Health Care Management Research Research Articles

Towards an AI-Enhanced sustainable health system: inferences from healthcare management research

Health management literature is critical in facilitating effective leadership and management in the health sector by imparting the knowledge and understanding required in health service planning, organization, coordination, and management. Through an exhaustive bibliometric examination, the current state of the “healthcare management” literature was assessed in this study, illuminating potential future developments in the field. By utilizing an extensive compilation of articles from the Web of Science (WoS) database, this study endeavors to scrutinize patterns in scientific inquiry, assess advancements made on subjects, and underscore significant fields of cooperation and scholarly input. An in-depth, extensive analysis revealed that three decades of research yielded over 46,000 publications; the number of publications has increased by six, particularly in the last ten years, and the United States and the United Kingdom produced most of the publications. Analysis identifying influential journals and authors in the field revealed that it is the focus of attention of health professionals, especially nurses. Although the COVID-19 pandemic has been recognized as the primary public health concern, scholarly attention has shifted towards a sustainable health system incorporating technology-supported preventive health practices and intelligence. To thoroughly comprehend the theoretical progression of health management research, its capacity to tackle worldwide issues, and its growth potential, the study’s findings are a valuable scholarly resource that offers practitioners, policymakers, and researchers a comprehensive overview.

ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH

The following two abstracts are from presentations at the Forum on Advances in Healthcare Management Research that took place in March 2023 during the Congress on Healthcare Leadership of the American College of Healthcare Executives. An annual event, the Forum presents theoretical and empirical research with the potential for high impact on healthcare management. An abstract by Jennifer Ford of the Veterans Health Administration and Patricia MacTaggart of George Washington University titled “Innovative Comprehensive Care Model: Pittsburgh VA Oncology” also was presented at the Forum after publication in the November/December 2021 issue of the Journal of Healthcare Management.

How do workplace stressors during COVID-19 affect health frontline employees in Iran: Investigating the role of employee resilience and constituent attachment

PurposeThe purpose of the present study is to extend the body of research on healthcare management by examining the effect of workplace stressors, including abusive supervision, customer incivility and the perceived threat of COVID-19 (PCT), on turnover intention. The study also contributes to healthcare management research by examining the mediating role of emotional exhaustion, the moderating role of employee resilience and constituent attachment.Design/methodology/approachThe study developed and tested a model explaining the relationship between abusive supervision, customer incivility, PCT, emotional exhaustion, turnover intention, employee resilience and constituent attachment. Data were collected from a sample of 375 frontline employees who work in private hospitals in Mashhad, the second-most populous city in Iran.FindingsThe findings indicate that abusive supervision and customer incivility, directly and indirectly, affect turnover intention through emotional exhaustion. Furthermore, employee resilience was found to mitigate the relationship between stressors excluding the PCT and emotional exhaustion. Moreover, constituent attachment decreased the likelihood of turnover intention among employees who experienced abusive supervision. The findings suggest that controlling abusive supervision, customer incivility and PCT can lead to less emotionally exhausted employees with lower turnover intention. Furthermore, enhancing employee resilience and constituent attachment can decrease emotional exhaustion and turnover intention.Originality/valueDespite the large body of research on the relationship between the variables mentioned above, few studies have presented a conceptual model based on the relationship between them. This article presents a conceptual model that has not been previously discussed in any other publication to examine the moderating effect of organizational and individual factors in the relationship between workplace stressors and their consequences, which have not been widely covered in existing literature. Drawing upon conservation of resources theory, job embeddedness theory and attachment theory, the present study aims to fill this gap in the literature.

ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALT HCARE MANAGEMENT RESEARCH.

The following three abstracts are from presentations for the Forum on Advances in Healthcare Management Research that took place in March 2022 during the Congress on Healthcare Leadership of the American College of Healthcare Executives. An annual event, the Forum presents theoretical and empirical research with the potential for high impact on healthcare management.

What do we know about no‐show behavior? A systematic, interdisciplinary literature review

AbstractNo‐show behavior, a distinct form of absenteeism, is often problematic, particularly in the service industry. Given the growing relevance of the phenomenon in the industry, an increasing number of researchers from such different disciplines as educational economics, healthcare management research, and sports economics have begun examining both the potential antecedents and measures to counteract no‐show behavior, recently. Although the continuously growing body of literature on no‐show behavior has been reviewed before, most such previous attempts were neither interdisciplinary nor systematic, sometimes lacking both completeness and thoroughness. In this article, we address this gap in the still‐emerging literature by providing a systematic, interdisciplinary review of the literature. We observe that, although the potential antecedents are manifold and not always neatly comparable across the different industries, there still exist commonalities, most of which are related to product characteristics and the opportunity costs arising from physical attendance. In contrast, although we document a promising effect of exploiting reminders in reducing no‐show behavior, our understanding of the effectiveness of potential countermeasures is less pronounced.

DEI Institutionalization in Health Care Organizations: Here Today, Gone Tomorrow?

Following the murder of George Floyd and the subsequent summer of racial reckoning of 2020, organizations in all industries have sought to address their efforts towards diversity, equity, and inclusion (DEI), seeking to address DEI through intense focus on equitable hiring practices, fairness in compensation and promotion, and public support of social justice and progress. In health care organizations (HCO), in particular, an additional call to action emerged as reports of race-based disparities in healthcare outcomes throughout the global COVID-19 pandemic. These reports confirmed a decades-long scholarly exploration of health care disparities in the U.S. Health Care System, and the insufficient progress in achieving equitable health outcomes that followed. Given the decades of inaction, or insufficient action, on these important issues preceding the summer of racial reckoning, there is concern regarding the sustainability of DEI initiatives. It remains a question whether DEI initiatives are a sustainable aspect of organizational reality or if addressing these issues is a trend or fad. The purpose of this panel symposium is to discuss the exploration of DEI institutionalization in health care organizations. The panel brings together a group of scholars who have each previously examined the influence of DEI-related concepts on various aspects of health care organizations. The symposium will foster a collaborative conversation to provide fruitful discussion around these concepts and the need for continued exploration within HCOs. We believe that a growing body of healthcare management researchers are motivated to engage in DEI research and the ultimate pursuit of health equity, and each of these scholars’ previous engagements with DEI topics in HCOs uniquely qualify them to contribute to the panel and to advance scholarship in this worthy domain.

Health care management research & health equity.

Co-Editors-in-Chief The authors have disclosed that they have no significant relationships with, or financial interest in any commercial companies pertaining to this article.

Lean Management Systems in Health Care: A Review of the Literature.

Many health care organizations now employ Lean tools to improve value in health care, yet reports of their effectiveness vary. This variation may be explained by the context in which Lean is implemented, whether as a tool or as a management system. This article reports on a structured literature review conducted to understand the evidence base for the impact of Lean Management System implementation in health care. A search of PubMed, Scopus, Emerald, EMBASE, CINAHL, and Business Source Complete databases was conducted in November 2017 and repeated in July 2020 to assess the evidence for the impact of Lean Management Systems in health care from 2000 to July 2020. Articles were included if they (1) reported on a Lean Management System or (2) reported on Lean Management System components as described by Mann 1 (ie, leader standard work, visual controls, daily accountability process, and discipline). A total of 52 articles met the inclusion criteria. Although all articles described some combination of leader standard work, visual management, and daily accountability as part of their Lean Management System, only a handful described use of all 3 components together. Only one explicitly mentioned the fourth component, discipline, required to consistently apply the first 3. The majority reported on single-unit or department implementations and most described daily huddles at the unit level that included review of key performance indicators, identification of improvement opportunities, and problem solving. The role of the leader in a Lean Management System was described a coach and a mentor. Barriers to adoption such as insufficient training and increased workload for nurses were noted along with the importance of relevance to the local context for unit teams to find value in huddle boards and huddles. As yet, evidence of Lean Management System effectiveness in driving health care improvement is absent due to weak study designs and lack of statistical rigor. Well-designed research on Lean Management Systems in health care is lacking. Despite increasing adoption of Lean Management Systems over the past 10 years and anecdotal reports of its effectiveness, very few articles provide quantitative data. Those that do report unit-level implementation only, little use of a comprehensive package of Lean Management Systems elements, and weaker study designs and statistical methods. More rigorous study designs and robust statistical analysis are needed to evaluate effectiveness of Lean Management Systems in health care. This represents a rich area for future health care management research.

ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH: Predicting COVID-19 Outbreak in U.S. Nursing Homes Based on Location, Quality Metrics, and Staffing Levels.

American College of Healthcare Executives Journal of Healthcare Management Frontiers of Health Services Management American College of Healthcare Executives Journal of Healthcare Management Frontiers of Health Services Management

Characterizing rescue performance in a tertiary care medical center: a systems approach to provide management decision support

BackgroundAllocation of limited resources to improve quality, patient safety, and outcomes is a decision-making challenge health care leaders face every day. While much valuable health care management research has concentrated on administrative data analysis, this approach often falls short of providing actionable information essential for effective management of specific system implementations and complex systems. This comprehensive performance analysis of a hospital-wide system illustrates application of various analysis approaches to support understanding specific system behaviors and identify leverage points for improvement. The study focuses on performance of a hospital rescue system supporting early recognition and response to patient deterioration, which is essential to reduce preventable inpatient deaths.MethodsRetrospective analysis of tertiary care hospital inpatient and rescue data was conducted using a systems analysis approach to characterize: patient demographics; rescue activation types and locations; temporal patterns of activation; and associations of patient factors, including complications, with post-rescue care disposition and outcomes.ResultsIncreases in bedside consultations (20% per year) were found with increased rescue activations during periods of resource limitations and changes (e.g., shift changes, weekends). Cardiac arrest, respiratory failure, and sepsis complications present the highest risk for rescue and death. Distributions of incidence of rescue and death by day of patient stay may suggest opportunities for earlier recognition.ConclusionsSpecific findings highlight the potential of using rescue-related risk and targeted resource deployment strategies to improve early detection of deterioration. The approach and methods applied can be used by other institutions to understand performance and allow rational incremental improvements to complex care delivery systems.

Health care management research & the Learning Health System.

Health care management research & the Learning Health System.

A text mining study of topics and trends in health care management journals: 1998-2018.

Advances in natural language processing and text mining provide a powerful approach to understanding trending themes in the health care management literature. The aim of this study was to introduce machine learning, particularly text mining and natural language processing, as a viable approach to summarizing a subset of health care management research. The secondary aim of the study was to display the major foci of health care management research and to summarize the literature's evolution trends over a 20-year period. Article abstracts (N = 2,813), from six health care management journals published from 1998 through 2018 were evaluated through latent semantic analysis, topic analysis, and multiple correspondence analysis. Using latent semantic analysis and topic analysis on 2,813 abstracts revealed eight distinct topics. Of the eight, three leadership and transformation, workforce well-being, and delivery of care issues were up-trending, whereas organizational performance, patient-centeredness, technology and innovation, and managerial issues and gender concerns exhibited downward trending. Finance exhibited peaks and troughs throughout the study period. Four journals, Frontiers of Health Services Management, Journal of Healthcare Management, Health Care Management Review, and Advances in Health Care Management, exhibited strong associations with finance, organizational performance, technology and innovation, managerial issues and gender concerns, and workforce well-being. The Journal of Health Management and the Journal of Health Organization and Management were more distant from the other journals and topics, except for delivery of care, and leadership and transformation. There was a close association of journals and research topics, and research topics evolved with changes in the health care environment. As scholars develop research agendas, focus should be on topics important to health care management practitioners for better informed decision-making.

Abstracts From the Forum on Advances in Healthcare Management Research.

Abstracts From the Forum on Advances in Healthcare Management Research.

In This Issue

This special issue responds to publications arising from presentations at the 2020 CPCE Health Conference held in Hong Kong in January. The conference was conducted by the College of Professional and Continuing Education of the Hong Kong Polytechnic University in association with a number a number of organisations including the Centre for Ageing and Healthcare Management Research and our colleagues from the Hong Kong College of Health Service Executives.The theme of the conference was ‘Ageing with Health and Dignity – Implications for Public Policy, Service Delivery Workforce, Technology and Financing’.....

A spotlight on cross-sectional research: Addressing the issues of confounding and adjustment

ABSTRACT Purpose: This study attempted to conceptualize confounding and guide healthcare management researchers to identify and adjust for potential confounders from the point of view of their theoretical frameworks as a basis of achieving internal validity. Design/methodology/approach: A comprehensive statistical procedure was applied to demonstrate how likely it is for misleading effect sizes to be reached in a cross-sectional healthcare management study as a result of failing to adjust for potential confounders. Participants of the study were 403 volunteer health workers in selected hospitals in Accra, Ghana. A self-reported questionnaire was used to gather data. Confirmatory factor analysis and linear regression analyses were used to present findings. Findings: The study revealed that failing to adjust for potential confounders can over- or under-estimate the ‘ultimate effect’, which was under-estimated in this study by a value of β = .006. The auxiliary regression estimates (e.g. the variance) were also wrongly estimated owing to failure to adjust for potential confounders. Originality/value: This study is the first of its kind to address the issue of confounding in healthcare management research and justifies how necessary it is for every study to control for all confounding variables.

Disasters and Health Care Management Research.

Disasters and Health Care Management Research.

Phenomenography — an avant-garde approach to extend the psychology methodological repertoire

ABSTRACT Phenomenography was initially developed as a qualitative response to the limitations of quantitative approaches to higher education research. Following on its success in deepening understanding of higher education and improving teaching and learning strategies, phenomenography has been applied in research in various fields, including nursing, health care, human resource and business management, physiotherapy, psychiatric care, guidance and career counselling, and sport science. However, this approach is virtually nonexistent in psychology research and is not mentioned in any of the prominent psychology texts the authors have read. This article provides qualitative psychology researchers with an introduction to the ontology, epistemology, and methods of phenomenography and advocates for its acceptance into the psychology methodological repertoire.

Examining the role of value congruence, professional identity, and managerial job engagement in the budgetary participation-performance link.

In health care, important phenomena of perceived incompatibility between professional and managerial values have emerged as consequences of New Public Management reforms. Although there is a growing evidence on the variation in the enactment of hybrid roles by medical managers, existing research in health care management is mostly descriptive with little emphasis on the conditions under which hybrid roles are enacted and, importantly, on the effects of this variation on performance. In this article, we seek to fill this research gap by empirically examining (a) whether budgetary participation aligns professional and organizational values, (b) the impact of this alignment on employees' work-related feelings and managerial performance, and (c) the effect of professional identity on value congruence. Data were collected by a survey conducted in an Italian hospital, and partial least square was used to test the relationships among variables. Overall, results show that (a) high involvement in budgeting is instrumental in facilitating medical managers' value congruence, and this, in turn, positively effects managerial job engagement; (b) the effect of budgetary participation on value congruence depends on the extent of professional identity; and (c) as a result of enhanced value congruence and managerial job engagement, employees tend to deliver superior role performance. Findings of this study provide some guidance for managers on how organizations can take steps to guarantee effective support to hybrid professionals.

Abstracts From the Forum on Advances in Healthcare Management Research

American College of Healthcare Executives Journal of Healthcare Management Frontiers of Health Services Management American College of Healthcare Executives Journal of Healthcare Management Frontiers of Health Services Management

Barriers in Case Managers' Roles: A Qualitative Systematic Review.

The challenges faced by case managers when implementing case management have received little focus. Several qualitative studies have been published that may be able to shed light on those challenges. This study is a systematic review of qualitative literature to identify barriers case managers have when implementing case management. Five electronic bibliographic databases were systematically searched, and 10 qualitative studies were identified for inclusion in the review which were published from 2007 to 2016. Through thematic synthesis of findings, five themes were identified as barriers to case management implementation: unclear scope of practice, diverse and complex case management activities, insufficient training, poor collaboration with other health-care providers, and client relationship challenges. This review study suggested that standardized evidence-based practical protocols and certification programs may help overcome case managers' barriers and improve case management practices. Health policymakers, case management associations, and health-care management researchers should develop educational and practical supports for case managers.