Journal of Health Organization and Management最新文献

Purpose: A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding financial situation have failed. A decommissioning programme was launched, and two years later, an evaluation indicated positive outcomes. The aim of this study was to explore factors politicians and public servants perceived as enablers to the successful implementation of the programme.

Design/methodology/approach: A deductive content analysis approach using a framework of factors facilitating successful implementation of decommissioning decisions was applied to analyse interviews with 18 informants.

Findings: Important factors were: (1) a review report contributing to the clarity of evidence, which (2) made the clarity of the rationale for change undeniable and (3) strengthened the political support for change. Additional factors were: (4) the strength of executive leadership, (5) the strength of clinical leadership supported by (6) the quality of project management and (7) a cultural and behavioural change seen as an important outcome for the path forward. A way to maximise the potential for a successful implementation of a large-scale decommissioning programme is to build a shared vision and a collaboration grounded in convincing evidence. Include public servants with a clinical background in the executive leadership team to contribute with legitimacy, competence, and trust in the decommissioning programme's intention.

Originality/value: The paper addresses the limited knowledge of best practices in decommissioning processes and contributes empirical knowledge from a successful case.

Purpose: This paper explores the use of Dynamic Business Modeling for Sustainability (DBMfS) in healthcare management settings as a holistic approach to integrating economic, social, and environmental dimensions into the business formula of these complex organizations.

Design/methodology/approach: After framing sustainable value in healthcare in terms of organizational complexity, wicked problems, and emerging managerial challenges, the paper proposes and illustrates the DBMfS approach that adopts a systemic view of sustainable value in healthcare. According to a qualitative perspective, a single-case study of a maternity-related healthcare treatment is also described to explore the implications and limitations of using this approach to sustainable business modeling in healthcare organizations.

Findings: Findings show that, by embracing sustainability through DBMfS, healthcare organizations can improve operational efficiency, reduce waste (like energy, water, and medical supplies), and enhance cost-effectiveness, thus contributing significantly to societal well-being.

Originality/value: In recent years, the healthcare sector has faced numerous challenges and wicked problems, including escalating costs, resource constraints, and growing environmental concerns. As a result, the concept of sustainability has gained significant attention, thus calling scholars and practitioners to develop methods and tools able to integrate it into strategic management systems of healthcare organizations. By proposing the adoption of DBMfS in the healthcare sector, this paper contributes to feeding up the current debate.

Purpose: This study aims to explore the adverse impacts of abusive supervision on helping behaviors among employees, as mediating by intention to leave and moderating by Islamic work ethics (IWE).

Design/methodology/approach: A quantitative approach was employed, and the sample consisted of 283 nurses working in various public sector hospitals in Pakistan. The data analysis was conducted using SPSS and AMOS with the PROCESS macro.

Findings: The results suggest that abusive supervision diminishes helping behavior among nurses. Additionally, the study reveals that intention to leave mediates the relationship of abusive supervision and nurses' helping behavior. Moreover, the introduction of IWE as a boundary condition reveals that the mediated link is weaker when IWE is higher, and vice versa.

Practical implications: This study provides valuable insights for hospital authorities to develop intervention strategies and policies aimed at reducing abusive supervision in hospitals. Hospital management should also be aware of the detrimental effects of abusive supervision on nurses' helping behaviors, which can be mitigated by promoting ethical values aligned with IWE.

Originality/value: This study makes a valuable contribution to the limited research on the link between abusive supervision and helping behaviors in hospital settings. It offers new perspectives by incorporating the Conservation of Resources theory, particularly within the healthcare sector. Furthermore, this research expands the current knowledge by investigating the mediating influence of intention to leave and the moderating effect of IWE in mitigating the adverse impact of abusive supervision on nurses' helping behavior in Pakistan's public sector hospitals.

Purpose: Healthcare organizations require more proactive behaviors from nursing professionals. However, nurse managers' proactivity has rarely been analyzed in the literature and little is known about the antecedents and consequences of their proactive behavior at work. This study examines the relationships between job characteristics (i.e. job autonomy and job variety), psychological empowerment, proactive work behavior and job effectiveness indicators (i.e. innovative work behavior, job performance). We tested a model in which psychological empowerment and proactive work behavior sequentially mediate the relationship between job characteristics and job effectiveness.

Design/methodology/approach: A cross-sectional study was conducted among nurse middle managers from a French hospital (N = 321). A hypothetical model was developed based on existing theory. Structural equation modeling was used to test the hypotheses.

Findings: Results show that psychological empowerment and proactive work behavior fully mediate the relationship between job characteristics and innovative work behavior, and partially mediate the relationship between job characteristics and job performance.

Originality/value: This study provides insights for understanding how job characteristics can contribute to fostering the proactivity of nurse middle managers and how their proactive work behavior can be positively related to innovative work behavior and job performance. Findings raise several implications for hospital administrators and upper management seeking new ways to enhance nurse middle managers' proactive work behavior and push further their effectiveness at work.

Purpose: The main objective of this study was to design a dynamic adaptive decision support model for healthcare organizations facing deep uncertainties by considering promising dynamic adaptive approaches. The main argument for this is that healthcare organizations have to make strategic decisions under deep uncertainty, but lack an approach to deal with this.

Design/methodology/approach: A Dynamic Adaptive Decision Support model (DADS) is designed using the Design Science Research methodology. The evaluation of an initial model leads, through two case studies on ongoing and strategic decision-making, to the final design of this needed model for healthcare organizations.

Findings: The research reveals the relevance of the designed dynamic and adaptive tool to support strategic decision-making for healthcare organizations. The final design of DADS innovates Decision Making under Deep Uncertainty (DMDU) approaches in an organizational context for ongoing and strategic decision-making.

Originality/value: The designed model applies the Dynamic Adaptive Policy Pathways approach in an organizational context and more specifically in health care organizations. It further integrates Corporate Real Estate Management knowledge and experience to develop a most needed tool for decision-makers in healthcare. This is the first DADS designed for an organization facing deep uncertainties in a rapidly changing healthcare environment and dealing with ongoing and strategic decision-making.

Purpose: This study, by applying the feedback process of the organizational learning model, examined the relationships among group learning, individuals' and groups' internalization of institutionalized evidence-based practice (I-EBP), and nurses' sustainment of I-EBP.

Design/methodology/approach: Twelve hospitals were included in this cross-sectional study, with 1,741 nurses from 59 wards. Anonymous questionnaires were administered from October to December 2021. Participants self-reported their wards' group learning, internalization of I-EBP, sustainment of I-EBP, EBP beliefs, intra-hospital transfers, and nursing research experiences. The number of nurses and I-EBP introduction length and type of I-EBP were assessed. Internalization of I-EBP of nurses and groups was considered the mediating variable, while group learning and nurses' sustainment of I-EBP were the independent and dependent variables, respectively. Significant variables in bivariate analyses were used as control variables. Multi-level Mediation Analysis and a significance test of indirect effect using the bootstrap method were conducted.

Findings: Responses from 360 nurses in 48 wards from 12 hospitals were analyzed. Groups' internalization of I-EBP significantly mediated the relationship between group learning and nurses' sustainment of I-EBP. In contrast, no significant mediating effect of nurses' internalization of I-EBP was observed.

Originality/value: In the feedback process of organizational learning, group learning and its subsequent effects on individuals and groups have not been previously examined. Regardless of the nurses' degree of internalization of I-EBP, those who belong to the ward with a high degree of internalization of I-EBP are more likely to sustain it. Conducting group learning may prevent superficial practice, resulting in its sustainability.

Purpose: Nosiness is an annoying behavior at the workplace that can lead to negative consequences. It is characterized by being overly curious about other people's affairs. Specifically, this study aims to identify the factors contributing to nosiness among nurses.

Design/methodology/approach: We conducted an exploratory qualitative interview study involving 38 nurses in Iran. The participants were selected by purposive sampling.

Findings: We identified nine themes as the antecedents of nosiness among nurses: defamation motive, the need for certainty, the need for power, recreational motive, empathy, social comparison, the allure of the subject for the individual, having an employee-friendly workplace, and work environment and workload.

Originality/value: Understanding the antecedents of nosiness can help healthcare organizations curtail this phenomenon and foster a positive work environment, particularly in nursing where empathy, compassion, and attention to detail make them susceptible to nosiness.

Purpose: The paper investigates English National Health Service (NHS) organisations partnering with private companies, a form commonly known as a Public-Private Partnership (PPP). Successive governments have promoted PPPs as a way of improving the delivery of health care, making the best of the different skills/experience which both sectors bring. However, the task of making these relationships work on the ground often falls to individual leaders/practitioners ("boundary spanners") whose role has been under-researched in this type of partnership.

Design/methodology/approach: The paper opted for a comparative three case study approach, including 13 semi-structured interviews and questionnaires with employees representing middle and senior management involved in managing the partnerships. The data were complemented by documentary analysis, including minutes, descriptions of internal processes and press releases.

Findings: The paper provides conceptual and empirical insights by creating a framework called the "boundary wall" that indicates the ways in which different elements of the boundaries between organisations influence the role and activities of boundary spanners (managers of the partnership).

Research limitations/implications: This is an initial framework in an under-researched area, so will need further testing and application to other case study sites in future research.

Practical implications: The paper includes implications for both practice and policy.

Originality/value: While we know an increasing amount about the role of boundary spanners in public partnerships, the paper makes a unique contribution by exploring these concepts in the context of relationships between the public and private sectors.

Purpose: The purpose of the study is to examine the psychological impact of COVID-19 on health workers' career satisfaction and intention to leave the health profession, with neurotic personality type as a moderator.

Design/methodology/approach: A total of 277 health workers in two public hospitals in Ghana were included in this study. Purposive and convenience sampling techniques were adopted for the study, focusing on eight departments that were involved in the management of COVID-19 cases. Validated instruments were used to measure burnout, intention to leave, neurotic personality and career satisfaction. Using AMOS and partial least squares structural equation modeling (PLS-SEM), various techniques were employed to analyze mediating and moderating mechanisms.

Findings: The departments had staff sizes ranging from 19 to 40, with 67% female and 33% male, with an average age of 31. Nurses accounted for the majority of responses (67.8%), followed by physicians (13.9%), sonographers (0.9%), lab technicians (0.9%) and other respondents (16.5%). The study found that health workers' level of burnout during COVID-19 had a positive effect on their intention to leave the health profession. Career satisfaction does not mediate this relationship; however, career satisfaction negatively influences the intention to leave the health profession. A neurotic personality does not moderate this relationship.

Originality/value: This study provides validation of burnout and intention to leave among health workers in Ghana during COVID-19 and supports the proposition that threats to resources (burnout) and having a resource (career satisfaction) have effects on the intention to leave one's profession.

Purpose: This study investigates how a hospital can increase the flow of patients through its emergency department by using benchmarking and process improvement techniques borrowed from the manufacturing sector.

Design/methodology/approach: An in-depth case study of an Australasian public hospital utilises rigorous, multi-method data collection procedures with systems thinking to benchmark an emergency department (ED) value stream and identify the performance inhibitors.

Findings: High levels of value stream uncertainty result from inefficient processes and weak controls. Reduced patient flow arises from senior management's commitment to simplistic government targets, clinical staff that lack basic operations management skills, and fragmented information systems. High junior/senior staff ratios aggravate the lack of inter-functional integration and poor use of time and material resources, increasing the risk of a critical patient incident.

Research limitations/implications: This research is limited to a single case; hence, further research should assess value stream maturity and associated performance enablers and inhibitors in other emergency departments experiencing patient flow delays.

Practical implications: This study illustrates how hospital managers can use systems thinking and a context-free performance benchmarking measure to identify needed interventions and transferable best practices for achieving seamless patient flow.

Originality/value: This study is the first to operationalise the theoretical concept of the seamless healthcare system to acute care as defined by Parnaby and Towill (2008). It is also the first to use the uncertainty circle model in an Australasian public healthcare setting to objectively benchmark an emergency department's value stream maturity.