A case study of Kanban implementation within the Pharmaceutical Supply Chain

The paper explores the implementation of the kanban system, which is a Lean technique, within the Pharmaceutical Supply Chain (PSC). The case study provides insight to the benefits and challenges arising from the application of this technique, within a group of cooperative pharmacists, in Greece. The research questions developed from the review of the literature were tested using evidence from field-based, action research within a pharmaceutical organisation. The reported case study contributes to the longer term debate on assessing the Lean maturity level within the healthcare sector. There are two primary findings: i) that the adoption of kanban system provides a strategic benefit and improves the quality of services. ii) it also provides a basis for a strategy of operational change; it gives the opportunity to the organisation to move away from the current push delivery and logistics systems toward improved logistics strategy models

Private expenditure and the role of private health insurance in Greece: Status quo and future trends

The health care system in Greece is financed in almost equal proportions by public and private sources. Private expenditure, consists mostly of out-of-pocket and under-the-table payments. Such payments strongly suggest dissatisfaction with the public system, due to under financing during the last 25 years. This gap has been filled rapidly by the private sector. From this point of view, one might suggest that the flourishing development of private provision may lead in turn to a corresponding growth in private health insurance (PHI). This paper aims to examine the role of PHI in Greece, to identify the factors influencing its development, and to make some suggestions about future policies and trends. In the decade of 1985-1995 PHI show increasing activity, reflecting the intention of some citizens to seek health insurance solutions in the form of supplementary cover in order to ensure faster access, better quality of services, and increased consumer choice. The benefits include programs covering hospital expenses, cash benefits, outpatient care expenses, disability income insurance, as well as limited managed care programs. However, despite recent interest, PHI coverage remains low in Greece compared to other EU countries. Economic, social and cultural factors such as low average household income, high unemployment, obligatory and full coverage by social insurance, lead to reluctance to pay for second-tier insurance. Instead, there is a preference to pay a doctor or hospital directly even in the form of under-the-table payments (which are remarkably high in Greece), when the need arises. There are also factors endogenous to the PHI industry, related to market policies, low organisational capacity, cream skimming, and the absence of insurance products meeting consumer requirements, which explain the relatively low state of development of PHI in Greece. © 2009 Springer-Verlag

Conflict management and job satisfaction in paediatric hospitals in Greece

Aim To assess the major causes of conflict and to identify choices of strategy in handling conflicts. Background Conflict is inherent to hospitals as in all complex organizations, and health personnel deal with internal and external conflicts daily. Methods The sample consisted of 286 participants. A five-part questionnaire, specific for conflicts in hospitals, was administered to health personnel. Results Of the participants 37% were physicians and 63% were nurses and nursing assistants. As far as choice of strategy in conflict management is concerned, avoidance was found to be the most frequent mode chosen while accommodation was the least frequent mode. Organizational problems were the main issue creating conflicts since 52% of nurses and 45% of physicians agreed that receiving direction from more than one manager may lead to conflicts (P=0.02). Educational differences and communication gaps were reported as another cause of conflicts, with nurses supporting this statement more than the other groups (P=0.006). Conclusion To become effective in conflict management nurses and physicians must understand causes and strategies in handling conflicts. Implications for nursing management Major changes are needed regarding human resource management, work incentives and dynamics of teamwork in order to improve working conditions in Greek public hospitals. © 2011 Blackwell Publishing Ltd

Mind the Gap: Assessing Alignment between Hospital Quality and its Information Systems

We present a method to assess how aligned hospital information systems (HIS) are with quality standards adopted by the organization. Canonical action research is our mode of inquiry, in a district hospital implementing multiple certification standards. We build on the ‘ground-truth’ provided by healthcare professionals to identify risks and opportunities for HIS developments while contributing to their awareness of its implications. We address different categories of design-reality gaps, namely the organizational, service, process, and individual. The findings suggest that HIS compliance should address five interrelated dimensions of Context, People, Process, IT, and Information/Data. The proposed method allows self-evaluation through gap analysis and a comprehensive assessment of hospital quality, integrating HIS and healthcare processes. Moreover, it supports multiple quality models in hospitals and the development of heterogeneous HIS solutions in different maturity stages. HIS developments should be a priority for hospital quality worldwide; especially in the emerging economies that require methods accessible to their resources, standards compliance, and demographic demands for healthcare

Private expenditure and the role of private health insurance in Greece: status quo and future trends

Private health expenditure in Greece, Private health insurance in Greece, I11, I111,