Journal of Health Organization and Management最新文献

Purpose: The purpose of this study is to investigate the determinants of job retention intention among healthcare workers (HCWs) in Canada during the COVID-19 pandemic.

Design/methodology/approach: Data are from a large nationally representative cross-sectional survey conducted by the Canadian National Statistics Agency. Ordered logistic regression is estimated to find an association between job retention and its main determinants as gleaned from the literature while controlling for a wide range of pertinent covariates. Odds and standardized odds are reported and discussed.

Findings: The results suggest that worsening working conditions, changes in health and well-being and lack of organizational support weaken intentions regarding job retention. Being employed rather than self-employed and working as a nurse also weakens job retention.

Originality/value: This is the first research on the determinants of intentions regarding job retention in Canada using nationally representative data. It allows us to test and confirm the results of previous studies on a large sample of Canadian HCWs. The paper also discusses the implications of the findings for health management and administration.

Purpose: This study aims to analyze the challenges in financing the healthcare system of Pakistan and develop a comprehensive health financing strategy aimed at achieving universal health coverage (UHC).

Design/methodology/approach: The paper utilizes World Health Organization (WHO) framework on health financing to build the argument. It uses qualitative research design involving focus group discussions and in-depth interviews with key stakeholders, including Federal Board of Revenue, Ministry of Finance, Planning Commission, development partners, academia and health ministries at federal and provincial levels, as well as social health insurance entities.

Findings: The research findings highlight several critical issues within Pakistan's healthcare system: Firstly, health spending is inadequate to provide financial protection to 24 million people. Secondly, the available health funding is allocated in clusters and caters primarily to specific groups, which exacerbates inequities in healthcare provision. Thirdly, the existence of multiple purchasing agents who operate concurrently to buy health services results in duplication and wastage of resources. Fourthly, the public financial management system, intended to support the swift distribution of public funds to health facilities, is not aligned with the requirements of the health system. Lastly, the devolved health setup has led to governance issues in managing the health sector.

Originality/value: This study fills a significant gap in the literature on health financing within Pakistan and proposes a unique empirical approach using WHO's framework in a decentralized healthcare context. It also provides actionable recommendations for policymakers to develop strategies that improve the effectiveness of public financial management and health service delivery.

Purpose: We aim to address the evolving phenomenon of dry promotions and its impact on employee well-being in organizations. Dry promotion, its possible effects on employee well-being and some strategies to mitigate its adverse consequences are presented as a viewpoint paper.

Design/methodology/approach: The arguments in this viewpoint are built on theoretical insights drawn from various organizational theories, such as Maslow's hierarchy of needs, Herzberg's two-factor theory and self-determination theory. However, the main line of thought revolves around positive psychology theory, which assesses the paper's existing literature, news articles and case studies to discuss the emerging phenomenon concisely.

Findings: Dry promotion is often characterized by job title upgrades without corresponding pay increases. While dry promotion may satisfy higher-level needs for some individuals, they usually neglect lower-level needs, leading to stress and work-life imbalance, ultimately causing detrimental effects on employee well-being. Strategies at individual, group and organizational levels are crucial to navigate this phenomenon and its consequences. We argue that fair communication, supportive workplace culture and providing avenues for skill enhancement curtail the adverse effects of dry promotion on employee well-being. In addition, a culture fostering mindfulness can help employees navigate the challenges of increased responsibilities without proportional financial rewards.

Practical implications: Our study can provide at least some guidance on how to navigate through the phenomenon of dry promotions.

Originality/value: Our paper contributes to the scant literature on dry promotions by assessing the likely effects of dry promotions on employee well-being and suggesting practical strategies to deal with it.

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.