Managed Health Care Organizations Research Articles

Patient versus person centeredness: embracing different perspectives

PurposeThe aim of this study is twofold: (1) to gain insight into the different perspectives on the relationship between patient and person centeredness and (2) to learn more about the differences between non-academic and academic stakeholders in the healthcare system.Design/methodology/approachThis mixed-methods study includes a scoping review on person and patient centeredness and in-depth interviews with patients, caregivers, staff and management of healthcare organizations. The data were analyzed by following the six phases of Braun and Clarke.FindingsThe analysis of the data showed four different perspectives on patient versus person centeredness: (1) they are synonyms; (2) one term is favorite; (3) they should be in balance; and (4) person centeredness is the surplus on top of patient centeredness.Research limitations/implicationsThere are different perspectives on patient versus person centeredness. Perspectives differ between people and can change over time. Some people feel like a patient all the time, other people feel like a person all the time, and some feel like a patient at one point in time and as a person at another point in time.Practical implicationsThese different perspectives can have important implications for the so-called moments of truth. In their role as patients, people value functional encounters and in their identity as people they value meaningful encounters with caregivers.Originality/valueBy unraveling these different perspectives, novel insights were found in the different perspectives people can take.

Mental health management in healthcare organizations: Challenges and strategies - a review

This research delves into the nuanced realm of mental health management within healthcare organizations, addressing challenges and unveiling transformative strategies. The study underscores the critical importance of integrating mental health into broader healthcare policies by examining the multifaceted role of training, education, technology, and interdisciplinary collaboration. Successful training initiatives empower healthcare professionals, reduce stigma, and enhance collaboration, contributing to a mental health-literate workforce. Technology, including telehealth and innovative solutions, acts as a catalyst, overcoming barriers and ushering in a new era of accessibility. Interdisciplinary collaboration fosters holistic care, while the future direction involves comprehensive research, policy integration, and technological innovation. In conclusion, a proactive and inclusive approach is crucial for shaping a healthcare ecosystem where mental health thrives and is central to holistic patient care. Keywords: Mental Health Management, Healthcare Organizations, Training and Education, Policy Integration.

Disruptive Innovation in China’s Primary Healthcare Market: A Case Study of a Startup to Challenge Incumbent and Business Growth Sustainability

This article examines primary healthcare reform in mainland China through a private-public partnership approach from a novel angle using disruptive innovation theory. The research is the first of its kind to apply Christensen’s disruptive innovation theory to the primary healthcare industry in China. A qualitative single case study was designed to focus on the GBA Healthcare Group Limited (“GBAH”). The disruptive innovation theory was framed under the 3H framework, hence offering managers of healthcare organizations a new holistic management framework for applying disruptive innovation theory in their business initiatives. It is also suggested that due to the highly regulated nature of the healthcare services industry, private organizations should actively engage with the relevant government organizations as core stakeholders in their strategic planning.

Enhancing the Performance of Healthcare Organizations: An Applied Analysis of Digital Technologies and Sustainability

Over the last two decades, scholars attempted to implement models to evaluate the effectiveness of digital technologies management in healthcare organizations balanced by its compliance with sustainability. However, a managerial framework for assessing digital technologies’ contribution to healthcare organizations’ performance is still lacking. Evidence-based research on digital and mobile technologies applied in the daily life environments of people over 65 in Italy has been implemented. Results were investigated by a) SWOT analysis and b) identifying the key performance indicators to evaluate the performance of healthcare organizations by following the implementation of digital technologies in healthcare processes in a sustainable perspective. The analysis reveals that some weaknesses can be overcome (e.g., the availability of GPs to be involved in the enrollment of the patients) while others cannot (e.g., systematic limitations of digital methodologies). At the same time, some threats can be tackled (e.g., users’ and operators’ difficulty adapting to technological developments) while others can only approximately be solved. Evidenced key performance indicators can be leveraged to carry out standardized assessments related to the digital practices implemented by healthcare organizations to achieve a fully developed sustainable relational ecosystem and generate a more efficient and effective healthcare organization system.

Operational disruption in healthcare associated with software functionality issue due to software security patching: a case report.

Despite many benefits, the extensive deployment of Health Information Technology (HIT) systems by healthcare organizations has encountered many challenges, particularly in the field of telemetry concerning patient monitoring and its operational workflow. These challenges can add more layers of complexity when an unplanned software security patching is performed, affecting patient monitoring and causing disruption in daily clinical operations. This study is a reflection on what happened associated with software security patching and why it happened through the lens of an incident report to develop potential preventive and corrective strategies using qualitative analyses-inductive and deductive approaches. There is a need for such analyses to identify the underlying mechanism behind such issues since very limited research has been conducted on the study of software patching. The incident was classified as a "software functionality" issue, and the consequence was an "incident with a noticeable consequence but no patient harm", and the contributing factor was a software update, i.e., software security patching. This report describes how insufficient planning of software patching, lack of training for healthcare professionals, contingency planning on unplanned system disruption, and HIT system configuration can compromise healthcare quality and cause risks to patient safety. We propose 15 preventive and corrective strategies grouped under four key areas based on the system approach and social-technical aspects of the patching process. The key areas are (i) preparing, developing, and deploying patches; (ii) training the frontline operators; (iii) ensuring contingency planning; and (iv) establishing configuration and communication between systems. These strategies are expected to minimize the risk of HIT-related incidents, enhance software security patch management in healthcare organizations, and improve patient safety. However, further discussion should be continued about general HIT problems connected to software security patching.

The Role of Strategic Human Resources Management in Healthcare Organizations – The Challenges We Face Today

The Role of Strategic Human Resources Management in Healthcare Organizations – The Challenges We Face Today

Exploring the impact of dynamic capabilities on entrepreneurial orientation in healthcare organizations: Findings from symmetric and asymmetric modeling

This work considers strategic flexibility (SF), structural flexibility (SX) and information acquisition (IA) as dynamic capabilities that promote entrepreneurial orientation in the health sector. Based on a quantitative survey carried out with managers of healthcare organizations in France, we demonstrate that IA positively impacts EO and that SF mediates the IA–EO relationship. The findings also indicate that SX moderates the effect of SF on EO. Our research has relevant theoretical implications because it extends the entrepreneurship literature through a novel focus on EO determinants in the healthcare sector. Practical implications for managers and decision-makers are also noted. The findings offer insights to healthcare care managers that will allow them to review the management method to fully involve and engage teams and to be more entrepreneurial.

THE ROLE OF THE EQUIPMENT OF HEALTHCARE INSTITUTIONS IN HUMAN RESOURCES

This paper provides an analysis of the current trend in HR practices and demonstrates added value for the management of healthcare organizations. This is done because of the assessment of the human resource function and explores the value of adding elements of human resource management and compares the risk reduction of its features. The results of this analysis show that, although high functions do not add value, they can also help to identify risks, which allows the development of strategies to reduce the impact of these risks.
 The paper refers to the reasons for the emphasis on added value, the aspect of human resources is due to professionals and the desire to be involved in the earliest stages of the decision-making process. The paper concludes the opposite view that HR professionals would become preoccupied with showing added value, arguing that the strategic importance of HR management reveals itself over time.

Direct Oral Anticoagulants’ Consumption and Expenditure in the COVID-19 Pandemic in Russia and Clinical Practice Guidelines for Their Use

Background: The coronavirus pandemic has led to the creation of clinical guidelines by a large number of professional medical communities. However, the quality and methodology of development of Russian clinical guidelines has been little studied. The continued relevance of studying the use of DOACs (Direct oral anticoagulants) in patients with COVID-19 was the basis for conducting this study. Aim: The objective of this study was to assess DOAC consumption and expenditure in the Russian Federation during the COVID-19 pandemic and to analyze whether it was supported by the domestic evidence base for the use of DOACs in COVID-19 patients through identifying all publicly available Russian-produced CPGs (Clinical practice guidelines) for the treatment of COVID-19 and assessing their quality as the source of recommendations for the use of oral anticoagulants for the prevention of thrombotic complications in COVID-19 patients. We searched Russian databases for CPGs, published between 2020 and 2023. We identified seven relevant documents that met our inclusion criteria. Three authors analyzed Russian clinical guidelines using an AGREE II questionnaire. We calculated DOAC DDD (defined daily dose) consumption according to Russian clinical guidelines and DDD consumption in patients with COVID-19 for the period 2020–2022. Results: Seven clinical CPGs were analyzed with the AGREE II tool. It was revealed that experts gave the highest scores for the sections on scope and purpose (from 62.98% to 100%), and clarity of presentation (from 96.30% to 100%). The lowest scores were given for the sections on stakeholder involvement (33.33% to 64.81%), rigour of development (from 0% to 49.31%), applicability (from 23.61% to 50%), and editorial independence (from 0% to 50%). When comparing the total score, it was found that two clinical guidelines received the highest scores—ROPNIZ (Livzan), and ROPNIZ (Drapkina). The minimum score was registered with the NIIOZMM (Khripun) clinical guideline. No guideline received a total score of more than 70%. According to clinical recommendations, the consumption of apixaban and rivaroxaban is 15 DDD (30-day course of therapy), or 22.5 DDD (45-day course of therapy). Consumption of apixaban in the Russian Federation in 2020 and 2021 corresponds to the indicators presented in clinical recommendations (in 2020—26.59 DDD per patient with COVID-19; in 2021—15.75 DDD per patient with COVID-19), and in 2022—10.67 DDD, which is below the recommended values. In 2020, consumption of rivaroxaban in the Russian Federation was 26.59 which corresponds to data from clinical recommendations; in 2021, consumption decreased to 7.87 DDD; in 2022 it decreased to 5.48 DDD, which is 2.74 times less than recommended. Conclusions: Analysis of seven clinical recommendations revealed that such sections of clinical recommendations as scope, purpose, and clarity of presentation had the highest degree of assessment in accordance with AGREE II. The lowest scores were given for the sections on stakeholder involvement, rigour of development, applicability, and editorial independence. When comparing the total score, it was found that two clinical guidelines received the highest scores—the Russian Society for the Prevention of Non-communicable Diseases (Livzan), and the Russian Society for the Prevention of Non-communicable Diseases (Drapkina). The minimum score was registered with the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department clinical guideline. No guideline received a total score of more than 70%. During the pandemic, the highest DDD consumption of DOACs was in 2020, which exceeded the DOACs’ recommended DDD by Russian clinical guidelines. DOAC consumption had decreased by 2022. There was a decrease in the consumption of rivaroxaban, with an increase in apixaban’s share in the structure of DOAC consumption during the coronavirus pandemic. Obtained data indicate that in 2021 the apixaban consumption in the Russian Federation corresponded to the recommended DDD in the national guidelines, which indicates the most correct use of apixaban according to Russian GPGs.

The problem of strategic human resource management in healthcare in Poland

Objective — to study the basic principles of the strategic human resource management in healthcare, to analyze the features of human resource management in healthcare organizations, to analyze the long‑term trends of the human resources in the healthcare in Poland and to propose the recommendations for the implementation of measures for strategic human resources management in healthcare organizations.
 Results. The problems of the long‑term and short‑term tendencies of human resources in the healthcare in Poland are discussed in the article. The age, gender and regional distribution of the human resources in the healthcare are shown and the main factors influenced on the dynamics of these indicators are described. Taking into account different problems in the healthcare in Poland the importance of the strategic human resource management is presented and the general recommendations for health institutions are given.
 Conclusions. Strategic management and analysis of human resources development are crucial in Polish healthcare. Health institutions need strategic plans and performance assessments for medical facilities. The expanded strategic management of medical organizations involves assessing both the external and internal environment, considering macroeconomic changes, regional shifts, market dynamics, mobility, qualifications, motivation of medical personnel, and evaluating the organization’s image among patients and public entities. In strategic human resources analysis, key factors include strategic intentions, forecasting challenges, positioning, and prioritizing human resources management. Given the complex macro environment of medical organizations, it’s crucial to identify the most significant factors, evaluate their potential impact, and formulate response measures within the organization’s strategy.

Innovative Approaches in the Management of Healthcare Organisations

Our study provides a comprehensive view of innovations in the management of healthcare facilities (HCF). It fills the research gap and contributes to discussions on the need to introduce new innovative management tools into the curricula of healthcare managers and professionals. The design of the study is based on answering research questions (RQ) by statistical processing of data from 181 managers of various types of HCF in Slovakia, obtained by questionnaire. We evaluate the use of innovative approaches in the management of healthcare organisations in the application of hard and soft management tools and their relationship to the economic results of these organisations. RQs are aimed at differentiating the application of innovative approaches in management depending on the characteristics of HCF and their managers and depending on the economic results. There is a positive relationship between the use of innovative approaches in management and the economic results of HCF. There are significant differences in the degree of application of innovative approaches between different types of facilities, the leaders in their implementation are university hospitals. The medical education of managers with the additional completed specialised management study has a significant relation to the application of innovative approaches in management.

Hybrid Leadership and Its Relationship to Inclusion in Healthcare

Leadership is critical in managing healthcare organizations to address financial limitations, availability of skilled workforce, globalization, disruptive innovation, new technology, and hyper-competition. This challenging environment has forced many healthcare organizations to change their bureaucratic organizational structure to a more organic one headed by leaders rather than managers. There are many leadership styles to consider for healthcare leaders. However, this research focuses on nine leadership and hybrid leadership styles to determine significant relationships to inclusion in the workplace. We used the VanSimpco Leadership Survey and Chung et al.’s Work Group Inclusion scale to survey 174 healthcare employees. We found that autocratic, autocratic-transformational, democratic-transactional, and laissez-faire leadership styles impacted workplace inclusion uniqueness. Democratic, autocratic-transformational, and autocratic-transactional leadership styles impacted workplace inclusion belongingness. This research is based on Leader-Member Exchange and Optimal Distinction theories.

Stress Management in Healthcare Organizations: The Nigerian Context.

Occupational psychosocial stress can increase the risk of several cardiometabolic diseases. Healthcare workers worldwide experience exceptionally high levels of occupational stress, leading to serious individual, organizational, and societal problems. This narrative review seeks to provide information about the overall consequences of having over-stressed healthcare workers and ascertain how it eventually holds back the advancement of healthcare. In addition, we present a review of the concept, study, and theories related to stress management in order to deeply understand this issue, providing a theoretical perspective of stress management and the subtle concepts of stress, stress management, healthcare structure, and organization in Nigeria. The current literature has shown that Nigerian healthcare workers are more stressed due to long working hours, caregiving responsibilities, and psychological contact with patients. Healthcare workers are more likely to experience stress and burnout than other professions. The level of stress in the healthcare sector has garnered a lot of attention in this regard because of the negative impact of stress on both staff and patients. However, health policies and better working conditions need to be adopted. Collaborative efforts from policymakers, healthcare institutions, and other stakeholders are necessary to prioritize the well-being and productivity of healthcare professionals in the journey toward a more robust and equitable healthcare system.

Italian translation and cultural adaptation of health literate organisation self-assessment tool

Abstract Background The International Working Group Health Promoting Hospitals and Health Literate Healthcare Organizations has developed an English-language self-assessment tool for Organizational Health Literacy of Hospitals, designed to quality managers of healthcare organizations. It aims to diagnose strengths and weaknesses of the organization's health literacy, and our goal is to translate and culturally adapt it for Italy. Methods We have been following the Translation, Review, Adjudication, Pretesting, and Documentation team model for cross-cultural translation of questionnaires. Initially, two separate teams of translators worked independently to translate the tool from English to Italian. Next, the national coordinator organised six meetings to discuss, integrate, and unify the two versions, and any translation difficulties and suggested solutions were reported in the supporting tool that will be sent along with final agreed version of the tool to the International Coordination Centre. Finally, two experts will review the translation for the cultural adaptation. Results Difficulties related to comprehension in translation can arise from ambiguity in word choice, the need for contextual precision, and a lack of cultural appropriateness. The translation of English words that have become part of Italian language (e.g. ‘feedback', ‘stakeholder', ‘management', ‘standard') was also hugely discussed between the teams. Finally, to categorize the information entered into the supporting tool, 50% pertains to adaptation to context, 30% to simplification or clarification, and 20% to non-applicable items. Conclusions Cultural adaptation will improve the translation by reducing ambiguities, providing contextual clarifications, and rephrasing items to make them more appropriate for Italy. The Italian version of the tool will be piloted in local hospitals to support healthcare operators, patients, and the community in better managing the complexities of healthcare organizations. Key messages • Translation of health literacy self-assessment tool for Italian hospitals, aiming to reduce ambiguity and increase appropriateness for local context. • Culturally adapted tool to diagnose organizational health literacy in Italian hospitals will help healthcare organizations deal with complexity of healthcare and improve patient outcomes.

Social-humanitarian aspects of dialogue in the healthcare system

The article presents an overview of the IV Forum “Sociology of Health: Contemporary Healthcare in Dialogue with Everyone” organized by the Research Institute for Healthcare Organization and Medical Management of the Moscow Healthcare Department on November 17, 2022. The article summarizes presentations made by sociologists, heads of medical organizations of Moscow and other Russian regions, academic researchers, and representatives of non-profit organizations. The authors identify four key social and humanistic aspects of dialogue in the healthcare system: value basis, methodology, role of the civil society, and main issues. The Forum focused not only on methodological issues, but also on the applied research, such as projects aimed at smoking cessation, motivating to blood donation, developing psychological support service for cancer patients, etc. The authors emphasize the need for social-humanitarian technologies in the healthcare system for its patient-oriented transformation, including introduction of sociological monitoring.

The relationship of mushroom management and collective justice in health institutions

ABSTRACT As in every sector, organizational management in the health sector plays an important role in the institution being successful and achieving its goals. Health care is a phenomenon that reminds individuals of the need for collective work. The aim of this study was to determine the relationship between the perceptions of mushroom management and collective justice in healthcare organizations. The sample for the study, using the relational survey model, consisted of 410 healthcare professionals. The “Mushroom Management Scale” and “Collective Justice Scale” were used to collect data. SEM path analysis revealed that there was a significant negative relationship between the mushroom management scale sub-dimensions and collective justice variable. In addition, a significant effect was found between these variables. Based on the demographic data of the participants, mushroom management sub-dimensions and collective justice perceptions of participants differed significantly according to the institution they worked in. It is thought that health institution managers who are transparent, honest and open, especially in information sharing, instead of using mushroom management style, who include employees in decision-making processes, and who adopt a more sharing management style will increase employees' trust in the organization and management as well as their perceptions of collective justice.

Effect of Emotional Intelligence on Employee Caring Behaviour: a Study of Professional Nurses in Tertiary Health Care Institutions in Benue State, Nigeria

This study examined the effect of emotional intelligence on caring behaviour of professional nurses in tertiary health care institutions in Benue State, Nigeria. Specifically the study sought to examine the effects of self-awareness, self-management, social awareness and relationship management on caring behaviour of professional nurses in tertiary health care institutions in Benue State. Anchored on Jean Watson’s Theory of Human Caring, the study adopted the survey design. Population of the study consisted of 586 professional nurses working in the two tertiary healthcare facilities in Benue State (312 from the Federal Medical Centre and 274 from the Benue State University Teaching Hospital). A sample size of 245 was arrived at with the aid of Taro Yamene’s sampling formula. Primary data were gathered through questionnaire. The data were coded and analysed with the aid of SPSS. Hypotheses of the study were tested using regression analysis at 5% level of significance. Findings revealed that self-awareness, self-management, social awareness and relationship management all have significant effect on caring behaviour of professional nurses in tertiary health care institutions in Benue State, Nigeria. The study concludes that there is a significant relationship between emotional intelligence and caring behaviour of professional nurses in tertiary health care institution in Benue State. The study recommends that in order to ensure quality care to patients, management of tertiary healthcare organisations in Benue State should recognize and develop EI abilities in nurses who constantly struggle to show care since EI can be taught and learnt.

Implementation evidence-based in healthcare organizations management and policy

Aim The goal of this paper is to introduce a perspective view of the formation and application of the evidence-based management approach to investigators, managers and policymakers as to how different determinants and managerial-decision processes can be more effectively linked for the salient of healthcare organizations. Methods The author compiled this analysis on the basis of published literature and his experience as a researcher in the healthcare management. The author briefly reviews the evolution of evidence-based management in this article and designs a perspective framework for improving its production and the impact of its application in a broad variety of contexts. Results This paper can inform the global healthcare evidence-based agenda by (1) providing a framework for operational recommendations for the implementation of the healthcare evidence-based, (2) defining evidence-based management guidelines’ recommendations, and (3) enhance methods for adopting and tailoring evidence-based management. Conclusion The use of the presented domains’ guidelines and recommendations will increase the consistency of the characterization of the evidence-based management approach. The author agrees that it is a high priority to establish approaches to monitoring evidence-based management in healthcare organizations. Laterally, this perspective review will help in the implementation of such an approach.

Commentary: A systematic review of informatics competencies: requirements for nurse managers in healthcare organisations.

Commentary: A systematic review of informatics competencies: requirements for nurse managers in healthcare organisations.

A systematic review of informatics competencies: requirements for nurse managers in healthcare organisations.

One vital strategy for the success of healthcare organisations currently resides in the capacity of the nurse managers (NMs) to develop informatics competencies in management. The aim of this review was to synthesise the evidence related to the informatics competencies of NMs in healthcare settings. The databases of PubMed, Web of Science, Scopus and Education Resources Information Center were searched. All publications were accepted if they had been published in English and full texts were accessible. The study was carried out using a systematic literature search of work published between January 2000 and December 2021. The Endnote v.17 software was used to facilitate reference management. Quality assessment of publications was carried out independently by two reviewers using the Critical Appraisal Skills Programme guidance. A descriptive summary with data tables was produced to summarise the literature. After screening the search results, 12 studies published between the period 2001 and 2019 met the inclusion criteria. Analysis of the included studies led to the classification of informatics competencies in three main themes: skills related to work with computers (four sub-themes), informatics skills of NMs (three sub-themes) and knowledge of NMs about informatics (five sub-themes). These systematic review results can lead to the identification of informatics competency gaps and recommend and provide solutions to address these gaps and increase competencies for nursing managers.