regression for the analysis.

Findings: After controlling for other factors, we find that Essence patients under the care of PCPs reimbursed more extensively through risk-bearing capitation arrangements received dramatically fewer medical services in all treatment venues than traditional Medicare patients under the care of PCPs without capitated reimbursement. Specifically, they received 60.7% fewer inpatient days, 71.9% fewer outpatient visits, and 51.8% fewer emergency department visits. Furthermore, they received 47.9% more medical procedures from a PCP. Thus, they were treated in less costly venues.

Practical implications: Longitudinal analysis is needed, but if this phenomenon persists with no long-term adverse effects on patients and the medical providers, capitated reimbursement for primary care could produce the desired outcomes of value-based care reimbursement mechanisms.

Originality/value: This research is unique in that it evaluates annual healthcare utilization based on the risk-bearing capitated reimbursement for patients' PCPs. Other research has not found a strong correlation between value-based reimbursement, healthcare utilization, and cost savings. This article demonstrates significantly less healthcare utilization for patients when PCPs receive greater risk-bearing capitated reimbursement. However, services received from a PCP were greater for these patients.

Purpose: This study explores how customer value is destroyed in Lean-managed public healthcare by applying the concepts of value destruction and value co-destruction.

Design/methodology/approach: The study draws on a qualitative analysis of customer feedback (n = 507) collected in 2024 from general practitioner and nurse consultations and oral healthcare services, including telephone interactions related to these services, within a Finnish wellbeing services county operating under Lean management principles. The dataset was limited to responses with a Net Promoter Score of 0, accompanied by open-ended comments detailing reasons for perceived value loss. An abductive content analysis was conducted, guided by existing theories of value destruction and co-destruction.

Findings: Customer value was destroyed or co-destroyed due to restricted access to care, dysfunctional service processes and inadequate service encounters. Some mechanisms reflected systemic failures that excluded customers from interaction altogether, while others emerged during deteriorated service encounters. These issues resulted in confusion, compromised self-care, emotional harm and a breakdown of trust.

Originality/value: This study contributes to service research by operationalising the concepts of value destruction and value co-destruction using empirical data from a Lean-managed public healthcare organisation. It challenges the assumptions of public service logic, which positions value co-creation as a normative ideal, by demonstrating that co-creation may become structurally impossible when essential conditions such as service accessibility, continuity of care and professional communication are absent.

Purpose: Many studies have investigated how job satisfaction and perceived stress link to job performance, yet the role of shared vision for healthcare professionals remains unexplored. This study examined the moderating effect of shared vision on the relationship between job satisfaction, perceived stress, and job performance among healthcare professionals in public teaching hospitals in Ghana.

Design/methodology/approach: This study analyzes cross-sectional data involving 1,698 healthcare professionals, including doctors, nurses, and midwives, across four public teaching hospitals. The main study variables were measured using existing scales for job satisfaction, perceived stress, shared vision, and individual employee performance. IBM SPSS software and SmartPLS 4 were used for the data analysis.

Findings: We found that job satisfaction benefits employee performance; however, job stress is detrimental. Furthermore, shared vision mitigated the negative effect of perceived stress and stimulated the positive impact of job satisfaction on employee performance.

Practical implications: Shared vision among healthcare employees is essential for achieving high performance. Thus, policymakers and healthcare organization managers should focus on effectively imparting the organizational vision to employees.

Originality/value: This is the first study to empirically examine the moderating role of shared vision in the relationship between job satisfaction, perceived stress, and job performance in healthcare settings. This knowledge could assist healthcare leaders in achieving high-quality performance from healthcare professionals.

Purpose: This study aimed to investigate the impact of emerging digital health technologies on the sustainability of primary healthcare systems in Tanzania, focusing on operational, institutional, social and environmental dimensions.

Design/methodology/approach: A convergent mixed-methods design was employed in Tanzania. Quantitative data were collected from 240 healthcare workers across 204 primary healthcare facilities using a structured questionnaire. Regression analysis identified predictors of sustainability outcomes based on the technology-organisation-environment (TOE) framework. In parallel, qualitative data were gathered through 25 semi-structured interviews with health professionals and administrators. Thematic analysis was employed to explore perceptions, experiences and institutional challenges associated with digital health implementation.

Findings: Usability, system reliability and staff capacity were significant predictors of operational sustainability (R2 = 0.760), while training availability, leadership support and policy support were strong predictors of institutional sustainability (R2 = 0.844). Environmental sustainability received the lowest overall rating (mean = 2.41, SD = 0.78), reflecting constraints such as unstable electricity, limited funding and a lack of maintenance planning. Qualitative findings reinforced these patterns, with participants reporting improved workflow and data visibility but raising concerns about digital exclusion, weak governance and inequities between urban and rural facilities. The integration of findings highlighted the need for coordinated investments beyond infrastructure, including sustained training, policy coherence and targeted support for under-resourced health centres.

Originality/value: This study extends the TOE framework to a multi-dimensional sustainability context, integrating operational, institutional, social and environmental perspectives in a low-resource primary healthcare setting. It provides evidence that sustainable digital health implementation requires not only technological functionality but also organisational readiness, inclusive policies and attention to environmental resilience.

Purpose: We explore what happens to home-based healthcare practice 11 years after implementing a healthcare reform, the Coordination Reform in 2012.

Design/methodology/approach: We conducted a qualitative study using document analysis and five focus group interviews with 27 department leaders in home-based healthcare practices in 2023. An inductive thematic analysis was conducted.

Findings: Our qualitative design sheds light on how macro-ideas, reforms, and policies shape practice across healthcare institutions and the challenges they face. It highlights that reforms, often driven by efficiency goals, rarely lead to swift changes due to resistance rooted in established norms, values and practices. Still eleven years post-reform, we observe minimal progress in cross-level clinical coordination. The study identifies key barriers, including issues with information flow, trust and collaboration between hospitals and municipal healthcare services. Additionally, it examines the role of path dependency, explaining the persistence of prior routines despite reforms and provides a theoretical lens for understanding resistance to change in healthcare.

Practical implications: By applying institutional theory to healthcare reforms, policymakers and practitioners can better navigate the complex forces shaping healthcare policy.

Originality/value: Our findings illustrate how macro-ideas and policies are diffused across institutional levels in the municipality healthcare sector and how organizational actors and their immediate context shape practice when it comes to cross-clinical coordination.

Purpose: Drawing on social exchange theory (SET) and social identity theory (SIT), this study investigates how the high-performance work systems (HPWS)-turnover intention () link is mediated by organizational identification (OID) and moderated by trust in leader (TIL) and perceived organizational support (POS).

Design/methodology/approach: A two-wave time-lagged survey research was conducted on healthcare professionals in Nigeria, comprising medical doctors, nurses and midwives, and 387 valid responses were received.

Findings: The results indicated that HPWS significantly and negatively predicted TI and significantly and positively predicted OID. In turn, OID significantly and negatively predicted TI. OID partially mediated the relationship between HPWS and TI. While the moderating effect of TIL on the relationship between HPWS and OID was not significant, POS was found to significantly strengthen the negative relationship between OID and TI.

Originality/value: Despite a considerable body of research on the outcomes of HPWS, its underlying mechanisms and boundary conditions remain elusive. This study therefore offers valuable theoretical contributions to advancing the literature on how and when HPWS influence employee outcomes.

Purpose: To determine the relationship between nursing care satisfaction levels and nursing image perceptions of patients hospitalized in inpatient units of a university hospital.

Design/methodology/approach: This is a descriptive, correlational and cross-sectional study. The study data were collected from 610 patients hospitalized in the inpatient units of a university hospital with the Introductory Information Form, Patient Perception of Hospital Experience with Nursing Care and the Nursing Image Scale. Descriptive analyses, independent groups t-test, one-way analysis of variance, Mann-Whitney U test, Kruskal-Wallis test and Spearman correlation analysis were employed in the analysis of the data.

Findings: It was determined that the Nursing Image Scale scores differed statistically significantly according to the participants' age, education level, state of thinking that they received quality nursing care and nursing image perception of the participants. It can be stated that the satisfaction of the patients participating in the study with the nursing care provided is high, and the nursing image they perceive is at a high level and positive. A positive and significant relationship was found between the participants' nursing care satisfaction levels and their perceptions of nursing image (r = 0.502, p < 0.01).

Originality/value: The results of the study are very important in terms of showing the effect of the image of nursing not only in terms of the development of the profession but also on the perception of the care provided. It is recommended that health institutions and managers determine more strategies in this regard because it affects the preferability of their institutions and the satisfaction of the care provided.

Purpose: This study aimed to determine the mediating effect of team job crafting in the relationship between sparking leadership and work engagement and establish a model.

Design/methodology/approach: This descriptive and correlational study included 400 nurses selected through convenience sampling. Data were collected using the Sparking Leadership Scale, Work Engagement Scale, and Team Job Crafting Scale, and analyzed with IBM SPSS and AMOS. The STROBE guideline was followed in reporting the study.

Findings: The conceptual model hypothesized, which included latent and observed variables, was a good fit to the data. The factor loadings of all observed variables were between 0.73 and 0.91 and significant. According to these findings, the latent variables were well represented. Sparking leadership had a direct positive effect on team job crafting (β = 0.792), and team job crafting had a direct positive effect on work engagement (β = 0.390). The direct effect of sparking leadership on work engagement was insignificant (β = 0.186), but its indirect positive effect through team job crafting was significant (β = 0.309). According to the results of the study, team job crafting was found to fully mediate the relationship between sparking leadership and work engagement.

Originality/value: The results of the study are very important in terms of showing the sparking leadership enhances nurses' work engagement indirectly by promoting team job crafting. These findings underscore the importance of leadership and teamwork in fostering engagement in healthcare settings. It is recomended that nurse managers' leadership approaches should be evaluated, and structured strategies should be developed to enhance sparking leadership skills. Educational programs and workshops will support the adoption of this style, fostering team job crafting, work engagement, and a sustainable leadership culture in nursing.

Purpose: This article studies the customer's purchase intention to choose healthcare services in the post-COVID-19 situation. The authors have used the most prominent SERVQUAL model to assess the service quality offered to patients and each variable's influence on customer intent to purchase healthcare services.

Design/methodology/approach: Tangibility, reliability, responsiveness, assurance, empathy, hospital image and customer purchase intention are the variables considered for this study. Data have been collected from customers who have recently experienced services in different hospitals. Standardized statements of the SERVQUAL model and purchase intention were adapted and modified as per the requirements of the constructs. Out of 271 filled questionnaires, the authors have undertaken the data cleaning process to circumvent any kind of biasness; finally the authors have considered 225 questionnaires to conduct this research work.

Findings: This study's findings indicate significant and positive relationships between service quality, hospital image and customer purchase intention to choose hospital services. Additionally, the mediating role of hospital image was confirmed in all four hypotheses.

Practical implications: The results of this study provide practitioners with valuable insights and guidance for developing effective strategies for providing better services to patients.

Originality/value: Confirmatory factor analysis (CFA) was used to check the validity and reliability of all the constructs. Due to the high correlation between tangibility, reliability, responsiveness, assurance and empathy, authors have created a second-order construct, i.e. service quality. Authors have also used structural equation modeling (SEM) to inspect the associations between different constructs. Authors have measured the mediating role of hospital image between the relationship of all the service quality dimensions and customer purchase intention.