Healthcare Executives Research Articles

Digital Transformation in Healthcare: Insights on Value Creation

ABSTRACT Current research on digital transformation in the healthcare context is limited, and doesn’t consider the patient’s definition of value, the need to support traditional healthcare process improvement in parallel with new value creation activities, nor does it clearly examine changes that occur in the structure of healthcare organizations due to technologically driven change. This research seeks to address these issues and determine the capabilities that influence the creation of new and existing value propositions and the subsequent structural changes of digital transformation in healthcare by analyzing interviews with 19 American healthcare executives. Results highlight the need for patient-focused modes of value creation necessary to improve care coordination, which is affected by the ability to integrate data and reconfigure processes. End user focused modes compel healthcare organizations to digitize their services, however, this can be hampered by difficulties with change management and enforcing IT governance processes.

Effective of an Intervention Program on Nurses Practices Concerning Infection Control Measures in Pediatric Surgical Wards

Background: Infection control has become a major concern in the health-care system, and health-care personnel, especially nurses, are particularly vulnerable to infection. The goal of this study is to see how effective an intervention program is in changing nurses' practices in pediatric surgery wards when it comes to infection management. Methods: This study used a quasi-experimental design for the pre- and post-test. The sample consisted of 40 persons. The intervention group included twenty nurses from the primary pediatric teaching hospital, while the control group included twenty nurses from the pediatric care teaching hospital. The questionnaire's dependability was proven through empirical study, and it was then submitted to specialists for validation. The total number of items in the questionnaire was 49. Self-reports were used to collect data, which was then evaluated using descriptive and inferential statistical data analysis. Results: According to the findings, 70% of nurses had insufficient practices before implementing the intervention program, while 60% of nurses had adequate practices after implementing the program. In the pre-test period of assessment, there is no statistically significant difference between the intervention and control groups (p>0.05). At the post-test measurement period, there is a statistically significant difference between the intervention and control groups (p0.05). Conclusions: In order to improve nurses' infection control practices, an interventional training program is essential. The findings of this study revealed that after receiving training, nurses' infection control practices improved. This study found that the training program is highly successful, and that all nurses should receive infection control training to gain the information and skills necessary to prevent infection in a hospital context. Health-care executives should recognize the importance of establishing rules to improve nurse working conditions and offer the required training to guarantee infection-control strategies are implemented. Keywords: Intervention Program, Practices, Nurses.

Strengthening leadership capacity: an unaddressed issue in Indian healthcare system

PurposeLeadership skills are vital for efficient delivery of health reforms. India, a low- and middle-income country, is transforming its public health care significantly. The health workforce, particularly doctors, however lacks leadership skills. This study aims to highlight the leadership skills gap and raise concerns about how India might achieve its ambitious health reforms in the lack of formal, prospective leadership training for its workforce.Design/methodology/approachThis study conducted nine management development programmes between 2012 and 2020 and collected data from 416 (N = 444, 94% response rate) health-care professionals using a questionnaire. Participants were asked to inform leadership challenges that they perceived critical. A total of 47 unique challenges were identified, which were distributed across five domains of American College of Healthcare Executives Competency Assessment Tool (2020). Relevant information was also obtained from review of secondary sources including journal articles from scientific and grey literature and government websites.FindingsMajority of participants (85.36%) had never attended any management training and were from public sector (56.1%). Mean total experience was 18 years. Top 5 challenges were lack of motivation (54.26%), communication (52.38%), contracts management (48.31%), leadership skills (47.26%) and retention of workforce (45.56%). Maximum challenges (29) were in domain of business skills and knowledge, followed by knowledge of health-care environment (9), leadership, professionalism, and communication and relationship management (3 each).Originality/valueIn absence of the leadership training, senior health professionals particularly doctors in India, suffer leadership challenges. Efforts should be made to strengthen leadership capacity in Indian health-care system to advance the country’s ongoing national health reforms.

Do Hospital Leaders Live in the Communities They Serve? A Comparative Analysis.

Purpose:Many factors contribute to persistent intractable disparities in health care, but the geographic separation of health care executives and patient communities has not been explored. From Congresspeople to police officers, individuals engaged in public service often face criticism for not living in the neighborhoods where they work. These critiques stem from the belief that to engage meaningfully with a community, one has to understand its experiences and share its interests—and geographic proximity offers one opportunity to bridge such divides. This article seeks to determine whether the senior executive leadership of American hospitals live in the same communities as their patient populations.Methods:From August 2020 to January 2021, the research team identified the leadership of the “largest” and “best” hospitals in the United States (n=68). Public directories were used to locate residential addresses. Newly released U.S. Census data provided proportions of individuals identifying as black/African American and Hispanic/Latinx in each zip code. Respective demographic proportions of hospital communities and hospital leadership residence were compared.Results:Hospitals shared the same zip codes with only three health system leaders (4.41%), seven hospital leaders (10.45%), and six deans (10.91%) of respective institutions. Hospital leadership lived in zip codes with a significantly lower proportion of black/African American (p<0.0009) and Hispanic/Latinx (p<0.0036) residents than their hospital communities.Conclusion:This article reveals significant differences between where health care leaders live and where they work. Future research should investigate the impact of residential disparities and the consequences of potential remedies on health equity.

Michael J. Fosina, FACHE, Immediate Past Chair, American College of Healthcare Executives.

Journal of Healthcare Management: March-April 2022 - Volume 67 - Issue 2 - p 66-70 doi: 10.1097/JHM-D-22-00019

Patient-Controlled Mechanism Using Pseudonymization Technique for Ensuring the Security and Privacy of Electronic Health Records

An Internet-based Electronic Health Record (EHR) system allows patients to access their medical history whenever they need it. Access to patient records and transactions related to diagnosis is helpful to patients and the health care department and executives. But this practice may lead to major privacy concerns of patients' private data. For EHR adaptation, the major elements are laws and regulations, monetary inducement and hurdles, technology state, and corporation effect. In this paper, I have proposed a Patient Controlled mechanism using the pseudonymization technique for ensuring the security and privacy of Electronic Health records. It is found that most of the potential approaches have used pseudonymization techniques to deal with the issues involved in a healthcare information system. This proposed solution is simple and efficiently ensures the privacy of patient data. Comparative analysis with other existing approaches has been undertaken.

Whistleblowing in Healthcare for Patient Safety: An Integrative Literature Review

Patient safety has progressed over the past decade from being a relatively insignificant issue to a position of high importance for healthcare executives and policy makers. However, most of the opportunities for healthcare professionals to identify and act upon patient safety concerns are likely to occur much further upstream, such as, within the day-to-day mundane activities. Because of this, policy makers have ramped up the focus on the role of “whistleblowers” towards raising concerns around patient safety in healthcare settings. The notion of whistleblowing in healthcare has been known to bring healthcare scandals to light, which in essence has contributed to preventing future harm to patients. Although this may be true, when compared to other industries, there remains relatively little research on whistleblowing in healthcare. For this reason, the purpose of this study was to examine the role of organizational culture and change in healthcare, the link between ethics and whistleblowing, and the processes and levels of whistleblowing within healthcare. By focusing on these, the researcher was successful in highlighting a series of organizational factors that has been known to both inhibit and foster whistleblowing within healthcare. Thereafter, the researcher then suggested steps that can be used to help organizations build and sustain an ethical culture where whistleblowing is viewed as a morale right.

Proposed Framework for the Assessment of Business Intelligence Platforms for Medium-to-Large Hospitals Using Hierarchical Decision Modeling and Expert Judgments

This research focuses on the assessment of business intelligence platforms for medium-to-large hospitals using hierarchical decision modeling methodology (HDM) and expert judgment. The healthcare data come from different source systems, like EMRs or HR software, to different departments, like radiology or pharmacy. The data comes from all over the organization. Healthcare data is complex and complicated, i.e., the data is structured and unstructured and has various formats like text, numeric, images, multimedia, paper, etc. Even before the pandemic, the healthcare data was growing. However, healthcare data has grown exponentially during the pandemic, resulting in a growing need for storage, retrieval, and analysis challenges using the traditional approaches. In addition, there is a growing demand for clinical and administrative information from hospital executives and services providers. The use of business intelligence (BI) is seen as a possible solution to this challenge. BI helps direct, high-level decision-making by evaluating practice performance and predicting patient outcome trends. BI application/use has the potential to reduce costs and build healthier revenue streams, and at the same time, deliver the best patient care. BI can assist decision-makers from clinic to billing, HR, and everything in between. The objective of the current research paper is to help healthcare executives in the assessment of BI alternatives by considering multiple criteria and multiple stakeholders. The research applied a multi-criteria approach, considered People, Business Processes, and Technology perspectives, and used Hierarchical Decision Modeling (HDM) methodology to evaluate solution alternatives. HDM methodology requires the expert judgment of experts to provide the relative ranking of the perspectives and criteria. There are four alternative solutions suggested. Three solutions are cloud-based, and one is legacy, aka traditional in-house solution. Cloud and legacy systems will co-exist for the long run.

Climate Change and Healthcare: A Complicated Relationship.

Climate change is a crisis with a devastating impact on health. The warming atmosphere is increasing the tolls of deaths and illnesses from heat waves, extreme weather, poor air quality, insect-borne diseases, and other conditions. Healthcare is connected to climate change in a way that is not fully appreciated by many healthcare leaders-in fact, the sector generates a significant share of greenhouse gas emissions that cause climate change. As additional costs, healthcare providers' margins are put at risk from treating more climate-related disease and illness, supply chain disruptions, and damage from severe storms and wildfires. These connections provide a compelling rationale for healthcare executives to create more resilience in operations, lead efforts toward decarbonization, and catalyze for climate action.

Паллиативная медицинская помощь детскому населению на федеральном и региональном уровне: экспертная оценка проблемы и новые вызовы системе здравоохранения

The Resolution on Palliative Care (PC) adopted by the World Health Assembly in 2014 implies PC integration into healthcare at all levels. In the Russian Federation, PC management and improvement are regulated by territorial health development programs. Objective. To analyze expert opinions on the quality of PC in various regions of the Russian Federation to optimize pediatric PC. Materials and methods. This prospective cohort study was conducted in 80 regions of the Russian Federation in October–December 2020. We interviewed 276 chief consultants, top healthcare executives, heads of healthcare institutions, pediatric departments, neonatology departments, and gynecological departments. Results. Respondents reported high quality of PC and equipment in healthcare institutions. However, they also marked limited territorial accessibility and volume of PC. They believe that PC in Russia requires better funding and expansion of home care, medical care in day hospitals and regular hospitals, and improvement of legal protection of patients. Conclusion. PC in the Russian Federation is one of the top priorities in healthcare. Several regulatory documents (including orders No 345n/372n and No 348n, resolution No 813, orders for the Moscow Region No 4-r and No 87-r) have been implemented. However, organizational problems still exist in some regions, which requires the improvement of the regulatory framework. Key words: pediatric palliative care, children, hospice and palliative care, medical and organizational measures, quality of life, suffering alleviation

Can paternalistic leaders enhance knowledge sharing? The roles of organizational commitment and Islamic work ethics

PurposeThis paper aims to investigate the effect of paternalistic leadership (benevolent, moral and authoritarian) on knowledge sharing of nurses through the mediation of organizational commitment (affective, continuance and normative). Further, the study examines the moderating role of Islamic work ethics on the association between organizational commitment and knowledge sharing.Design/methodology/approachIn this quantitative study, data was collected from 312 nurses working in the health-care sector of Pakistan through “Google Forms” in two waves. Moreover, structural equation modeling was used to test the proposed hypotheses.FindingsThe study noted affective and normative commitment as mediators between the associations of benevolent, moral and authoritarian leadership with knowledge sharing, whereas continuance commitment was not found as an explaining variable. In addition, Islamic work ethics was found to strengthen the association of affective and normative commitment with knowledge sharing. However, Islamic work ethics was found to weaken the association between continuance commitment and knowledge sharing.Practical implicationsThis study offers practical insights for health-care executives to act as fatherly figures to enhance the knowledge sharing of their nurses. The study recommends that managers in the health-care system build such an environment that helps nurses follow Islamic work ethics. It may enhance their level of organizational commitment and encourage them to engage in knowledge sharing behaviors to have a successful work environment.Originality/valueTo the best of the authors’ knowledge, this research is the first to extend the literature on paternalistic leadership. More specifically, this study investigated how various dimensions of paternalistic leadership (benevolent, moral and authoritarian) effects three-dimensional commitment (affective, continuance and normative) to enhance knowledge sharing behavior among nurses.

ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH: Predicting COVID-19 Outbreak in U.S. Nursing Homes Based on Location, Quality Metrics, and Staffing Levels.

American College of Healthcare Executives Journal of Healthcare Management Frontiers of Health Services Management American College of Healthcare Executives Journal of Healthcare Management Frontiers of Health Services Management

ASA-ACHE Physician Leadership Collaborative Develops Health Care Executive Leadership

Career Connection| October 2021 ASA-ACHE Physician Leadership Collaborative Develops Health Care Executive Leadership Amy Gallagher Amy Gallagher Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor October 2021, Vol. 85, 39. https://doi.org/10.1097/01.ASM.0000795124.57281.be Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Amy Gallagher; ASA-ACHE Physician Leadership Collaborative Develops Health Care Executive Leadership. ASA Monitor 2021; 85:39 doi: https://doi.org/10.1097/01.ASM.0000795124.57281.be Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu nav search search input Search input auto suggest search filter All ContentAll PublicationsASA Monitor Search Advanced Search Topics: acetylcholinesterase, leadership It is said that “crisis creates community and communications.” The COVID-19 pandemic was the great proving ground of communicating as collaboration with the solid foundation of education and training. The opportunities that emerged during the pandemic showed how leadership initiatives through disaster training, teamwork, change management, creative problem-solving, and a dose of humility and empathy can ultimately be transferred to grow the day-to-day operations of the present-day organization. ASA and the American College of Healthcare Executives (ACHE) created a formal relationship to provide ASA members with meaningful and rigorous education for leadership development through such collaborative interactions. The ASA-ACHE Physician Leadership Development Collaborative was formed when anesthesiologists identified the need to partner with health care executives and operational management as health care becomes a more integrated system from both clinical and economic perspectives. The collaboration offers participants professional networking opportunities and can help anesthesiologists gain an understanding of the many... You do not currently have access to this content.

Advisory Board on potential import substitution of follitropin alfa preparations in IVF cycles

On July 17, 2021, Advisory Board with the participation of more than 60 leading reproductive specialists and healthcare executives was held. The primary task was to discuss the real world data on the first Russian biosimilar follitropin alfa and the possibilities of import substitution of follitropin alfa drugs. The information about drug development stages, experience of usage in ovarian stimulation for artificial insemination and assisted reproductive technologies (ART), the results of the largest Russian study in reproduction "FОLLITROPIN" (2020), where biosimilar recombinant human follicle stimulating hormone (FSH) was studied in 5484 IVF cycles in real clinical practice, experience of drug use in leading ART medical centers have been provided in research reports. After discussion the Advisory Board Resolution has been developed.

Putting the Physician Back Into Anesthesiologist on the Front Lines of Advocacy

Features| August 2021 Putting the Physician Back Into Anesthesiologist on the Front Lines of Advocacy Jay Epstein, MD, FASA Jay Epstein, MD, FASA Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor August 2021, Vol. 85, 24. https://doi.org/10.1097/01.ASM.0000768796.84283.8a Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Jay Epstein; Putting the Physician Back Into Anesthesiologist on the Front Lines of Advocacy. ASA Monitor 2021; 85:24 doi: https://doi.org/10.1097/01.ASM.0000768796.84283.8a Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu nav search search input Search input auto suggest search filter All ContentAll PublicationsASA Monitor Search Advanced Search Topics: advocacy Anesthesiologists are physicians first and specialists in anesthesia second. This important distinction is often lost on policymakers and has been well documented in public surveys conducted by ASA in which many of our neighbors and friends apparently fail to realize we are doctors. The latest “blur-the-lines” tactic developed by the American Association of Nurse Anesthetists is the nonsensical and self-appointed “nurse anesthesiologists” moniker, which the ASA and multiple state component societies are aggressively pushing back against. This misrepresentation and lack of transparency confuses patients, lawmakers, the media, and health care executives into thinking that anesthesiologists are interchangeable with non-physicians, who despite possessing less education and training, are attempting to take advantage of these ambiguities. Within this challenging health care nomenclature landscape, anesthesiologists should continue to distinguish themselves from those who are not doctors but who nonetheless claim to be able to do what we do as well as we do... You do not currently have access to this content.

Accreditation and Certification: Do They Improve Hospital Financial and Quality Performance?

The relationship between healthcare organizational accreditation and their leaders’ professional certification in healthcare management is of specific interest to institutions of higher education and individuals in the healthcare management field. Since academic program accreditation is one piece of evidence of high-quality education, and since professional certification is an attestation to the knowledge, skills, and abilities of those who are certified, we expect alumni who graduated from accredited programs and obtained professional certification to have a positive impact on the organizations that they lead, compared with alumni who did not graduate from accredited programs and who did not obtain professional certification. The authors’ analysis examined the impact of hiring graduates from higher education programs that held external accreditation from the Commission on Accreditation of Healthcare Management Education (CAHME). Graduates’ affiliation with the American College of Healthcare Executives (ACHE) professional healthcare leadership organization was also assessed as an independent variable. Study outcomes focused on these graduates’ respective healthcare organization’s performance measures (cost, quality, and access) to assess the researchers’ inquiry into the perceived value of a CAHME-accredited graduate degree in healthcare administration and a professional ACHE affiliation. The results from this study found no effect of CAHME accreditation or ACHE affiliation on healthcare organization performance outcomes. The study findings support the need for future research surrounding healthcare administration professional graduate degree program characteristics and leader development affiliations, as perceived by various industry stakeholders.

Organisational support of physician well-being: A survey of healthcare executives

Physician burnout has reached epidemic proportions in the United States, and COVID-19 has only exacerbated the strain on the physician workforce. To gather data on organisation-level support for physician burnout prevention initiatives, the American Hospital Association, AdventHealth, and the Coalition for Physician Well-Being collected responses from more than 500 top-level executives from healthcare systems across the United States, documenting the current state of organisation-level interventions to support physician well-being. This paper discusses the findings, which revealed that organisational initiatives to curb physician burnout vary in scope and degree, but the need for organisation-level interventions appears to be widely recognised.

Power, legitimacy and urgency: Unravelling the relationship between Dutch healthcare organisations and their financial stakeholders

Healthcare organisations rely on their financial stakeholders for capital to invest in state-of-the-art buildings, equipment, innovation and the delivery of healthcare services. Nevertheless, relations between healthcare organisations and their financial stakeholders have not been well studied. Here, we studied the relations between Dutch healthcare organisations and two of their main financial stakeholders (banks and health insurers) against the backdrop of system reforms and the financial crisis. We conducted a survey of healthcare executives to evaluate their relations with banks and health insurers in terms of power, legitimacy and urgency. These three attributes are based on the salience model of Mitchel, Agle and Wood (1997). We further tested for differences in power, legitimacy and urgency across organisational sector and size. The results showed that healthcare organisations value banks as legitimate stakeholders with a well-demarcated influence and a clear-cut function. The relationship with health insurers is more complex. Healthcare organisations experience considerable influence from health insurers but question the legitimacy of their claims. Since health insurers play a crucial role in the Dutch healthcare system, these findings question the workability of the relationship between healthcare organisations and health insurers and the position of health insurers in the overall healthcare sector. Our results are relevant to countries with public-private health systems and contribute to the development of the salience model by showing the individual value of stakeholder attributes and the relevance of context.

Leadership challenge: lateral systems integration for healthcare

PurposeGovernment imperatives that drive integrated care are challenging corporate executive leadership. Conspicuous by its absence in both government's imperatives and the literature, is any reference to corporate executive leadership in transitioning a hierarchically oriented health system to a laterally integrated health system referred to, in this paper, as an integrated health system. This lack of reference to executive leadership involvement conveys either significant consequences or opportunities for corporate healthcare executives. The purpose of this qualitative, multi-case study is to explore corporate executive leadership in transitioning a hierarchically oriented health system to an integrated health system.Design/methodology/approachBetween December 2017 and February 2018, a qualitative methodology and multi-case study design facilitated one hour telephone interviews with 11 presidents and four senior vice presidents. Critical case sampling was used to select the study sample from a target population of 246 corporate healthcare executives representing Ontario's major acute healthcare organizations/systems.FindingsCorporate healthcare executives possess the requisite skills and knowledge to transition a hierarchically oriented to a laterally integrated the health system but are constrained by an undefined partnership role with government and fear of government changes.Originality/valueThis paper provides corporate executive leaders with a systematic leadership approach to organizational readiness, in transitioning to an integrated health system. Features and outcomes of the approach are illustrated.

What do midwifery leaders need in order to be effective in contributing to the reform of maternity services?

ProblemLittle is known about what midwifery leaders need to effectively contribute to maternity services reform. BackgroundDespite evidence establishing midwifery continuity of care as the gold standard of maternity care, implementation of these models has been slow. Midwives in health service leadership roles are in an ideal position to re-orientate maternity services to midwifery continuity of care. QuestionWhat do midwives in leadership positions need in order to be effective in contributing to the reform of maternity services in Australia? MethodsThis qualitative descriptive study used purposive sampling to recruit 13 midwifery leaders from across Australia. Individual telephone interviews were conducted and analysed through line-by-line coding and identification of themes. FindingsFive main themes emerged from the data: ‘core leadership skills and education are essential’; ‘motivation and commitment to implementing evidence-based maternity care’; ‘ability to create and sustain strategic relationships’; ‘bringing the vision to life’ which contained two sub-themes of ‘changing the culture’ and ‘reaching midwifery’s full potential’; and, ‘organisational support and commitment are key to maternity reform’. DiscussionThis study echoes findings from previous research emphasising the importance of leadership attributes and development opportunities for midwifery leaders. Additional needs of midwifery leaders were also revealed, which have not yet been extensively explored in the literature, including a strong commitment to continuity of care, effective relationships with key stakeholders and support from healthcare executives. ConclusionMidwifery leaders need to be equipped to contribute to maternity care reform through leadership development opportunities, effective relationships and support from healthcare executives.