Jamison V. Kovach, Lee Revere and Ken Black
This study aims to provide healthcare managers with a meaningful synthesis of state of the art knowledge on error proofing strategies. The purpose is to provide a foundation for…
Abstract
Purpose
This study aims to provide healthcare managers with a meaningful synthesis of state of the art knowledge on error proofing strategies. The purpose is to provide a foundation for understanding medical error prevention, to support the strategic deployment of error proofing strategies, and facilitate the development and implementation of new error proofing strategies.
Design/methodology/approach
A diverse panel of 40 healthcare professionals evaluated the 150 error proofing strategies presented in the AHRQ research monograph using classification systems developed by earlier researchers. Error proofing strategies were ranked based on effectiveness, cost, and ease of implementation as well as based on their aim/purpose, i.e. elimination, replacement, facilitation, detection, or mitigation of errors.
Findings
The findings of this study include prioritized lists of error proofing strategies from the AHRQ manual based on the preferred characteristics (i.e. effectiveness, cost, ease of implementation) and underlying principles (i.e. elimination, replacement, facilitation, detections mitigation of errors) associated with each strategy.
Research limitations/implications
The results of this study should be considered in light of certain limitations. The sample size of 40 panelists from hospitals, medical practices, and other healthcare related companies in the Gulf Coast region of the USA prevents a stronger generalization of the findings to other groups or settings. Future studies that replicate this approach, but employ larger samples, are appropriate. Through the use of public forums and expanded sampling, it may be possible to further validate research findings in this paper and to expand and build on the results obtained in this study.
Practical implications
Using the error‐proofing strategies identified provides a starting point for researchers seeking to better understand the impact of error proofing on healthcare services, the quality of those services and the potential financial ramifications. Further, the results presented enhance the strategic deployment of error proofing strategies by bringing to light some of the important factors that healthcare managers should consider when implementing error proofing solutions. Most notably, healthcare managers are encouraged to implement effective solutions, rather than those that are merely inexpensive and/or easy to implement, which is more often the case.
Originality/value
This study provides a much‐needed forum for sharing error‐proofing strategies, their effectiveness, and their implementation.
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Shreeranga Bhat, E.V. Gijo, Jiju Antony and Jennifer Cross
This study aims to present Lean Six Sigma (LSS) deployment and sustainment strategies for the healthcare sector from a multi-level perspective. The objective is to present LSS…
Abstract
Purpose
This study aims to present Lean Six Sigma (LSS) deployment and sustainment strategies for the healthcare sector from a multi-level perspective. The objective is to present LSS implementation insights to enable policymakers, practitioners and academicians to test and develop an LSS framework for healthcare sectors.
Design/methodology/approach
The strategies identified are the result of a multi-method research design involving literature review, action research (AR) and Delphi study. Further, the AR portion of the study involved more than 10 years of projects focused on the deployment of LSS in the healthcare sector.
Findings
The strategies include a holistic view from the multi-level perspective, considering the Top Management Level, Middle Management Level and Operational Level. The authors ascertained 27 strategies across the three levels of organizational structure for the effective deployment of LSS. Further, the authors present a customized LSS “pocket guide” from the healthcare perspective for quick reference.
Research limitations/implications
The strategies delineated in this study are based on the Indian healthcare section only; thus, further research in additional geographic contexts is needed. Also, further research is necessary to provide additional empirical validation of the effects of the identified strategies on LSS program outcomes and to verify that the strategies operate at the proposed organizational levels. Future research should also focus on identifying the interrelationships between strategies within and across levels, developing a “road map” for LSS implementation in hospitals and designing the LSS curriculum for medical schools and other medical training programs.
Practical implications
Observations of this study can contribute to developing a holistic framework for successful LSS implementation in the healthcare sector for academicians, practitioners and policymakers. This, in turn, ensures an enhanced value proposition, improved quality of life and reduced healthcare operational costs. Thus, it ensures a win-win situation among all the stakeholders of the healthcare sector.
Originality/value
The strategies put forth will enable the LSS researchers, academicians and, more particularly, practitioners to delve deeper into specific enablers and safeguard the LSS deployment from backlash. The research has two significant benefits. Firstly, it enhances the understanding of LSS from the healthcare perspective. Secondly, it provides direction for future studies with specific components for hospitals’ LSS framework, which can be further tested, refined and improved.
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Mohammed Mesabbah and Amr Arisha
Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare…
Abstract
Purpose
Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services.
Design/methodology/approach
An extensive review of relevant HSE’s publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented.
Findings
PM and performance measurement systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g. feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals’ management systems.
Research limitations/implications
The HSE delivers several services such as mental health, social inclusion, etc. This study focuses on the HSE’s PM framework, with a particular interest in acute hospitals and emergency services.
Originality/value
This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.
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The main goal of this research is to analyze and assess the barriers to Digital Transformation (DT) of the healthcare Supply Chain (SC) in developing countries and evaluate…
Abstract
Purpose
The main goal of this research is to analyze and assess the barriers to Digital Transformation (DT) of the healthcare Supply Chain (SC) in developing countries and evaluate strategies to overcome such barriers. The DT has been related not only to the development of SC performance but also to the expansion of its resilience capabilities in a healthcare setting to overcome the results of unavoidable risk events and return to its previous or new state, which has at least the same or better conditions, after the occurrence of an unpredicted event.
Design/methodology/approach
Assessment of the barriers and determination of the importance or effectiveness of proposed strategies to handle these barriers are conducted through a hybrid Multi-Criteria-Decision-Making method consisting of an Analytical Hierarchy Process and multi-attributive border approximation area comparison (MABAC) under picture fuzzy (PiF) environment.
Findings
Based on the outcomes of the research, the most important barriers for DT in healthcare SC functions were the organizational and technological issues, including Low support from top managers (O1), Lack of digital culture (O2), and Info/data safety and privacy (T4). To handle these barriers, the prior strategy was selected as “Making breakthroughs and incentives of top managers for the DT in the industry (ST3)”.
Research limitations/implications
The study may be extended to include developed countries and or experts from developed countries. Through this, the study will be generalized to a global level. The most common qualitative criteria, which include subjectivity, are considered. The research may be enhanced by including quantitative criteria in the decision-making process. The barriers related to DT for healthcare SC were considered. Thus, the study may be detailed by looking at the problem in terms of operational failure and determining the digital technology that can overcome such operational failures. The precedence or importance of any barrier may fluctuate with the upgradation of technological tools and improvements.
Practical implications
In terms of practical contribution, this research provides real-world suggestions to facilitate digital transformation in their SCs. Specifically, this study increases the awareness of healthcare and other industries' managers about obstacles that prevents digital transformation in SC and provides managerial path to relieve the effects of barriers.
Originality/value
To the authors' best knowledge, this is the first study to examine barriers of DT required for the promotion of resilient healthcare SCs in this concept. In addition, no previous research applied PiFSs-based AHP and MABAC integration to assess barriers and develop strategies for the DT of healthcare SC. The findings may be references for governmental institutions, policymakers, decision-makers, and stakeholders to develop proper strategies for a successful DT in healthcare SC resilience and the healthcare industry.
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Lena Ansmann, Vera Vennedey, Hendrik Ansgar Hillen, Stephanie Stock, Ludwig Kuntz, Holger Pfaff, Russell Mannion and Kira Isabel Hower
Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying…
Abstract
Purpose
Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying resource-dependency-theory (RDT), we explore how healthcare organizations in different settings perceive pressure arising from uncertain access to resources and examine organizational strategies they deploy to secure resources.
Design/methodology/approach
A cross-sectional survey of key decision-makers in different healthcare settings in the metropolitan area of Cologne, Germany, on perceptions of pressure arising from the environment and respective strategies was conducted. For comparisons between settings radar charts, Kruskal–Wallis test and Fisher–Yates test were applied. Additionally, correlation analyses were conducted.
Findings
A sample of n = 237(13%) key informants participated and reported high pressure caused by bureaucracy, time constraints and recruiting qualified staff. Hospitals, inpatient and outpatient nursing care organizations felt most pressurized. As suggested by RDT, organizations in highly pressurized settings deployed the most vociferous strategies to secure resources, particularly in relation to personnel development.
Originality/value
This study is one of the few studies that focuses on the environment's impact on healthcare organizations across a variety of settings. RDT is a helpful theoretical foundation for understanding the environment's impact on organizational strategies. The substantial variations found between healthcare settings indicate that those settings potentially require specific strategies when seeking to address scarce resources and high demands. The results draw attention to the high level of pressure on healthcare organizations which presumably is passed down to managers, healthcare professionals, patients and relatives.
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This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the…
Abstract
Purpose
This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the strategies and contextual influences to attain patient recovery flexibility.
Design/methodology/approach
This paper uses a case study method based on a semi-structured interview with healthcare professionals, observations and informal discussions.
Findings
In the present study, several dimensions of patient recovery flexibility are reported. Different internal and external strategies to exhibit patient recovery flexibility, as well as two contextual influences, are identified. An integrative framework is developed to establish the relationship of patient recovery flexibility with service experience in public healthcare.
Research limitations/implications
The study was conducted in a public healthcare setting in India. The sample size for the semi-structured interview was limited to healthcare professionals, and the patient’s perspective is missing.
Originality/value
This paper contributes to the growing need for patient recovery flexibility as a strategy in the public healthcare delivery system. It offers new insights to address the gap in the literature regarding the linkage of patient recovery flexibility and service experience. The study provides an integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and the impact on the service experience. The framework and propositions presented in the study will guide future research that is needed in this area. This study provides an overview to shape and redesign the after-service support from a flexibility perspective in public healthcare for the improved service experience.
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Kartika Nur Alfina, R.M. Chandima Ratnayake, Dermawan Wibisono, Nur Budi Mulyono and Mursyid Basri
The purpose of this study is to explore the integration of risk management and circular economy (CE) principles within the healthcare sector to promote sustainability and…
Abstract
Purpose
The purpose of this study is to explore the integration of risk management and circular economy (CE) principles within the healthcare sector to promote sustainability and resilience. Specifically, the study aims to demonstrate how risk management can support the transition to a circular economy in healthcare supply chains. By integrating risk management practices with CE principles, healthcare organizations can identify potential risks and opportunities associated with circular initiatives.
Design/methodology/approach
This study adopts a qualitative research approach, using a case study methodology with semi-structured interviews conducted at primary care facilities to understand the application of CE principles in practice. The study uses fuzzy logic methods to assess and mitigate risks associated with strategies promoting CE principles. Additionally, key performance indicators are identified to evaluate the effectiveness and enhance the resilience of these strategies within healthcare supply chains.
Findings
The study highlights the critical role of robust risk management strategies in facilitating the transition to a circular economy within healthcare organizations. Primary care facilities, which are critical to frontline healthcare delivery, are particularly vulnerable to product shortages due to supply risks. This study focuses on critical protective equipment, specifically latex gloves and assesses operational risks, including supply, demand and environmental risks, using a fuzzy logic-based model. Import delays were found to be a moderate risk, typically occurring once a year. The research highlights critical KPIs for a successful CE transition within healthcare supply chains, such as on-time delivery and service quality, which are directly related to the risk of supply chain disruption. In addition, the study highlights the significant impact of other CE strategies on healthcare supply chains, including localized production and manufacturing, innovation in product development, reverse logistics, closed-loop supply chains and the adoption of lean principles.
Practical implications
This study provides valuable insights for healthcare organizations to optimize resource efficiency, reduce waste and promote circularity in their operations. By implementing the proposed solutions and focusing on the identified KPIs, organizations can develop strategies to achieve sustainability goals and enhance resilience in healthcare supply chains.
Originality/value
This study contributes to the literature by demonstrating the application of risk management in facilitating the transition to a circular economy in the healthcare sector. The use of fuzzy logic methodology offers a novel approach to assessing and mitigating risks associated with critical product failures in supply chain activities. The study’s findings provide practical guidance for healthcare organizations seeking to integrate circular economy principles and improve sustainability performance.
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Health-care marketing typically entails a coordinated set of outreach and communications designed to attract consumers (patients in the health-care context) who require services…
Abstract
Purpose
Health-care marketing typically entails a coordinated set of outreach and communications designed to attract consumers (patients in the health-care context) who require services for a better health outcome and guide them throughout their health-care journey to achieve a higher quality of life. The purpose of this study is to understand the progress and trends in healthcare marketing strategy (HMS) literature between 2018 and 2022, with a special emphasis on the pre- and post-Covid-19 periods.
Design/methodology/approach
The authors examine 885 HMS-related documents from the WOS database between 2018 and 2022 that were extracted using a keyword-based search strategy. After that, the authors present the descriptive statistics related to the corpus. Finally, the authors use author co-citation analysis (ACA) and bibliographic coupling (BC) techniques to examine the corpus.
Findings
The authors present the descriptive statistics as research themes, emerging sub-research areas, leading journals, organisations, funding agencies and nations. Further, the bibliometric analysis reveals the existence of five thematic clusters: Cluster 1: macroeconomic and demographic determinants of healthcare service delivery; Cluster 2: strategies in healthcare marketing; Cluster 3: socioeconomics in healthcare service delivery; Cluster 4: data analytics and healthcare service delivery; Cluster 5: healthcare product and process innovations.
Research limitations/implications
This study provides an in-depth analysis of the advancements made in HMS-related research between 2018 and 2022. In addition, this study describes the evolution of research in this field from before to after the Covid-19 pandemic. The findings of this study have both research and practical significance.
Originality/value
To the best of the authors’ knowledge, this is the first study of its kind to use bibliometric analysis to identify advancements and trends in HMS-related research and to examine the pattern before and after Covid-19 pandemic.
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Eline Ree, Louise A. Ellis and Siri Wiig
To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future research…
Abstract
Purpose
To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future research and implementation studies can use this to further operationalize the concept and promote healthcare resilience.
Design/methodology/approach
The authors first provide an overview of and discuss the main approaches to healthcare resilience and research on management and resilience. Second, the authors provide examples on how managers work to promote healthcare resilience during a one-year Norwegian longitudinal intervention study following managers in nursing homes and homecare services in their daily quality and safety work. They use this material to propose a model of management and resilience.
Findings
The authors consider managerial strategies to support healthcare resilience as the strategies managers use to engage people in collaborative and coordinated processes that adapt, enhance or reorganize system functioning, promoting possibilities of learning, growth, development and recovery of the healthcare system to maintain high quality care. The authors’ model illustrates how managers influence the healthcare systems ability to adapt, enhance and reorganize, with high quality care as the key outcome.
Originality/value
In this study, the authors argue that managerial strategies should be considered and operationalized as part of a healthcare system's overall resilience. They propose a new model of managers' role in supporting resilience to be used in practice, interventions and future research projects.
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Nebil Achour and Andrew D.F. Price
The purpose of this paper is to explore UK healthcare resilience strategies, define gaps and provide suggestions based on international best practice.
Abstract
Purpose
The purpose of this paper is to explore UK healthcare resilience strategies, define gaps and provide suggestions based on international best practice.
Design/methodology/approach
The study adopted a pluralistic qualitative research approach to achieve its purpose including: research papers, governmental and non‐governmental reports, code and guidance documents and databases. In addition, two case studies were visited in May 2009: the first was one of the major hospitals in the UK; and the second is a major health facility located at the south of Taiwan. Semi‐structured interviews were conducted with the hospitals responsible and/or emergency officers to clarify the strategies setup to respond to emergencies.
Findings
The results show that despite the “robust” emergency planning in the UK, many issues could have been avoided if international experience was reviewed carefully. This is due to the failure of not working closer with multi‐disciplinary experts, who provide technical and tactical help and lessons learned from international best practices, in addition to limiting accessibility of experts to information. The study also suggests that climate change must be addressed comprehensively through fusing resilience and sustainability strategies into a more comprehensive strategy of adaptation.
Originality/value
The paper provides a significant contribution in terms of reducing the fragmentation of healthcare resilience‐related work done previously; constructive criticism of UK healthcare resilience strategies and evidence of better practice from local and international facilities which will help in enhancing the resilience of healthcare facilities in the UK and elsewhere in the world.