Journal of Health Organization and Management最新文献

Purpose: This study examines the challenges in digital technology adoption among older volunteers in an organisation addressing social isolation. Using Margaret Archer's critical realist theory of emotions as causal commentaries on wider concerns, it investigates why older individuals might reject or need to adapt to digital technology adoption.

Design/methodology/approach: The paper examines a qualitative case study of Lindsay Leg Club (LLC) volunteers through two sequential projects: assessing attitudes towards digital communication technology and understanding motivations for in-person social interactions. In total, 27 interviews were conducted with volunteers in three Leg Clubs to analyse these aspects of the volunteer experience.

Findings: Volunteers' emotional reactions to technology revealed two wider concerns: leaving the role of the Leg Club volunteer, fundamentally grounded in face-to-face social relationships and reflexivity about technology adaptation, underpinned by evaluative decisions about the extent of willingness to engage with change.

Research limitations/implications: The sequential design meant that there was not a complete overlap between participants in both studies. Exact age and sex demographics were not recorded.

Practical implications: The study suggests that technology can be relationally oppressive, so its introduction in organisations focused on in-person support for older people must consider the risks of technological appropriation of social relationships.

Originality/value: Rather than presenting technology introduction as a technical process and emotions as its subjective by-product, the paper uses critical realism to show emotions can represent commentaries on technology's risks to transforming the context of human relationality.

Purpose: Efficient and effective healthcare delivery relies on the optimal performance of healthcare workers. By understanding the key performance factors, decision-makers can make data-driven decisions and implement targeted improvements to achieve the best results. In the literature, no comprehensive framework yet exists that simultaneously captures the relative importance, hierarchical interactions and prioritized structure of the performance factors specific to doctors. This study aims to fill this gap by systematically identifying, structuring and weighting the key drivers of doctors' professional performance using an advanced fuzzy decision-making methodology.

Design/methodology/approach: This study proposes an interval-valued Fermatean fuzzy analytic hierarchy process (AHP)-based decision-making framework to examine the decision problem. Within the model, five main factors are defined: "personal factors," "workplace conditions," "social factors," "management factors" and "career and development factors." Each main factor is broken down into various subfactors. The interval-valued Fermatean fuzzy AHP method is used to compare and prioritize the factors.

Findings: According to the results, "personal factors" is the most significant main factor. The five most important subfactors are determined as "education and experience," "skills and competencies," "quality of the working environment," "technological infrastructure and resources" and "knowledge management and communication."

Practical implications: The findings of this study serve to inform healthcare decision-making, facilitate policy development and design an effective performance management process. Additionally, they provide a valuable guide for doctors to self-assess and enhance their effectiveness.

Originality/value: This study formulates the evaluation of doctors' professional performance as a complex fuzzy multicriteria decision-making problem. It pioneers the application of the interval-valued Fermatean fuzzy AHP method in healthcare and contributes by adding new dimensions to the existing body of literature. The originality of this research lies not only in the application of an advanced fuzzy methodology but also in the integration of key factors into a hierarchical structure and their systematic prioritization. The study contributes new perspectives to both theory and practice in healthcare performance management.

Purpose: This study addresses critical gaps in understanding hospital financial resilience during the COVID-19 pandemic by developing an AI framework that enhances traditional analyses through capturing nonlinear interactions among clinical, financial and operational drivers of operating margins.

Design/methodology/approach: Using 21 clinical, financial and operational parameters from US hospital financial reports, we evaluated 12 machine learning, ensemble and deep learning regression models to predict hospital operating margins. SHapley Additive exPlanations (SHAP) quantified feature importance, while Spearman correlation validated pairwise relationships. Interactive SHAP dependence plots analyzed hospital size-dependent dynamics.

Findings: The Gradient Boosting model outperformed other regressors (MSE = 1,253, R2 = 0.79). SHAP analysis identified eight key determinants of operating margins during the COVID-19 era: supply expenses, licensed beds, patient days, charity care, Medicaid/Medicare revenues, employee benefits and the case mix index (CMI). Interactive SHAP analysis revealed hospital size-dependent financial dynamics - while supply and employee benefit expenses had a less pronounced impact on financial stability in larger hospitals, higher patient days and Medicaid/Medicare revenues played a more critical role. The impact of CMI in mid-sized hospitals remained uncertain. Smaller hospitals exhibited greater financial vulnerability, necessitating targeted cost management strategies.

Originality/value: This study is among the first to integrate explainable AI with SHAP for hospital financial analysis during COVID-19, offering a blueprint for AI-powered, equity-focused stewardship. It can help leaders to balance cost containment with care quality while exposing systemic disparities in reimbursement structures.

Purpose: Telemedicine represents a promising innovation to complement conventional cancer care in Europe to improve treatment quality and patient outcomes. Funded between September 2022 and December 2024, the Joint Action "Strengthening eHealth including telemedicine and remote monitoring for health care systems for CANcer prevention and care" (eCAN JA) aimed to bring the benefits of telemedicine to cancer patients across the European Union (EU) Member States, with 35 partner organizations from 16 countries and explored its feasibility through multicenter clinical trials. This study sheds light on key factors to implement telemedicine services for cancer care in European healthcare organizations (HCOs) and offers a forward-looking perspective by conducting a foresight exercise as part of the Sustainability Work Package (WP4) of the eCAN JA.

Design/methodology/approach: Foresight is an umbrella term for innovative strategic planning, policy formulation and solution design methods that empower decision-makers. For our multi-country foresight study, we followed three sequential steps to gain qualitative and quantitative findings on the facilitators of telemedicine services for cancer patients in clinical settings, comprised of (1) literature review; (2) surveys to HCOs in different EU Member States and (3) a foresight workshop with survey respondents.

Findings: Telemedicine implementation in HCOs requires equipping healthcare professionals with the necessary skills, ensuring system compatibility and addressing resource constraints for hybrid care models for success. Future policies in the EU should focus on establishing telemedicine training for healthcare professionals and support interoperability as well as user-friendliness of telemedicine services in HCOs. Policies should also address clinical workload challenges, enable harmonized telemedicine protocols across Europe, provide incentives for implementation and invest in digital infrastructure in HCOs for a sustainable telemedicine adoption.

Originality/value: To the best of our knowledge, this is the first study to conduct a foresight analysis on the feasibility of telemedicine for cancer care across different HCOs in EU Member States.

Purpose: This research investigates the barriers for Complementary and Alternative Medicine (CAM) adoption among the patients in India. Despite the established role of CAM in the Indian healthcare system for several years, the WHO (WHO) reports limited adoption of these therapies among Indian patients. This study investigates the key barriers toward wider CAM use within the Indian context.

Design/methodology/approach: This study used a combined interpretive structural modeling (ISM)-MICMAC approach to identify barriers to CAM usage. In the first phase, a comprehensive literature review was conducted to understand the barriers. Subsequently, experts in the Indian healthcare system were identified and interviewed to capture the contextual intricacies of these barriers within the Indian context.

Findings: The study identified ten key barriers to CAM adoption through ISM. A hierarchical model was developed to understand the relationships and interactions among these barriers, revealing their linkages. A MICMAC chart was created to determine the driving and dependent power of the barriers, categorizing them as dependent barriers, linkage barriers or independent barriers. The House of CAM framework was then derived from the ISM-MICMAC analysis, providing a structured, sequential approach for CAM adoption.

Practical implications: The awareness of the potential benefits and usage of CAM is significantly low among Indian patients. There is a pressing need to investigate and systematically conceptualize the barriers to CAM adoption. This research provides valuable insights for policymakers, insurers, practitioners of alternative and complementary medicine, multi-specialty hospitals offering CAM services and regulatory bodies. Understanding these barriers will enable these stakeholders to develop and implement strategies that effectively address these issues.

Originality/value: This research makes substantial contributions to the understanding of barriers to the adoption of CAM. Through a comprehensive investigation, the study introduces the House of CAM framework developed using ISM-MICMAC analysis, providing a strategic approach for targeted intervention against identified barriers.

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: This paper explores the significance of work-based learning in the context of leadership development, organizational growth and the promising economic success in Tennessee organizations. It aims to investigate the practical implications of work-based learning, focusing on its role in enhancing leadership capabilities, fostering innovation and contributing to a prosperous economic future.

Design/methodology/approach: The research employs a systematic literature review to examine existing studies on work-based learning, leadership development, organizational growth and economic success in Tennessee. It also involves data collection from various sources, including government agencies, colleges and organizations in the state. The collected data are rigorously verified and cross-referenced to ensure reliability and relevance.

Findings: The findings emphasize the transformative potential of work-based learning initiatives in Tennessee. They reveal that work-based learning programs are vital in developing influential leaders, fostering a culture of learning and innovation and contributing to economic competitiveness. The research also highlights the interconnectedness of leadership development, organizational growth and economic success, emphasizing the critical role of work-based learning in driving positive outcomes in all these dimensions.

Originality/value: This research contributes to the existing body of knowledge by emphasizing the practical applicability of work-based learning findings. It provides insights into the unique context of Tennessee organizations and their motivations, challenges and opportunities related to work-based learning. The research also outlines recommendations and future research directions to bridge the gap between theory and practice, enhancing the impact of work-based learning initiatives in Tennessee and beyond. The insights gained can assist other states and industries in developing effective work-based learning programs tailored to their specific economic needs and industry demands, fostering broader economic prosperity.