Health Services Management Research最新文献

{"title":"Year nine (and why clinical leadership is no longer optional).","authors":"Federico Lega","doi":"10.1177/09514848251321158","DOIUrl":"https://doi.org/10.1177/09514848251321158","url":null,"abstract":"","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251321158"},"PeriodicalIF":1.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and well-being of staff in substance use services: The case of Scotland.","authors":"Joshua Bird, Sarah Henning","doi":"10.1177/09514848251318296","DOIUrl":"https://doi.org/10.1177/09514848251318296","url":null,"abstract":"<p><p><b>Background:</b> Addressing high rates of drug and alcohol mortality requires a sustained commitment to supporting a resilient and skilled substance use workforce. Employee well-being in wider health and social care has been the subject of much empirical research, however there is a dearth of evidence specific to professionals working in substance use services.<b>Methods:</b> Data were derived from a cross-sectional survey of publicly-funded drug and alcohol services operating in Scotland during autumn 2021. Nested semi-log regression models estimated the associations between workplace characteristics and workforce composition, and the main outcome measure: non-Covid sickness absence. Qualitative data were analysed using thematic analysis.<b>Results:</b> 88 services, representing 43% of Scotland's drug and alcohol services, were included in the study. Factors significantly and positively associated with non-Covid sickness absence in multivariable analysis included average caseload per whole-time equivalent and number of whole-time equivalent clinical roles. Descriptive statistics show that vacancy rates and caseloads are comparatively higher in statutory services, and are also higher for clinical than non-clinical positions.<b>Conclusion:</b> This study revealed that and burnout leading to sickness absence are serious issues for frontline staff in drug and alcohol services, and these worsened during the Covid-19 pandemic. This research provides a foundation for validating the current findings via future large-scale longitudinal studies, and improving the well-being of people delivering health and social care services in substance use settings.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251318296"},"PeriodicalIF":1.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable quality management in hospitals: The experiences of healthcare quality managers.","authors":"Fien Claessens, Eva Marie Castro, Deborah Seys, Jonas Brouwers, Astrid Van Wilder, Anneke Jans, Dirk De Ridder, Kris Vanhaecht","doi":"10.1177/09514848231218631","DOIUrl":"10.1177/09514848231218631","url":null,"abstract":"<p><strong>Background: </strong>Quality management systems are essential in hospitals, but evidence shows a real literature gap on the sustainable implementation of quality.</p><p><strong>Purpose: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"50-57"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138435233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design organization and clinical processes around patient characteristics: Evidence from a multiple case study of Hemophilia.","authors":"Stefano Villa, Raimondo De Cristofaro, Giovanni Di Minno, Simone Laratro, Flora Peyvandi, Lara Pippo, Sara Villa, Antonio G De Belvis","doi":"10.1177/09514848241231585","DOIUrl":"10.1177/09514848241231585","url":null,"abstract":"<p><p><b>Background:</b> There is growing evidence of the relevance of designing organization of care around patient characteristics; this is especially true in the case of complex chronic diseases.<b>Purpose:</b> The goal of the paper - that focuses on the analysis of the clinical condition hemophilia in three different centers - is to address two different research questions:1. How can we define, within the same clinical condition, different patient profiles homogeneous in terms of intensity of service required (e.g. number of visits or diagnostics)? 2. What are the conditions to re-organize care around these patient profiles in a multidisciplinary and coordinated manner?<b>Research design:</b> The authors have used a multiple case study approach combining both qualitative and quantitative methodologies; in particularly the semi-structured interviews and the direct observation were aimed to map the process in order to come up with an estimate of the cost of the full cycle of care.<b>Study sample:</b> The research methodology has been applied consistently in three different centers. The selection of the structures has been based on two main different criteria: (i) high standards regarding both organizational and clinical aspects and (ii) willingness from management, nurses and physicians to provide data.<b>Results:</b> The study clearly shows that different patient profiles - within the same clinical condition - trigger a different set of diagnostic and therapeutic activities. It is, thus, important considering patient characteristics in the development and implementation of clinical pathways and this will imply relevant differences in terms of organizational and economic impact.<b>Conclusions:</b> These process-based analyses are very much critical especially if we want to move to a bundled and integrated payment system but, as shown by this study itself, require a lot of time and efforts since our healthcare information systems are still fragmented and vertically designed.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"10-21"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing the burden of travel and environmental impact through decentralization of cancer care.","authors":"Giovanni Fattore, Michela Bobini, Francesca Meda, Benedetta Pongiglione, Luca Baldino, Stefano Gandolfi, Licia Confalonieri, Manuela Proietto, Stefano Vecchia, Luigi Cavanna","doi":"10.1177/09514848241229564","DOIUrl":"10.1177/09514848241229564","url":null,"abstract":"<p><p>Life expectancy, quality of life and satisfaction of oncologic patients highly depend on access to adequate specialized services, that consider their conditions in a holistic way. The present study aims to evaluate the introduction of oncology services in an outpatient setting in a mountain village in Northern Italy. The initiative is evaluated using the three pillars of sustainability (social, economic and environmental) as dimensions that are often overlooked by healthcare policy makers. Using micro data on 18,625 interventions, we estimate the number of kilometers saved by patients (reduction of \"travel burden\" as indicator of social sustainability), the additional travel costs for the NHS (indicator of economic sustainability) and the implied reduction of CO₂ emissions (indicator of environmental sustainability). Over the period July 2016-2021, the decentralized health center delivered 2,292 interventions saving 218,566 km for a corresponding value of €131,140. The additional costs for the NHS was €26,152. The reduction of CO₂ emissions was 32.37 Tons (€5,989). Overall, the socio-economic benefit of reducing travel of care for the patients residing in this remote valley was €110,976. This study adds original understanding of the benefits of decentralizing oncologic care and shows its operational feasibility conditions. Given the modest number of similar projects, it provides evidence to policy makers and, especially, managers who are faced with the challenge to implement the decentralization of specialized services.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary care team reorganisation after the SARS-COV-2 pandemic. Differences between Catalonia and Spain in the PRICOV study.","authors":"Antoni Peris Grao, Núria Freixenet, Toni Mora, David Roche","doi":"10.1177/09514848241265784","DOIUrl":"10.1177/09514848241265784","url":null,"abstract":"<p><strong>Background: </strong>Spanish primary care services are managed differently by each region's authorities. Catalonia started its services provision and design nearly two decades before other Spanish regions and developed nurses' roles and task shifting in primary care.</p><p><strong>Purpose: </strong>This work identifies differences in the Europe PRICOV-19 study answers between Catalonia and those submitted from the rest of Spain regarding how primary care teams (PCT) were organised during the SARS-CoV-2-2019 pandemic, how tasks and roles changed, and the pandemic's impact on the care providers. Initially, we computed bivariate relationships and tested using contingency association and unpaired Wilcoxon.</p><p><strong>Analysis: </strong>Still, we estimated multiple linear regressions controlling with a list of individual and GP practice characteristics and clustering standard errors at the kind of location.</p><p><strong>Results: </strong>Main statistically significant differences were found in the adaptation to the new tasks, the ability to solve most health problems, and specific accessibilities to primary care. In Catalonia, satisfaction with the adaptation to the new tasks was higher (41.9% satisfied and 30.2% neutral) than in the rest of Spain (50.9% dissatisfaction). Also, GPs in Catalonia reported to a greater extent than the rest of Spain that chronic patients were listed for extensive follow-up. These differences may be related to Catalonia's strategy for empowering primary care professionals other than family doctors.</p><p><strong>Conclusions: </strong>Considering future pandemics, demographic ageing, and professional shortages, we point out the potential benefits of these changes in PCT organisations and the need to review the centres's design.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"31-36"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a shared understanding of the learning health system in a large academic-based health system: A qualitative analysis.","authors":"Allyson L Varley, Trudi Venters Horton, Maria Pisu, Raegan W Durant, Michael J Mugavero, Andrea L Cherrington, Kevin R Riggs","doi":"10.1177/09514848241254928","DOIUrl":"10.1177/09514848241254928","url":null,"abstract":"<p><p>Healthcare delivery is currently undergoing major structural reform, and the Learning Health System (LHS) has been proposed as an aspirational model to guide healthcare transformation. As efforts to build LHS take considerable investment from health systems, it is critical to understand their leaders' perspectives on the rationale for pursuing an LHS and the potential benefits for doing so. This paper describes the qualitative analysis of semi-structured interviews (<i>n</i> = 17) with health system leaders about their general perceptions of the LHS, description of key attributes and potential benefits, and perception of barriers to and facilitators for advancing the model. Participants universally endorsed the goal of the local health system aspiring to become an LHS. Participants identified many recognized attributes of LHS, though they emphasized unique attributes and potential benefits. There was also heterogeneity in participants' views on what to prioritize, how to structure the local LHS within existing initiatives, and how new initiatives should be implemented. Improving conceptual clarity of attributes of the LHS would improve its potential in guiding future reform.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"22-30"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The characteristics of leadership and their effectiveness in quality management in healthcare - A systematic literature review and a content analysis.","authors":"Susanna Friman, Riikka Maijala, Sini Eloranta, Sakari Suominen, Tuija Ikonen","doi":"10.1177/09514848241254921","DOIUrl":"10.1177/09514848241254921","url":null,"abstract":"<p><p>Effective quality leadership is identified as a critical factor for organisational success. Leadership style has an important role in the implementation of quality management. This systematic review describes the characteristics of leadership in quality management in healthcare, and analyses their association with successful or unsuccessful quality management by using content analysis. Papers published in peer-reviewed journals between 2011 and June 2023 were selected by exploring the Abi/Inform, Business Source Complete, Cinahl, Pubmed and Web of Science electronic databases. Altogether 3014 records were found. PRISMA-protocol was used for selection of studies. 12 original and three review articles were included. Six leadership characteristics were identified that were linked to successful or unsuccessful implementation of quality management. The six categories were strategic, knowledge-oriented, value-based, supportive, participatory and communicative leadership. Supercategories and subcategories of successful and unsuccessful implementation are described. The results can be used to identify the leadership characteristics that promote successful quality management in healthcare organisations. In education for leaders and managers, attention should be in the characteristics and style of leadership and their impact on the effectiveness of quality management.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"37-49"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric analysis and trends related to dental tourism: Qualitative, social, economic and ethical implications.","authors":"Valerio Brescia, Francesco Cavarra, Maura Campra, Paolo Boffano, Vincenzo Rocchetti","doi":"10.1177/09514848251314111","DOIUrl":"https://doi.org/10.1177/09514848251314111","url":null,"abstract":"<p><p>This article delves into the multifaceted realm of dental tourism, scrutinizing patient incentives, economic ramifications, and ethical aspects. An in-depth 2023 analysis discerns research gaps, underscoring the necessity for a more exhaustive investigation to enrich the understanding of the global oral healthcare landscape. Utilizing bibliometric analysis method, the study examines the worldwide trajectory of scientific publications on dental tourism. Employing Scopus, it dissects document types, annual production, authorship, and international collaborations. The results spotlight microvariables derived from Saxena, Deheriya, Datla's macrovariables, unveiling influencers on dental tourism, ranging from social and economic to cultural factors. The study advocates for defined bilateral agreements to ensure quality care and stresses ethical considerations, emphasizing shared standards and legal implications. Economic ramifications, both positive and negative, are discussed, with an expanding global focus on dental tourism evident. In conclusion, the study accentuates micro variables, signaling avenues for future research.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251314111"},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of hospital resilience as the main challenge of hospital management during the COVID-19 pandemic: A grounded theory study.","authors":"Sulmaz Ghahramani, Kamran Bagheri Lankarani, Mohammadreza Zakeri, Sahar Ghahramani, Payam Shojaei","doi":"10.1177/09514848241309285","DOIUrl":"https://doi.org/10.1177/09514848241309285","url":null,"abstract":"<p><strong>Background: </strong>Traditional hospital management responses during the coronavirus disease 2019 (COVID-19) pandemic proved ineffective, particularly considering the pre-existing challenges in healthcare systems. The study examines hospital management challenges during the COVID-19 pandemic, transforming their lived experiences into a conceptual approach to prevent repetition and benefit health planners and policymakers in future crises and normal times.</p><p><strong>Methods: </strong>This qualitative study utilized the grounded theory methodology, conducting in-depth interviews with 12 hospital administrators from seven major referral hospitals in Shiraz, Bushehr, and Tehran, focusing on COVID-19 patients' complex conditions. The participants had a mean age of 46.6 ± 8.8 years. Data analysis was conducted using the grounded theory (Straussian approach).</p><p><strong>Results: </strong>A total of 98 subthemes and 25 themes were identified during the data analysis process. Using axial and selective coding, we found that in the presence of contextual and causal conditions, the lack of hospital resilience was recognized as the core theme in the final model. Intervening conditions, strategies to overcome the challenges of hospital management, and the outcomes were identified.</p><p><strong>Conclusions: </strong>Iranian hospital administrators dealing with COVID-19 recognize the lack of hospital resilience as their main management obstacle. Non-resilient hospitals' response to crises with new management strategies can fail due to insufficient documentation and information sharing, leading to persistent problems. Prioritizing evidence-based strategies and sharing successful approaches from other healthcare systems can improve resilience. Nationwide guidelines will ensure equitable patient treatment and reduce lawsuits against physicians for resource-efficient use. Hospital resilience implementation in real-world settings is widely sought for evidence.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848241309285"},"PeriodicalIF":1.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}