Public Healthcare Organizations Research Articles

Delivering a Specialised Best Practice Service for People with Functional Neurological Disorder: An Australian Qualitative Descriptive Study

Specialised functional neurological disorder (FND) clinics are emerging as the preferred way of providing best practice care to people with FND. However, questions remain around optimal care pathways, service provision, and resources. This study aimed to identify (1) service characteristics of Australian FND models of care; (2) barriers and enablers to implementing a specialised FND service; and (3) enablers and barriers to providing best practice management for people living with FND. Clinicians were recruited from Australian public and private healthcare organisations identified as leading best practice for adults with FND. Clinicians completed a structured interview via phone. A descriptive content analysis was used. Five out of 12 healthcare organisations interviewed had a specialised multidisciplinary FND service. All specialised FND services were outpatient programs, but the structure and referral pathways varied. Barriers identified by organisations with an FND service included “funding” and “staff and service fragility,” while enablers included “engaging stakeholders” and having a clear “service driver.” “Diagnosis delay” and “insufficient access to staff” were identified as barriers to implementing best practice by organisations without a specialised FND service. Despite specialised clinics being recognised as a practical way to deliver care to people with FND, only a few services operate in Australia. Timely and educated diagnosis and access to an interdisciplinary team consisting of neurology, physiotherapy, and psychology are central pillars for FND services. Further work to establish clinically and economically effective delivery models is required to facilitate the provision of best practice care for people living with FND.

Benefits realization in digital transformation: the translation from policy to practice in health care

PurposeWhile digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits realization are translated into practice.Design/methodology/approachThe authors apply a qualitative, comparative case study of two large, public-sector health care organizations in Sweden. Through document and interview data, the authors analyze the process of translation.FindingsThe study finds that practice variation is primarily caused by two types of decoupling: policy-practice and means-ends. Contrary to previous studies, coercion in policy compliance is not found to decrease practice variation.Research limitations/implicationsThe limitations primarily stem from the empirical selection of two large public health-care organizations in Sweden, affecting the study’s generalizability. Reducing practice variation is more effectively achieved through goal alignment than coercion, leading to implications for the design of governance and control.Practical implicationsPolicymakers should, instead of focusing on control-related compliance, work to align organizational objectives and policies to decrease practice variation for successful benefits realization.Social implicationsThe study contributes to better benefits realization of digital transformation initiatives in health care. As such, the authors contribute to a better functioning and more transformative health care in times of increased demand and decreased supply of health-care services.Originality/valueThe study challenges conventional wisdom by identifying that coercion is less effective than goal alignment in reducing practice variation, thereby enhancing the understanding of policy implementation dynamics in health-care settings.

Navigating data governance challenges in healthcare

This teaching case study delves into the journey of a public sector healthcare organisation in Australia, Vitality Alliance Queensland (VAQ), as they strive to future-proof the organisation’s data governance framework. Drawing from a real-world scenario, the case describes three key governance challenges faced by the organisation: data accessibility, data sensitivity, and data democratisation and empowerment. The rich narrative allows students to gain a deep understanding of the tensions that arise within and across these challenges and insights into how diverse stakeholders must navigate complexities to create and realise value from organisational data.

Promoting Planetary Health at Regional Level: A Qualitative Analysis of a Multisectoral Health and Environment Program

Abstract The central idea of planetary health is a strong interdependency between human health and the environment. Thus far, practical initiatives often focus on a few narrow sectors at a time. We are lacking knowledge on the efficacy of broader interorganizational collaborations at the city or regional level. Nature Step to Health – Lahti Regional Health and Environment Programme 2022–2032 in Finland is a planetary health program. It provides a practical example of regional collaboration between various organizations such as public healthcare, municipalities, and educational and research organizations in order to achieve tangible results in striving for more sustainable futures. The program facilitates collaboration and communicates to actors that can initiate projects and implement planetary health in their everyday work. This case study aims to find out how the program has succeeded in coordinating initiatives that could support different organizations to enhance sustainability and planetary health. We conducted six semi-structured interviews about the experiences of practical actors participating in projects that relate to Nature Step to Health. The goal was to find out strengths as well as potential challenges or barriers in implementing planetary health in their organizations. The participants were generally positive about the measures, collaboration, and networking. The organization’s comprehensive approach to health promotion was considered a strength. Challenges raised by the participants were related to the difficulty to uptake the concept of combining health and sustainability in their work. There were also shortcomings in, for example, communication of the project, and lack of time and expertise. Information © The Authors 2024

ORGANIZATIONAL CAPITAL AND EMPLOYEES’ COUNTERPRODUCTIVE WORK BEHAVIOUR IN THE NIGERIAN PUBLIC HEALTH SECTOR

This study was carried out with the view to assessing the impact of organizational capital on employees’ counterproductive work behaviour among some public healthcare organizations in Nigeria using Bayelsa state as a reference point. The study used a sample of two hundred and forty-three (243) employees of the selected organizations and data obtained were analyzed using both descriptive and inferential statistical tools. Specifically, the regression results indicated an insignificant but positive influence of organization capital on employees’ counterproductive work behaviour in public healthcare organizations.  On the basis of the findings, it was recommended among others that organizations should regularly assess and monitor employee behaviour including counterproductive work behaviour via appropriate performance management systems and employee feedback mechanisms; this would allow organizations to identify early warning signs and take proactive measures to address any emerging issues.
 Keywords: Human Capital, Intellectual Capital, Public Health, Stress Facilitation Theory, Structural Capital, Work Overload.

Internet of things in public healthcare organizations: the mediating role of attitude

<span lang="EN-US">Internet of things (IoT) is a promising technology to face the challenges of COVID19 and enhance the capacities of public hospitals. However, few of the literature examined the behavioural intention (BI) of patients to use the IoT wearable health device (IoTWHD). This paper aims to examine the factor that affect the BI toward using the IoTWHD. The study proposes that variables of Technology acceptance model (TAM3) along with unified theory of acceptance and use of technology (UTAUT) can explain the BI. The population is the patients of public hospitals. Convivence sampling was deployed to collect the data using a questionnaire. 161 respondents participated in this study. The finding of Smart Partial Least Square showed that subjective norms (SN) affected the perceived usefulness (PU). Perceived enjoyment (PE) affected the perceived ease of use (PEOU). Further, PU, PEOU and perceived security (PS) affected the BI to use IoTWHD. Attitude mediated the effect of PU and PEOU on BI. More positive word of mouth are needed to enhance the perception of patients about BI to use IoTWHD in public health organizations.</span>

Implementation of Artificial Intelligence Applications in Australian Healthcare Organisations: Environmental Scan Findings.

Artificial Intelligence (AI) has great potential to improve healthcare, but implementation into routine practice remains a challenge. This study scoped the extent to which AI and Natural Language Processing (NLP) is being implemented into routine practice in Australian healthcare organisations. An environmental scan of publicly available data was undertaken to identify AI applications. Publicly available data consisted of news posts from Australian public healthcare organisations and conference proceedings from key research organisations. Two researchers reviewed and analysed posts related to AI applications to create a list of potential implementation case studies. The final list of AI applications was reviewed by a governance committee in order to identify any missing applications. One application was identified by the governance committee and subsequently added. The environmental scan identified eighteen AI applications, of which eleven met all eligibility criteria. Only one application included NLP. Twelve applications were included when the application identified by the governance committee was added to the list. Implementation of AI applications is spread across four broad categories of use: 1) Decision Support, 2) Monitoring Treatment Effectiveness, 3) Personalised Care and 4) Risk Prediction.

Do conformity and bailouts affect misreporting? The case of public health-care organisations

Most literature on the antecedents of misreporting in the public sector focuses on the propensity to report financial breakeven, with limited attention to the regulatory and normative incentives that may alter such propensity. This study provides novel explanations for public sector organisations' deviation from breakeven. Its underlying assumption is that misreporting may be shaped by mimetic pressures encouraging conformity as well as regulatory pressures conveyed through soft budget constraints. The empirical analysis includes all Italian public healthcare organisations over 17 years. The findings suggest that public healthcare organisations may manipulate accruals not only to achieve financial breakeven, but also to conform with peers’ financial performance or to worsen reported financial performance in anticipation of a bailout.

Sustainability Accounting and Reporting: Searching for a Viable Framework in Public Healthcare Organizations

Sustainability Accounting and Reporting: Searching for a Viable Framework in Public Healthcare Organizations

Self-Spirituality in Organizations: A Review of Qualitative Research

This review focuses on the incorporation of self-spirituality and mindfulness into secular institutions such as for-profit organizations, as well as into public and private healthcare organizations. The review considers research into the value of self-spirituality and the reasons for organizational rejection, or acceptance as a response to manifestations of self-spirituality; research proposing frameworks for analyzing modes of incorporating self-spirituality into organizations; and research into the enactment of self-spirituality in different sectors. The review shows that individuals reported a reduction in stress, a reinforced capacity for coping with challenging workplace demands, and improved workplace communication. The review also argues that the encounter of organizations with self-spirituality is shaped by, and reenforces, existing social forces such as instrumentalism. At the same time, it generates alternative ideas and practices. At present, the capacity of self-spirituality to create transformation in organizations is limited, although specific practices (e.g., mindfulness) can be more influential.

Impact of Medicare DRGs Reform on the Economic Operation of Public Healthcare Organizations

Impact of Medicare DRGs Reform on the Economic Operation of Public Healthcare Organizations

Healthcare digitalisation and its association with quality and employee health, a mixed-methods study

PurposePrevious research has identified associations between quality management and employee health. This study's purpose was to (1) examine those associations in a public healthcare organisation and (2) explore and describe the association between digitalisation and employee health.Design/methodology/approachAn online questionnaire including indices to measure quality management values, employee health and digitalisation was answered by 118 managers in Swedish public healthcare. Correlation analysis was used to analyse the data. Based on the survey results, 12 qualitative, in-depth interviews were conducted with healthcare managers.FindingsThe findings show that employee health is associated with quality management and digitalisation. Categories were defined to describe the managers' views of the relationship between digitalisation and health.Research limitations/implicationsCausality was not explicitly tested and cannot be assumed. However, the results strengthen the body of research showing that quality management is related to employee health, and associations between health and digitalisation were identified.Practical implicationsThe findings and model should be helpful for healthcare managers in a digitalising environment who aim to preserve or enhance employee health whilst ensuring high service quality.Originality/valueThe results were used to create an integrated conceptual model depicting the association between quality, digitalisation and health. This association has not previously been studied.

Aspects of Healthcare Staffing With Specialists in Healthcare Organization and Public Health in Moscow

Introduction. How many public health and healthcare organization professionals a health facility has on staff has a significant impact on the integration of all functional units, the ability to successfully address pressing issues, and the quality and safety of medical care.
 Purpose. The goal was to conduct a comparative analysis of staffing dynamics in health facilities with public health specialists in Moscow and Russia from 2017 to 2021.
 Materials and methods. Statistical, logical, and analytical methods were used. Data on the number of public health specialists in Moscow and Russia, workforce density and quantity of health facilities were obtained from statistical data of the Central Research Institute of Organization and Informatization of Healthcare of the Ministry of Health of the Russian Federation from 2017 to 2021. The demand for chief physicians, deputy chief physicians, methodologists, and medical statisticians was identified based on job vacancies on job search websites (HeadHunter (hh.ru), SuperJob.ru, zarplata.ru, careerist.ru) at the beginning of 2023.
 Result. It was shown that there remained a negative trend in Moscow, Russia, between 2017 and 2021 in the number of heads of medical organizations and their deputies. Conversely, over the five-year period the number of methodologists have increased, and the number of medical statisticians remained virtually the same. There are open positions for experts in healthcare organization and public health in the Moscow healthcare system, despite the established network of academic and educational institutions for the training of medical specialists.

Health and social care managers' perceptions of factors affecting the competence of managers in knowledge management: A qualitative study.

To describe health and social care managers' perceptions of the factors affecting the competence of managers in knowledge management. A qualitative descriptive study. A semi-structured interview was conducted with 15 managers from three public health and social care organizations in Finland. Data were collected in the spring of 2022 and analysed using inductive content analysis. Health and social care managers perceived that the competence of managers working in knowledge management is affected by managers' behavioural and attitudinal characteristics, their interactive network competence in knowledge management, the dimensions of their competence in knowledge management, the knowledge management infrastructure with which they work and the organizational learning culture within which they work. The competence of health and social managers in knowledge management is influenced by various factors, including their personal characteristics, management competence and the infrastructure and culture of the organization for which they work. However, their competence is constrained by an absence of clear processes, structures and resources in knowledge management as well as a lack of systematic support and training for managers working in knowledge management. The study provides valuable information for improving the competence of managers working in knowledge management in health and social care organizations. The competence of managers working in knowledge management is instrumental for successful implementation and sustaining of knowledge management practices and thus, such competence has a positive impact on the overall performance of an organization. Clarifying the roles and responsibilities of health and social care managers, as well as establishing organizational structures, is essential for effective knowledge management in organizations. Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist has been used in the reporting. No patient or public contribution.

Assessing midwifery services inIran via the balanced scorecard framework.

This study investigates the impact of intra-organizational information, midwife job satisfaction and performance assessment on the quality of midwife services. The questions are empirically tested with survey data obtained from 276 midwives, specialist doctors and nurses, and mothers who recently gave birth in a cross-section of Iranian public healthcare organizations. The results from a structural equation model suggest that an improved performance assessment system leads to higher quality midwife services. In addition, the results indicate that midwife job satisfaction and intra-organizational information increases the quality of midwife services, both directly and indirectly, through the mediating effect of a performance assessment system. Our study contributes to the growing research exploring the interface between accounting and health issues by recognizing the importance of a performance assessment system of midwifery services via the balanced scorecard framework for understanding the quality of midwife services.

[The becoming and development of the academic subject and scientific discipline "public health and health care organization" (to the centenary of the academician Yu. P. Lisitsyn Chair of Public Health and Health Care). Report I (beginning of XX century - 1963)].

The article presents analysis of becoming of academic subject and scientific discipline "Public Health and Health Care Organization" in Russia from beginning of the 20th century to 1963. The special attention was paid to the role in their becoming and development that played the Chair of Public Health and Health Care Organization of the Pirogov Russian National Research Medical University that is celebrating its centenary in 2023-2024 academic year. The contribution into this process of its prominent scientists and heads is considered.

Does Organizational Commitment to Mental Health Affect Team Processes? A Longitudinal Study.

Team processes, such as reflexivity and participation, are critical for organizational sustainability, especially in high-reliability professions such as healthcare. However, little is known about health-related predictors of team processes. Basing our hypotheses on the Input-Process-Output (IPO) model, this study investigates the influence of perceived organizational commitment to mental health (OCMH) on healthcare workers' team reflexivity and participation via mental health-specific leadership (MHsL) and team autonomy. The study involved 82 participants (ie, physicians, nurses, healthcare assistants, healthcare technicians, and physiotherapists) working in the Medicine, Emergency, and Neurological Departments at a large public healthcare organization in Italy. Data was gathered at 2-time points, 14 months apart. The results suggest that healthcare workers' perception of their organization's support for mental health at T1 significantly impacts team participation at T2 through MHsL and team autonomy. Likewise, the indirect effect of OCMH through MHsL and team autonomy was also significant in the model predicting team reflexivity. However, in both models, no direct relationship of OCMH on the dependent variables was found. The findings highlight the importance of a mental health-supportive environment and leadership to foster team autonomy and, subsequentially, team processes, which are fundamental for performance and patient care.

Transferable lessons learned from improving health literacy responsiveness in Dutch rheumatology care

Abstract Background Health literacy difficulties among (groups of) individuals represent a significant public health challenge. Improving health literacy responsiveness of systems and services could reduce health inequalities in communities and patient populations. Methods We conducted a mixed-methods study to improve health literacy responsiveness in three Dutch rheumatology centres, using the OPtimising HEalth LIteracy and Access (Ophelia) approach. Patients and health professionals were involved in an inclusive needs assessment (n = 895 and 39, respectively) and co-design consultations to identify local solutions (n = 14 and 38, respectively). Based on all steps, we formulated transferable lessons learned (outcome-related or process-related) for public health and health care. Results Outcome-related lessons: a mixed-methods Ophelia approach was successful in identifying health literacy challenges and 175 potential solutions. Challenges are similar between disease groups and centres, but require solutions specific to the local context. Recognising challenges at the point of care is difficult. For a healthcare service to be responsive to health literacy needs, increased awareness alone is not enough; it will require a conscious actions and systemic change at multiple levels, including training. Process-related lessons: prerequisites for a successful health literacy responsiveness project include using multidimensional measurements, an inclusive participatory approach with all stakeholders, collaboration with experts in a community of practice, and strong project governance. Conclusions The Ophelia project in rheumatology care was successful in its aims of finding solutions to improve health literacy responsiveness. Public health and healthcare organisations should consider improving their health literacy responsiveness using a grassroots co-design approach. However, project success will depend on the quality of its governance; future programmes should follow a systematic approach. Key messages • Using a grassroots co-design approach such as Ophelia can help identify locally relevant solutions to health literacy challenges and support organisational efforts to reduce health inequalities. • Successfully improving health literacy responsiveness requires, at minimum, inclusion of people with most complex health literacy challenges, strong project governance, and stakeholder engagement.

Intersectoral health governance during floods: a qualitative case-study into the Dutch 2021 flood

Abstract Background With the planetary crisis comes an increasing risk of flooding events. As shown during the 2021 floodings in Limburg, these can have disastrous consequences for the public health system and healthcare organisations. Historically flooding events are often treated as either affecting public health or acute care, but the 2021 events showed the necessity of an intersectoral governance approach. In this study, we investigated how governance actors from different domains collaborate and perform shared sensemaking processes to ensure patient safety continuity of (public health) care. Methods For the past months, we conducted a qualitative case-study in the Dutch region of Limburg where we interviewed governance actors from public health, acute healthcare, water management, and safety and crisis management. We also observed and analysed crisis exercises and hospital crisis management meetings, including relevant paper trails. All data were abductively coded and thematically analysed. Results Our analysis shows that during and after the flooding event, actors were confronted with numerous vulnerabilities about decisions to evacuate hospitals, care homes, or even villages. These include decisions about what are public health risks, and what are not. To curb such uncertainties, intersectoral sensemaking proofed essential with a central role for the public health crisis system. In our presentation we highlight how such sensemaking was done in practice. Conclusions To deal with the effects of the planetary crisis on healthcare, events such as floodings must be approached intersectorally. The public health system plays a central role in perceiving the vulnerabilities in a crisis from all angles. Key messages • Floodings are more likely to affect the public health and healthcare system. • Highly complex crises, such as floodings, require an intersectoral governance response with the public health system in a central role.

ACCREDITATION AND HEALTH SERVICE DELIVERY IN RWANDA - A CASE STUDY OF ACCREDITATION PROJECT OF KING FAISAL HOSPITAL, KIGALI

Accreditation is a crucial internationally recognized evaluation process used to assess and enhance the quality, efficiency, and effectiveness of healthcare organizations. It is based on the idea that adhering to evidence-based standards can lead to high-quality healthcare services. However, accreditation often involves significant costs, making it essential to evaluate its worth, especially in resource-limited regions like public healthcare organizations in Rwanda. This study examined the contribution of the accreditation project to the quality of healthcare in King Faisal Hospital, Kigali. This study used a retrospective research design with a quantitative approach whereby 354 patient records were reviewed, of which 71 represented the period before accreditation, 169 represented the period after the first accreditation, and 114 represented the year in which the hospital was preparing for the third accreditation. In addition, secondary data analysis was conducted on available data from the Office of Continuous Quality Improvement (CQI), Office of the Chief Executive Officer, and Office of Human Resources. One-way analysis of variance was performed at a significance level of <0.05 to test for differences between the three time periods examined. The findings resulting from this analysis showed that accreditation is associated with improved healthcare service delivery (p < 0.001). The health service provided was permitted for only 11.3% of the patients served before the hospital's accreditation, while it was permitted for 90.5% of the patients served after the accreditation. In addition, the accreditation process optimized management and leadership efforts to improve the delivery of healthcare services through ratification, implementation, and monitoring of clinical policies, guidelines, and protocols, as well as an established workforce capacity-building system. Therefore, it is worth tackling accreditation as a strategic approach to improving the quality of healthcare services.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0037/a.php" alt="Hit counter" /></p>