Public Healthcare Organizations Research Articles

Quality management practices toward project performance in healthcare sector: modelling the mediating role of intellectual capital

PurposeThe study examines the influence of quality management practices (QMP) on project performance (PP) and the indirect association of QMP with PP through the mediating role of intellectual capital (IC). QMP may be one of the most successful strategies to improve project performance. Drawing on the resource-based view (RBV) and institutional theory, the study examines the impact of QMP on PP through the mediating role of IC.Design/methodology/approachThe sample frame of 329 employees in different NGOs and public healthcare organizations was selected. Data were analyzed on SmartPLS 3.2.7 by applying SEM.FindingsThe outcome reveals that QMP has a significant impact on PP. The results found partial mediation of IC on the linkage between QMP and PP.Research limitations/implicationsThe key research limitation was that it examined only two antecedents (QMP and IC) of project performance based on RBV and institutional theory, which did not yield deep insights from other institutional forces that could influence the model, such as mimetic pressure, institutional pressure and business orientation.Originality/valueQMP is highly significant in the healthcare sector; however, research on the relationship between QMP, IC and PP is lacking. Thus, this research is an initial attempt to investigate these relationships empirically. We add to our understanding of RBV by investigating the role of IC in mediating the QMP-PP linkage.

Elevated hematologic ratios are correlated with acne severity: a national, retrospective cohort study.

Prior studies demonstrated conflicting results regarding hematologic ratios in acne patients. We sought to further characterize hematologic ratios in acne patients, according to demographics and acne severity. National, retrospective cohort study of 122,822 patients using medical records from 2005 to 2024 of patients insured with the largest public healthcare organization in Israel, Clalit Health Maintenance Organization. Moderate-severe acne patients had higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) than mild acne patients at diagnosis and 12-18 months before diagnosis. A multivariable regression confirmed the significance of the correlation of increased NLR and PLR with acne severity. Adults and females had higher NLR and PLR than children and males, respectively, at diagnosis, and 12-18 months before diagnosis. Acne severity was significantly associated with elevated NLR and PLR. NLR and PLR may also serve as indicators of upcoming acne severity, as they were elevated 12-18 months before diagnosis. These biomarkers may contribute to the diagnosis, management, and follow-up of patients with acne.

Effective prevention in clinical practice may save human capital loss: Real-world evidence from Taiwan's National Health Insurance

Background/PurposeEffective prevention could protect the health of the workforce, save human capital loss, and maintain employee productivity as well as economic growth. MethodsUsing real-world data of patients with end-stage kidney disease (ESKD) and lung cancer, we multiplied their lifetime survival functions with employment ratios and working salaries to estimate the lifetime employment durations and earnings. They were compared with corresponding age-, sex-, and calendar year-matched referents to assess the differences in loss of lifetime employment duration and earnings. From 2000 to 2017, 83,358 patients with end-stage kidney disease (ESKD) were associated with 32–66% lifetime productivity losses. Similarly, we collected 24,904 incident cases of lung adenocarcinoma during 2011–2018 and estimated the potential savings in human capital due to early detection. Based on the evolving trends of ESKD incidence rates in Taiwan, we calculated the lifetime human capital losses of ESKD patients in GDP (gross domestic product) percentages during 2000–2020. ResultsThe aggregate lifetime productivity losses of ESKD in terms of GDP% varied between 0.000398% and 0.01% for male patients and between 0.0001% and 0.009% for female patients. The younger the patients, the bigger the losses in GDP%. Similarly, early detection of lung adenocarcinoma saved lives and productivity to some extent. ConclusionsSuccessful prevention of catastrophic illnesses at early stages would save the lifetime employment duration and productivity of the workforce. Future reform on the NHI could consider closer coordination between public health and healthcare organizations, focusing on effective prevention of diseases and complications to save productivity loss.

National waiting time monitoring in oral healthcare - The role of triage dental nurses.

Our study analyzed dental nurses' use and use behavior determinants of electronic patient IS modules in telephone triage. The modules were implemented in public oral healthcare organizations' patient ISs to digitalize the national waiting time monitoring system. For the cross-sectional survey, we collected data from dental nurses using convenience sampling and applied a modified UTAUT as the theoretical framework. The results indicate that using the module for different purposes varied, and the nurses used it sparsely in recording data for monitoring national waiting times. Using the module was laborious, and triage work was busy. Dental nurses' low system usage resulted in poor-quality data for waiting time monitoring. As healthcare data is increasingly used for purposes other than clinical decision making, we must ensure that healthcare professionals performing clinical tasks perceive data recording for non-clinical purposes as meaningful and have time for proper data entry.

Performance feedback in healthcare organizations: The role of accountability measures and competition

This study examines the impact of accountability arrangements in the form of performance feedback on organizational behaviors among healthcare organizations. Specifically, it evaluates the effectiveness of a performance management program implemented in South Korean healthcare settings, focusing on antibiotic prescription patterns. The study presents three key findings. First, significant performance improvement occurred mainly among low performing organizations. Second, public healthcare organizations exhibited greater performance enhancements compared to their private counterparts. Third, organizational responses to performance feedback were more pronounced when robust competition prevailed among the assessed healthcare institutions. This synergy between performance management and competitive environments was primarily evident in private organizations.

Background of Data Envelopment Analysis Implementation in Moscow Healthcare System: International and Russian Experience

Background. The efficiency of healthcare organization activity should be improved and measured using new techniques, as the healthcare system has widely applied advanced technologies and optimized the workflow of all medical facilities. The methodology of data envelopment analysis (DEA) is one of the fast-evolving approaches to assessing the performance of healthcare organizations. The article examines Russian and international experience in applying the DEA method, which can be used for assessing the performance of Moscow public healthcare organizations. Purpose. To study the basics of DEA and the experience of its use for assessing the efficiency of healthcare organizations in Russia and abroad, and to consider its potential implementation in the Moscow healthcare system. Materials and methods. The publications were selected using the PRISMA guidelines. A complex of modern general scientific methods of cognition was also used: system and structural approach, analytical method, comparison, and generalization. Results. The practice of using the DEA method in Russian regions and abroad was analyzed. The main advantages and disadvantages of DEA, as well as the main parameters used in constructing the model of efficiency measurement for healthcare organizations, were categorized. The prerequisites for using the DEA method to assess the efficiency of Moscow healthcare organizations were identified.

Psychologists aspiring to leadership positions in public sector health care.

Psychologists are well-positioned to take on leadership roles in health care systems as a result of the broad-based skills included in doctoral level, professional training programs. These include knowledge of evidence-based practice, extensive training in applied research and clinical practice, emphasis on critical thinking in scientific methods and hypothesis testing, teaching, supervision, team consultation, and continuous learning (APA Presidential Task Force on Evidence-Based Practice, 2006; Korman, 1974; McFall, 2007). Formal opportunities to learn how to apply these skills in leadership and organizational management roles are, however, limited during graduate training. There have been recent efforts within the American Psychological Association to foster interest and readiness for leadership roles among psychologists. These efforts have included a leadership development fellowship, on-demand webinars, and online learning for continuing education (American Psychological Association, 2023). The content of these training opportunities is typically general in nature so that it can be applied to all types of organizational settings. Psychologists interested in leadership positions within public sector health care organizations are likely to benefit from information that aligns more specifically with the mission and organizational structures of such systems. This article presents a conceptual framework to prepare psychologists aspiring to leadership positions in public sector health care. Leadership theories and models from organizational management science are outlined which capture the context and organizational goals of such programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Nationwide Electronic Prescription Services in Finland in 2010-2023.

This research aimed to follow up a 14-year period (2010-2023) public and private healthcare service organizations' and community pharmacies' entries to and exits from the centralized, interoperable and shared electronic Prescription Services in Finland. Our material were the official Social Welfare and Healthcare Organization Registry and the official Pharmacy Registry; their data were extracted in January 2024. Outcomes were continuous registration of services or registered exist from the services. In addition, we used information from the Kanta Services for presenting monthly and annual number of electronic prescriptions and medicine dispensations on national level. In 2010-2023, totally 838 community pharmacies' and their subsidiary pharmacies' entries to and 24 exits from the nationwide Prescription Services took place, and in total 814 pharmacy outlets had the Prescription Services in production in 2023. Totally, 1980 public and private healthcare service organizations' entries to and 494 exits from the Prescription Service took place, and 1486 organizations had the Prescription Services in production in 2023. Healthcare service organizations recorded totally 303.8 million electronic prescriptions into the Prescription Services. Recorded numbers were lower during the Covid-19 epidemic in Finland in 2020-2021. We also observed seasonal effects in the time series. Pharmacies recorded totally 660.4 million medicine dispensations (purchases) into the Prescription Services with an increasing trend year after year. We also observed seasonal effects in the dispensation time series.

Assessing Lean Six Sigma and quality performance improvement in Italian public healthcare organizations: a validated scale

PurposeThis study aims to fully assess the readiness for Lean Six Sigma (LSS) and Quality Performance Improvement (QPI) in an Italian Public Healthcare ecosystem.Design/methodology/approachDrawing from previously established survey development and adaptation protocols, a replication study was carried out; Lean, Six Sigma and QPI were extracted and validated through confirmatory factor analysis in an Italian Public Healthcare setting, with a sample of health professionals from the Campania region.FindingsThis study reports the adaptation of an existing scale for measuring LSS and QPI in an Italian public healthcare organisation. This analysis extracts six conceptual domains and constitutes an original adaptation of an existing scale to assess the readiness to adopt Lean, Six Sigma and Quality Performance in Italian Public Health Organizations. The constructs show strong levels of internal consistency, as demonstrated by each item factor loading and each subscale reliability.Practical implicationsManagers, policymakers and academics can employ the proposed tool to assess the public healthcare ecosystem’s capability to implement LSS initiatives and strategies to improve quality performance.Originality/valueThis is one of the first studies to assess cross-regional organisational readiness for LSS and QPI in an Italian Public Healthcare environment at this scope and level.

INTERACTIONAL QUALITY AS AN ANTECEDENT OF PATIENT ATTITUDES: EVIDENCE FROM AN ARMY HOSPITAL IN THE FEDERAL TERRITORY OF KUALA LUMPUR

Background and Purpose: The quality of interactions between service providers (employees) and patients in the course of providing everyday services may have a major impact on patient attitudes, according to a thorough evaluation of several recent quality management studies released in the 21st century. The relationship has been extensively studied in public and private healthcare organizations, but little is known about the role of interactional quality as a key antecedent in army hospitals. The purpose of this study is to investigate the connection between patient attitudes and interactional quality. Methodology: The study adopted a cross-sectional research design, with 212 self-administered questionnaires collected from patients in an army hospital in the Federal Territory of Kuala Lumpur, Malaysia, using a purposive sampling technique. The SmartPLS was used to evaluate the measurement model and to test the structural model. Findings: According to the findings of structural equation modelling, interactional quality attributes, namely responsiveness, assurance, and empathy were significant predictors of patient attitudes such as satisfaction and loyalty. Contributions: To sustain and improve the service performance of the organisational sample, this study offers crucial advice, that is quality of interaction between employees and patients is built according to responsiveness, assurance, and empathy. The competence of employees to practice this interaction in delivering daily services can enhance patients’ satisfaction and loyalty. Practitioners may utilize to comprehend various perspectives on interactional quality. These recommendations can also be used to improve patient relationship management programmes. Keywords: Interactional quality, patient satisfaction, patient loyalty, army hospital. Cite as: Ismail, A., Mokhtar, A. Jamil, A. H., Ibrahim, N. S., Rino, Hussin, T., & Tajuddin, A. (2024). Interactional quality as an antecedent of patient attitudes: Evidence from an army hospital in the Federal Teritory of Kuala Lumpur. Journal of Nusantara Studies 9(2), 80-105. http://dx.doi.org/10.24200/jonus.vol9iss2pp80-105

Self-Assessment of the Intercultural Competences of Medical Doctors and Nurses in Poland in the Face of Current Refugee Challenges

Health care is one of the most important systems in both society and the economy. At the same time, it is a highly complex system that is subject to an increasing number of challenges in the contemporary world. For example, the health care system in Poland struggles primarily with inadequate numbers of nurses and medical doctors, as well as insufficient funding. A relatively new challenge is to provide for the health needs of refugees, whose number is increasing due to the war in Ukraine beyond Poland’s eastern border. This raises the question of the substantive preparation of nurses and medical doctors to work in a culturally diverse environment. Have they had the opportunity to train in intercultural competences? How do they assess their own intercultural competences? Do they see challenges in their interactions with foreigners? The aim of this paper is therefore to present a self‑assessment of the intercultural competences of medical doctors and nurses in Poland, in particular in the context of current refugee challenges. In order to achieve the assumed goal, a proprietary questionnaire form was created, and a nationwide survey was conducted among a group of professionally active medical doctors and nurses. The results of the research, in addition to providing valuable knowledge, were used to draw up specific recommendations for improving the continuing education of medical and nursing staff in the area of intercultural competences. Based on the research results, guidelines for better management in public health organisations were also created. This text may be of interest to researchers of management in public health care organisations, and in particular human resources management in health care institutions, as well as practitioners trying to deal with the current problems facing public health management.

HOSPITAL ADMINISTRATION IN A PERIPHERAL REMOTE LOCATION HOSPITAL: A EVIDENCE BASED STUDY

Objective: The organisation of the human society has undergone a unique transition throughout the last decades. With the rise of ever growing technologization and disruptive innovations, populations also demand more social and environmental initiatives from firms and governments. In 2015, the United Nations (UN) member states agreed upon a 2030 Agenda for Sustainable Development. Developing a sustainable UHC is decisive to ensure better economic prospects and social equality across socioeconomic classes. This can be achieved by lowering the barriers to access health services to the most vulnerable groups and improve mortality and disability rates in the potential workforce. Methods: The present study was conducted in a remote location defence hospital catering to the health care needs of serving personnel of Indian armed forces and civilians residing in this peripheral area. The basic specialties including Obstetrics, paediatrics, medicine and general surgery are provided at this centre 24*7 by the dedicated medical officers of Indian Armed forces. Results: Sustainability of care continuously evolves towards becoming a major factor for public healthcare organisations, and more accountability will likely be demanded of managers to deliver on each aspect of its triple bottom line. This study shows that prevention and patient empowerment both carry great potential to attain this objective. Conclusion: It is necessary to set priorities and act according to available resources and organisational vision. The central threats to sustainability of public health care welfare systems in peripheral hospitals identified, namely the ageing population and rise in chronic diseases. UHC at a meso and micro level, could provide a much better rationale for scholars to evaluate the need for change, and contribute to draft more inclusive sustainable strategies.

Implications of refugee crisis on public sector healthcare organizations: Empirical observation from Myanmar’s Rohingya refugees in Bangladesh

Abstract Political crises, like the refugee crisis, present significant challenges to nation-states and public sector entities. The influx of refugees from Myanmar to Bangladesh has intensified over recent decades, notably after severe violence erupted in Myanmar’s Rakhine state on 25 August 2017. This study focuses on public service organizations, aiming to understand the impact of the Rohingya refugee crisis. Using a qualitative approach and drawing on existing literature, the research examines how the crisis affects the capacity of public healthcare providers in Bangladesh. The findings reveal both detrimental and beneficial effects on organizational functioning, including management, resource availability, and absorptive and adaptive capacities. Through data analysis, eight key themes emerge, such as changes in service quality, disease control, resource allocation dynamics, and impacts on professional knowledge, shedding light on the complex repercussions of the Rohingya refugee crisis on public healthcare services in Bangladesh.

Radiation safety of dentomaxillofacial radiology in Finland: Reported abnormal irradiation-related incidents during 2012–2022

IntroductionThis study evaluates adverse events (AEs) in dentomaxillofacial radiology (DMFR) in Finland, including their quantity, nature, and outcomes. It also compares reporting activity between public and private healthcare organizations, as they share same legal obligations to report AEs. Two-thirds of dental images are taken in public, the rest in private healthcare. MethodsIn Finland, radiation-related AEs are reported to the Radiation and Nuclear Safety Authority (STUK). We categorized DMFR-related AEs by nature, outcome, and imaging modality. We also submitted a questionnaire to STUK to gather information on their observations and remarks made during inspections of establishments providing dental imaging services. ResultsDuring 2012–2022, STUK received reports of 1343 DMFR-related AEs, mostly causing patient harm (92.9%) leading almost always to excessive radiation doses (99.7%). Private healthcare reported most AEs (65.2%), with municipal institutions reporting the remainder (34.8%). Intraoral-related AEs (20.0%) slightly outnumbered panoramic-related ones (18.7%), but the majority (56.7%) didn't specify the imaging modality. CBCT-related incidents were least reported (4.5%). During STUK's inspections, remarks mostly concerned deficiencies in practical quality assurance (31.3%) or technical quality assurance (32.9%). ConclusionDMFR-related AEs may be underreported despite legal obligations, with most stemming from human error, highlighting the need to enhance patient safety culture. There's a notable reporting gap between private and public healthcare providers relative to the number of dental radiographs conducted. Organizational deficiencies in practical and technical quality assurance underscore the importance of ongoing education, as well as monitoring by STUK. Implications for practiceEnhancing patient safety culture in dentistry, including dentomaxillofacial radiology, demands customized multiprofessional development, as unaltered patient safety procedures from medicine and secondary care may not align with dentistry's requirements.

Controversies in employee-driven innovation: Exploring the Danish public healthcare

This article applies the lens of controversies to explore tensions in the ­interactions among different actors engaged in employee-driven innovation (EDI) in the Danish public healthcare. Semi-structured interviews were conducted with innovation executives and consultants, non-clinical professionals with managerial responsibilities, and clinical professionals. In addition, observation and document analysis were conducted for triangulation purposes. The findings suggest that controversies are process-sensitive, dynamic forces that could become either destructive or constructive, with the potential to re-shape EDI. When mitigation is possible, new insights are generated; when mitigation is not achievable, the more destructive side of controversies emerges, calling for external interventions. This article contributes to the growing study of the human side of innovation and to the call for research on tensions in innovation processes. Leaders of public healthcare organizations could apply the insights to improve EDI strategies, nurture a sense of belonging in the workplace, and reduce opposition to change.

Технологии профилактики профессионального выгорания и поддержания ресурсного состояния персонала в первичном звене Московского здравоохранения.

Advanced technologies for maintaining the resource state of personnel form the basis of a multi-level Comprehensive Program for the Prevention and Combating of Professional Burnout among Medical Workers, developed by the Moscow Department of Health based on an analysis of the experience of global and Russian public and private healthcare organizations. This program covers all aspects of the existing problem and solves it at the system level. Its implementation helps to increase the satisfaction of medical workers with working conditions, leads to a decrease in the number of days of incapacity and dismissals, which in turn leads to an increase in the availability and quality of medical care provided to citizens, as well as an improvement in the image of primary care in Moscow healthcare, and an increase in satisfaction with social policy city from the population as a whole.

Prospects for the development of scientific research in nursing in Russia

Theoretical analysis of scientific research in nursing carried out by nursing staff and doctors showed that research was mainly carried out within the framework of the scientific specialty “Public health and healthcare organization, sociology and history of medicine.” Priority direction of research at the end of the 20th century and the first decade of the 21st century. – improvement of nursing activities. This coincided with the opinion of survey participants (n=530), who identified this area as one of the most promising today. To develop clinical nursing research, it is necessary to open a new scientific specialty specifically in nursing.

Mitigating Job Burnout in Jordanian Public Healthcare: The Interplay between Ethical Leadership, Organizational Climate, and Role Overload.

In today's dynamic organizational landscape, characterized by rapid technological advancements and evolving workplace dynamics, understanding the factors influencing employee well-being is paramount. This study investigates the interplay between ethical leadership, organizational climate, role overload, and job burnout in public healthcare organizations across northern Jordan. By focusing on ethical leadership, organizational climate, and role overload as determinants of job burnout, this research provides insights into strategies for enhancing employee well-being. Drawing on ethical leadership theory, social exchange theory, and the job demands-resources model, this study employs PLS-SEM to analyze data collected from 260 employees working in Jordanian government hospitals. The findings reveal negative associations between ethical leadership and job burnout, highlighting the importance of ethical leadership behaviors in mitigating employee burnout. Additionally, a positive organizational climate is associated with lower levels of burnout, underscoring the impact of the broader organizational context on employee well-being. The study also explores the mediating role of organizational climate and the moderating effect of role overload in the relationship between ethical leadership and job burnout, providing insights into the complex dynamics at play in healthcare organizations. These findings enrich our understanding of the factors influencing employee well-being in healthcare contexts and underscore the importance of fostering ethical leadership and supportive organizational climates to mitigate job burnout.

Managing Patient Safety in Public Healthcare Organizations

This study is conducted to explore how patient safety is being managed in public healthcare organizations. For the purpose senior doctors were interviewed and asked about patient safety measures and management in public sector hospitals. Results revealed that doctors are well aware of the concept of patient safety, they are making efforts to ensure patient safety and in particular, they take necessary steps for infection control in their organizations. It was also explored that they work in teams and have proper communication within their teams but lack of proper policies and their implementation are some of the reasons for occurrence of patient safety incidents and inconvenience, that patients face in public healthcare organizations. Based on the analysis, it can be said that systems in public healthcare organizations need improvement and revising patient safety policies is recommended.

Reliability and validity of the Italian Version of the Chase Nurse Manager Competencies Scale

ObjectivesThis study aimed to translate and test the psychometric properties of the Chase Nurse Manager Competency Instrument (CNMCI) among Italian nurse managers and to provide further support for the scale’s validity testing. MethodsAn instrument translation and cross-sectional validation study was conducted. The English version was translated into Italian using the translation method, which included pre-translation (establishing equivalence), initial translation, pretesting, review, and administration. From August 2022 to June 2023, 349 nurse managers were recruited through a web survey from 31 public and private healthcare organizations in North, Central, and Southern Italy. Validity assessments included content and structural validity. Reliability was evaluated using Cronbach’s α coefficient and test-retest reliability. ResultsThe content validity confirmed all the items of the CNMCI in the Italian version, including the two measurement sections, “knowledge and understand” and “ability to implement and/or use.” The instrument’s item-content validity index (I-CVI) ranged from 0.83 to 1.00, while the scale-level content validity index (S-CVI) for both instrument sections was 0.97. The confirmatory factor analysis showed an acceptable fit. In the “knowledge and understand” section, Cronbach’s α coefficient was 0.978, and in the “ability to implement and/or use” section, Cronbach’s α coefficient was 0.976. The correlation coefficient between each dimension was 0.494–0.908. The test-retest reliability score was 0.82, suggesting good instrument consistency. ConclusionsOverall, the Italian CNMCI demonstrates good reliability and validity for measuring nurse managers’ core competencies and supports the construct’s multi-dimensionality. Also, our findings support the hierarchical nature of the factors, further supporting the validity of the instrument.