Public Sector Healthcare Organisations Research Articles

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.

Resource-based View: A new strategic perspective for public health service managers

The resource-based view (RBV) theory is a widely accepted strategic management theory, particularly within private sector organisations. [1,2,3] However, within public healthcare settings, the level of empirical support available on the use and appropriateness of RBV within this environment is largely unchartered. Consequently, this paper aimed to further understand the level of evidence for the purpose of providing an insight into how it may be used to improve the efficiency and effectiveness of public health organisations. An extensive literature search returned a total of 859 studies. Of these, just 13 studies met the inclusion criteria of being an investigation of the use of RBV theory in public sector healthcare organisations. The analysis conducted demonstrates that while the use of RBV theory has been relatively slow, the benefits are positive. The practical application of RBV theory lies in strategically mapping the relationships between resources, capabilities, and public value, relevant to healthcare organisations, in order to gain and understand how public value is created to provide a competitive advantage and superior performance for the organisation.

Primary care dental professionals' experiences of sharp injuries in Qatar: A cross-sectional study.

Very few studies assess sharp injuries solely among dental professionals globally. This study aims to understand the experiences of sharp injuries among primary care dental professionals in Qatar. This is a cross-sectional study where dental professionals working at the Primary Health Care Corporation (PHCC), a public sector healthcare organization and Qatar's largest primary care provider with 27 primary healthcare centers in Qatar, were invited to participate. An online questionnaire was administered to understand participants' experience of sharp injuries and access to occupational health services and training. A total of 114 dental professionals participated in this study. In total, 68.42% (N=78) of participants reported experiencing a sharp injury in the 12months prior to the survey. Majority (N=58; 75.36%) of the reported causes of sharp injuries were related to dental explorers (N=31; 40.26%) and dental injection needles (N=27; 40.26%). Of those who had experienced a sharp injury, 84.47% (N=87) did not report them. In conclusion, the results highlight that sharp injuries are common among primary care dental professionals, and despite having good access to occupational support services, most dental professionals did not report their injuries. Continuous education and training programs must be implemented to improve knowledge and raise awareness to reduce the burden of sharp injuries among dental professionals. More studies from other dental settings are needed to better understand dental professionals' experiences of sharp injuries in Qatar and elsewhere.

Marketing and Its Impact on Service Quality in the Healthcare Industry of Pakistan

The quality of healthcare services in every society has been a dire need across each era. The effective implementation of which is only possible if the healthcare workers get provided with a suitable environment to perform their duties in. Considering this, the current study determines the impact of internal marketing on the quality of external services delivered to the patients in the labor-intensive healthcare industry of Pakistan. Further, the mediatory role of internal service quality between the said variables is taken into account. The survey-based study was conducted in the twin metropolitans of Pakistan (Islamabad & Rawalpindi). The collected data from 500 individuals comprised of internal customers i.e. doctors, staff members, and external customers i.e. patients, of the public sector as well as private sector hospitals. The study conclusively suggested a significantly positive impact of internal marketing over the external service quality; in both service sectors. Though the public-sector healthcare organizations were found to be comparatively more effective in the implementation of service quality delivered to its customers, in contrast to the private sector healthcare institutions.

Towards Explaining Knowledge Hiding through Relationship Conflict, Frustration, and Irritability: The Case of Public Sector Teaching Hospitals

Organizations grow and excel with knowledge sharing; on the other hand, knowledge hiding is a negative behavior that impedes innovation, growth, problem solving, and timely correct decision making in organizations. It becomes more critical in the case of teaching hospitals, where, besides patient care, medical students are taught and trained. We assume that negative emotions lead employees to hide explicit knowledge, and in the same vein, this study has attempted to explain the hiding of explicit knowledge in the presence of relational conflicts, frustration, and irritability. We collected data from 290 employees of a public sector healthcare organization on adopted scales to test conjectured relationships among selected variables. Statistical treatments were applied to determine the quality of the data and inferential statistics were used to test hypotheses. The findings reveal that relationship conflicts positively affect knowledge hiding, and frustration partially mediates the relationship between relationship conflicts and knowledge hiding. Irritability moderates the relationship between relationship conflicts and frustration. The findings have both theoretical and empirical implications. Theoretically, the study tests a novel combination of variables, and adds details regarding the intensity of their relationships to the existing body of literature. Practically, the study guides hospital administrators in managing knowledge hiding, and informs on how to maintain it at the lowest possible level.

The Impact of Employees’ Gender and Age on Organizational Citizenship Behavior Using a Fuzzy Approach

Organizational citizenship behavior (OCB) is vital for continuous organizational growth and development. OCB also plays an evident role in advancing the quality of health care services and practicing OCB in hospitals can be useful. Although OCBs’ contributing factors have been studied in Jordan in earlier researches, the utilization of OCB in health sector is still a new topic. Therefore, this article aimed to investigate the impact of employees’ gender and age on OCB at Jordanian governmental hospitals using a fuzzy approach. A convenient sample of 126 employees working in three main governmental hospitals in the north of Jordan has been taken. The collected data include linguistic terms that suffer from uncertainty which, in turn, cannot be dealt with traditional numerical values. This study indicates that gender impact on OCB has statistically significant differences at α = .05 in favor of males with the total score of 0.011% as far as altruism, courtesy, and civic virtue are concerned. Similarly, the effect of age factor on OCB is statistically significant differences at α = .05 in relation to courtesy, sportsmanship, and civic virtue with the total score of 0.27%. Finally, the results provide baseline data for further studies that may pay more attention toward employees’ demographics in OCB. This study can support mangers and leaders holding dominant positions in public sector health care organizations.

Managing sensor data streams in a smart home application

A challenge in developing an ambient activity recognition system for use in elder care is finding a balance between the sophistication of the system and a cost structure that fits within the budgets of public and private sector healthcare organisations. Much activity recognition research in the context of elder care is based on dense networks of sensors and advanced methods, such as supervised machine learning algorithms. This paper presents the data processing aspects of an activity recognition system based on a simpler, knowledge-based unsupervised approach, designed for a sparse network of sensors. By structuring sensor data management as a streaming system, we provide a simple programming model for the application logic, which facilitates building a fault-tolerant system with the potential for distributed data management within the sensor network. The system, evaluated by a public sector healthcare organisation, constitutes an example of a system that is useful and has a sustainable cost structure.

Differentiating between average and high-performing public healthcare managers: implications for public sector talent management.

Objective Ensuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual and organisational performance, there have been few studies exploring these concepts in the public healthcare sector. This study addresses this gap by exploring the perceived differences in demonstration of core competencies between average and higher-performing managers in public sector healthcare organisations. Methods Mixed methods were used to define and measure a set of competencies for health service managers. In addition, supervisors of managers were asked to identify the differences in competence between the average and high-performing managers reporting to them. Results Supervisors could clearly distinguish between average and higher-performing managers and identified related competencies. Conclusions The consistent pattern of competence among community health and hospital public sector managers demonstrated by this study could be used to develop a strategic approach to talent management for the public healthcare sector in Australia. What is known about this topic? Although there are validated competency frameworks for health service managers, they are rarely used in practice in Australia. What does this paper add? This paper illustrates the perceived differences in competencies between top and average health services managers using a validated framework. What are the implications for practitioners? The public health sector could work together to provide a more effective and efficient approach to talent management for public hospitals and community health services.

The impact of ethical leadership style on job satisfaction

PurposeCombining two distinct streams of research studies in leadership and organizational management i.e. ethical leadership and Green human resource management (Green HRM) practices, the purpose of this paper is to investigate the impact of ethical leadership style (ELS) on employees’ job satisfaction (JS) with a mediating role of Green HRM and psychological safety in health sector organizations.Design/methodology/approachA quantitative methodology was adopted to achieve the aims of this study. Data were collected through pencil/paper questionnaires from the respondents (n=177) working in a public sector healthcare organization of Pakistan. Reliability and validity of measures were tested via AMOS (18) software. Results of proposed hypotheses were tested via Preacher and Hayes (2008) macro of mediation.FindingsContrary to the first hypothesis, no evidence of the direct impact of ELS on employees’ JS was found. However, the mediating roles of Green HRM and psychological safety were supported by the results.Originality/valueThrough this study, the authors have addressed three key gaps in the extant literature of ELS and corporate social responsibility, i.e. exploring the underlying mechanism through which ELS leads to important outcomes with two novel mediators, i.e. Green HRM and psychological safety, the role of ELS in promoting Green HRM in organizations and evidence from a public sector health organization in a developing country, Pakistan. Implications of the study are discussed.

From events to personal histories: narrating change in health-care organizations

ABSTRACTTo cope with large-scale change managers must understand complex events, but representations of change are never objective and factual, they reflect choices. They are not simply chronicles but personal histories. We apply this perspective to analyze change in public sector health-care organizations. Health-care is an illuminating context because it is affected by large-scale policy-driven reform. There is a clear macro-context against which to map personal histories, which although diverse in terms of content, have common narrative templates which give them with structure. This helps managers understand a chaotic and complex flow of events; enabling them to cope with change.

FOSTERING EMPLOYEES’ INNOVATIVE WORK BEHAVIOUR IN HEALTHCARE ORGANISATIONS

Healthcare workers’ innovative work behaviour plays a key role in generating innovation. To date determinants of innovative work behaviour are not completely detected and there is a call for additional empirical evidence on organizational-level factors influencing individual’s innovation.This study empirically explores the relationships between organizational climate, organisation’s openness to innovation, and innovative work behaviour in the context of a public sector healthcare organization.A survey has been conducted on employees of a large Italian public sector hospital. Data collected on 560 professionals have been analyzed through Structural Equation Modelling technique.The results show that organisational climate affects employees’ innovative work behavior both directly and indirectly through organisation’s openness to innovation. Specifically our findings highlight that organization’s openness to innovation partially mediates the relationship between organizational climate and employees’ innovative work behavior.The results should lead managers to consider the importance of organizational climate and openness to innovation as effective levers to pull in order to improve employees’ innovative work behavior.

Relationship Between Organizational Injustice and Work Interference with Family: The Role of Social Support

This study investigates the moderating role of social support (i.e., supervisor, co-workers and the family) in the relationship between organizational injustice (i.e., distributive and procedural) and work interference with family (WIF; i.e., strain and behaviour based). Quantitative data were collected from employees working in public sector health-care organizations of Pakistan through survey questionnaires ( N = 255). This study finds significant effects of distributive and procedural injustice in engendering the negative experiences of strain- and behaviour-based WIF, in the employees of health-care organizations. The moderating effect of co-worker and family support provided mixed results. The supervisory social support was not found as a moderator. Findings of this study suggest that health-care organizations should pay serious attention to the ineffective work family policies and procedure to develop a family-friendly work environment. The supervisors should be given a role in work family policies and procedure development. The mitigating effect of co-workers’ support showed that the employees should be provided with proper knowledge on the policies and procedures of their organizations. The support of family members can also be either benign or harmful.

Building capacity for change: evaluation of an organisation-wide leadership development program.

Objective This study evaluated Leading 4 Change, a change leadership development program designed to support healthcare middle managers through a period of significant organisational change and enhance workplace resilience. Methods A mixed methods evaluation was conducted within the program's framework of a quality improvement activity. Quantitative measures were participant responses (n=160) to online questionnaires, which were compared before and after the program, using an uncontrolled pre-post study design. Four questionnaires were used: Resilience @ Work, General Self-Efficacy, the 11-item Learning Organization Survey and organisational climate. Differences between the pre- and post-program periods were compared using linear mixed-effects models, incorporating repeated measures between 'pre' and 'post' periods. Qualitative data were obtained by interviewing four participants on three occasions during the program, and through text responses provided by participants during a presentation session after the program finished. Both interview data and textual data were subjected to thematic analysis. Results Integration of data from quantitative and qualitative analyses generated three main findings: (1) participants were satisfied and engaged with the program, which met their learning objectives; (2) the program led to increased workplace resilience, in particular the ability to manage stress and self-efficacy for individuals; and (3) organisational learning perceptions were unchanged. Conclusion Although conducted during a period of intense internal and external pressure, Leading 4 Change led to demonstrable effects. It effectively engaged middle managers across a health system. However, there was no evidence that the effect of the program extended beyond individual participants to their perceptions of their work environment as a learning organisation. What is known about the topic? Although much has been written about change management and change leadership within healthcare, the failure to manage the 'people' element and engage employees hampers the success of that change. However, how to engage employees and enhance their resilience and self-efficacy (self-belief to proactively manage) during change has been little explored. Further, the concept of a learning organisation has been developed in private, non-healthcare fields and there is little known about it in other areas, such as healthcare, particularly during change. What does this paper add? The paper describes the evaluation of a 16-week change leadership development program (Leading 4 Change) for middle managers of a public health system undergoing significant reform. It assesses how the program engaged employees, and how and to what extent their workplace resilience, self-efficacy and perceptions of their workplace as a learning organisation changed after the program. Based on the present study, individual development of staff does not necessarily translate directly to better staff perceptions of organisational outcomes. What are the implications for practitioners? Despite being clearly engaged with Leading 4 Change, quantitative and qualitative measures suggested mixed effects of the program on participants. Participants' self-rated workplace resilience, ability to manage stress and self-efficacy increased after the program. However, there was no evidence that the effect of the program improved staff perceptions of their work as a learning organisation. For complex public sector healthcare organisations to become learning organisations, other organisational factors, in addition to staff development and training, require consideration.

Interplay between trust and distrust in the workplace: examining the effect of psychological contract breach on organizational disidentification

PurposeThis study aims to examine the effect of psychological contract breach on organizational disidentification through the “affect-based” mediating mechanisms of trust and distrust.Design/methodology/approachUsing a convenient sampling technique, cross-sectional data were collected from 281 doctors working in public sector health-care organizations in Pakistan. After initial data screening, a confirmatory factor analysis (CFA) was conducted to test the measurement models’ validity and reliability. The hypothesized relationships were tested using structural equation modeling (SEM) with AMOS.FindingsThe results of this study showed that psychological contract breach had significant direct and indirect positive effects through the mediating mechanism of distrust on organizational identification. However, trust was not supported as a mediator in that relationship.Research limitations/implicationsThis study uses cross-sectional data. Other researchers should use longitudinal design with two or three time lags. This study uses a sample of doctors from different cities of Pakistan, as this is a global era, so results cannot be generalized; this opens the future avenue for other scholars to select a broad sample from multiple organizations like businesses and NGOs from different countries or to use it in different context. The authors have used single source (questionnaires) and quantitative method to collect data for this study, so there is a probability of self-report bias. As future is of mixed method, so future researchers should use mixed method for deep and thorough understanding of different selected phenomena.Practical implicationsDue to the experiences of breach of psychological contract, the doctors may either lose trust or may experience distrust which may further reduce their level of identification in an organization. Their contribution toward best interest of hospital decreases and their willingness to identify with their working place declines. Practically, the authors have compared that it is either the trust or distrust which can lead to organizational disidentification among doctors.Social implicationsThe findings will help employers and hospital authorities to understand that doctors are the most important strategic element of every hospital. Having sound financial, physical and informational capital is incomplete and worthless if there is no “doctor”. Because they have to deal directly with patients, so in this case, they are most important and crucial. A doctor’s identification and their loyalty with high level of trust directly on employer and indirectly on hospital all contributes toward an organization’s long-term success, and ultimately for the success of society.Originality/valueThis study contributes to the existing literature on the consequences of employees’ psychological contract breach by simultaneously testing trust and distrust as the two competing affect-based mediating mechanisms between psychological contract breach and organizational disidentification.

Assessing Quality of Service through Customer Satisfaction: The Case of Public Sector Healthcare Organization in Pakistan

This study is an attempt to assess the quality of services provided by public sector hospitals using patients’ satisfaction as the indicator. Mixed method approach with multiple data collection mechanisms was adopted to conduct the study. A structured survey was circulated to the patients of one of the major hospitals i.e. Mayo Hospital of Lahore. Respondents were interviewed to collect further data wherever needed. Activities happening in the hospital were observed also. Findings depicted higher level of patient satisfaction (92%) that indicates considerably high quality of service provided by public sector teaching hospitals. Attendant satisfaction, medical errors, accuracy of diagnostic services and provision of free medicine and meal were found as the variables that affect the quality of healthcare service. The study suggests that the few dimensions of treatment needs greater attention. Automation of office work and patients’ record will enhance quality of service and patient satisfaction

Analysis of Employees' Perception of Workplace Support and Level of Motivation in Public Sector Healthcare Organization

This study investigates workplace support and employees' work motivation and their mutual relationships in a healthcare setting. It attempts to partly test Eisenberger's theory of perceived organizational support in the given context. A total of 400 questionnaires were collected from a large public-sector healthcare organization. Chi-square, cross tabulation and correlation statistics was applied to analyze the data. Results showed an association between the variables and high degree of consistency with that of previous studies. The study also confirmed 'flexible hours' as a viable dimension of workplace support which was not delineated by earlier studies.

Public healthcare practices and criteria for a sustainable procurement: A comparative study between UK and Italy

The Health sector can play a significant role towards achieving sustainable development by putting sustainability at the heart of procurement activities. This research analyses the differences relating to how two different National Healthcare Systems (NHS), the Italian and the British, are managing their Sustainable Public Procurement (SPP) in terms of supplier’s and bidders’ sustainable evaluation through specific practices and criteria. The research mainly adopts quantitative inquiry using a survey with procurement professionals from public sector healthcare organisations. A Likert’s scale questionnaire was designed to test seven hypotheses covering SPP criteria analysed using Fisher’s Exact and Mann-Whitney U tests. While the UK health sector organisations seem to have a propensity for requesting suppliers with an improvement in environmental performances over time and a compliance with voluntary social accountability standards, the Italian organisations seem more focused on the mandatory laws and regulations concerning environment and safety. Other interesting differences lie in the requests to the suppliers of the compliance with voluntary standards related to packaging. The research is just limited to two countries; future studies aimed at comparing SPP criteria for the public healthcare among the other European countries is recommended. Moreover, the findings raised issues such as the trade-off between costs of the product and environmental criteria, the use of national and international standards as supplier’s evaluation criteria, the carbon footprint as a way for gaining more trust from local stakeholders and the possible impact of suppliers’ ethical scandals in the public sector.

A Synthesis on SWOT Analysis of Public Sector Healthcare Knowledge Management Information Systems in Pakistan

Healthcare is a community service sector and has been delivering its services for the betterment of civic health since its establishment at communal level. For working efficiently and effectively, this sector profoundly relies on correct and complete health information of people and a proficient integrated healthcare knowledge management information system (HKMIS) to manage this information. The performance of Healthcare organizations has significantly augmented by inception of Information and Communications Technology (ICT) in HKMIS in developed countries, but is yet to exhibit its full potential in developing countries specifically those with huge populations like Pakistan. An exploratory qualitative research methodology was adopted to conduct this study. The purpose and objective of this study was to determine and investigate the internal and external factors that influence the performance of HKMIS by performing SWOT analysis on two of the largest public-sector healthcare organizations of Pakistan. The findings of this study will certainly help authorities to devise methods of improvement in Pakistani HKMIS eventually paving ways towards a better and improved healthcare in the future.

Coping with the financiers: attracting venture capital investors and end-users in the biomaterials industry

A substantial amount of research has been committed to exploring how university-based research can be transferred to industry and be commercialised. This literature emphasises the substantial institutional, cultural and financial barriers to what has been referred to as academic entrepreneurship. At the same time, and most noteworthy in the USA, university patenting has grown remarkably since the mid-1960s; today (2014), much of the basic life science research conducted by universities is being transformed into health care innovations. This paper reports on a case study of the biomaterials and medical device industry in Sweden and emphasises that, while capital funding is a key challenge for university spin-outs, an additional and less widely recognised concern facing these companies is how to make the public sector health care organisations, primarily, actually buy the products developed. The study suggests that perhaps too much emphasis is being put on ‘upstream activities’, including the early stage support provided by incubators and state agencies that provide seed-money funding, while more mature biomaterials and medical device companies are suffering from both a lack of unified regulatory frameworks and policies governing the procurement of new health care innovations.

Job satisfaction among public health professionals working in public sector: a cross sectional study from Pakistan

BackgroundJob satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee’s work environment, job responsibilities and powers and time pressure; the determinants which affect employee’s organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector.MethodsThis was a cross sectional study conducted in Islamabad, Pakistan. Sample size was universal including 73 public health professionals, with postgraduate qualifications and working in government departments of Islamabad. A validated structured questionnaire was used to collect data from April to October 2011.ResultsOverall satisfaction rate was 41% only, while 45% were somewhat satisfied and 14% of professionals highly dissatisfied with their jobs. For those who were not satisfied, working environment, job description and time pressure were the major causes. Other factors influencing the level of satisfaction were low salaries, lack of training opportunities, improper supervision and inadequate financial rewards.ConclusionOur study documented a relatively low level of overall satisfaction among workers in public sector health care organizations. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of public health professionals as they represent a highly sensitive domain of health system of Pakistan. Improving the overall work environment, review of job descriptions and better remuneration might bring about a positive change.