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Open Access
Article
Publication date: 13 July 2023

Sabina De Rosis, Kendall Jamieson Gilmore and Sabina Nuti

Using data from a continuous and ongoing cross-sectional web survey on hospitalisation service experiences in two Italian regions, the authors used multilevel and multivariate…

Abstract

Purpose

Using data from a continuous and ongoing cross-sectional web survey on hospitalisation service experiences in two Italian regions, the authors used multilevel and multivariate logistic regression models to identify factors related to users' demographics, emotional and informative support, technical and physical aspects of the provision, influencing satisfaction and willingness-to-recommend, before and during a crisis.

Design/methodology/approach

The value-in-use, defined in terms of a positive or negative value given by the experience with services, can be evaluated by users and influenced by the context of provision. The authors tested whether and how the value-in-use of services changed in a context of crisis. This study is applied to the healthcare sector during the coronavirus disease 2019 (COVID-19) epidemic, by evaluating the impact of the pandemic on hospitalisation experience.

Findings

Overall, analyses of 8,712 questionnaires found a greater value after the pandemic spread. In a time of crisis, technical and informative aspects of care were found to be most valued by patients that may recognise the extraordinary professionalism of workers during the crisis.

Research limitations/implications

This study empirically suggests that context can affect the evaluation of value-in-use by patients during unprecedented circumstances, producing additional value-in-context.

Practical implications

These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.

Social implications

The level of healthcare system distress, due to the COVID-19 epidemic, positively affects patients' propensity to recommend, which the authors suggest is driven by healthcare services' feelings of reverse compassion. These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience, which can have positive social implications. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.

Originality/value

Research based on the intersection of theoretical and empirical research regarding value-in-use, value-in-context and service quality measured through user experience is scarce, in particular in the healthcare sector. The authors' findings set the direction for future research on the influence of context on value creation and value creation's perception by users, on the concept of reverse compassion and on reverse compassion's impact on organisational well-being, particularly in times of crisis.

Details

The TQM Journal, vol. 35 no. 9
Type: Research Article
ISSN: 1754-2731

Keywords

Article
Publication date: 15 June 2018

Sabina Nuti, Guido Noto, Federico Vola and Milena Vainieri

Current performance measurement systems (PMSs) are mainly designed to measure performance at the organizational level. They tend not to assess the value created by the…

1257

Abstract

Purpose

Current performance measurement systems (PMSs) are mainly designed to measure performance at the organizational level. They tend not to assess the value created by the collaboration of multiple organizations and by the involvement of users in the value creation process, such as in healthcare. The purpose of this paper is to investigate the development of PMSs that can assess the population-based value creation process across multiple healthcare organizations while adopting a patient-based perspective.

Design/methodology/approach

The paper analyzes the development of a new healthcare PMS according to a constructive approach through the development of a longitudinal case study. The focus is on the re-framing process of the PMS put in place by a large group of Italian regional health systems that have adopted a collaborative assessment framework.

Findings

Framing information according to the population served and the patients’ perspective supports PMSs in assessing the value creation process by evaluating the contribution given by the multiple organizations involved. Therefore, it helps prevent each service provider from working in isolation, and avoids dysfunctional behaviors. Re-framing PMSs contributes to re-focusing stakeholders’ perspective toward value creation; legitimizes organizational units specifically aimed at managing transversal communication, cooperation and coordination; supports the alignment of professionals’ and organizations’ goals and behaviors; and fosters shared accountability among providers.

Originality/value

The paper contributes to the scientific debate on PMSs by investigating a case that focuses on value creation by adopting a patient-centered perspective. Although this case comes from the healthcare sector, the underlying user-centered approach may be generalized to assess other environments, processes, or contexts in which value creation stems from the collaboration of multiple providers (integrated co-production).

Details

Management Decision, vol. 56 no. 10
Type: Research Article
ISSN: 0025-1747

Keywords

Open Access
Article
Publication date: 26 January 2024

Alessandra Da Ros, Francesca Pennucci and Sabina De Rosis

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management…

1396

Abstract

Purpose

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

Design/methodology/approach

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Findings

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Practical implications

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

Originality/value

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.

Details

Management Decision, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0025-1747

Keywords

Open Access
Article
Publication date: 17 October 2019

Giorgio Giacomelli, Nora Annesi, Sara Barsanti and Massimo Battaglia

The purpose of this paper is to contribute to the scholarship on public management models and to advance the theoretical conceptualization of the complexity of performance…

3169

Abstract

Purpose

The purpose of this paper is to contribute to the scholarship on public management models and to advance the theoretical conceptualization of the complexity of performance management systems (PMSs). The paper explores how the characteristics of PMSs vary within and across different organizational units in common institutional context, based on the case of a regional authority in Italy.

Design/methodology/approach

A framework of analysis considering both objective and subjective factors was derived from a combination of performance typologies in the public sector, namely ideal types of managing performance (Bouckaert and Halligan, 2007) and performance regimes (Jakobsen et al., 2017). The combination of the characteristics of these two models across different Directorates General (DGs) has also been explored through a nested case study (Starman, 2013). Data were gathered via a desk analysis of official documents regarding the planning and programming of a regional authority along with in-depth interviews with top-level managers.

Findings

The results highlighted a clear differentiation of PMSs, both within and across DGs. The findings of the study reveal the hybrid nature of PMSs within a common institutional context.

Originality/value

Drawing on the theoretical frameworks of Bouckaert and Halligan (2007) and Jakobsen et al. (2017), the paper provides an integrated approach for analysing PMSs, considering both objective and subjective dimensions. Insights and indications for future research on hybridity at a meso level of public organizations are highlighted.

Details

International Journal of Public Sector Management, vol. 32 no. 7
Type: Research Article
ISSN: 0951-3558

Keywords

Open Access
Article
Publication date: 24 December 2021

Sabina De Rosis, Chiara Barchielli, Milena Vainieri and Nicola Bellé

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on…

5637

Abstract

Purpose

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.

Design/methodology/approach

65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.

Findings

Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.

Research limitations/implications

Different features referring to different nursing models make the difference in producing an excellent user experience with the service.

Practical implications

These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.

Originality/value

This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.

Highlights

  • This is one of the first studies on the relationship between provision models of nursing care and patient experience.

  • Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

  • Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

  • Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

This is one of the first studies on the relationship between provision models of nursing care and patient experience.

Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

Details

Journal of Health Organization and Management, vol. 36 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 December 2001

Martha Zarate

Looks at the first 100 years of Italian cinema examining its role in Italy’s recent history. Provides a bibliography of major film directors, Italian cinema sources, reference…

2926

Abstract

Looks at the first 100 years of Italian cinema examining its role in Italy’s recent history. Provides a bibliography of major film directors, Italian cinema sources, reference works, histories, themes, theory and criticism and articles in journals.

Details

Collection Building, vol. 20 no. 4
Type: Research Article
ISSN: 0160-4953

Keywords

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