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Article
Publication date: 12 January 2010

Adrian Edwards, Melody Rhydderch, Yvonne Engels, Stephen Campbell, Vlasta Vodopivec‐Jamšek, Martin Marshall, Richard Grol and Glyn Elwyn

The Maturity Matrix is a tool designed in the UK to assess family practice organisational development and to stimulate quality improvement. It is practice‐led, formative and…

691

Abstract

Purpose

The Maturity Matrix is a tool designed in the UK to assess family practice organisational development and to stimulate quality improvement. It is practice‐led, formative and undertaken by a practice team with the help of trained facilitators. The aim of this study is to assess the Maturity Matrix as a tool and an organisational development measure in European family practice settings.

Design/methodology/approach

Using a convenience sample of 153 practices and 11 facilitators based in the UK, Germany, The Netherlands, Switzerland and Slovenia, feasibility was assessed against six criteria: completion; coverage; distribution; scaling; translation; and missing data. Information sources were responses to evaluation questionnaires by facilitators and completed Maturity Matrix profiles.

Findings

All practices taking part completed the Maturity Matrix sessions successfully. The Netherlands, the UK and Germany site staff suggested including additional dimensions: interface between primary and secondary care; access; and management of expendable materials. Maturity Matrix scores were normally distributed in each country. Scaling properties, translation and missing data suggested that the following dimensions are most robust across the participating countries: clinical performance audit; prescribing; meetings; and continuing professional development. Practice size did not make a significant difference to the Maturity Matrix profile scores.

Originality/value

The study suggests that the Maturity Matrix is a feasible and valuable tool, helping practices to review organisational development as it relates to healthcare quality. Future research should focus on developing dimensions that are generic across European primary care settings.

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 1
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 January 2006

Steven Doherty

There is evidence that some strategies for guideline implementation are more successful than others. This paper aims to describe the process of developing an evidence‐based…

1978

Abstract

Purpose

There is evidence that some strategies for guideline implementation are more successful than others. This paper aims to describe the process of developing an evidence‐based guideline implementation strategy for use in rural emergency departments.

Design/methodology/approach

Participation in a nationally funded, research fellowship program involved attendance at workshops run by internationally renowned experts in the field of knowledge translation. Attendance at these workshops, associated reading and a literature review allowed those implementation strategies with the most supportive evidence of effectiveness to be determined.

Findings

A multi‐faceted implementation strategy was developed. This strategy involved the use of an implementation team as well as addressing issues surrounding individual clinicians, the “emergency department team”, the physical structure and processes of the ED and the culture of the department as a whole. Reminders, audit and feedback, education, the use of opinion leaders, and evidence‐based formatting of guidelines were all integral to the process.

Practical implications

It is postulated that an evidence‐based implementation strategy will lead to greater changes in clinician behaviour than other strategies used in quality improvement projects.

Originality/value

This is an important article as it describes the concept and development of evidence‐based interventions, which, if tailored to the individual hospital (as evidence‐based medicine is tailored to the individual patient), has the potential to improve compliance with clinical guidelines beyond that achieved with most QI projects.

Details

International Journal of Health Care Quality Assurance, vol. 19 no. 1
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 27 September 2022

Minna Pikkarainen, Laura Kemppainen, Yueqiang Xu, Miia Jansson, Petri Ahokangas, Timo Koivumäki, He Hong Gu and Julius Francis Gomes

Covid has increased the usage of multisided digital platforms. For companies, this has become a business opportunity. Data usage on platforms requires that platform companies…

530

Abstract

Purpose

Covid has increased the usage of multisided digital platforms. For companies, this has become a business opportunity. Data usage on platforms requires that platform companies co-create services for common customers. In this case, the target is not to make the same value proposition but rather to use the resources such as data, knowledge, technology, or institutions in a complementary manner. Platforms are characterized as a combination of hardware and software including standards, interfaces, and rules making it possible for different ecosystem players to complement and interact in the ecosystem. Current ecosystems include several platforms that do not work without resource integration. The purpose of this study is to increase understanding what do we mean by resource complementarity in service ecosystems.

Design/methodology/approach

This study was done via an in-depth qualitative case study in which a health service ecosystem co-creating technological surgery innovation was used as a unit of analysis.

Findings

The authors’ findings suggest that key resource capabilities, to enable complementarity in service ecosystems, are motivation, knowledge, skills, data and complementary designed technology components.

Research limitations/implications

The authors’ study increases theoretical understanding of what does one mean by construct of resource complementarity.

Practical implications

From a managerial perspective, it is shown that organizations need to develop adaptive capabilities to utilize internal and external competencies and resources and enable co-creative processes within the service ecosystem.

Originality/value

Very few empirical studies in the marketing literature have focused on multi-sided digital platforms and their resource complementarity in the data-driven healthcare ecosystem settings.

Details

Baltic Journal of Management, vol. 17 no. 5
Type: Research Article
ISSN: 1746-5265

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Article
Publication date: 15 June 2010

Annette J. Berendsen, Wim H.G.M. Benneker, Klaas H. Groenier, Jan Schuling, Richard P.T.M. Grol and Betty Meyboom‐de Jong

This paper aims to assess the validity of a questionnaire aimed at assessing how general practitioners (GPs) and specialists rate collaboration.

547

Abstract

Purpose

This paper aims to assess the validity of a questionnaire aimed at assessing how general practitioners (GPs) and specialists rate collaboration.

Design/methodology/approach

Primary data were collected in The Netherlands during March to September 2006. A cross‐sectional study was conducted among 259 GPs and 232 specialists. Participants were randomly selected from The Netherlands Medical Address Book. Specialists rarely contacting a GP were not invited to participate.

Findings

Exploratory factor analysis indicated that the questionnaire, consisting of 20 items, measured five domains: organisation; communication; professional expertise; image; and knowing each other. Cronbach's alpha coefficients ranged from 0.64 to 0.83 indicating sufficient internal consistency. Correlation coefficients between domains were all <0.4. All but “communication” clearly produced distinguishing scores for different respondent groups.

Research limitations/implications

This study shows that the doctors' opinions on collaboration (DOC) questionnaire is valid and that it may have the potential to give feedback to both medical professionals and policy makers. Such feedback creates an opportunity to improve collaboration.

Originality/value

The DOC questionnaire is a useful instrument for assessing collaboration among GPs and specialists. It can provide feedback to both medical professionals and policy makers. Such feedback creates an opportunity to improve collaboration.

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Available. Content available
Book part
Publication date: 21 April 2010

Abstract

Details

Understanding Emerging Epidemics: Social and Political Approaches
Type: Book
ISBN: 978-1-84855-080-3

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Article
Publication date: 14 December 2023

Ali Al Owad, Neeraj Yadav, Vimal Kumar, Vikas Swarnakar, K. Jayakrishna, Salah Haridy and Vishwas Yadav

Lean Six Sigma (LSS) implementation follows a structured approach called define-measure-analyze-improve-control (DMAIC). Earlier research about its application in emergency…

1415

Abstract

Purpose

Lean Six Sigma (LSS) implementation follows a structured approach called define-measure-analyze-improve-control (DMAIC). Earlier research about its application in emergency healthcare services shows that it requires organizational transformation, which many healthcare setups find difficult. The Kotter change management model facilitates organizational transformation but has not been attempted in LSS settings till now. This study aims to integrate the LSS framework with the Kotter change management model to come up with an integrated framework that will facilitate LSS deployment in emergency health services.

Design/methodology/approach

Two-stage Delphi method was conducted by using a literature review. First, the success factors and barriers of LSS are investigated, especially from an emergency healthcare point of view. The features and benefits of Kotter's change management models are then reviewed. Subsequently, they are integrated to form a framework specific to LSS deployment in an emergency healthcare set-up. The elements of this framework are analyzed using expert opinion ratings. A new framework for LSS deployment in emergency healthcare has been developed, which can prevent failures due to challenges faced by organizations in overcoming resistance to changes.

Findings

The eight steps of the Kotter model such as establishing a sense of urgency, forming a powerful guiding coalition, creating a vision, communicating the vision, empowering others to act on the vision, planning for and creating short-term wins, consolidating improvements and producing still more change, institutionalizing new approaches are derived from the eight common errors that managers make while implementing change in the institution. The study integrated LSS principles and Kotter’s change management model to apply in emergency care units in order to reduce waste and raise the level of service quality provided by healthcare companies.

Research limitations/implications

The present study could contribute knowledge to the literature by providing a framework to integrate lean management and Kotter's change management model for the emergency care unit of the healthcare organization. This framework guides decision-makers and organizations as proper strategies are required for applying lean management practices in any system.

Originality/value

The proposed framework is unique and no other study has prescribed any integrated framework for LSS implementation in emergency healthcare that overcomes resistance to change.

Details

Benchmarking: An International Journal, vol. 32 no. 1
Type: Research Article
ISSN: 1463-5771

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Article
Publication date: 4 October 2021

Adeel Akmal, Nataliya Podgorodnichenko, Richard Greatbanks, Jeff Foote, Tim Stokes and Robin Gauld

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims…

449

Abstract

Purpose

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

Design/methodology/approach

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

Findings

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

Practical implications

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

Originality/value

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

Details

International Journal of Lean Six Sigma, vol. 15 no. 3
Type: Research Article
ISSN: 2040-4166

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Article
Publication date: 25 May 2010

Chris Mowles, Anna van der Gaag and Jane Fox

In the last five years more and more scholars have drawn on insights from the complexity sciences as a way of understanding the process of managing and organising in the NHS…

4450

Abstract

Purpose

In the last five years more and more scholars have drawn on insights from the complexity sciences as a way of understanding the process of managing and organising in the NHS differently. This paper aims to describe working methods derived from the theory of complex responsive processes, a more radical interpretation of these insights, used by a consultancy team in one NHS setting.

Design/methodology/approach

The authors were invited to undertake this intervention over a two year period to bring about service improvement. The paper sets out a critique of systems theory, which underpins most management literature, as well as offering a critique of some of the ways that complexity theory gets taken up in the health literature. As an alternative it explores the theoretical underpinnings of complex responsive processes and gives practical examples of methods that the authors believe are more suitable for understanding the complex environment NHS staff work within.

Findings

Working with ideas of ambiguity, paradox and complexity are not easy for staff educated in a Western tradition of linear cause and effect. However, as a result of this intervention managers and staff pointed to a much greater confidence and skill in dealing with the complex daily process of organising, which they attribute to the methods used. Although the authors make no claim that service improvement arose as a direct consequence of the methods employed, significant, observable improvements in service provision did occur during and after the consultancy intervention.

Originality/value

The description of working methods based on reflective and reflexive group processes, alongside more empirical data‐gathering methods, is offered as a radical alternative to more orthodox ways of understanding, and attempting to work with change in the NHS.

Details

Journal of Health Organization and Management, vol. 24 no. 2
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 6 January 2022

Bianca Buijck, Bert Vrijhoef, Monique Bergsma and Diederik Dippel

To organize stroke care, multiple stakeholders work closely together in integrated stroke care services (ISCS). However, even a well-developed integrated care program needs a…

120

Abstract

Purpose

To organize stroke care, multiple stakeholders work closely together in integrated stroke care services (ISCS). However, even a well-developed integrated care program needs a continuous quality improvement (CQI) cycle. The current paper aims to describe the development of a unique peer-to-peer audit framework, the development model for integrated care (DMIC), the Dutch stroke care standard and benchmark indicators for stroke.

Design/methodology/approach

A group of experts was brought together in 2016 to discuss the aims and principles of a national audit framework. The steering group quality assurance (SGQA) consisted of representatives of a diversity of professions in the field of stroke care in the Netherlands, including managers, nurses, medical specialists and paramedics.

Findings

Auditors, coordinators and professionals evaluated the framework, agreed on that the framework was easy to use and valued the interesting and enjoyable audits, the compliments, feedback and fruitful insights. Participants consider that a quality label may help to overcome necessity issues and have health care insurers on board. Finally, a structured improvement plan after the audit is needed.

Originality/value

An audit offers fruitful insights into the functioning of an ISCS and the collaboration therein. Best practices and points of improvement are revealed and can fuel collaboration and the development of partnerships. Innovative cure and care may lead to an increasing area of support among professionals in the ISCS and consequently lead to improved quality of delivered stroke care.

Details

Journal of Integrated Care, vol. 30 no. 2
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 24 April 2009

Angus Laing, Terry Newholm and Gill Hogg

The internet driven information revolution is frequently cited as one of the key drivers (re‐)shaping contemporary consumption. In particular, the internet has been seen as…

1000

Abstract

Purpose

The internet driven information revolution is frequently cited as one of the key drivers (re‐)shaping contemporary consumption. In particular, the internet has been seen as disrupting established conventions in professional services. Popularly, it has been viewed as a liberating medium, a mechanism by which consumers and citizens have been able to challenge the authority of the professional establishment. Yet for consumers, the internet can equally be viewed as generating new uncertainties and challenges in terms of negotiating a new settlement with professionals and reconfiguring the service encounter. The purpose of this paper is to explore experiences of consumers with the use of internet derived information in respect of complex professional services and the impact of such information utilisation on the format of the service encounter.

Design/methodology/approach

Empirical data is generated through interviews with professionals (n=24) and consumer focus groups (n=10/53).

Findings

The paper argues that the multi‐faceted nature of the internet creates informational “spaces” which present both opportunities and threats to consumers in renegotiating the service encounter. Balancing the paradoxes created by these informational spaces is at the core of the challenge confronting contemporary service consumers. Irrespective of the nature of that space, the effect is to create a driver for change, challenging the established practices of both consumer and professional to reshape the service encounter.

Research limitations/implications

Focus group research does not enable a judgement about the prevalence or distribution of behaviours among consumers. Nevertheless, this paper advances understanding of contemporary consumption practices and provides a new perspective on nature of consumer utilisation of information within the consumption process.

Practical implications

It is inevitable that professionals and service organisations will be required to respond to a complex and rapidly evolving set of consumer behaviours and rethink approaches to the delivery of professional services.

Originality/value

The paper addresses an emergent phenomenon and provides unique insights into the changing dynamics of consumption practices in the contemporary knowledge economy.

Details

Journal of Service Management, vol. 20 no. 2
Type: Research Article
ISSN: 1757-5818

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