JournalTOCs

Health Services Management Research
Journal Prestige (SJR): 0.273

Citation Impact (citeScore): 1
Number of Followers: 18

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0951-4848 - ISSN (Online) 1758-1044
Published by Sage Publications

[1176 journals]

Delphi Plus: A novel methodology for identifying evidence-based data
standards for health service decision-making
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  Authors: Peter W Clark, Lauren T Williams, Jessica Lee, Lauren Ball
  Abstract: Health Services Management Research, Ahead of Print.
  The underlying tenet of evidence-based decision-making in health services is assessing all the relevant evidence. Using the traditional qualitative and quantitative approaches to identifying evidence may not capture the full spectrum of factors that need to be addressed. A selective mixed-method approach may provide a comprehensive assessment of the relevant knowledge. This paper adds to the methodological literature by outlining a novel sequential, mixed-method, exploratory process for identifying evidence-based data standards that may be used for health service decision-making. The three-phase process, entitled Delphi Plus, engages peer-nominated topic-specific experts to assess all publicly available and practice-based items and, through a series of reviews, reach an evidence-based consensus on standards for decision-making. Each process phase is outlined in-depth and supplemented by practical learnings gained through its implementation. The Delphi Plus methodology provides the first comprehensive process for combining the published and practised data to develop evidence-based data standards. The routine use of Delphi Plus would provide a framework for benchmarking in health services, enabling greater monitoring and evaluation of client outcomes and improving quality care. This manuscript describes the process of implementing Delphi Plus and provides an example of data standards generated from its use, which directly inform the Australian Government’s Primary Health Care 10 Year Plan.
  Citation: Health Services Management Research
  PubDate: 2023-11-29T12:31:48Z
  DOI: 10.1177/09514848231218637
“A different sense of what we do here, who we are and what we
deliver”: Provider perspectives on the effects of a change in governance
of healthcare services in correctional facilities in British Columbia
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  Authors: Katherine E McLeod, Jane A Buxton, Ruth Elwood Martin
  Abstract: Health Services Management Research, Ahead of Print.
  In 2017, British Columbia (BC) transferred responsibility for healthcare services in provincial correctional facilities from the Ministry of Public Safety and Solicitor General to the Ministry of Health. This study explored how healthcare leadership perceived the impact of the transfer on services, work-life, and job satisfaction. We conducted one-on-one interviews (n = 8) with healthcare managers and medical and administrative leadership within Correctional Health Services. Using the Two-Factor theory of job satisfaction as a framework, we applied Interpretive Description methodology to analyse interview data. Participants identified changes to four areas of the working environment: (1) staffing, equipment, and resources (2) systems of supervision and support (3) standards, policies, and quality improvement and (4) culture and orientation. These changes predominantly affected motivational factors of job satisfaction and were described as enriching the roles of managers and staff. Participants described improved autonomy and recognition of providers, increased quality of services delivered, and a shift toward patient-centred care. The perspectives of healthcare leaders provide new insight into the potential impact of transferring healthcare services in custody to a public healthcare system. Discussion of changes and their affects also provide practical learning for jurisdictions seeking to improve healthcare under a variety of governance and service-delivery models.
  Citation: Health Services Management Research
  PubDate: 2023-11-29T10:28:21Z
  DOI: 10.1177/09514848231218626
A multi-dimensional study of organisational boundaries and silos in the
healthcare sector
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  Authors: Esben Rahbek Gjerdrum Pedersen, Frantisek Sudzina, Francesco Rosati
  Abstract: Health Services Management Research, Ahead of Print.
  Purpose: The aim of this study is to understand how healthcare practitioners experience organisational boundaries and silos in day-to-day operations. Based on a multi-dimensional scale of organisational boundaries, the study examines how organisational demarcation lines enable and constrain daily work tasks in the healthcare sector.Research design: The study is based on a quantitative and qualitative analysis of survey responses from 895 healthcare practitioners in Denmark.Results: The results indicate that tendencies toward organisational silos relate to systems and hierarchies (management-staff) rather than professions and departments. Moreover, the study identifies resource scarcity as an important undercurrent in the understanding of the respondents’ perceptions of boundaries and silos.Conclusion: The study contributes to existing research by documenting the coordination and collaboration challenges linked to the multitude of demarcation lines in complex health organisations.
  Citation: Health Services Management Research
  PubDate: 2023-11-27T06:18:12Z
  DOI: 10.1177/09514848231218617
Sustainable quality management in hospitals: The experiences of healthcare
quality managers
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  Authors: Fien Claessens, Eva Marie Castro, Deborah Seys, Jonas Brouwers, Astrid Van Wilder, Anneke Jans, Dirk De Ridder, Kris Vanhaecht
  Abstract: Health Services Management Research, Ahead of Print.
  Background: Quality management systems are essential in hospitals, but evidence shows a real literature gap on the sustainable implementation of quality. Purpose: This study aimed to explore and identify enablers towards sustainable quality management in hospitals. Research design and Study Sample: Interviews were conducted with 23 healthcare quality managers from 20 hospitals. Data collection and/or Analysis: Data collection and analysis were conducted simultaneously by using the Qualitative Analysis Guide of Leuven and following the COREQ Guidelines. Thematic analysis from interview transcripts was performed in NVivo 12. Results: The results reveal two categories: (1) quality in the organisation’s DNA and (2) quality in the professional’s DNA. The first category consists of: bottom-up and top-down management, the organisation-wide integration of quality and an organisational culture shift. The second one consists of: quality awareness, understanding the added value, the encouragement and engagement, the accountability and ownership for quality. Moving towards sustainable quality management systems in hospitals requires a good interaction between a bottom-up approach and leadership to ensure continuous support from healthcare stakeholders. Conclusions: This study contributes to existing conceptual and theoretical foundations with practical insights into sustainable quality management. The findings can guide quality departments and hospital management to regain professionals’ commitment to quality and to establish a sustainable quality management system.
  Citation: Health Services Management Research
  PubDate: 2023-11-25T04:31:40Z
  DOI: 10.1177/09514848231218631
Editorial
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  Abstract: Health Services Management Research, Ahead of Print.
  
  Citation: Health Services Management Research
  PubDate: 2023-09-25T05:34:44Z
  DOI: 10.1177/09514848231205426
A self-care process model for patients with chronic noncommunicable
diseases
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  Authors: Marija Milavec Kapun, Vladislav Rajkovič, Olga Šušteršič, Uroš Rajkovič
  Abstract: Health Services Management Research, Ahead of Print.
  Self-care of patients with chronic noncommunicable diseases is an essential component of contemporary healthcare. The purpose of this paper is to present a novel self-care process model and place it in the broader context of professional care. The extended Event-driven Process Chain approach to process modelling was used, focusing on a detailed overview of sequences of events, connections and activities and other elements/building blocks. A self-care process model was designed. The model is divided into two parts. The first part represents the self-care process when patients are able to manage their symptoms and be independent. The second part includes the process when patients are unable to perform self-care and/or need professional support. By identifying the essential elements of this process and incorporating them into the patients' care process, we can ensure that professional support for self-care creates a dynamic balance in the patients’ ecosystems. Patients with chronic noncommunicable diseases need to make timely decisions about individual aspects of their health and seek professional help. In this way, an optimal level of health and well-being of patients can be achieved. Focusing on the patients’ self-care process could also reduce treatment costs and improve the quality of life of patients. The novel designed model of the process of self-care, with all its essential elements, can be supported by digital technology, especially in the decision-making process and needs to become an important part of healthcare and long-term care systems.
  Citation: Health Services Management Research
  PubDate: 2023-09-12T07:33:24Z
  DOI: 10.1177/09514848231201405
A framework for lean implementation in preoperative assessment: Evidence
from a high complexity hospital in Italy
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  Authors: Giulia Goretti, Martina Pisarra, Maria Rosaria Capogreco, Patrizia Meroni
  Abstract: Health Services Management Research, Ahead of Print.
  Purpose: A routine preoperative assessment is considered both ineffective and inefficient. Despite the widespread application of lean thinking in healthcare, there is little evidence of successful experiences in preoperative admissions in order to reduce “No value added” activities. A conceptual framework reporting the drivers (clinic, tools, innovation, organization, and governance) and impacts (patient, efficiency, sustainability, time, learning and growth) was developed. Methodology: Drawing on the experience of an Italian high complexity hospital, this paper analyzes the case study by reporting evidence on how to implement lean in preoperative assessment and how to evaluate the positive results obtained. Results: Applying lean principles, the identification of value improved the appropriateness of care by creating 40 personalized pathways; the value stream resulted in a reduction of “No Value Added Time” from 37% to 28%, chest X-rays from 41% to 14% and cardiac visits from 49% to 37%; the pursuit of continuous flow through innovation contributed to increase the use of digitalization; the new pull organization helped to reduce the average time spent per year by 1.5 h; the continuous improvement was ensured through the governance of results. Conclusion: The proposed framework should be used to improve the quality of care in preoperative admissions by adopting the lean drivers for successful implementation and reporting the impacts.
  Citation: Health Services Management Research
  PubDate: 2023-08-23T09:09:02Z
  DOI: 10.1177/09514848231194853
Exploring the determinants of private healthcare providers’ market
power: A performance-based perspective
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  Authors: Antonio Fabio Forgione, Guido Noto
  Abstract: Health Services Management Research, Ahead of Print.
  This research focuses on market power in the private healthcare sector. This topic has been poorly explored by the extant literature and the reasons mainly rely on the peculiarities of the sector and the specific market. In fact, health providers’ market power is influenced by multiple factors and by the fact that prices are often regulated by national or regional public authorities. To fill this gap, the article explores the relationship between performance characteristics and health providers’ market power, measured through the Lerner index. The research is based on the analysis of panel data for 437 Italian private healthcare providers over the period 2012–2020. To explore the determinants of health providers’ market power, this research employs System-generalized method of moments (SYS-GMM) estimation models. The results highlight a significant and non-linear relationship between market power and process performance, as well as with gender diversity. Intangible assets are another input variable that has a significant and positive relationship with market power. The study contributes to the identification of the performance characteristics driving health providers’ market power.
  Citation: Health Services Management Research
  PubDate: 2023-08-14T05:42:42Z
  DOI: 10.1177/09514848231194850
Service design for the transformation of healthcare systems: A systematic
review of literature
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  Authors: Noe Vaz, Cláudia Affonso Silva Araujo
  Abstract: Health Services Management Research, Ahead of Print.
  There is a growing interest in applying the Service Design (SD) approach to innovate and transform healthcare systems. However, comprehensive studies are scarce. This study systematically reviews the literature on SD initiatives towards healthcare system transformation. The research questions are: How has the SD approach been applied to the healthcare sector' To what extent are the SD initiatives contributing to transform the health systems' What are the main challenges faced by SD initiatives to transform the health system' Which are the main stakeholders involved in the process, and how could they change according to the type of initiative' The search was conducted in March 2021 in eight databases and returned 990 articles evaluated through a research protocol, resulting in 47 studies included in this review. These studies were explored through thematic analysis and considering two conceptual models: the SD approach (Patrício et al., 2020) and the ecosystem perspective (Beirão et al., 2017). The findings show that SD initiatives have been implemented at all levels of the ecosystem, but only 49% (47/23 studies) present a transformative character. The SD initiatives challenges were organized into four themes: (1) Planning SD initiatives as a lever in transforming health systems; (2) Using SD tools creatively; (3) Considering the use of new technologies to transform health systems positively, and (4) Facing the challenges of applying the Experience-Based Design and Experience Based in Co-Design approaches in project development. This study is relevant for helping managers and researchers in their efforts to design truly transformative services with a focus on improving health systems and social wellbeing.
  Citation: Health Services Management Research
  PubDate: 2023-08-09T02:40:14Z
  DOI: 10.1177/09514848231194846
Addressing the healthcare waste management barriers: A structural equation
modeling approach
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  Authors: Abhishek Raj, Cherian Samuel, Abhishek Kumar Singh
  Abstract: Health Services Management Research, Ahead of Print.
  Due to the growing population and advancing economy, medical waste accumulation has come to the attention of all facets of society. Although the issue of medical waste management planning has been addressed in developed nations, it still exists in several developing nations. This paper examines the effects of barriers under the Organization action, work handling, and Human Resource Practices section on the healthcare waste management (HCWM) sector in a developing country India. In this study, three hypotheses were constructed and tested using Structural equation modeling. The questionnaire was distributed among 200 health professionals to collect their responses. Ninety-seven responses were received, and 15 barriers were identified affecting the healthcare waste management sector. The results show that all three barriers (i.e., Organizational, Waste handling, and Human resources) hinder the Healthcare waste management sector. Organizational Barriers are the most significant among other barriers. So, the hospitals have to take appropriate actions to overcome these barriers. This paper helps to complete the research gap by providing the different characteristics of barriers. The development of a model for the analysis of barriers influencing HCWM is the Author’s original contribution.
  Citation: Health Services Management Research
  PubDate: 2023-07-03T08:25:35Z
  DOI: 10.1177/09514848231186775
Insights into how universal, tax-funded, single payer health systems
manage their waiting lists: A review of the literature
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  Authors: Francesco Amigoni, Federico Lega, Elena Maggioni
  Abstract: Health Services Management Research, Ahead of Print.
  Background: A conspicuous consequence of gatekeeping arrangements in universal, tax-funded, single-payer health care systems is the long waiting times. Besides limiting equal access to care, long waiting times can have a negative impact on health outcomes. Long waiting times can create obstacles in a patient’s care pathway. Organization for Economic Co-operation and Development (OECD) countries have implemented various strategies to tackle this issue, but there is little evidence for which approach is the most effective. This literature review examined waiting times for ambulatory care. Objective: The aim was to identify the main policies or combinations of policies universal, tax-funded, and single-payer healthcare systems have implemented to improve the governance of outpatient waiting times. Methods: Starting from 1040 potentially eligible articles, a total of 41 studies were identified via a 2-step selection process. Findings: Despite the relevance of the issue, the literature is limited. A set of 15 policies for the governance of ambulatory waiting time was identified and categorized by the type of intervention: generation of supply capacity, control of demand, and mixed interventions. Even if a primary intervention was always identifiable, rarely a policy was implemented solo. The most frequent primary strategies were: guidelines implementation and/or clinical pathways, including triage, guidelines for referral and maxim waiting times (14 studies), task shifting (9 studies), and telemedicine (6 studies). Most studies were observational, with no data on costs of intervention and impact on clinical outcomes.
  Citation: Health Services Management Research
  PubDate: 2023-07-03T01:37:30Z
  DOI: 10.1177/09514848231186773
How does staff and patient feedback on hospital quality relate to
mortality outcomes' A provider-level national study
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  Authors: Antonio Michael Borrelli, Rebecca J Birch, Katie Spencer
  Abstract: Health Services Management Research, Ahead of Print.
  This study aimed to use national data to examine the relationship between staff and inpatient survey results (National Health Service (NHS) Friends and Family Test (FFT)) and assess how these align with more traditional measurements of hospital quality as captured by the summary hospital mortality indicator (SHMI). Provider level FFT responses were obtained for 128 English non-specialist acute providers for staff and inpatients between April 2016 and March 2019. Multilevel linear regression models assessed the relationship between staff and patient FFT recommendations, and separately how SHMI related to each of staff and patient FFT recommendations. A total of 1,536 observations were recorded across all providers and financial quarters. Patients were more likely to recommend their provider (95.5%) than staff (76.8%). In multivariable regression, a statistically significant association was observed between staff and patient FFT recommendations. A statistically significant negative relationship was also observed between staff FFT recommendations and SHMI. The association between SHMI and staff FFT recommendations suggests that staff feedback tools may provide a useful analogue for providers in potential need of intervention and improvement in care. For patients meanwhile, qualitative approaches and hospital organisations working in partnership with patients may provide better opportunities for patients to drive improvement.
  Citation: Health Services Management Research
  PubDate: 2023-06-27T03:39:10Z
  DOI: 10.1177/09514848231179182
Exploring the relationship between performance feedback and medical
managers’ budgetary performance:The role of managerial self-efficacy
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  Authors: Marco Giovanni Rizzo
  Abstract: Health Services Management Research, Ahead of Print.
  This study addresses recent calls for more research on the potential intervening role exerted by certain individual variables in the relationship between performance feedback and performance. Specifically, this study selects medical managers’ sense of managerial self-efficacy as a potential mediational variable in the feedback–performance relationship. A mediational model examining how the effect of performance feedback on medical managers’ budgetary performance is influenced by their sense of managerial self-efficacy was established based on survey data from 60 medical managers working in a hospital. Data analysis was conducted using the partial least squares technique, and the results confirmed the hypothesised relationships. Specifically, performance feedback was positively associated with managerial self-efficacy, and managerial self-efficacy exerted a positive influence on medical managers’ budgetary performance. Further, performance feedback was determined not to be directly associated with budgetary performance; however, a full mediating effect of managerial self-efficacy was found. These findings make several contributions to the literature and can help healthcare managers have a better understanding of the consequences and importance of the technical features of performance feedback reports.
  Citation: Health Services Management Research
  PubDate: 2023-05-29T09:45:24Z
  DOI: 10.1177/09514848231179177
A systematic review of typologies on aged care system components to
facilitate complex comparisons
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  Authors: Jenni Suen, Suzanne Dyer, Wendy Shulver, Tyler Ross, Maria Crotty
  Abstract: Health Services Management Research, Ahead of Print.
  Objectives: Typologies are frequently utilised in analyses of the quality, funding, and efficiency of aged care systems. This review aims to provide a comprehensive resource identifying and critiquing existing aged care typologies. Methods: Systematic search of MEDLINE, Econlit, Google Scholar, greylit.org and Open Grey databases from inception to July 2020, including typologies of national, regional or provider aged care systems. Article screening, data extraction, and quality appraisal were conducted in duplicate. Results: 14 aged care typologies were identified; five applied to residential care, two to home care and seven to mixed settings; eight examined national systems and seven regional or provider systems. Five typologies classifying national financing or home care services, provider financing of staff and services and quality of residential care were considered high quality. The schematic provided summarises the focus area and aids in typology selection. Discussion: The aged care typologies identified cover a wide range of areas and contexts of aged care provision. This schematic, summary and critique will aid researchers, providers, and aged care policy makers to examine their own setting, compare it to other approaches to aged care provision and assist in identifying alternatives and important considerations, when undertaking aged care reform.
  Citation: Health Services Management Research
  PubDate: 2023-05-29T04:18:38Z
  DOI: 10.1177/09514848231179176
Hospital workforce engagement, satisfaction, burnout and effects on
patient mortality: Findings from the English national health service staff
surveys
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  Authors: Robert E Boyle, Leon Jonker, Sudha Xirasagar, Hayrettin Okut, Robert G Badgett
  Abstract: Health Services Management Research, Ahead of Print.
  Previous studies of healthcare organizations’ workforces and their performance have focused on burnout and its impact on care. The aim of this research is to expand on this and examine the association of positive organizational states, engagement and recommendation of employer as a place to work, in comparison to burnout on Hospital performance. Methods: This was a panel study of the respondents to the 2012–2019 yearly Staff Surveys of the English National Health Service (NHS) hospital Trusts with hospital performance measured by the adjusted inpatient Summary Hospital-level Mortality Indicator (SHMI). Results: In univariable regression, all three organizational states significantly and negatively correlated with SHMI, with recommendation and engagement showing a nonlinear effect. In multivariable analysis, all three states remained significant predictors of SHMI. Engagement and recommendation showed mutual correlation, with engagement being a more prevalent state than recommendation. Conclusion: Our study indicates that organizations could benefit from monitoring multiple workforce variables to preserve or enhance workforce well-being, while optimizing organizational performance. The surprising finding that higher burnout was associated with improved short-term performance requires further investigation, as does the finding of less frequent staff recommendation of work compared to staff engagement with their work.
  Citation: Health Services Management Research
  PubDate: 2023-05-26T01:50:44Z
  DOI: 10.1177/09514848231179175
Antecedents of innovative work behavior among leading physicians:
Empirical evidence from German hospitals
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  Authors: Bettina Kriegl, Herbert Woratschek, Andrea Raab
  Abstract: Health Services Management Research, Ahead of Print.
  Healthcare professionals’ innovative work behavior (IWB) plays a key role in the development and implementation of innovative solutions in hospitals. However, relevant antecedents of IWB have not been fully captured to date. This study empirically examines the relationships between proactive personality, collaborative competence, innovation climate, and IWB. Hypotheses were tested using a sample of 442 chief physicians from 380 German hospitals. The results indicate a positive and significant influence of proactive personality, collaborative competence, and innovation climate on IWB, with collaborative competence having a stronger influence on IWB than innovation climate. Managers should note that important resources for IWB are accessible through a variety of actors and relationships. To leverage these resources and thus promote IWB, more emphasis should be placed on an employee’s network.
  Citation: Health Services Management Research
  PubDate: 2023-04-25T11:26:24Z
  DOI: 10.1177/09514848231172073
Reducing turnover intentions among first-year nurses: The importance of
work centrality and coworker support
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  Authors: Martha C. Andrews, Andrew Woolum, Jessica Mesmer-Magnus, Chockalingam Viswesvaran, Satish Deshpande
  Abstract: Health Services Management Research, Ahead of Print.
  Turnover among nurses has been recognized as a frequent and enduring problem in healthcare worldwide. The widespread nursing shortage has reached the level of a healthcare crisis. The COVID-19 pandemic has illustrated the importance of understanding the contributing factors of nurse turnover, and more importantly how to mitigate the problem. Using cross-sectional survey data collected from 3370 newly licensed nurses working across 51 metropolitan areas within 35 U.S. states, we explore how role overload and work constraints can both diminish job satisfaction and increase turnover intentions of new nurses. Coworker support and work role centrality are identified as moderators of these relationships which show potential to mitigate these negative outcomes. This study highlights the importance of coworker support and work centrality in improving job satisfaction and subsequent turnover intentions among newly licensed nurses.
  Citation: Health Services Management Research
  PubDate: 2023-03-28T09:31:41Z
  DOI: 10.1177/09514848231165891
Implementation of clinical assistants in a pediatric oncology department:
An impact analysis
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  Authors: Cristina Adroher, Celia Calvo, Laura Pavon, Ricard Casadevall, Esther Alvarez, Mariona Marsal, Francesc Lopez, Miquel Pons, Manel del Castillo, Andres Morales
  Abstract: Health Services Management Research, Ahead of Print.
  Bureaucratic and administrative tasks associated with health care provision have historically fallen on health care professionals, which is one among the factors contributing to low job satisfaction and lower productivity. Incorporating new professional roles that help to better respond to the needs of both patients and professionals can increase the quality and efficiency of service provision. This article aims to evaluate the impact of the clinical assistant’s introduction in the Sant Joan de Déu Barcelona Children’s Hospital’s pediatric oncology department, in terms of (i) displacement of activity loads carried out by this new professional role and the consequent time freed up for physicians, (ii) physicians’ satisfaction and (iii) efficiency of the new care model. This is an observational and retrospective study using administrative data based on the type of activity performed by clinical assistants and the measurement of the time freed up in favor of the physicians. The potential skill mix productivity increase, survey of physicians’ satisfaction, and reduction in costs with the new model was analyzed. During the first year of its implementation in the pediatric oncology department, clinical assistants have performed 13,553 requests (69% of the total), representing a total saving of 266.83 hours or 6.67 workweeks of 40 hours. They performed 74% of outpatient surgical requests in the oncology department, 87% of day hospital requests and 54% of total requests in the outpatient consultations area. Physicians are overall satisfied with the new role and think they can use the time gained to do other things such as research or improving the quality of care. The role change allows reducing the cost per request by 56% in relation to the conventional model. In conclusion, the introduction of clinical assistants in the oncology department could be efficient to the extent that it displaces a significant part of the bureaucratic and administrative tasks previously performed by health care professionals and thus enables to reduce the cost of these processes. This delegation allows them to work more closely to the maximum of their competences and the physicians to have more time for higher added value clinical tasks and increase professional satisfaction.
  Citation: Health Services Management Research
  PubDate: 2023-03-24T04:48:22Z
  DOI: 10.1177/09514848231165193
Framing doctor-managers’ resilience during Covid-19 pandemic: A
descriptive analysis from the Italian NHS
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  Authors: Simona Leonelli, Federica Morandi, Romina G Giancipoli, Fausto Di Vincenzo, Maria L Calcagni
  Abstract: Health Services Management Research, Ahead of Print.
  With the aim of providing evidence about doctor-managers’ resilience during the Covid-19 pandemic, this study analyzes the characteristics of 114 doctor-managers operating within the Italian National Health Service (NHS). During the emergency, doctor-managers had to show adaptive capacities to deal with unexpected situations and develop new paradigms, procedures, and quick responses to patients’ needs. This is in line with resilience, and in this perspective, it is crucial to investigate resilience determinants. The paper, therefore, provides an identikit of the resilient doctor-manager. The research was conducted between November and December 2020. Primary data were collected through an online questionnaire consisting of six sections. Participation was voluntary and anonymous. Data were analyzed using quantitative techniques and employing Stata 16. Confirmatory Factor Analysis was employed to test construct validity and scale reliability. Results show that increasing levels of individual resilience are related to increasing levels of managerial identity. Moreover, physicians’ individual resilience has a positive association with commitment, knowledge diffusion, and Evidence-Based Medicine adoption. Finally, physicians’ individual resilience has a negative association with their role in the university, their specialty, and their gender. The study suggests some practical implications for healtcare organizations. In general, career paths are decided primarily on competency assessment, while an important role should be devoted to behavioral characteristics. Furthermore, organizations should take care of the levels of individual commitment and encourage professional networking because both help doctor-managers cope with uncertainty. The originality of the study relies on a fresh look at all previous work. There are currently few contributions in the literature to explore and investigate resilience elements in doctor-managers during the pandemic era.
  Citation: Health Services Management Research
  PubDate: 2023-03-18T09:23:58Z
  DOI: 10.1177/09514848231165197
Meaning of sustainability of innovations in healthcare organizations: A
systematic review
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  Authors: Fernanda de Sousa Gusmão Louredo, Eduardo Raupp, Cláudia Affonso Silva Araujo
  Abstract: Health Services Management Research, Ahead of Print.
  BackgroundThere is pressure on healthcare organizations to provide high-quality care to all patients while innovating the way care is delivered. As they take on the challenge of delivering high-quality, innovative services, any gains made tend to stall before a radical change impacts key outcomes given the difficulty in sustaining innovations over time.MethodsA systematic search was performed in 5 electronic databases using the PRISMA structure that resulted in 1313 articles, of which 260 were duplicated, leaving 1053 articles. After reading their abstracts, 877 had an inadequate scope for analysis because they did not deal with research on the sustainability of innovations. After a full assessment of the remaining 176 articles, only 10 studies met the inclusion criteria with the snowball strategy generating one additional paper, leading to 11 empirical studies. A theoretical discussion and the proposition of a framework were used to analyze the data.ResultsStudies in university hospitals shed light on determining sustainability factors of innovations not yet fully explored such as the meaning given by individuals to innovation, culture, partnerships, and multidisciplinary collaboration, which complement the literature. This research sought to contribute to the dialogue between management theory and practice in studies on the sustainability of health innovations based on experiences observed in university hospitals. Health managers can verify how sustainability relates to the challenges presented and identify a path that helps them overcome the limitations imposed on the process. The literature shows that the understanding of sustainability as a mediating dimension can collaborate in sustained innovations in order to allow managers to identify actions related to the individual-organization dimension that may be compromising the process and thus act in a more efficient, assertive way in determining the factors that sustain ongoing innovations.ConclusionsA relevant point is that innovation sustainability needs to be an objective to be achieved where managers/individuals must incorporate this perspective of innovation continuity since the beginning of the process, otherwise this may represent a greater propensity for discontinuity. This analysis can potentially be applied in university hospitals, but it can also be applicable to other types of hospitals and public or private institutions as long as it is an organization that adopts, implements, and seeks to sustain innovations in service delivery.
  Citation: Health Services Management Research
  PubDate: 2023-01-30T02:27:31Z
  DOI: 10.1177/09514848231154758
Measuring social responsibility towards employees in healthcare settings
in Egypt and its interrelation to their job satisfaction
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  Authors: Mohamed Abd-Rabou, Mona Ashry, Heba Elweshahi
  Abstract: Health Services Management Research, Ahead of Print.
  ObjectivesDeveloping a valid tool to measure perceived social responsibility (SR) practices towards employees and examining the impact of employee-centered SR considerations on the employees’ job satisfaction.MethodsA cross sectional survey of employees at three private hospitals was conducted. Data was collected using a self-administered questionnaire. It consists of baseline characteristics, structured SR measuring scale, job satisfaction questionnaire and Perception of Empowerment Instrument (PEI).ResultsThe questionnaire developed to measure SR towards employees showed excellent internal consistency reliability (Cronbach’s alpha is> 0.7). A considerable number of SR criteria were perceived as partially or fully met by the majority of studied employees except for rewarding, training activities, salary satisfaction and enhancement activities. Significant correlation was found between employees’ job satisfaction and all domains of SR as well as employees’ empowerment. Multiple linear regression analysis showed that significant predictors of employee’s satisfaction are fulfillment of economic and social responsibility criteria as well as the level of perceived empowerment.ConclusionsIn healthcare industry in Egypt, fulfillment of the basis for SR is one of the predictors of achieving high job satisfaction. Extra-performance rewarding and career development should be looked at while managing human resources.
  Citation: Health Services Management Research
  PubDate: 2023-01-28T03:32:33Z
  DOI: 10.1177/09514848231154754
Hybridity enabled: A research synthesis of the enabling conditions for
hybrid professionalism in healthcare
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  Authors: Marco Sartirana, Giorgio Giacomelli
  Abstract: Health Services Management Research, Ahead of Print.
  Hybrid professionals in healthcare organizations play a critical role, the characteristics, processes and implications of which have been thoroughly studied by scholars in the field. However, not as much attention has been paid to the conditions under which such roles might be taken by professionals entering the ground of management. This gap results into a lack of conceptual clarity and eventually ends being an obstacle in framing and ameliorating the tools needed to act such a role in its different phases. This is a research area worthy of a finer-grained understanding: the ability of organizations to effectively support role hybridization, in fact, is a requisite for professionals-managers' willingness to stay in the role and cope with the complexity that such a two-fold position entails, no matter what. Based on the results of a scoping literature review, this paper presents the enabling conditions for hybrid professionalism in healthcare, and proposes a classification of them into categories corresponding to different facets of hybrid role-taking: opportunities for interaction with management, tools supporting sense-making, and provision of delegation and autonomy. For each of these categories, organizational and management tools discussed in the literature are presented. The results of the study provide a road-map of the enabling conditions for hybrid professionalism that aims to be of practical convenience for managers and policy-makers in health care. Eventually, suggestions for organizational design and personnel management, as well as directions for further research, are highlighted.
  Citation: Health Services Management Research
  PubDate: 2023-01-18T08:39:42Z
  DOI: 10.1177/09514848231151829
Patient satisfaction with therapeutic education in oncology: Antecedents,
consequences, and the moderating effect of perceived value
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  Authors: Blandine Labbé-Pinlon, Cindy Lombart, Virginie Berger, Didier Louis
  Abstract: Health Services Management Research, Ahead of Print.
  This research aims to deepen our understanding of patients’ satisfaction with therapeutic patient education (TPE) in oncology. The research model proposed was tested, with structural equation modeling, on 207 French breast-cancer patients who participated in a TPE program. The results confirm that post-TPE empowerment and relational proximity to the TPE team are two major antecedents of patient’s satisfaction—and attitude and word-of-mouth toward TPE are two important consequences of this concept of satisfaction. However, the established relationships are moderated by the patients’ profiles (i.e., utilitarin believers, passionate followers, or holistic followers) in terms of the perceived value of their own experience of patient education. These results will enable stakeholders to adapt their TPE promotion strategies to the profiles of the patients. The study will also help to demonstrate and highlight the patient benefits of TPE to various stakeholders and thus will favor access to this personalized care practice, which is essential in the management of chronic diseases, but is still limited in oncology.
  Citation: Health Services Management Research
  PubDate: 2023-01-12T07:10:32Z
  DOI: 10.1177/09514848231151825
The emergence of a value transformation strategic initiative in the
healthcare context
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  Authors: A. Erin Bass, Ivana Milosevic, Mary Uhl-Bien, Meagan Millier
  Abstract: Health Services Management Research, Ahead of Print.
  How do strategic initiatives emerge' Despite rich tradition in the emergent strategy literature—focused on significant organizational change—surprisingly little insight exists on the dynamics of a new initiative’s emergence. This is particularly relevant in healthcare because of the increasing pressure to implement value transformation models focused on maximizing value at the point of care. The value transformation model prioritizes the decisions of the frontline providers and thus requires their expertise and commitment for the model’s implementation and success. In our case study of a dental organization, “OptiPlex,” we trace the emergence of a value transformation strategic initiative from its origination at the point of care to its formalization into the organization’s strategic plan. Using qualitative methods, we identify three phases in the emergence of the value transformation strategic initiative, each embodying different championing behaviors necessary for the initiative’s emergence. In doing so, we explicate the nature of these behaviors and how they link up across the organizational hierarchy to drive the value transformation strategic initiative’s emergence and implementation.
  Citation: Health Services Management Research
  PubDate: 2023-01-11T03:56:03Z
  DOI: 10.1177/09514848231151819
High-cost drugs for rare diseases: their expenditure and value based on a
regional area-based study
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  Authors: Silvia Manea, Laura Visonà Dalla Pozza, Cinzia Minichiello, Linda Altieri, Monica Mazzucato, Mauro Bonin, Paola De Ambrosis, Elio Borgonovi, Paola Facchin
  Abstract: Health Services Management Research, Ahead of Print.
  Background: in the field of rare diseases (RDs) most of the European studies on budget impact analysis of drugs that have been conducted often lay on theoretical assumptions and focus only on Orphan drugs (ODs). Objectives: we aimed to estimate the budget impact of specific drugs for non-oncological RDs, both ODs and non-ODs, using real-world data about patients residing in Veneto Region (Italy) and to describe its expenditure structure and dynamics. Methods: a population-based multi-source observational study was conducted using data from Regional administrative databases; an ad-hoc drugs’ list specific for RDs including both ODs and non-ODs and classifying them by ATC codes has been created. Results: In 2019, the total expenditure for drugs specific for RDs was EUR 97.2 million (6.6% of the total Regional budget). The RD drug list included 58 ATC codes, of which 15 ATC had an annual budget impact over EUR 1 million (“blockbuster drugs”). The most expensive treatment was a non-OD drug (Coagulation factor VIII). The two most represented therapeutical areas were the metabolic and the hematological ones. Conclusions: Cost analyses on RD high-cost drugs expenditure should consider any specific RD drug, not only ODs. Expenditure dynamics for RD drugs are peculiar showing “blockbuster drugs”. Some therapeutical areas seem to be lacking in the drug research field.
  Citation: Health Services Management Research
  PubDate: 2023-01-11T02:41:49Z
  DOI: 10.1177/09514848231151814
Assessment of variables determining the health management departments’
efficiency with analytical hierarchy process
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  Authors: Gozde Yesilaydin, Menderes Tarcan
  Abstract: Health Services Management Research, Ahead of Print.
  This study was conducted to determine the variables that play a role in the efficiency of Health Management departments in Turkey and the ranking of them in order of importance. These variables were determined by systematic analysis. The Prisma method was used in the systematic analysis approach. Input and output variables used in studies assessing the efficiency of higher education institutions in the literature were listed. The ranking of these variables was determined by Analytical Hierarchy Process (AHP) method. The questionnaire used for the AHP analysis and the judgments of 127 academicians working in Health Management Departments in universities in Turkey were assessed. The first three input variables found as a result of the AHP were “the number of registered undergraduate students per faculty member”, “the number of faculty members”, and “the number of other academic staff”. The most important three output variables included “the number of articles searched on SCI, SSCI, SCI-E”, “the number of papers presented in international congresses”, and “the count of publications published in international peer-reviewed journals”. To achieve positive developments in the efficiency of Health Management Departments, it is recommended to carry out studies to increase the number of qualified publications.
  Citation: Health Services Management Research
  PubDate: 2023-01-04T10:58:18Z
  DOI: 10.1177/09514848221115089