Business Process Redesign in the Perioperative Process: A Case Perspective for Digital Transformation

This case study investigates business process redesign within the perioperative process as a method to achieve digital transformation. Specific perioperative sub-processes are targeted for re-design and digitalization, which yield improvement. Based on a 184-month longitudinal study of a large 1,157 registered-bed academic medical center, the observed effects are viewed through a lens of information technology (IT) impact on core capabilities and core strategy to yield a digital transformation framework that supports patient-centric improvement across perioperative sub-processes. This research identifies existing limitations, potential capabilities, and subsequent contextual understanding to minimize perioperative process complexity, target opportunity for improvement, and ultimately yield improved capabilities. Dynamic technological activities of analysis, evaluation, and synthesis applied to specific perioperative patient-centric data collected within integrated hospital information systems yield the organizational resource for process management and control. Conclusions include theoretical and practical implications as well as study limitations

Addendum to Informatics for Health 2017: Advancing both science and practice

This article presents presentation and poster abstracts that were mistakenly omitted from the original publication

The drug logistics process: an innovation experience

Purpose - The purpose of this paper is to present the latest innovations in the drug distribution processes of hospital companies, which are currently dealing with high inventory and storage costs and fragmented organizational responsibilities. Design/methodology/approach - The literature review and the in-depth analysis of a case study support the understanding of the unit dose drug distribution system and the subsequent definition of the practical implications for hospital companies. Findings - Starting from the insights offered by the case study, the analysis shows that the unit dose system allows hospitals to improve the patient care quality and reduce costs. Research limitations/implications - The limitations of the research are those related to the theoretical and exploratory nature of the study, but from a practical point of view, the work provides important indications to the management of healthcare companies, which have to innovate their drug distribution systems. Originality/value - This paper analyzes a new and highly topical issue and provides several insights for the competitive development of a fundamental sector

Accessing Antecedents and Outcomes of RFID Implementation in Health Care

This research first conceptualizes, develops, and validates four constructs for studying RFID in health care, including Drivers (Internal and External), Implementation Level (Clinical Focus and Administrative Focus), Barriers (Cost Issues, Lack of Understanding, Technical Issues, and Privacy and Security Concerns), and Benefits (Patient Care, Productivity, Security and Safety, Asset Management, and Communication). Data for the study were collected from 88 health care organizations and the measurement scales were validated using structural equation modeling. Second, a framework is developed to discuss the causal relationships among the above mentioned constructs. It is found that Internal Drivers are positively related to Implementation Level, which in turn is positively related to Benefits and Performance. In addition, Barriers are found to be positively related to Implementation Level, which is in contrast to the originally proposed negative relationship. The research also compares perception differences regarding RFID implementation among the non-implementers, future implementers, and current implementers of RFID. It is found that both future implementers and current implementers consider RFID barriers to be lower and benefits to be higher compared to the non-implementers. This paper ends with our research implications, limitations and future research

E-Health business models prototyping by incremental design

User-Driven Healthcare: Concepts, Methodologies, Tools, and Applications provides a global discussion on the practice of user-driven learning in healthcare and connected disciplines and its influence on learning through clinical problem solving. This book brings together different perspectives for researchers and practitioners to develop a comprehensive framework of user-driven healthcare.Postprint (published version

Performance-Based Specifications: Exploring When They Work and Why

There is extensive research and attention on innovation and sustainable public procurement (SPP) in the European Union at present, with the 2014 revision of the Procurement Directives, the Innovation Union strategy and other European Union policy initiatives. This report seeks to contribute to this discussion through the investigation of the use of performance based specifications (PBSs) in public procurement in the European Union and the United States. The report outlines the benefits and limitations of the use of PBSs, even in the most "progressive" public procurement environments, such as the Netherlands, particularly around their ability to support sustainable development goals and deliver environmental benefits for a procuring authority, such as energy and resource efficiency. Additionally, this report aims to identify the sectors in which the enabling conditions for the successful use of PBSs in public procurement are in place and to understand what policies and regulations are needed to promote the use of PBSs in public tenders and public procurement framework agreements

Practitioner Perceptions of the A3 Method for Process Improvement in Health Care

The focus of this article is to present students’ perceptions of the recently developed A3 method, a structured problem-solving approach based on lean concepts and tools that have been adapted to the health care environment. The students were all employees of a large health care provider and were enrolled in a customized health care executive MBA Program. Each student was required to complete an individual A3 Project in order to improve a process at the department for which they worked. At the end of the semester the students presented their A3 projects to their peers who voted on the best projects. A survey measuring perceptions of the A3 method for problem solving in health care was administered and from it we present propositions for A3 implementation. These propositions are applicable both to health care practitioners and to academic researchers

A rounded picture is what we need : rhetorical strategies, arguments, and the negotiation of change in a UK hospital trust

This article is concerned with the introduction of the agenda of New Public Management (NPM) within the board of a UK Hospital Trust: West London Hospital (WLH). We discuss the literature on New Public Management, including its limitations for analysing the organizational reality of implementing NPM. But we will also be drawing on discourse theory and the literature on rhetoric. The main argument in this article is that in order to understand the reality of the NPM paradigm, we need to study the rhetorical strategies of protagonists involved in the negotiation of the NPM agenda. Rhetorical strategies are means of making general viewpoints more convincing, for example, by comparing 'our' organization with similar organizations. Rhetorical strategies show patterns, which reappear in conversations and arguments made by protagonists. Specifically, we identified three rhetorical strategies justifying why and what kind of a more 'rounded picture' was required: widening the argument to include national productivity comparisons with other hospitals; widening the argument away from a narrow focus on finance toward a strategic and political perspective; and, lastly, widening the argument to look at innovation in the whole clinical process

Improving access to health services – Challenges in Lean application

Purpose: Healthcare organisations face significant productivity pressures and are undergoing major service transformation. This paper serves to disseminate findings from a Lean healthcare project using a NHS Single Point of Access environment as the case study. It demonstrates the relevance and extent that Lean can be applied to this type of healthcare service setting. Design/methodology/approach: Action research was applied and Lean tools used to establish current state processes, identify wastes and develop service improvement opportunities based upon defined customer values. Findings: The quality of referral information was found to be the root cause of a number of process wastes and causes of failure for the service. Understanding the relationship and the nature of interaction between the service‟s customer/supplier led to more effective and sustainable service improvement opportunities and the co-creation of value. It was also recognised that not all the Lean principles could be applied to this type of healthcare setting. Practical implications: The study is useful to organisations using Lean to undertake service improvement activities. The paper outlines how extending the value stream beyond the organisation to include suppliers can lead to improved co-production and generation of service value. Originality/value: The study contributes to service productivity research by demonstrating the relevance and limitations of Lean application in a new healthcare service setting. The case study demonstrates the practical challenges of implementing Lean in reciprocal service design models and adds validity to existing contextual models