Angele Pieters, Kim E. van Oorschot, Henk A. Akkermans and Sally C. Brailsford
The purpose of this paper is to investigate inter-organizational designs for care–cure conditions in which low-risk patients are cared for in specialized care organizations and…
Abstract
Purpose
The purpose of this paper is to investigate inter-organizational designs for care–cure conditions in which low-risk patients are cared for in specialized care organizations and high-risk patients are cared for in specialized cure organizations. Performance impacts of increasing levels of integration between these organizations are analyzed.
Design/methodology/approach
Mixed methods were used in Dutch perinatal care: analysis of archival data, clinical research and system dynamics simulation modeling.
Findings
Inter-organizational design has an effect on inter-organizational dynamics such as collaboration and trust, and also on the operational aspects such as patient flows through the system. Solutions are found in integrating care and cure organizations. However, not all levels of integrated designs perform better than a design based on organizational separation of care and cure.
Practical implications
A clear split between midwifery practices (care) and obstetric departments (cure) will not work since all pregnant women need both care and cure. Having midwifery practices only works well when there are high levels of collaboration and trust with obstetric departments in hospitals. Integrated care designs are likely to exhibit superior performance. However, these designs will have an adverse effect on organizations that are not part of this integration, since integrating only a subset of organizations will feed distrust, low collaboration and hence low performance.
Originality/value
The originality of this research is derived from its multi-method approach. Archival data and clinical research revealed the dynamic relations between organizations. The caveat of some integrated care models was found through simulation.
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Birgit Schyns, Sarah Gilmore and Graham Dietz
Football, or soccer as it is known in the United States, is one area in which managerial positions are hugely volatile with what is often called a ‘merry-go-round’ of managers…
Abstract
Football, or soccer as it is known in the United States, is one area in which managerial positions are hugely volatile with what is often called a ‘merry-go-round’ of managers sacked for poor performance at their club and reemployed by another club. Not only does this practice often not increase performance but it is also very costly. Considering the nature of football, that is, the relatively high impact of chance on the rare events that goals are, and the high correlation between success and the wage bill, the influence of managers on performance is often over-estimated. However, potentially better preparation of future managers might help to increase competitive advantages. In this chapter, we are looking in depth at leadership in the context of football and the lessons we can draw for other contexts.
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Korina Katsaliaki, Sally Brailsford, David Browning and Peter Knight
Purpose – Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show…
Abstract
Purpose – Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show the potential of the simulation methodology in such situations. Design/methodology/approach – A discrete‐event simulation was used to determine the system capacities and to estimate the likely associated reimbursement costs. Findings – A prototype simulation model was developed showing the potential value of this approach. Research limitations/implications – Restrictions in data access shifted the focus from quantitative service mapping to a more descriptive approach. Practical implications – Currently, many older patients experience delayed discharge from acute beds because of capacity limitations in Social Services’ traditional post‐acute care services. At the same time, new regulations require Local Authorities to reimburse NHS Acute Trusts if hospital discharge is delayed solely due to inadequate provision of social care assessments and services. In order to overcome the so‐called “bed‐blocking” problem, a new range of services termed “Intermediate Care” has been introduced to offer alternative options for older patients. These services are examined in terms of capacity and appropriateness. Originality/value – This paper fulfils an identified need to record and evaluate the new post‐acute packages introduced by the Social Services and NHS and proposes simulation as one of the most suitable methodologies for such objectives.
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Theresa C. Brown, Jennifer Volberding, Timothy Baghurst and John Sellers
The purpose of this paper is to determine the reason for faculty and staff (N=657; 35 percent males; M age=45.20) at a large Southern university, for either using…
Abstract
Purpose
The purpose of this paper is to determine the reason for faculty and staff (N=657; 35 percent males; M age=45.20) at a large Southern university, for either using or not using the free fitness facilities on campus.
Design/methodology/approach
Participants identified themselves as either current (n=306), former (n=213), or never-users (n=138) of the facilities, and completed an on-line self-report qualitative questionnaire asking them to describe their reasons for using or not using the campus fitness facilities.
Findings
Thematic coding revealed that motives fell into three broad categories for all user types: personal (i.e. cost, location, social support), facility-specific (i.e. quality and amount of equipment, class variety, hours of operation), and motivational climate (i.e. feeling valued, welcomed, best effort was emphasized). Current users highlighted positive aspects of each category whereas former and never users described each category as a barrier to their exercise routines.
Practical implications
The identified themes offer campus administration specific suggestions to entice more non-users and former-users to exercise in the fitness facilities available on campus.
Originality/value
While researchers have considered barriers to exercise in past studies, the barriers identified were not specific to fitness facilities. The current work not only examines individuals’ reasons for choosing or not choosing a campus fitness facility for their exercise, but also compares the perspectives of former- and never-users to current-users.
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Rebecca Wilson and Yvette Winnard
Missed appointments within the National Health Service (NHS) are a drain on resources, associated with not only considerable time and cost implications, but also sub-optimal…
Abstract
Purpose
Missed appointments within the National Health Service (NHS) are a drain on resources, associated with not only considerable time and cost implications, but also sub-optimal health outcomes. This literature review aims to explore non-attendance within the NHS in relation to causes, impacts and possible mitigation of negative effects of missed appointments.
Design/methodology/approach
MEDLINE, CINAHL Plus and PubMed were searched with a date range of 2016–2021. Databases were searched for peer-reviewed articles published in English addressing non-attendance of adults within the NHS. Studies were excluded if they were theoretical papers, dissertations or research concerning patients aged under 18. A total of 21 articles met the inclusion criteria and were selected for analysis.
Findings
The results indicate a significant association of non-attendance and poor health outcomes. Patients from a lower socioeconomic status, adults aged over 85 and those with multiple co-morbidities are more likely to miss appointments. The most commonly reported patient-centred reasons for failing to attend were forgetfulness, transportation difficulties, and family commitments. Practice-specific reasons were cited as inefficiencies of the appointment booking system, failure of traditional reminders and inconvenient timings. Interventions included text reminder services, the inclusion of costs within reminders and enhanced patient involvement with the booking process.
Originality/value
Non-attendance is complex, and to secure maximum attendance, targeted interventions are required by healthcare facilities to ensure patient needs are met. The adaption of scheduling systems and healthcare services can assist in reducing DNA rates.
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Ron Gray, Debra Bick and Yan-Shing Chang
The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve…
Abstract
Purpose
The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve outcomes in women and their children.
Design/methodology/approach
Selective review of the literature. A number of electronic bibliographic databases were searched, including the Cochrane Database of Systematic Reviews, PubMed and PsycINFO, for relevant studies published since 1990. Papers were restricted to those published in English which presented data from studies conducted in high-income countries, with priority given to systematic reviews, randomised controlled trials and other quantitative studies which present a higher level of evidence.
Findings
Many factors may affect maternal and infant health during and after pregnancy. Potentially modifiable factors with an evidence base to support intervention include improving diet, and the avoidance of smoking, alcohol and illicit drugs. Good clinical management of underlying illness is also important, along with attempts to engage women in improving health prior to conception and postnatally rather than once pregnancy is established.
Research limitations/implications
The evidence base for interventions on some potentially modifiable risk factors is incomplete. There is good evidence of benefit from some health behaviours such as smoking cessation and uptake of breastfeeding and accumulating evidence of the benefit of some models of maternity care.
Practical implications
Good maternal health during and after pregnancy plays a key role in giving the child a better start in life. Improved health behaviours are vital but often these are heavily dependent on social context and hence working to tackle social inequality and provide maternity care tailored to individual need is likely to be just as important as trying to directly alter behaviour.
Originality/value
Pregnancy and the postnatal period present an opportunity to improve maternal health and have a positive effect on future child health. Greater investment is required in this antenatal period of life.