Front-office/back-office configurations and operational performance in complex health services

Background: Acquired brain injury (ABI) occurs from various causes at different ages and leads to many different types of healthcare needs. Several Dutch ABI-networks installed a local co-ordination and contact point (CCP) which functions as a central and easily accessible service for people to consult when they have questions related to ABI. Goals: To explore the relationship between front/back office design and operational performance by investigating the particular enquiry service provided by different CCPs for people affected by an ABI. Methods: In-depth interviews with 14 FO/BO employees from three case organizations, complemented with information from desk research and three one-day field visits. Results: The CCPs applied different FO/BO configurations in terms of customer contact and in terms of grouping of front and/or back office activities into tasks for one employee. Discussion: It is the complexity of the enquiry that determines which approach is more appropriate. For complex enquiries, the level of decoupling is high in all CCPs. This allows multiple experts to be involved in the process. For regular enquiries, CCPs have a choice: either working in the same way as in the complex enquiries or coupling FO/BO activities to be able to serve clients faster and without handovers

Improving long-term care provision: towards demand-based care by means of modularity

<p>Abstract</p> <p>Background</p> <p>As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes.</p> <p>Methods</p> <p>Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software.</p> <p>Results</p> <p>Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services.</p> <p>Conclusion</p> <p>The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further enable demand-based provision of long-term care by means of modularity.</p

THE IMPACT OF IMPOSED COVID-19 MEASURES ON BELGIAN HIGHER EDUCATION STUDENTS

Objective: The objective of this study is to explore how higher education students behave when they are confronted with imposed measures that provide temporal cues, also called organizational temporal structures, and how their behavior evolves with time. &nbsp; Theoretical Framework: The Temporal Cognitive-Affective Processing System (T-CAPS), developed by Shipp and Richardson (2021) is used as the overarching theory to study the phenomenon. The theory describes five possible behavioral responses when individuals are confronted with organizational temporal structures. &nbsp; Method: The study uses a mixed-method design including surveys and interviews during three large COVID-19 waves in Belgium. In total, 1246 students filled in the survey and 30 interviews were carried out. &nbsp; Results and Discussion: The findings suggest that, in general, students mostly complied to the imposed measures. Especially in the beginning of the pandemic, resistance was almost non-existent. However, resistance increased over time, particularly when measures interfered with social life. Our qualitative data provides more insight into the reasoning behind indicated behavioral responses. Convenience appeared to be an important reason for compliance with remote learning and resistance towards the restrictions in social contact increased because of their deteriorating effect on mental health. &nbsp; Research Implications: Our research gives rise to recommendations aimed at governments, educational institutions and people entrusted with educational policy making, as it provides better insight into when and why students comply to new regulations. &nbsp; Originality/Value: This study contributes to the literature by applying the conceptually developed T-CAPS in an empirical setting and as a result validates propositions related to the theory

Customization and personalization in clinical pathways using a modular perspective

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Speak up! Factors that influence involvement of nurses in oncological multidisciplinary team meetings

Purpose – Nurses are capable of acting as advocates for patients since they hold valuable knowledge on patient preferences and their psychosocial needs. Yet, in practice they tend to contribute little to multidisciplinary team meetings (MDTMs). This study analyses the factors that influence whether or not nurses will speak up and increase patient-centred decision-making in MDTMs.Design/methodology/approach – A multiple case study with cross-case comparison of twelve tumour groups across two Belgian hospitals was conducted. Data collection involved fifty structured non-participant observations and 41 semi-structured interviews with participants from the twelve tumour groups.Originality/value – This study yields factors that increase the opportunities for nurses to speak up in MDTMs to enhance patient-centred decision-making. The findings help in the design of future interventions concerning multidisciplinary teamwork, that address nurses’ contributions to augment patient-centred care

Providing person-centered care for patients with complex healthcare needs: A qualitative study

Background People with chronic conditions have complex healthcare needs that lead to challenges for adequate healthcare provision. Current healthcare services do not always respond adequately to their needs. A modular perspective, in particular providing visualization of the modular service architecture, is promising for improving the responsiveness of healthcare services to the complex healthcare needs of people with chronic conditions. The modular service architecture provides a comprehensive representation of the components and modules of healthcare provision. In this study, we explore this further in a qualitative multiple case study on healthcare provision for children with Down syndrome in the Netherlands. Methods Data collection for four cases involved 53 semi-structured interviews with healthcare professionals and 21 semi-structured interviews with patients (the parents of children with Down syndrome as proxy). In addition, we gathered data by means of practice observations and analysis of relevant documents. The interviews were audio-recorded, transcribed verbatim and analyzed utilizing the Miles and Huberman approach. Results Our study shows that the perspectives on healthcare provision of professionals and patients differ substantially. The visualization of the modular service architecture that was based on the healthcare professionals’ perspective provided a complete representation of (para)medical outcomes relevant to the professionals’ own discipline. In contrast, the modular service architecture based on the patients’ perspective, which we define as a person-centered modular service architecture, provided a representation of the healthcare service that was primarily based on functional outcomes and the overall wellbeing of the patients. Conclusion Our study shows that visualization of the modular service architecture can be a useful tool to better address the complex needs and requirements of people with a chronic condition. We suggest that a person-centered modular service architecture that focuses on functional outcomes and overall wellbeing, enables increased responsiveness of healthcare services to people with complex healthcare needs and provision of truly person-centered care

Needs and barriers to improve the collaboration in oral anticoagulant therapy: a qualitative study

Contains fulltext : 96138.pdf (publisher's version ) (Open Access

Interdisciplinary collaboration in the treatment of alcohol use disorders in a general hospital department:A mixed-method study

Background !nterdisciplinary collaborations (i.e., where various disciplines work coordinated and interdependently toward shared goals) are stated to yield higher team effectiveness than multidisciplinary approaches (i.e., where various disciplines work in parallel within their professional boundaries) in somatic health care settings. Nevertheless, research is lacking on interdisciplinary approaches for alcohol use disorder (AUD) treatment of hospitalized patients as these types of approaches are still uncommon. This study aims to evaluate an innovative interdisciplinary AUD treatment initiative at a general hospital department by 1) identifying which and to what extent network partners are involved and 2) to explore how network partners experienced the interdisciplinary collaboration. Methods A mixed-method study was conducted, using 1) measures of contact frequency and closeness in a social network analysis and 2) semi-structured interviews, which were analyzed thematically. Respondents were network partners of an interdisciplinary collaboration in a general hospital department, initially recruited by the collaborations' project leader. Results The social network analysis identified 16 network partners, including a 'core' network with five central network partners from both inside and outside the hospital. The project leader played an important central role in the network and the resident gastroenterologist seemed to have a vulnerable connection within the network. Closeness between network partners was experienced regardless of frequency of contact, although this was especially true for the 'core' group that (almost) always consisted of the same network partners that were present at biweekly meetings. Interview data showed that presence of the 'core' network partners was reported crucial for an efficient collaboration. Respondents desired knowledge about the collaborations' effectiveness, and one structured protocol with working procedures, division of responsibilities and agreements on information sharing and feedback. Conclusions The design of this interdisciplinary collaboration has potential in improving the treatment of hospital patients with AUD and was evaluated positively by the involved network partners. Interdisciplinary collaborations may offer a critical solution to increase treatment rates of patients with AUD and should be adopted in hospitals on a larger scale. Research towards the effectiveness of interdisciplinary collaborations in the treatment of hospitalized patients with AUD is needed. A correction to this paper has been published: https://doi.org/10.1186/s13011-022-00492-