High-performing Organizations Research Articles

Transforming health care systems towards high-performance organizations: qualitative study based on learning from COVID-19 pandemic in the Basque Country (Spain)

BackgroundThe COVID-19 pandemic is one of the worst health catastrophes of the last century, which caused severe economic, political, and social consequences worldwide. Despite these devastating consequences, lessons learned provide a great opportunity that can drive the reform of health systems to become high-performing, effective, equitable, accessible, and sustainable organisations. This work identifies areas in which changes must be encouraged that will enable health systems to deal effectively with current and future challenges, beyond COVID-19.MethodsA realist design was chosen, based on qualitative data collection techniques, content analysis and triangulation to identify key domains of organizational interventions behind the changes implemented to react to the COVID-19 pandemic in the Basque Country. Twenty key informants were used as an expert source of information. Thematic analysis was done using the Framework Method.ResultsThe analysis of the interviews resulted in the identification of 116 codes, which were reviewed and agreed upon by the researchers. Following the process of methodological analysis, these codes were grouped into domains: seven themes and 23 sub-themes. Specifically, the themes are: responsiveness, telehealth, integration, knowledge management, professional roles, digitisation, and organisational communication. The detailed description of each theme and subtheme is presented.ConclusionsThe findings of this work pretend to guide the transformation of health systems into organisations that can improve the health of their populations and provide high quality care. Such a multidimensional and comprehensive reform encompasses both strategic and operational actions in diverse areas and requires a broad and sustained political, technical, and financial commitment.

Does only performance feedback matter in public organizations? Testing the moderating role of directional managerial networking on performance improvement

ABSTRACT Public management scholarship emphasizes the impact of performance feedback on organizational responses, but little attention is paid to the role of managerial networking. We use panel data of Korean quasi-governmental organizations (quangos) to examine these responses and the moderating effects of directional managerial networking. Findings reveal that negative feedback consistently leads to performance improvement, while positive feedback has adverse effects. Downward networking enhances improvement in low-performing organizations, whereas outward networking alleviates performance stagnation in high-performing organizations. This research contributes to the public management literature by offering a more nuanced understanding of organizational responses to feedback and the significance of managerial networking.

Modern medical schools curricula: Necessary innovations and priorities for change.

Medical schools' curricula have expanded over the decades to incorporate important new medical breakthroughs and discoveries. Their current focus and overall structures remain, however, stubbornly captive of early 20th-century thinking, with changes having been undertaken in a piecemeal fashion. Indeed, since the notable Flexner reform in 1910, medical schools' study plans have suffered successive and typically always partial adjustments which have failed to keep up with scientific, technological and sociological change. This difficulty may be attributable to the well-known conservatism of medical schools, where updating study plans is a process that invariably encounters numerous barriers to change. These observations were afforded detailed attention some 15 years ago when de Oliveira wrote: 'it is now perfectly demonstrated that public medical schools have not been able to adapt their operation in depth and in due time to the new demands of teaching dictated by an explosive scientific and technological development'. Recent advances in communication and information technologies, as well as the introduction of new pedagogical techniques, have the potential to bring significant benefits to medical practice and healthcare systems, but these have not in the main become properly taught and utilized. The proposition that healthcare is evolving from reactive disease care to care that is predictive, preventive, personalized and participatory was initially regarded as highly speculative, yet systems approaches to biology and medicine are now beginning to provide experience of both health and disease at the molecular, cellular and organ levels. Medicine is a broad scientific field. In contrast to the 19th century, current medical 'sectarianism' is a positive by-product of rapid and gratifying medical progress, and the multiplicity of new models means that the lines of evidence legitimately bearing on practice and health policymaking are already highly diverse and likely to become ever more variegated over time. Put simply, most sound decisions, by definition, will be evidence-informed and not evidence-based, where divergence may be as informative as convergence. Here, the most enduring lesson of history is, perhaps, that clinical medicine is constantly rediscovering its humanistic core. Complexities create opportunities for innovation. In innovative environments, high-performing organizations are finding ways to create a culture that supports a diverse workforce preparing to deliver different models of care, with direct implications for excellence of patient experience and strong repercussions for medical education. The COVID-19 crisis saw major increases in the use of telemedicine, virtual office visits and other forms of online contact, and these are likely to increase considerably. This particular transformation will not be easy or comfortable to make. But reconfiguration of medical education seems inevitable, fuelled by online educational technology and the need to transform clinical training to more outpatient settings with promotion based on competency and person-centeredness, not simply time. As we prepare to enter 2024, this is an exciting time to be working in healthcare. We have more evidence than ever about how to provide high quality, person-centered care, and to keep patients safe. Shame on us if there is any hesitation about applying this knowledge to make the healthcare experience better for patients and providers. Embracing change and making continuous improvements are essential and urgent priorities for medicine and healthcare and, as we describe in the current article, will become more and more indispensably important in our rapidly changing world.

Leadership Competencies for Effective Quality Improvement: A Qualitative Study of Best Practices and Success Factors in High-Performing Organizations

Leadership Competencies for Effective Quality Improvement: A Qualitative Study of Best Practices and Success Factors in High-Performing Organizations

Managing interorganizational renqing practices in high-performance organizations in Taiwan: the when, where and how of renqing giving

PurposeRelationships are a critical success factor for business operations across markets with dominant Chinese culture, like Taiwan. The intersection of a high-quality institutional environment and a traditional Chinese cultural background in Taiwan provides a unique setting for exploring different types of relational mechanisms and ensuing renqing practices (i.e. reciprocal exchange of favors with empathy). The purpose of this paper is to examine when, where and how Taiwanese high-performance organizations manage and deploy interorganizational renqing across their business relationship portfolios. Answering these questions can help build a theory of interorganizational renqing and advance interorganizational reciprocity theorization more generally.Design/methodology/approachThis research is motivated by two key research questions. First is related to how renqing givers understand renqing in the context of their organizations and their interorganizational business relationship portfolios. Second, whether organizations prefer a neutral renqing balance, a renqing debt or a renqing surplus is another point of interest. The study is based on interviews with upper echelon elite informants at six high-performing Taiwanese organizations with business relationship portfolios worldwide.FindingsIt is found that interorganizational renqing is deployed as a hybrid resource, taking on the functions of both an investment and a type of insurance against risk. Two notable differences between interorganizational and interpersonal renqing are also noted. First, the social exchange norm aspect of renqing points to salient social exchange norms also in interorganizational exchanges. This confirms the importance of understanding not only the regulative and normative dimensions of business relationships, as a type of institution, but also the cognitive dimensions and underlying institutional logics. Second, this study shows that unlike at the interpersonal level, the notion of renqing debt is not common at the interorganizational level – at least not within high-performance organizations with market leader positions.Originality/valueThis study explores interorganizational renqing practices and their strategic deployment through the use of “accessing” and “embedding” relational mechanisms. The study also adds to the poorly understood nature of interorganizational reciprocity and provides support for developing a theory of interorganizational renqing, as a form of interorganizational reciprocity within a Chinese cultural context.

An Exploration of the Implications of Human Resources Analytics for Workforce Planning

Workforce is a tangible and talent-driven asset for high-performing organisations in today's global economy. Arguably, if workforce is not adequately planned, it impacts the effective execution of future business strategies. This research uses Standard Chartered and HSBC Holdings as a case study. A sample size of 60 participants is selected and descriptive data analysis employed to examine the online survey questionnaire. The findings indicate that HRA helps organisations to develop and sustain high-quality planning and eliminates the conventional obstacles HRA provides. It aligns strategic planning by head counting and establishing a clear view of talent demand and supply problems. It is a useful tool used to evaluate the impact of their decision and prioritise future investments in the workforce. Key identifiers include: Control, employee production efficiency, and structure.  The study recommends organisations combine demand planning and internal supply analysis to identify workforce gaps and plan accordingly.

БЕНЧМАРКІНГ КОНКУРЕНТОЗДАТНОСТІ НА ПРИКЛАДІ ГО «ШКОЛА БІЗНЕСУ І МЕНЕДЖМЕНТУ»

Benchmarking is a comparative analysis of the organization with the best direct and indirect competitors, as well as imitating their experience. It makes it possible to establish the key parameters of the organization’s activity, which should be worked on in order to achieve stable competitiveness. The purpose and main content of benchmarking is to identify the differences between the organization under study and the reference organization, as well as to establish the reasons for such differences and find ways to overcome them. Benchmarking objects include not only organizations in general, but also processes, technologies, methods, indicators of financial and economic activity, quality parameters, a motivation mechanism, development strategy formation, etc. The essence of benchmarking is to identify internal opportunities for improvement. By studying high-performing organizations, analyzing what makes that performance possible, and then comparing those processes to how your own organization works, you can make changes that lead to significant improvements. The article examines the essence of the concept of “benchmarking” in the works of domestic and foreign scientists, and offers its own interpretation. Types of benchmarking are grouped and characterized: performance benchmarking, process benchmarking, strategic benchmarking, internal benchmarking, competitive benchmarking, functional benchmarking, financial benchmarking, general benchmarking, and product benchmarking. The benchmarking implementation technology is considered through five successive stages: planning, data collection, analysis, implementation, control and evaluation. Benchmarking of competitiveness was carried out on the example of the non-governmental organization “School of Business and Management” in the part of the official website. The official websites of the business school of the Ukrainian Catholic University (LvBS) and one of the best European business schools – London Business School – were used for the analysis. In general, the use of benchmarking allows you to eliminate the weaknesses of the organization and realize existing opportunities to increase competitive advantages in the market.

The association between nurse managers' transformational leadership and quality of patient care: A systematic review.

To examine and summarize the reported association of nurse managers' transformational leadership and quality of patient care based on the perceptions of registered nurses. Transformational leadership behaviors of nurse managers result in staff nurses' satisfaction and retention and patient satisfaction. Patient safety and quality of care are vital to high-performing healthcare organizations. Perceptions of registered nurses are important because nurses are frontline healthcare providers fundamental to patient safety and quality of care and are considered the final line of defense in preventing adverse events and errors and improving the safety of patients. We searched the CINAHL, ProQuest, PubMed, Science Direct, and Web of Science databases for evidence published between 2018 and 2022 in the English language. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in carrying out this meta-analysis. Nine quantitative studies were appraised using the Joanna Briggs Institute checklists and were included in the final review that involved a total sample of 3633 registered nurses. The included studies were reported across Asian, Middle East, and European countries within the past five years. The association between the transformational leadership behaviors of nurse managers and the quality of patient care was found in varying degrees (i.e., insignificant, weak, indirect, and strong direct association) based on the perceptions of registered nurses. There is a direct and indirect association between the transformational leadership behaviors of nurse managers and the quality of patient care internationally. This association is influenced by confounding and mediating factors, including gender, organizational culture, structural empowerment, and job satisfaction. Healthcare organizations need to support nursing leaders to have a stronger transformational leadership style by considering several factors that influence their leadership to improve the quality of patient care their staff nurses provide at the bedside.

How health systems facilitate patient-centered care and care coordination: a case series analysis to identify best practices

Large- and small-scale transformation of healthcare delivery toward improved patient experience through promotion of patient-centered and coordinated care continues to be at the forefront of health system efforts in the United States. As part of a Quality Improvement (QI) project at a large, midwestern health system, a case series of high-performing organizations was explored with the goal of identifying best practices in patient-centered care and/or care coordination (PCC/CC). Identification of best practices was done through rapid realist review of peer-reviewed literature supporting three PCC/CC interventions per case. Mechanisms responsible for successful intervention outcomes and associated institutional-level facilitators were evaluated, and cross-case analysis produced high-level focus items for health system leadership, including (1) institutional values surrounding PCC/CC, (2) optimization of IT infrastructure to enhance performance and communication, (3) pay structures and employment models that enhance accountability, and (4) organizing bodies to support implementation efforts. Health systems may use this review to gain insight into how institutional-level factors may facilitate small-scale PCC/CC behaviors, or to conduct similar assessments in their own QI projects. Based on our analysis, we recommend health systems seeking to improve PCC/CC at any level or scale to evaluate how IT infrastructure affects provider-provider and provider-patient communication, and the extent to which institutional prioritization of PCC/CC is manifest and held accountable in performance feedback, incentivization, and values shared among departments and settings. Ideally, this evaluation work should be performed and/or supported by cross-department organizing bodies specifically devoted to PCC/CC implementation work.

A Thematic Approach to Succession Planning, Leadership Continuity, and Organizational Growth: Spotlight on Chief Executive Officers in Ghanaian Industry

Purpose: This study examines how succession planning (SP) for Chief Executive Officers (CEO) of high-performing organizations in emerging markets ensures the steady success of business continuity through competitive advantage and organizational growth. It also takes a keen interest in the role of the board of directors in perpetuating succession planning practices and the key qualities expected of future CEOs which include value-added competencies, specialized knowledge, leadership capabilities, and performance-based success.
 Design/Methodology/Approach: This study adopts a qualitative and exploratory approach using a thematic approach to analyze the data.
 Findings: Through a qualitative lens, the study found that most organizations have no succession-planning practices. Again, those that have it had a weak one, and only a few organizations have a mildly strong succession-planning policy. Furthermore, the board of directors plays a crucial role in the succession-planning processes of these organizations.
 Research Limitation: There were some constraints during the study and writing of this paper which are indicated. The outbreak of the coronavirus (Covid-19) pandemic caused the closing down of targeted companies for research.
 Practical Implications: Companies should have strategic initiatives to enable the identification of a talent pool for training in all divisions.
 Social Implications: Training activities such as seminars and workshops should be implemented to improve the understanding of leadership and succession planning.
 Originality: Studies on succession planning did not consider the role of the board of directors which this study sheds light on.  Finally, studies on SP have not emphasized how important it is for chief executive officers to understand the crucial role that strategic decision-making and succession planning play in guaranteeing the long-term growth of organizations in sub-Saharan Africa.

Learning health system, positive deviance analysis, and electronic health records: Synergy for a learning health system.

Over the past decade, numerous efforts have encouraged the realization of the learning health system (LHS) in the United States. Despite these efforts, and promising aims of the LHS, the full potential and value of research conducted within LHSs have yet to be realized. New technology coupled with a catalyzing global pandemic have spurred momentum. In addition, the LHS has lacked a consistent framework within which "best evidence" can be identified. Positive deviance analysis, itself reinvigorated by recent advances in health information technology (IT) and ubiquitous adoption of electronic health records (EHRs), may finally provide a framework through which LHSs can be operationalized and optimized. We describe the synergy between positive deviance and the LHS and how they may be integrated to achieve a continuous cycle of health system improvement. As we describe below, the positive deviance approach focuses on learning from high-performing teams and organizations. Such learning can be enabled by EHRs and health IT, providing a lens into how digital clinical interventions are successfully developed and deployed.

Dynamic Knowledge Management Capabilities: An Approach to High-Performance Organization

The purpose of this research was to study the effect of dynamic knowledge management capability on high-performance organizations and organizational performance. The data collection was carried out using questionnaires from 4-5-star hotels in Thailand, for a total of 148 hotels. The data analysis was performed using descriptive statistics followed by Pearson’s correlation analysis, confirmatory factor analysis, and structural equation modeling. The research results revealed that dynamic knowledge management capability had a positive direct effect on high-performing organizations and a positive indirect effect on organizational performance. Therefore, executives should emphasize the building of dynamic knowledge management capabilities to improve the performance of high-performance organizations, which will lead to performance strength beyond rivals. Doi: 10.28991/HIJ-2022-03-03-01 Full Text: PDF

Eliminate Unnecessary Laboratory Work to Mitigate Iatrogenic Anemia and Reduce Cost for Patients on Extracorporeal Membrane Oxygenation.

Laboratory testing is a helpful tool for clinicians, but can be costly and harmful to patients. A quality improvement project was initiated to reduce laboratory testing for patients receiving extracorporeal membrane oxygenation (ECMO) in a pediatric intensive care unit (PICU) at a tertiary care center. Preliminary data was gathered to demonstrate preimplementation practice, cost, and patient need for packed red blood cell (pRBC) transfusions. A new protocol was created by an interprofessional team based on best practice and benchmarking with high-performing organizations. The project was evaluated using two comparison groups, pre- and postimplementation for anyone receiving ECMO therapy in the PICU. The average laboratory tests per ECMO day decreased by 52% (128.4 vs. 61.1), cost per case decreased by 14.7%, pRBC transfusions decreased from 100% to 85%, length of stay (LOS) decreased by 8 days, and mortality rates decreased by 9.5%. The revised pediatric ECMO laboratory testing guidelines were successfully implemented and reduced laboratory cost without adverse effects on mortality rates or LOS.

Eliminate Unnecessary Laboratory Work to Mitigate Iatrogenic Anemia and Reduce Cost for Patients on Extracorporeal Membrane Oxygenation

Laboratory testing is a helpful tool for clinicians, but can be costly and harmful to patients. A quality improvement project was initiated to reduce laboratory testing for patients receiving extracorporeal membrane oxygenation (ECMO) in a pediatric intensive care unit (PICU) at a tertiary care center. Preliminary data was gathered to demonstrate preimplementation practice, cost, and patient need for packed red blood cell (pRBC) transfusions. A new protocol was created by an interprofessional team based on best practice and benchmarking with high-performing organizations. The project was evaluated using two comparison groups, pre- and postimplementation for anyone receiving ECMO therapy in the PICU. The average laboratory tests per ECMO day decreased by 52% (128.4 vs. 61.1), cost per case decreased by 14.7%, pRBC transfusions decreased from 100% to 85%, length of stay (LOS) decreased by 8 days, and mortality rates decreased by 9.5%. The revised pediatric ECMO laboratory testing guidelines were successfully implemented and reduced laboratory cost without adverse effects on mortality rates or LOS.

Adaptive leadership during challenging times: Effective strategies for health professions educators: AMEE Guide No. 148

Leadership and management are becoming increasingly recognised as vital for high-performing organisations and teams in health professions education. It is often difficult for those embarking on leadership activities (as well as more experienced leaders) to find their way through the volume of literature and generic information on the topic. This guide aims to provide a framework for developing educators’ understanding of leadership, management, and followership in the context of health professions education. It explains many relevant approaches to leadership and suggests various strategies through which educators can develop their practice to become more effective.

Five strategic tech and talent trends for 2022 and beyond

PurposeOver the past year, the IBM Institute for Business Value (IBV) surveyed and interviewed tens of thousands of executives, employees and consumers around the world to learn what high-performing organizations are doing differently, and where executives are making the biggest bets.Design/methodology/approachAfter thousands of interviews over several years the researchers identified five trends that executives can explore to help prepare for a future characterized by disruption and change.FindingsExecutives are learning how to redefine how humans and technology work together.Practical/implicationsBusinesses need to reinvent their operations holistically to realize the full benefits of digital transformation.Originality/valueA comprehensive record of strategic tech and talent trends the leaders can use to prepare for 2022 and beyond.

Linking Top Leader Turnover to the Performance of Public Organizations: Evidence from New York City Public High Schools

Limited research has taken the contingency perspective to analyze the conditions under which the impact of top leader turnover on public organizations’ performance may vary. Using panel data from New York City public high schools, this study not only examines the main effect of principal turnover on schools’ performance but also how the main effect depends on schools’ baseline performance. Two estimation strategies—namely fixed effect models and Blundell–Bond dynamic panel models—find a consistent pattern that leader turnover is negatively associated with subsequent organizational performance, and the negative impact is stronger in low-performing organizations than it is in high-performing organizations. This study contributes to the literature by showing that the disruptive effects of leader turnover outweigh the adaptive effects in some public organizations. Moreover, the contingency perspective highlights the role of pre-turnover performance in moderating the effect of leader turnover.

Comparative Analysis of PMO Functions between the Public and Private Sectors: Survey of High-Performing Construction Organizations

AbstractPublic and private organizations are distinct in terms of ownership structure and stakeholders because they approach project management processes and structures differently. Thus, it is lik...

Organizational Performance in Banking Sector of Pakistan: Assessing the Impacts of Strategic Orientation and Organizational Culture

This study investigated the moderating effect of organizational culture on the relationships between organizational strategic orientation and organizational performance. Data were collected from 281 middle managers of the banking sector in Pakistan. Partial least squares structural equation modelling (PLS-SEM) was used to test the hypotheses. The results showed that strategic orientation and organizational culture have significant and positive impacts on the performance of the organization. Unexpectedly, organizational culture does not moderate the relationships between strategic orientation and performance. The findings of the study show that organizations that are strategically positioned as well as have a strong culture can be high-performing organizations. As there is a clear lack of research on the moderating effect of culture on the relationships between an organization’s strategic orientation and organizational performance, the current study fills this gap. Likewise, the present study highlights both practical and theoretical implications for the banking sector in Pakistan.

The effects of performance evaluation on punishment in organisations

This article expands understanding of the relationship between punishment and performance in organisations. We analyse Korean data on performance and punishment as follows. While prior literature has focused on the effect of punishment on performance, this article examines the effect of performance gaps on punishment. Based on behavioural theory, strategic reference point theory and principal–agent theory, it sheds light on the negative relationship between performance gaps (cause) and punishment (effect). The article demonstrates that low performers are more often punished and high performers less so (i.e. a negativity bias). Our results also show that organisations prioritise light punishment over heavy punishment when disciplining employees in response to performance. Points for practitioners Low-performing organisations are more often punished and high-performing organisations less often so. The degree to which negative performance increases punishment is greater than that to which positive performance decreases punishment. Organisations prioritise light punishment over heavy punishment when disciplining employees in response to performance.