Journal of Health Organization and Management最新文献

Purpose: Telemedicine is a context-specific intervention that implies significant procedural changes in a health organization. The objective of the study is to explore healthcare professionals' usage of and perceptions towards telemedicine technology and identify the perceived factors and related process change, influencing the effective adoption of telemedicine from an organizational perspective.

Design/methodology/approach: The study includes multi-disciplinary commentaries of a purposive sample of 31 healthcare professionals, conducted through semi-structured qualitative interviews and employs Grounded Theory and Thematic Analysis techniques to analyze the data.

Findings: Telemedicine is perceived as a highly beneficial digital intervention in healthcare, focusing on the delivery of effective healthcare, and promoting healthcare equity. Healthcare professionals showed their willingness to assimilate technology into clinical decision-making, resulting in better treatment outcomes, and recommended its' adoption into mainstream healthcare as a viable approach to providing remote healthcare. The key organizational issues with telemedicine adoption were system requirements, network connectivity, non-standardized medical records, and legal bottlenecks, that can be addressed by improving infrastructural convenience, optimizing service processes, imparting training, and adopting better technical measures.

Originality/value: The focus is on exploring factors significant for the adoption of telemedicine technology from the perspective of multi-specialties in a health organization, rather than a specific specialty, as studied in previous scholarly work. This study contributes to the theory by proposing a conceptual framework on critical factors for telemedicine adoption, integrating the theory of planned behavior (TPB) and diffusion of innovation (DOI).

Purpose: The aim of this study was to identify and describe the collaborative and professional boundary challenges at a hospital ward from a bottom-up perspective.

Design/methodology/approach: The study was conducted as a bottom-up improvement project at a hospital ward in western Sweden. An insider action research (IAR) approach was used during the project. The theoretical framework for this project was based on the Cultural-Historical Activity Theory (CHAT). Data were collected between 2019 and 2021.

Findings: The findings showed that unclear professional boundaries and limited resources challenged and hindered interprofessional collaboration. The project group had to reorganize its daily work to adjust to the different disciplines' legal responsibilities in relation to the patients' recovery process. To safely discharge patients, the professionals needed to talk about each other's professional responsibilities, professional boundaries and ethical codes.

Originality/value: The IAR project revealed that revising the daily team-round routine improved the status of assistant nurses and encouraged physicians to consider input from all professions during the patients' recovery process. However, the new approach faced resistance from clinic leadership, who believed it could prolong patients' stays in the ward. The findings underscore the challenges of modifying hierarchical structures and social orders within hospital settings.

Purpose: Leadership was a critical component in managing the Covid-19 pandemic. A scoping review of clinical leadership investigates the leadership styles employed by clinicians during times of unprecedented crisis, with the Covid-19 pandemic as a focus.

Design/methodology/approach: The scoping review was designed based on a five-stage approach proposed by Arksey and O'Malley (2005). Three key databases were searched: Scopus, Cumulative Index for Nursing and Allied Health Literature (CINAHL), and ProQuest Healthcare Administration between 2020 and 2022.

Findings: Of the 23 papers included in the review, the majority were based on developed countries. Seven leadership approaches were found to be useful in times of crises, with compassionate leadership being particularly effective. Seven key themes relating to the pandemic were also identified.

Research limitations/implications: This review is limited by the search strategy employed and the possibility some publications could have been missed. However, it is clear from the results that there is limited research on healthcare leadership outside of the acute setting and in developing countries. These are important areas of further research that need to be pursued to inform our learning for other times of unprecedented crisis.

Originality/value: Various leadership styles were employed during the pandemic, but compassionate leadership, which fosters a collaborative, caring and kind environment, becomes a necessity when faced with uncertainty and adversity. This review identifies key factors that leaders need to manage during the pandemic. Practically, it sheds light on leadership strategies that may be employed in future unprecedented crises.

Purpose: The integration of big data with artificial intelligence in the field of digital health has brought a new dimension to healthcare service delivery. AI technologies that provide value by using big data obtained in the provision of health services are being added to each passing day. There are also some problems related to the use of AI technologies in health service delivery. In this respect, it is aimed to understand the use of digital health, AI and big data technologies in healthcare services and to analyze the developments and trends in the sector.

Design/methodology/approach: In this research, 191 studies published between 2016 and 2023 on digital health, AI and its sub-branches and big data were analyzed using VOSviewer and Rstudio Bibliometrix programs for bibliometric analysis. We summarized the type, year, countries, journals and categories of publications; matched the most cited publications and authors; explored scientific collaborative relationships between authors and determined the evolution of research over the years through keyword analysis and factor analysis of publications. The content of the publications is briefly summarized.

Findings: The data obtained showed that significant progress has been made in studies on the use of AI technologies and big data in the field of health, but research in the field is still ongoing and has not yet reached saturation.

Research limitations/implications: Although the bibliometric analysis study conducted has comprehensively covered the literature, a single database has been utilized and limited to some keywords in order to reach the most appropriate publications on the subject.

Practical implications: The analysis has addressed important issues regarding the use of developing digital technologies in health services and is thought to form a basis for future researchers.

Originality/value: In today's world, where significant developments are taking place in the field of health, it is necessary to closely follow the development of digital technologies in the health sector and analyze the current situation in order to guide both stakeholders and those who will work in this field.

Purpose: While prevalence and value of nonclinical hospital workers, like quality or education professionals, increase, their work engagement is understudied. Work engagement of nonclinical and clinical hospital workers is critical considering the pressure of major challenges in healthcare. The pandemic was a natural experiment for this.

Design/methodology/approach: We conducted an observational survey study among all nonclinical and clinical hospital workers of the Jeroen Bosch Hospital, the Netherlands. In an employee satisfaction survey, we measured work engagement under acute pressure (just after the first COVID-19 wave in July 2020) and chronic pressure (within the second COVID-19 wave in November 2020) and to what extent psychological demands and co-worker support were related to work engagement.

Findings: For all hospital staff, "average" levels of work engagement were found under acute (response rate 53.9%, mean 3.94(0.81)) and chronic pressure (response rate 34.0%, mean 3.88(0.95)). Under acute pressure, nonclinical hospital workers scored lower on the subcategory dedication than clinical workers (mean 4.28(1.05) vs mean 4.45(0.99), p < 0.001). Under chronic pressure, no differences were found. For both nonclinical and clinical hospital workers, co-worker support was positively related to overall work engagement (beta 0.309 and 0.372). Psychological demands were positively related to work engagement for nonclinical hospital workers (beta 0.130), whereas in clinical hospital workers, psychological demands were negatively related to vigor (beta -0.082).

Practical implications: Hospitals face times of pressure. Fostering co-worker support under pressure may be vital for hospital management.

Originality/value: Work engagement of nonclinical hospital workers is understudied.

Purpose: The objective of this article is to make an exploratory study about European public administrations (public administration, public agencies, public law entities, entities dependent on the public administration and public universities) in relation to workplace health promotion interventions. The sample was extracted from the ESENER-3 (Third European Survey of Enterprises on New and Emerging Risks) (EU-OSHA, 2019) and consists of 7,981 public entities from the EU-27 countries. Four WHPI have been studied: healthy nutrition interventions, sports activities after working hours, back exercises at work and prevention of addictions.

Design/methodology/approach: This is an exploratory study. The sample was extracted from the ESENER-3 (Third European Survey of Enterprises on New and Emerging Risks) (EU-OSHA, 2019) and consists of 7,981 public entities from the EU-27 Public Administration. In total, 45,420 establishments were interviewed.

Findings: Different patterns have been observed when implementing workplace health promotion interventions in the EU-27 public administration. The promotion of sports activities outside working hours is the one with the highest level of implementation in European public administration. On the other hand, the measure with the least implementation level is the promotion of healthy nutrition.

Research limitations/implications: The limitations of the study are that the studied items are nominal and comprise more than two categories, so it has not been possible to develop a correlation analysis.

Practical implications: The EU-27 public administrations can see which workplace health promotion interventions need to be improved.

Originality/value: Differences that may exist in the adopted workplace health promotion interventions by European public administrations have not yet been addressed in depth by the literature.

Purpose: The aim of this study is to investigate ways in which healthcare organisations can successfully maintain operational resilience within intricate and varied engagements during digital transformation processes.

Design/methodology/approach: The present research applied cultural-historical activity theory as the theoretical framework and the ethnographic account as an approach and strategy to interpret and understand the operational resilience of digital transformation tools in daily practices. Fieldwork was based on the research technique of shadowing, whereby the researcher closely accompanied the participants to record their conduct, activities and exchanges.

Findings: Research results propose that effective operational resilience management in the implementation of digital transformation projects is based on (1) identifying and interpreting internal contradictions in everyday interactions as opportunities for capability developments; (2) navigating through multiple sites in fast and improvised movements, which derives in distributed and emergent practices; (3) interplaying between dyadic interactions and networked dependencies, which is achieved through the articulation of varied interests and (4) implementing novel intermediary tools, roles and regulations that facilitate the reduction of disturbances.

Originality/value: The propositions of the present study indicate that the management of operational resilience extends beyond conventional adaptive and socio-technical models in healthcare services. The study emphasises the significance of expressing and converting differing interests into mutual advantages. It additionally demonstrates the intricacy of this obstacle, as it entails navigating through uncertain information, concealed interpretations and conflicting interests.

Purpose: The 2020-2021 COVID-19 pandemic spurred change across multiple healthcare industries. This study explores how managing vaccination data in the United States of America required cooperation among many different organizations necessitated by an emergency response. We studied how individual states interacted with the federal government to address the need for vaccination-related information during the pandemic.

Design/methodology/approach: In total, 11 interviews were conducted with individuals responsible for collecting vaccination data and reporting it to the US Federal Government. Seven of those individuals were directors of USA jurisdictional Immunization Information Systems (IIS). Archival data were also combined with the interview responses to inform the analysis and development of guidelines.

Findings: States across the USA had different ways of tracking and storing immunization data that was heavily influenced by state-level and federal legislation. The lack of a universal patient identifier made cross-state patient identification difficult. Federal requirements for reporting dictated much of how the different state-level entities collected, stored and reported data.

Practical implications: This study highlights the importance of data interoperability and data sharing by exploring how a loosely coupled set of entities without direct top-down control or a profit motive can govern data effectively. Our analysis provides greater clarity about the interactions between different stakeholders in a complex system.

Originality/value: This study presents primary interviews of 11 individuals, each responsible for tracking and reporting immunization information. Analysis of the data expands existing research on IIS on data sharing, system interoperability and dynamic pandemic responses.

Purpose: Network configurations have been proposed as an efficient form of organisation and a promising area of research; however, a lack of conceptual clarity can be noted. The purpose of this review is to allow for a broad appreciation of network configurations and provide guidance for future studies of the concept.

Design/methodology/approach: A systematic literature review was conducted based on the PRISMA method; Scopus, Web of Science, PubMed and the Cochrane Library were searched for conference proceedings and journal articles describing organisational networks to integrate resources aimed at care delivery. Around 80 articles were included in the final review and analysed thematically and by use of bibliographic coupling.

Findings: The last decades have seen an increase in the frequency of articles describing networks for healthcare delivery. The most common contexts are care for multiple and/or long-term conditions. Three clusters of articles were found, corresponding to different conceptualisations of networks in healthcare: efficiency-enhancing cooperation, efficiency-enhancing integration and involvement for cocreation.

Research limitations/implications: To increase conceptual clarity and allow the research on network configurations in healthcare to produce meta-learnings and guidance to practice, scholars are advised to provide ample descriptions of studied networks and relate them to established network classifications.

Originality/value: The current review has only included articles including networks as a key concept, which provides a focused overview of the use of network configurations but limits the insights into similar approaches not described explicitly as networks.

Purpose: This study aims to evaluate healthcare practitioners' perceptions of electronic health record (EHR) systems and their effectiveness in supporting clinical decision-making in Tanzanian Primary Healthcare (PHC) facilities.

Design/methodology/approach: A mixed-methods approach was employed, combining quantitative data from structured questionnaires and qualitative insights from open-ended responses. The study was conducted in the Dodoma region of Tanzania, focusing on a diverse representation of PHC facilities, including district hospitals, health centres and dispensaries. Data were analysed using multiple linear regression for quantitative data, and thematic analysis was applied to qualitative responses.

Findings: The results revealed that while EHR systems are widely used in Tanzanian PHC facilities, their impact on clinical decision-making remains limited. Only a moderate portion of practitioners perceived EHR systems as effective in decision support, and frequent system use was negatively correlated with user satisfaction. Challenges such as inadequate training and support, system crashes, slow performance and poor usability and integration into clinical workflows were significant barriers to effectively utilising EHR systems.

Originality/value: This study contributes to the limited literature on EHR system implementation in low-resource settings, specifically Tanzania, by focusing on decision-support features within EHR systems. The findings offer valuable insights for healthcare policymakers, system designers and practitioners to optimise EHR implementation and improve healthcare outcomes in resource-constrained environments.